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Introduction: Pulmonary infections in renal transplant recipients (RTR) may range from diverse forms lung parenchyma and pleura involvement with different typical and atypical bacteria, viruses, fungi and mycobacteria. Radiological and microbiological diagnosis is essential to plan management. This study assesses the clinico-radiological, microbiological and outcomes of pulmonary infections in RTR. Methods: This study was a single-center prospective observational study, conducted over 4 years in a tertiary care hospital in Mumbai. The study included RTR > 18 years with pulmonary infections. Pulmonary infections were defined as typical clinical features like cough, expectoration, fever, dyspnea, hemoptysis, etc with radiological findings like new infiltrates/consolidation on chest X-ray / CT scan with or without microbiological abnormality on sputum/ broncho-alveolar lavage (BAL) fluid/ pleural fluid. COVID-positive cases were excluded from the study. The clinical details of transplant, risk factors, induction, and maintenance regimens were recorded. All investigations done and treatment undertaken were part of standard management protocols. Patients were followed up for the assessment of outcome and resolution. Appropriate IEC approval was taken. Results: 50 RTR patients were included, predominantly males (60%), mean age 39.62 ±12.14 years, with 37 (74%) having live-related renal transplants. 9 (18%) patients presented 6 months of transplant, 5 (10%) from 6-12 months, 12 (16%) from 1-2 years and 24 (48%) ≥ 2 years since transplant. Risk factors included history of acute rejection in 6 patients (12%), NODAT in 5 (10%), prior diabetes in 8 (16%), and ATG induction in 19 (38%). Fever was the chief presenting complaint in 47 cases (94%), cough with expectoration in 32 (64%), and breathlessness in 24 (48%). Associated graft dysfunction was seen in 21 (42%) patients. 10 (28%) patients needed mechanical ventilation support while 18 (36%) had features of severe sepsis with MODS. Sputum was contributory in 16 patients with features of Streptococcus spp in 04 (8%), H. influenza in 1 (2%), gram-negative bacteria (GNB) in 4 (8%), AFB positive in 04 (6%), fungal/PCP in 3 (6%). BAL showed positive findings in 35 cases with positive bacteria (culture/ staining) in 15 (30%) [gram positive in 9 (18%) and GNB in 6 (12%)], BAL AFB/gene expert positive in 8 (16%), fungal stain/culture in 5 (Aspergillus 03, Mucor 01, candida 01), PCP stain/culture in 05 (10%) and CMV PCR positive in 2 (4%). In 14 cases, no organism could be isolated and was treated empirically. 2 patients who had exudative pleural effusion with raised ADA were treated for tuberculosis. Multivariate regression analysis showed that the statistically significant factors associated with pulmonary infections were diabetes/ NODAT, ATG induction. Mean duration of hospital stay was 14.26 ±4.22 days. Most patients recovered completely while death occurred in 06 (12%). Conclusions: Pulmonary infections were a significant cause of morbidity and mortality in RTR patients, with an increased risk in patients who were exposed to ATG induction or diabetes. HRCT chest and BAL were the key diagnostic modalities. Bacterial organisms are the commonest followed by fungal/mycobacterial or viral. High index suspicion and early antimicrobial therapy are key to successful therapy. No conflict of interest
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A severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) led novel coronavirus disease (COVID-19)outbreak spread through China has become the biggest global public health challenge today. The virus upon sev-eral mutations has led to the resurgence of more infectious and lethal variants infecting over 298 million peoplewith more than 5.46 million deaths worldwide by the end of December, 2021. Though vaccines are available, var-ious preventive measures particularly a high body immunity is still extremely important which determines thelikelihood of disease severity and subsequent recovery in the current and future pandemics. This review acknowl-edges the potentiality of miraculousMoringa oleiferaLam. against recently evolved novel coronavirus and accom-panying health complications. Moringa a well-proven super-food, densely packed with an abundant quantity of92 minerals, several vitamins, 46 antioxidants, and numerous bioactive compounds, thus own a massive thera-peutic potential for healing all levels of nutritional deficiencies and poor immunities and cure above 300 diseases.Moringa acts as anti-asthmatic, anti-cancerous, anti-diabetic, anti-inflammatory, hypotensive, hepatic, renal andcardio-protective, and anti-viral in nature. Thus it may reduce the severity of COVID-19 infections and associatedserious medical emergencies. In addition, self-isolation at home or the workplace has put people at increased riskof physical and mental sicknesses, which could be simply addressed by integrating this wonderful plant intoeveryday diet. Furthermore, the immune-modulatory properties and viral inhibiting nature of moringa contributeto reduced risk of COVID-19 infection and quicker recovery from its symptoms. As per the existing pieces of literature, it is a great time to harness the esteemed moringa for safeguarding people from the terrible ongoingCOVID-19 situation and other future pandemics
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Background: Post COVID-19 pulmonary complications are the leading cause of morbidity. There is very limited information on the benefits of comprehensive rehabilitation in such patients. Methodology: A retrospective review was conducted of the patients with Post Covid-19 sequel who underwent multi-disciplinary rehabilitation program at Sakra World Hospital. Study Type and Setting: (1) Type of study design: Retrospective analysis. (2) Sample size: 48. (3) Sampling: Convenient sampling. (4) Setting: Sakra World Hospital, Bangalore, India. (5) Intended intervention: Multidisciplinary Rehabilitation. Process Flow: Results: Conclusion: Comprehensive Pulmonary Rehabilitation has shown significant improvement in the patients' ability to perform daily activities, respiratory mechanics and overall quality of life. (Figure Presented).
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Background: Currently, we can only speculate on what the effects of the COVID-19 pandemic have been on medical students and interim foundation year doctors. In order to support them appropriately both now and, in the future, it is imperative that we understand the impact it has had upon them. This study assessed the effects of the COVID-19 pandemic on medical students and interim foundation year doctors across the United Kingdom (UK), and the support that they received and sought. Methods: A prospective, observational, multicentre study was conducted. All medical students and interim foundation year doctors were eligible to participate. The data analysis was carried out as detailed a priori in the protocol. Findings: A total of 2075 individuals participated in the SPICE-19 survey from 33 medical schools. There was a significant (p<0.0001) decrease in participants' mood when comparing their mood before the pandemic to during the pandemic. Social distancing and more time at home/with family were the factors that negatively and positively respectively impacted the mood of the greatest number of participants. All areas of life included in the survey were found to have been significantly more negatively impacted than positively impacted (p<0.0001). 931 participants wanted more support from their university. Participants were mainly seeking support with exam preparation, course material, and financial guidance. Discussion: Medical and foundation schools need to prepare adequate and effective support. If no action is taken, there may be a knock-on effect on workforce planning and the health of our future workforce. When medical students return to their universities, there is likely to be need for enhanced wellbeing support, adaptations in the short-term and long-term strategies for medical education, and provision of financial guidance.
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This paper discusses facts and fictions of poplar (Populus deltoides) in Jammu and Kashmir, India. Recently, after the COVID-19 outbreak, it was claimed that 'pollen grains of female poplar may be carriers of the SARS-CoV-2 virus'. The Government of Kashmir issued an order for the felling of about 42,000 female poplar trees, even though many environmentalists and scientists provided evidence that pollen from poplar causes meagre effect on human health when compared to other trees and it has no relation with COVID-19. Experts also suggest that the silky cotton seed of poplar may not cause much harm, but it has been misinterpreted due to carrier nature of other pollen grains. On the other hand, unscientific harvesting of millions of poplar trees could result in desert-like conditions in the future and also affect the livelihood opportunity of farmers and local people in J&K.