Voices from Behind Bars: Narratives of Under Trial Prisoners in the Indian Justice System (preprint)

The conditions faced by undertrial prisoners in India are often harsh and deplorable. These individuals are incarcerated in overcrowded prisons, often subjected to inhumane treatment and denied basic amenities. Juvenile undertrials are particularly vulnerable in this system. They are often subjected to physical and emotional abuse and are denied access to education and rehabilitation programs. The Covid-19 pandemic has inflamed the circumstance, with undertrial prisoners at a higher risk of infection due to the cramped living conditions. Many prisons have reported outbreaks, leading to a further deterioration of the already dire situation. The deficiency of access to legal aid and the prolonged detention without trial often leads to a sense of hopelessness and despair among undertrial prisoners. This has resulted in a spate of suicides among these individuals, highlighting the urgent need for prison reforms in India.The plight of undertrial prisoners in India is a cause for concern. The government shall take initiative to improve the living conditions in prisons, ensure access to legal aid, and expedite the trial process to prevent the prolonged detention of individuals. Only then can we hope to bring about a more just and equitable society.

Coronavirus Disease 2019 and Cold Agglutinin Syndrome: An Interesting Case.

The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. While patients with COVID-19 most frequently present with pneumonia, respiratory failure and acute respiratory distress syndrome, increasing cases of immune-mediated disorders such as autoimmune thrombocytopenia, haemolytic anaemia and antiphospholipid syndrome have been reported. In this article we describe a rare case of cold agglutinin syndrome (CAS) in a patient with COVID-19. The patient was a 77-year-old man with a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency who presented with COVID-19 infection and acute respiratory failure. Initially he was started on intravenous steroids, antibiotics and hydroxychloroquine. Laboratory analysis revealed haemolytic anaemia with a positive direct anti-globulin test (DAT) and high titres of cold agglutinins. Hydroxychloroquine was stopped due to suspicion of haemolysis due to G6PD deficiency but the haemolysis persisted. Unfortunately, the respiratory failure progressed and the patient died. In summary, this article describes a rare case of CAS associated with COVID-19. CAS is a heterogenous group of cold autoimmune haemolytic anaemias occurring secondary to infections or malignancies. No definite treatment for CAS in COVID-19 patients has been approved so far. LEARNING POINTS: Autoimmune haemolytic anaemia has been reported in COVID-19 patients.Cold agglutinin syndrome (CAS) can occur in patients with COVID-19.Efforts to determine the optimal management of CAS in COVID-19 patients must continue.