ABSTRACT
Coronavirus disease 2019 (COVID19) is the recently reported disease caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID19 spreads among population through the close/direct contact and nasal droplets when an infected person sneezes, coughs, talks or breaths. On an average, COVID19 infected patient develops clinical symptoms 5-6 days after the infection and some develops symptoms even after 14 days of infection. Detailed study on the symptoms shown by COVID19 patients can help in identifying individuals so that proper identification and isolation of patients can be done and transmission of virus can be reduced significantly. In this study, a total of 99 (66 males and 33 female) COVID19 infected symptomatic patients without any comorbidities were included. Nasopharyngeal and oropharyngeal swabs were used for the collection of samples from the suspected patients to extract total RNA and perform real time PCR for the detection of genetic material for SARS-CoV-2. Samples with Ct value = 36 in case of Orf1ab gene and E gene with good sigmoidal curve were reported as positive for novel SARS-CoV-2. Fever, shortness of breath, dry cough and cough with sputum production persisted for longer timer and were more common symptoms reported by the COVID19 infected patients. In conclusion, understanding of the clinical symptoms shown by COVID19 infected patients can help in identification and isolation of patients so that transmission of virus can be reduced significantly.
ABSTRACT
Presence of Nepal in global clinical trials has been visibly negligible despite the history of conducting large scaled randomized controlled trial on Hepatitis E vaccine decades ago. Majority of the problem is attributed to the lack of collaborative work, financial and human resource constrains. COVID-19 pandemics seems to have triggered urgency among the authorities of Nepal leading to a substantial increase in the number of clinical trials in collaboration with national and international organizations/institutions. Immediately after detection of the first COVID-19 case on 13 January 2020, the Ethical Review Board (ERB) of NHRC received several research proposals, subsequently leading to the approval of the first clinical trial for COVID-19 on 01 July 2020 to investigate potential of traditional Ayurveda based medicine for COVID treatment. Soon, number of other clinical trial proposals received approval and implemented in the country, however budgetary allocation from the Government of Nepal (GON) was prioritized for COVID-19 outrage management and vaccination coverage only. Collaborations with various international institutions played a significant role in the successful implementation of large-scale clinical trials in the country and further laid the path for future. In this review paper we present the recent developments in clinical trials in Nepal, budgetary allocation from the government and the mechanisms in place for regulation of clinical research in the country along with challenges and way forward.
ABSTRACT
Context: The effects of coronavirus disease 2019 (COVID-19) on the endocrine system remain uncertain. Objective: Our study aimed to explore the possible effects of COVID-19 on endocrine organs and to determine the impact of glycemic status, 25-hydroxyvitamin D levels, calcium levels, and thyroid dysfunction on the final outcome of patients with COVID-19. Design and methods: This single-center, retrospective study evaluated endocrine function abnormalities in 102 patients hospitalized with COVID-19 in the intensive care unit (ICU). Results: Of 102 patients admitted to ICU, 42 (41.2%) succumbed to illness. The most frequently observed abnormality in thyroid function tests was low free triiodothyronine (FT3) levels (56%). A thyroid profile indicating thyrotoxicosis was detected in five (4.9%) patients, and overt hypothyroidism was identified in two (1.9%) patients. New-onset diabetes was detected in five (4.9%) patients whereas diabetic ketoacidosis at presentation was found in six (5.9%) cases. Rhino-orbital mucormycosis was detected in one patient with diabetes during treatment of COVID-19 while three (2.9%) patients were diagnosed with pulmonary mucormycosis after recovery from COVID-19. Hypocalcemia was observed in 52 (51 %) patients. Out of 42 patients who died, 32 patients had low FT3, 26 patients had high glycated haemoglobin (HbA1c), and 33 patients had low 25-hydroxyvitamin D. Multivariate analysis demonstrated that low concentration of 25-hydroxyvitamin D, low FT3 and higher HbA1c levels were significantly associated with increased mortality. Conclusion: New-onset thyrotoxicosis in COVID-19 patients is mostly due to subacute thyroiditis. Hypocalcemia is also frequently encountered in patients with moderate disease and those with critical COVID-19. A high index of suspicion is required to timely diagnose mucormycosis in COVID-19 patients with diabetes.
ABSTRACT
The authors have withdrawn this manuscript because they found a serious issue in data-analysis which leads to wrong interpretation of the results. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.