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1.
Annals of Phytomedicine-an International Journal ; 10:5-11, 2021.
Article in English | Web of Science | ID: covidwho-2072556

ABSTRACT

The novel coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The immune response to SARS-CoV-2 can play an important role in disease pathogenesis and clinical manifestations. Considering the antiviral, immuno-modulatory, anxiolytic, antiinflammatory and antioxidant properties, this open labelled, controlled, interventional, prophylactic study was conducted on individuals at risk in containment zones of different cities of India, viz., Lucknow, Aligarh, New Delhi, Srinagar, Mumbai and Bengaluru. The study focuses on number of patients turning COVID-19 positive, change in ISQ and WHOQOL-BREF scales in both the groups. Apparently, healthy individuals at risk in containment zones were divided into intervention and control groups. The intervention group was further divided into two subgroups. The first subgroup received Unani regimen- I including Unani Joshanda with Khamira Marwareed (KM), the second subgroup received Unani regimen- II including Unani Joshanda with Tiryaq Arba (TA). The control group did not receive any intervention. The duration of intervention was 20 days;follow ups were planned on day 10, day 20 and day 35. A total number of 33021 participants were enrolled in the study, of which 30,931 participants completed the study. It was observed that individuals receiving Unani regimen-I demonstrated lower risk of developing COVID-19 by 74% and those receiving Unani regimen-II by 62% in comparison to the control group. Interventional groups showed highly significant (p<0.001) effect on the quality of life.

2.
Chest ; 162(4):A1485-A1486, 2022.
Article in English | EMBASE | ID: covidwho-2060829

ABSTRACT

SESSION TITLE: Actionable Improvements in Safety and Quality SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: The overall mortality rate for patients ‘transfered’ to the medical intensive care units is thought to be significantly higher than the mortality rate amongst those admitted directly. (1) It has also been suggested that uninsured critically ill patients have a higher probability of being ‘transferred’ to other hospitals as well as a higher mortality rate. (2, 3) We aim to determine whether insurance coverage impacts the transfer of critically ill patients. METHODS: This study was conducted at a quaternary care hospital which is also a regional transfer center. We accessed the public data for the year 2020 through our institutions Transfer Center Dashboard, System Analytics. The two aspects of transferred patients we focused upon were: 1) Hospital service (subspecialty care required) and 2) Financial class. Major subspecialties included in the study were: Pulmonology, Internal Medicine, Neurosurgery, Cardiology, and Neurology. Our study was a patient safety project, hence it qualified for IRB exemption. We classified the percentage of transfers as ‘Accepted’, ‘Declined’, or ‘Canceled’;and determined the insurance status of the patient. RESULTS: We found a total of 3552 patients transfers were initiated. 31.9% (1136) transfer patients were accepted, 46.79% (1662) transfers were declined, and 21.23% (754) were canceled due to reasons including unsafe transfer, acceptance at other institutions, or death prior to transfer. Major categories for transfers were Pulmonology (16.1%), other Internal Medicine related diseases (15.3%), and Neurosurgery (11.8%) were the subspecialties with the highest rate of transfers. In terms of financial class, we determined that 44.81% (n=509) of the ICU transfers had no insurance, 27.81% (n=316) had Medicare support, and 17.81% (n=202) had managed care through a health maintenance organization (HMO);the remaining 9.59% had other insurance plans. We used a binomial test to determine the probability of a transfer under no insurance (p) with the formula p + q=1, across the total number of transfer requests (n). K was the number of actual transfers that occurred. Total transfer requests were n=3552, actual transfers were k=1136 and transfers without insurance were 509/44.8%, converted into p=0.45 with a resulting q of 0.55.For z-test, we used the formula z = ((K - np) +- 0.5) / √npq = 15.58. Our one-tailed probability of exactly, or fewer than, 1136(K) out of 3552(n) was p <.000001. Our study was limited because of the COVID-19 pandemic occurring in the same year. CONCLUSIONS: Based on our results, we conclude that the ‘uninsured’ patients are more susceptible to getting transferred to other institutions. CLINICAL IMPLICATIONS: Critically ill ‘uninsured’ patients are selctively subjected to be transfered to other hospitals for higher level of care. These transfers may have significant health implications thereby resulting in higher morbidity and mortality in unisured populations. DISCLOSURES: No relevant relationships by Joodi Akhtar No relevant relationships by Sahar Fatima Advisory Committee Member relationship with Astra Zeneca Please note: 24 months Added 03/16/2022 by FAISAL MASUD, value=Honoraria Advisory Committee Member relationship with Teleflex Please note: 12 months Added 03/16/2022 by FAISAL MASUD, value=Consulting fee Advisory Committee Member relationship with La Jolla Please note: 12 months Added 03/16/2022 by FAISAL MASUD, value=Consulting fee No relevant relationships by Iqbal Ratnani No relevant relationships by Salim Surani No relevant relationships by Anza Zahid

3.
Bangladesh Journal of Medical Science ; 21(4):901-911, 2022.
Article in English | EMBASE | ID: covidwho-2043416

ABSTRACT

Objectives: The study aimed to establish the effectiveness of Unani add-on regimen by comparing theduration required for change in disease status from COVID-19 positive asymptomatic / mildto moderate symptomatic patients to asymptomatic negative. Methods: This single-centric, randomized, twin arm, controlled, clinical trial was carried out on a totalnumber of 62 RT-PCR confirmed COVID-19 patients. The Intervention group (IG) receivedUnani Regimen (Khameera Marwareed and Unani Joshanda) in addition to the conventional management, while the Control group (CG) received only conventional management. Results: It was observed that 16 (51.6%) patients in Intervention Group and 3 (9.4%) patients incontrol group became negative for COVID-19 at day 7 and remaining 13 out of 15 (93.5%) patients in Intervention Group and 20 out of 28 (74.1%) patients in control group becamenegative for COVID-19 at day 14.This effect of the Unani Regimen in comparison to thecontrol group was statistically significant (p =0.003). Conclusions: It can be concluded that the change of COVID-19 positive asymptomatic / mild to moderate symptomatic patients to RT-PCR negative was much earlier in the add-on Unani regimen group as compared to control group.

4.
Indian Journal of Natural Products and Resources ; 13(2):248-254, 2022.
Article in English | Scopus | ID: covidwho-2026916

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally. COVID-19 presents varied clinical features. The present study focuses on number of patients turning COVID-19 positive, change in Immune Status Questionnaire (ISQ) and WHO quality of life-Bref (WHO Qol – BREF) scales after taking intervention. This open labelled, double arm, controlled, interventional, clinical trial was conducted on high-risk individuals i.e., those residing with a COVID-19 positive member in the identified quarantine area. This twin armed study was conducted on asymptomatic individuals exposed to COVID-19. The test group were prescribed Unani poly-herbal decoction together with Unani formulations Khamira Marwareed and Tiryaq e Arba whereas the control group was not on any intervention. The duration of intervention was 20 days;follow ups were planned on day 10 and day 20. Of the 81 participants enrolled, none of the patients turned COVID-19 positive. However, 13.58% (n=11) developed COVID like symptoms and 70 patients completed the study. The mean age of the participants was 41.42±16.9 years;however, majority of the participants were 18-28 years male with Damvi (Sanguine) temperament. The quality of life of the intervention group improved significantly however, the immune status in both the groups increased with P <0.001. The Unani prophylactic regimen provides a 62% (relative risk reduction) protection against COVID-19. This pilot study paves for a study on a larger population. No adverse effects were observed during the study. Absence of biochemical investigations were limitations to the study. © 2022, National Institute of Science Communication and Information Resources. All rights reserved.

5.
Journal of Scientometric Research ; 11(1):47-54, 2022.
Article in English | Web of Science | ID: covidwho-1897066

ABSTRACT

This study aims to analyze the dynamics of the published articles and preprints of Covid-19 related literature from different scientific databases and sharing platforms. The PubMed, ScienceDirect, and ResearchGate (RG) databases were under consideration in this study over a specific time. Analyses were carried out on the number of publications as (a) function of time (day), (b) journals and (c) authors. Doubling time of the number of publications was analyzed for PubMed "all articles" and ScienceDirect published articles. Analyzed databases were (1A) PubMed (01/12/2019-12/06/2020) "all_articles" (16) PubMed Review articles) and (1C) PubMed Clinical Trials (2) ScienceDirect all publications (01/12/2019- 25/05/2020) (3) RG (Article, Pre Print, Technical Report) (15/04/2020 - 30/4/2020). Total publications in the observation period for PubMed, ScienceDirect, and RG were 23000, 5898 and 5393 respectively. The average number of publications/day for PubMed, ScienceDirect and RG were 70.0 +/- 128.6, 77.6 +/- 125.3 and 255.6 +/- 205.8 respectively. PubMed shows an avalanche in the number of publications around May 10, the number of publications jumped from 6.0 +/- 8.4/day to 282.5 +/- 110.3/ day. The average doubling time for PubMed, ScienceDirect, and RG was 10.3 +/- 4 days, 20.6 days, and 2.3 +/- 2.0 days respectively. The average number of publications per author for PubMed, ScienceDirect, and RG was 1.2 +/- 1.4, 1.3 +/- 0.9, and 1.1 +/- 0.4 respectively. Subgroup analysis, PubMed review articles mean review <0 vertical bar 17 +/- 17 vertical bar 77> days: and reducing at a rate of -0.21 days (count)/day. The number of publications related to the COVID-19 until now is huge and growing very fast with time. It is essential to rationalize and limit the publications.

6.
Jcpsp, Journal of the College of Physicians & Surgeons - Pakistan ; 31(1):S75-S78, 2021.
Article in English | MEDLINE | ID: covidwho-1417490

ABSTRACT

OBJECTIVE: To document the measures adopted during the COVID-19 pandemic strict lockdown on pediatric surgical services and residents' training at a tertiary care hospital. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Department of Pediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University, Karachi, from April 2020 to June 2020. METHODOLOGY: Data from the Outpatient Department, Emergency Department, and Operation Theatre records were collected. The number of patients seen in the outpatient department, surgeries performed, index emergency cases dealt with, and the residents' duty roster and teaching methodology were documented. Descriptive statistics were used for reporting. RESULTS: During the strict lockdown period, outpatient services continued;however, elective cases were not operated. A total of 2,930 patients were seen in clinics, and 1,316 surgical procedures were performed. The index cases managed included anorectal malformation (n=35), esophageal atresia with and without tracheoesophageal fistula (n=13), small bowel atresia (n=11), omphalocele (n=6), acute appendicitis (n=35), intestinal obstructions (n=23), intussusceptions (n=18), and intestinal perforations (n=16). On-call days of residents were reduced from every third to the fifth day, and online educational sessions were added. During the pandemic, 13 members of surgical and anaesthesia teams got infected with COVID-19. CONCLUSION: COVID-19 pandemic elective surgical services were restricted;however, emergency cases were managed as per routine. In clinical teaching, virtual technologies were incorporated. Working hours of residents were limited to decrease the exposure to infected persons. Key Words: COVID-19, SARS-CoV-2 pandemic, Healthcare workers, Residency programme.

7.
Monaldi Archives for Chest Disease ; 91(2):16, 2021.
Article in English | MEDLINE | ID: covidwho-1209753

ABSTRACT

COVID-19 has involved numerous countries across the globe and the disease burden, susceptible age group;mortality rate has been variable depending on the demographical profile, economic status, and health care infrastructure. In the current clinical environment, COVID-19 is one of the most important clinical differential diagnoses in patients presenting with respiratory symptoms. The optimal mechanical ventilation strategy for these patients has been a constant topic of discussion and very importantly so, since a great majority of these patients require invasive mechanical ventilation and often for an extended period of time. In this report we highlight our experience with a COVID-19 patient who most likely suffered barotrauma either as a result of traumatic endotracheal intubation or primarily due to COVID-19 itself. We also aim to highlight the current literature available to suggest the management strategy for these patients for a favorable outcome. The cases described are diverse in terms of age variance and other comorbidities. According to the literature, certain patients, with COVID-19 disease and spontaneous pneumothorax were noted to be managed conservatively and oxygen supplementation with nasal cannula sufficed. Decision regarding need and escalation to invasive mechanical ventilation should be taken early in the disease to avoid complications such as patient self-inflicted lung injury (P-SILI) and barotrauma sequelae such as pneumothorax and pneumomediastinum Recent systematic review further supports the fact that the use of non-invasive ventilation (NIV) in certain patients with COVID-19 pneumonia may give a false sense of security and clinical stabilization but has no overall benefit to avoid intubation. While invasive mechanical ventilation may be associated with higher rates of barotrauma, this should not mean that intubation and invasive mechanical ventilation should be delayed. This becomes an important consideration when non-intensivists or personnel with less experience provide care for this vulnerable patient population who may rely too heavily on NIV to avoid intubation and mechanical ventilation.

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