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1.
Health Psychol Res ; 10(3): 38352, 2022.
Article in English | MEDLINE | ID: covidwho-2044404

ABSTRACT

This article is a literature review of mental health concerns in non-oncologic urology patients. Pathologies represented in this review include Peyronie's Disease (PD), erectile dysfunction (ED), urinary incontinence and urinary tract infections (UTI), infertility, benign prostatic hyperplasia (BPH), kidney stones, and urinary retention. While there has been great interventional focus as of late for urogenitary malignancies (i.e. prostate cancer awareness with the Movember campaign), literature studies and intervention focused on non-oncologic urology patients has been limited. As such, we conducted a review on urology patients with non-oncologic pathologies as an effort to increase clinician awareness of mental health concerns among such patients, increase the comfort level for clinician communication on socially sensitive topics surrounding pathologies, and review ongoing interventions conducted within these pathologies. We outlined different ongoing Mental Health Illness (MHI) needs and treatments for various pathologies. Patients with non-cancerous urologic pathologies had lower quality of life and higher incidence of MHI than the general population. As such, in line with the American Urological Association recommendations, psychological and social support from peers, therapists, and healthcare providers further prove to be crucial for some subpopulations. The review also yielded pathology specific interventions such as group therapy for ED patients. Given the higher incidence of MHI in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of non-oncologic urology treatment continues to be crucial when creating a collaborative treatment platform for patients.

2.
BMC Infect Dis ; 22(1): 606, 2022 Jul 09.
Article in English | MEDLINE | ID: covidwho-1928161

ABSTRACT

BACKGROUND: Statins and aspirin have been proposed for treatment of COVID-19 because of their anti-inflammatory and anti-thrombotic properties. Several observational studies have shown favourable results. There is a need for a randomised controlled trial. METHODS: In this single-center, open-label, randomised controlled trial, 900 RT-PCR positive COVID-19 patients requiring hospitalisation, were randomly assigned to receive either atorvastatin 40 mg (Group A, n = 224), aspirin 75 mg (Group B, n = 225), or both (Group C, n = 225) in addition to standard of care for 10 days or until discharge whichever was earlier or only standard of care (Group D, n = 226). The primary outcome variable was clinical deterioration to WHO Ordinal Scale for Clinical Improvement ≥ 6. The secondary outcome was change in serum C-reactive protein, interleukin-6, and troponin I. RESULTS: The primary outcome occurred in 25 (2.8%) patients: 7 (3.2%) in Group A, 3 (1.4%) in Group B, 8 (3.6%) in Group C, and 7 (3.2%) in Group D. There was no difference in primary outcome across the study groups (P = 0.463). Comparison of all patients who received atorvastatin or aspirin with the control group (Group D) also did not show any benefit [Atorvastatin: HR 1.0 (95% CI 0.41-2.46) P = 0.99; Aspirin: HR 0.7 (95% CI 0.27-1.81) P = 0.46]. The secondary outcomes revealed lower serum interleukin-6 levels among patients in Groups B and C. There was no excess of adverse events. CONCLUSIONS: Among patients admitted with mild to moderate COVID-19 infection, additional treatment with aspirin, atorvastatin, or a combination of the two does not prevent clinical deterioration. Trial Registry Number CTRI/2020/07/026791 ( http://ctri.nic.in ; registered on 25/07/2020).


Subject(s)
COVID-19 , Clinical Deterioration , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Aspirin/therapeutic use , Atorvastatin/therapeutic use , COVID-19/drug therapy , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Interleukin-6 , SARS-CoV-2 , Treatment Outcome
4.
Pacing Clin Electrophysiol ; 45(4): 574-577, 2022 04.
Article in English | MEDLINE | ID: covidwho-1794593

ABSTRACT

A middle-aged woman presented with symptomatic complete heart block and underwent an uneventful dual chamber pacemaker implantation. Three weeks post procedure, she developed left arm pain and weakness, with neurological localization to the lower trunk of left brachial plexus. Possibilities of traumatic compression by the device/leads or postoperative idiopathic brachial plexopathy were considered. After ruling out traumatic causes, she was started on oral steroids, to which she responded remarkably. This case highlights the importance of recognizing this rare cause of brachial plexopathy following pacemaker implantation, because not only does an expedited diagnosis and medical treatment lead to prompt recovery with minimal neurological deficits, but it also circumvents an unnecessary surgical re-exploration.


Subject(s)
Brachial Plexus Neuropathies , Brachial Plexus , Pacemaker, Artificial , Brachial Plexus Neuropathies/diagnosis , Brachial Plexus Neuropathies/etiology , Female , Humans , Middle Aged , Pacemaker, Artificial/adverse effects
5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-311088

ABSTRACT

Background: Statins and aspirin have been advocated for treatment of Covid-19 owing to anti-inflammatory and anti-thrombotic properties and have shown favorable results in observational studies. There is a need for randomized controlled trial.Methods: We conducted a single-center, four-arm parallel design, open-label randomized controlled trial on RT-PCR positive Covid-19 patients, ≥ 40 years and < 75 years of age, requiring hospitalization [World Health Organization (WHO) Ordinal Scale for Clinical Improvement 3 to 5]. Patients were randomly assigned to either atorvastatin 40 mg (group A), aspirin 75 mg (group B), or both (group C) in addition to standard of care for 10 days or until discharge whichever was earlier or only standard of care (group D). The primary outcome variable was clinical deterioration to WHO Ordinal Scale for Clinical Improvement ≥ 6. The secondary outcome was change in serum inflammatory markers (C-reactive protein and Interleukin-6), and Troponin I.Findings: A total of 900 patients underwent randomization (with Groups A, B, C and D assigned 224, 225, 225 and 226 patients respectively). The primary outcome occurred in 25 (2.8%) patients: 7 (3.2%) in Group A, 3 (1.4%) in Group B, 8 (3.6%) in Group C and 7 (3.2%) in Group D. There was no difference in primary outcome across the study groups (P=0.463). Comparison of all patients who received atorvastatin or aspirin with the control group (Group D) also did not show any benefit [Atorvastatin: HR 1.0 (95% CI 0.41 - 2.46);Aspirin: HR 0.7 (95% CI 0.27 - 1.81)]. The secondary outcomes revealed lower serum IL-6 among patients in Groups B and C. There was no excess of adverse events.Interpretation: Among patients admitted with mild to moderate Covid-19 infection, additional treatment with aspirin, atorvastatin or a combination of the two does not prevent clinical deterioration.Trial Registry Number: CTRI/2020/07/026791 (http://ctri.nic.in;registered on 25th July 2020)Funding: None to declare. Declaration of Interest: None to declareEthical Approval: The trial was approved by the institutional ethical committee.

6.
Journal of the Practice of Cardiovascular Sciences ; 7(2):89-96, 2021.
Article in English | Academic Search Complete | ID: covidwho-1456420

ABSTRACT

A 35-year-old female presented to us with a history of exertional dyspnea from the last 20 years and low oxygen saturation noticed from last 1 month during her COVID-19-related illness. The patient did not seek medical attention over these years as the degree of limitation of physical activity was modest. She had a bad obstetric history: five second trimester pregnancy losses and one early neonatal death. Her symptoms were worse during pregnancy and improved thereafter. Physical examination was notable of cyanosis and features of pulmonary hypertension (PH). Echocardiography was suggestive of double outlet right ventricle, large subaortic ventricular septal defect with bidirectional shunt, and severe PH. This case highlights a variable clinical outcome of Eisenmenger syndrome in pregnancy. We did a literature review for studies reporting the outcomes of PH in pregnancy. The overall mortality rates seem to have declined dramatically from as high as 56% reported in studies in the 1990s to < 5% in more contemporary studies. The common adverse obstetric outcomes include prematurity and growth restriction. [ABSTRACT FROM AUTHOR] Copyright of Journal of the Practice of Cardiovascular Sciences is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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