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1.
Indian J Ophthalmol ; 71(1):249-256, 2023.
Article in English | PubMed | ID: covidwho-2201801

ABSTRACT

PURPOSE: To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the "second wave" of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. METHODS: Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. RESULTS: A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. CONCLUSION: Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.

2.
Multiple Sclerosis Journal ; 28(3 Supplement):749-750, 2022.
Article in English | EMBASE | ID: covidwho-2138805

ABSTRACT

Introduction: Inducible nitric oxide synthase (iNOS) catalyses production of nitric oxide during an inflammatory stimuli and is a signature marker of M1-like microglia/macrophages. iNOS mRNA and protein were found in brain lesions of MS patients however its role in demyelination remains unclear. We employed RSA59, a mild hepatoneurotropic strain of Mouse hepatitis virus (MHV) which in 4-weeks-old C57BL/6 mice causes biphasic CNS disease characterised by acute neuroinflammation (day5 p.i.) and chronic demyelination and axonal loss (day30 p.i.). Microglia/ macrophages are central to the disease pathology and require assistance from infiltrating CD4+ T cells to mount protective host immune response. The CNS immune interactions during the acute-adaptive transition stage thus determine disease trajectory. Objective(s): To understand the role of iNOS in microglia/macrophage and peripheral T cell communication and assess its effect on demyelination. Aim(s): To study the role of iNOS in demyelination. Method(s): 4-5-weeks-old MHV-free wildtype C57BL/6 (WT) and iNOS knockout (iNOS-/-) mice were infected intracranially with 20000 or 10000 pfus of RSA59 and assessed daily for weight loss and disease score. Mice were sacrificed at day9/10 and day30 p.i. CNS viral titers were detected by plaque assay. Transcript levels of anti-inflammatory and phagocytic M2-like phenotype markers were analysed by qRT PCR. Differential CNS immune cell infiltration was assessed by flow cytometry. LFB and Iba1 staining was used to study demyelination and microglia/macrophage activation in the CNS. Result(s): iNOS-/- mice infected with RSA59 at 20000 pfus exhibited aggravated disease and high mortality at the acute-adaptive transition stage i.e., day9/10 p.i. as compared to wildtype controls despite being no differences in virus clearance by the CNS. Histopathology at this stage showed early demyelination in the spinal cords accompanied by presence of amoeboid microglia macrophages;high CNS mRNA expression of M2-like phenotype markers, TGFbeta, Arg1, CD206 and TREM2;and more infiltration of T regulatory cells. iNOS-/- mice infected at low pfus of virus i.e., 10000 also showed significantly more chronic demyelination at day30 p.i. Conclusion(s): Our studies reveal a protective role of iNOS against RSA59 induced demyelination by regulating the CNS inflammatory phenotype specifically the phenotypic transition of microglia/macrophages and thereby their interaction with peripheral immune cells.

3.
Topics in Antiviral Medicine ; 30(1 SUPPL):39, 2022.
Article in English | EMBASE | ID: covidwho-1880477

ABSTRACT

Background: To improve the management of SARS-Co2 infection there is an urgent unmet need for an orally administered antiviral drug to prevent disease progression, hospitalization, and clinical complications. Molnupiravir was developed in response to this need. This study assesses its efficacy and safety in Indian patients with mild SARS-CoV2 infection. Methods: This study is a phase III multi-centre open label randomized controlled trial of oral molnupiravir plus standard of care (MOL/SOC) versus SOC alone in Indian adults with mild SARS-CoV2 infection. The molnupiravir formulation used was developed and manufactured by HETERO LABS LTD, Hyderabad, India, under license from MERCK INC, NJ, USA. Eligible patients with RT PCR-confirmed mild SARS CoV2 infection, uncomplicated upper respiratory tract infection, with mild symptoms without any evidence of breathlessness, were randomized 1:1 to either oral MOL 800 mg b.i.d. for 5 days plus SOC or SOC alone. The primary endpoint was rate of hospitalization up to day 14. Secondary endpoints included proportion with a 2-point improvement in WHO 11-Point Clinical Progression Scale and rate of SARS CoV2 RT PCR negativity in naso/oropharyngeal swab at day 5, 10 and 14 and incidence of adverse events. Results: Of 1284 patients screened, 1218 were eligible and randomized, 608 to MOL+SOC, and 610 to SOC. The population consisted mainly of male patients (68%). Both arms were well balanced for age, height and weight. In the MOL/SOC arm 9 patients (1.5%) required hospitalisation vs. 26 (4.3%) in the SOC arm (p<0.01). In the MOL/SOC arm 80.8%, 95.6% and 97.4% had clinical improvement by Day 5, 10 and 14, respectively, compared to 32.1%, 74.3% and 94.1% in the SOC arm (p<0.0001 at day 5 and 10, and <0.01 at day 14). The rate of SARS CoV2 negativity was 77.1%, 91.3% and 93.9% in MOL/SOC vs. 29.3%, 70.2% and 89.0% in SOC at day 5, 10 and 14, respectively (p<0.001). There were no serious adverse events. Mild and self-limiting adverse events occurred in 4.8% of MOL/SOC and 2.6% of SOC participants. The most common adverse events were neurological (headache, somnolence) and gastrointestinal. Conclusion: A lower rate of hospitalisation, earlier clinical improvement, and earlier SARS CoV2 RT PCR negativity document superiority of Molnupiravir to SOC in mild SARS-CoV2 infection in this trial in India. Molnupiravir was well tolerated: adverse events were mild and rare.

4.
Tenside Surfactants Detergents ; 58(6):410-415, 2021.
Article in English | Web of Science | ID: covidwho-1559939

ABSTRACT

The coronavirus disease 2019 (COVID-19) has led to serious health and economic damage to all over the world, and it still remains unstoppable. The SARS-CoV-2, by using its S-glycoprotein, binds with an angiotensin-converting enzyme 2 re-ceptor, mostly present in alveolar epithelial type II cells. Eventually pulmonary surfactant depletion occurs. The pulmonary surfactant is necessary for maintaining the natural immunity as well as the surface tension reduction within the lung alveoli during the ex-piration. Its insufficiency results in the reduction of blood oxyge-nation, poor pulmonary regeneration, lung fibrosis, and finally the respiratory system collapses. Exogenous surfactants have pre-viously shown great promise in the treatment of infant respiratory distress syndrome, and they may also aid in the healing of dam-aged alveolar cells and the prevention of respiratory failure. Sur-factant based therapy has been advised for the prevention of COVID-19, and the trials have begun around the world. Further-more, greater research on the timing, dose, and the distribution of surfactant to the COVID-19 patients is required before this tech-nique can be implemented in clinical practice.

5.
Journal of Association of Physicians of India ; 69(11):14-16, 2021.
Article in English | Scopus | ID: covidwho-1507498

ABSTRACT

Background: Chemoprophylaxis (CP) along with masking and physical distancing seem an undeniable alternative. Considering the significant but uncertain role of CP for the current COVID-19 pandemic situation, we aimed to determine the various aspects of CP prescribing practices among physicians across India. Methods: An online survey was conducted among prescribing physicians across India where physicians were assessed for their prescribing practices on COVID-19 CP. Responses to the questionnaire were obtained via telephone, email and WhatsApp messages. Responses were duly analyzed thereafter. Result: Ivermectin was the preffered choice in 44% individuals followed by hydroxychloroquine in 34% individuals. Odds of COVID contact among those using HCQ and/or IVR prophylaxis was less than 1 of which IVR was found more protective. The present study also made a survey among 309 community dwellers, where odds of contacted COVID among those with any prophylaxis was 0.46 times than those without any prophylaxis. Conclusion: The HCPs found IVR to have a greater risk reduction than with HCQ;while the combination showed the greatest reduction and lack of CP use was associated with a high risk of SARS-CoV-2 infection. © 2021 Journal of Association of Physicians of India. All rights reserved.

6.
2021 International Conference on Automation, Control and Mechatronics for Industry 4.0, ACMI 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1447785

ABSTRACT

The COVID-19 situation has created an exceptional challenge in the power management system (PMS). This work mainly focuses on the load management through load forecasting. Power generation and distribution is the most important part of PMS. Accurate load forecasting can help to secure electricity scheduling, supply, and reduce the wastage of power. Right now, social distancing has created a great challenge to the administrators to run the power system efficiently and uninterruptedly with minimum involvement of human. In the sector of load management, it can be done through a proper and faster load forecasting approach. Electrical Load Forecasting through deep learning algorithm can perform an effective role in Power Management System (PMS). In this research real data is collected from West Zone Power Distribution Company Limited (WZPDCL) and meteorological data like temperature and humidity are collected from the website of Bangladesh Meteorological Department to train and forecast electrical load using MATLAB. Long-Short Term Memory (LSTM), Feed Forward Back Propagation (FFBP) and ELMAN Neural Network (NN) are used to forecast electrical load. As exogenous data, the load factor (L.F.), power factor (P.F.), current and temperature were used to train algorithms in forecasting the electrical load. A comparative analysis is shown to indicate which is the best suitable method for load forecasting of WZPDCL. Electrical load forecasting results are evaluated through Root Mean Square Error (RMSE). In this research for short-term electrical load forecasting, Feed Forward Back Propagation has shown a minimum RMSE value. © 2021 IEEE.

7.
Journal of the Indian Medical Association ; 118(10):86-89, 2020.
Article in English | Scopus | ID: covidwho-1426851

ABSTRACT

Age old anthelmintic drug ivermectin Is showing some promises In the management of COVID 19 patients. In vitro study suggests anti SARS CoV2 viral role of ivermectin but there is some controversy regarding dose selection. Ivermectin has immunomodulatory roie which may be responsible for Its beneficial effects. Though it Is not included in interim COVID 19 management guideline by GOt, but several states like West Bengal, Bihar, UP, Assam have included it in state COVID 19 management guideline. It Is important to be vigilant and more focused to prospectlvely observe the outcome in COVID 19 patients. © 2020, Indian Medical Association. All rights reserved.

8.
Istanbul Ticaret &Uuml ; niversitesi Sosyal Bilimler Dergisi; 19(37):240-261, 2020.
Article in Turkish | ProQuest Central | ID: covidwho-948340

ABSTRACT

Mevcut COVID-19 salgını tüm dünyada insanları etkileyen küresel bir sa&gcaron;lık krizidir. 2020 yılının Mart ayında teyit edilmiş vaka sayısı hızla artmış, salgın Dünya Sa&gcaron;lık Örgütü tarafından pandemi kategorisine alınmıştır. Pandemi gibi büyük krizler büyük çaplı davranış de&gcaron;işiklikleri gerektirir, bireylere önemli yükler getirir. Bu süreçte pandeminin olumsuz etkilerini azaltmak, kamuoyunun do&gcaron;ru bilgilere ulaşmasını sa&gcaron;lamak ve bireylere yol göstermek üzere başta ülkelerin sa&gcaron;lık bakanlıkları olmak üzere tüm kurumlara önemli görevler düşmektedir. Pandemi ile mücadelede toplum ile ba&gcaron;kurulmasını sa&gcaron;layan iletişim araçlarının önemi her geçen gün daha iyi anlaşılmaktadır. Ínfografikler hızlı kavrayış ve hızlı hareket gerektiren konularda kaynak ve alıcıya büyük imkânlar sunmaktadır. Bilgilerin uzun metinler yerine grafikler ile aktarıldığı infografikler verilerin bir bakışta kolayca anlaşılmasın&0131;, bireylerle ilişki kurmay&0131;, zor kavramların daha kolay kavranmasını ve tıbbi jargonun anlaşılır hale gelmesini sa&gcaron;lar. Bu çalışmada Türkiye'de Sa&gcaron;lık Bakanlığı'nın hazırlayıp dağıttığı COVÍD-19 temalı infografikler görsel tasarım, anlam ve yazında bulunan izleyici tercihleri varsayımlarına göre incelenmiş, pandemi ile mücadelede nasıl kullanıldıkları ortaya koyulmuştur.Alternate abstract:The current COVID - 19 disease is a crisis that affects people all over the world. The number of confirmed cases increased rapidly in March 2020, and the epidemic was placed in the pandemic category by the World Health Organization. Large crises such as a pandemic require major behavioral changes, imposing significant burdens on individuals. In this process all institutions, especially the health ministries of the countries, have important duties in order to reduce the negative effects of the pandemic, provide the public with the right information and guide individuals. The importance of communication tools that ensure the connection with the society in the fight against the pandemic is better understood day by day. Infographics offer great opportunities to the source and the receivers in matters requiring rapid understanding and rapid movement. Infographics, in which the information is transferred with graphics instead of long texts, allow the data to be easily understood at a glance, to establish relationships with individuals, to comprehend difficult concepts and to make the medical jargon understandable. In this study, the infographics prepared and distributed by the Ministry of Health in Turkey were examined in terms of visual design, composition and meaning and how they are used to combat the pandemic.

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