Analysis of pathogen detection results of upper respiratory tract specimens from fever clinic patients

Objective: To explore the pathogen composition and distribution characteristics of pathogens in respiratory samples from patients with fever of unknown origin. Methods: A total of 96 respiratory samples of patients with unknown cause fever with respiratory symptoms were collected from four hospitals above grade II in Shijiazhuang area (Hebei Provincial Hospital of Traditional Chinese Medicine, Luancheng District People's Hospital, Luquan District People's Hospital, Shenze County Hospital) from January to April 2020, and multiplex-fluorescent polymerase chain reaction(PCR)was used to detect influenza A virus, influenza B virus, enterovirus, parainfluenza virus I/II/III/IV, respiratory adenovirus, human metapneumovirus, respiratory syncytial virus, human rhinovirus, human bocavirus, COVID-19, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, Pseudomonas aeruginosa, Streptococcus pneumoniae, Klebsiella pneumoniae, Group A streptococcus, Haemophilus influenzae, Staphylococcus aureus nucleic acid detection, the results were analyzed for chi-square. Results: A total of 8 pathogens were detected in the upper respiratory tract samples of 96 fever patients, including 1 kind of virus, 6 kinds of bacterias, and Mycoplasma pneumoniae. There were 12 viruses including influenza virus and parainfluenza virus, Legionella pneumophila and Chlamydia pneumoniae were not detected. The pathogen detection rates in descending order were Streptococcus pneumoniae (58/96, 60.42%), Haemophilus influenzae(38/96, 39.58%), Klebsiella pneumoniae (14/96, 14.58%), Staphylococcus aureus (10/96, 10.42%), Mycoplasma pneumoniae (8/96, 8.33%), Pseudomonas aeruginosa (6/96, 6.25%), Group A streptococcus (4/96, 4.17%) and human rhinovirus (2/96, 2.08%). The proportions of single-pathogen infection and multi-pathogen mixed infection in fever clinic patients were similar, 41.67% (40/96) and 45.83% (44/96), respectively, and 12.50% (12/96)of the cases had no pathogens detected. The infection rate of Mycoplasma pneumoniae in female patients with fever (21.43%) was higher than that in male patients with fever (2.94%) (P < 0.05). There was no statistical difference between the distribution of of other pathogens and gender and age(P > 0.05). Conclusions: The upper respiratory tract pathogens were mainly bacterial infections, and occasional human rhinovirus and Mycoplasma pneumonia infections. In clinical diagnosis and treatment, comprehensive consideration should be given to the pathogen detection.

Gastrointestinal features of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in selected referral hospitals in Iran

Background and purpose: Multisystem Inflammatory Syndrome in Children (MIS-C) occurs after having COVID-19. The severity and outcomes of COVID-19 with gastrointestinal symptoms are higher. The aim of this study was to investigate gastrointestinal manifestations in MIS-C patients in selected referral hospitals in Iran to obtain comprehensive information about the treatment and prevention of MIS-C. Materials and methods: In this cross-sectional study, all MIS-C patients <21 years in Dec 2019 to Oct 2021 were included. The patients were identified by the Centers for Disease Control and Prevention (CDC) checklist and data were analyzed applying t-test and Chi-square in STATA11. Results: There were 225 patients with a median age of 55 months (26-96 months), including 59.56% boys and all had fever on admission. At least one gastrointestinal symptom was seen in 200 patients and the most common symptoms were vomiting (60.9%) and abdominal pain (45.77%). Almost 60% of the patients had positive RT-PCR results. Among the patients with and without gastrointestinal symptoms 85.5% and 48% were admitted to intensive care unit (ICU), respectively. There were significant differences between the two groups in respiratory symptoms, ALT, AST, NT-pro BNP, ESR, and PLT (P < 0.05). All patients without gastrointestinal symptoms were discharged but nine patients in the group with gastrointestinal symptoms deceased. Conclusion: According to the current study, gastrointestinal symptoms are common in MIS-C patients and are associated with higher rates of death and intensive care unit admission. Therefore, in providing services to COVID-19 patients, all typical and atypical signs and symptoms should be considered to prevent unnecessary interventions.

An outbreak of school influenza complicated with Mycoplasma pneumoniae infection

Objective: To describe the clinical features, causal agent and transmission mode of a fever outbreak in a school in Shanghai. Methods: Field epidemiological approaches including case definition development, searching for contacts, distribution of diseases description, environmental sampling and laboratory testing. Results: A total of 16 influenza-like cases were included, all concentrated in the one class of grade two, including 15 students and 1 teacher. Among student cases, the incidence rate was 36.59%(15/41), the average age was 7.4 years, the incidence rate was 36.84%(7/19) for boys, 36.36%(8/22) for girls. The clinical course was 5-15 days, with the median of 9 days, and 18.75%(3/16) of the cases stayed studying while sick. The nasopharyngeal swab specimens in 16 cases all tested positive for influenza B, of which 11 tested positive for mycoplasma pneumoniae and 1 case also tested positive for coronavirus OC43. Body temperature, number of mononuclear cells, and treatment time of patients infected with Influenza B and mycoplasma pneumoniae were higher than those of patients infected with influenza B alone(P < 0.05). The outbreak lasted for 12 days, all sick students were treated and discharged from hospital, with no severe cases or death, and the outbreak was effectively controlled. Conclusion: This campus cluster outbreak caused by influenza B and mycoplasma pneumoniae. Patients with influenza B with mycoplasma pneumoniae have severe symptoms and a long course of illness, suggesting the importance of early management of the epidemic.

Photodynamic therapy: a new treatment against COVID-19

In 2019, a new coronavirus (COVID-19) was discovered in Wuhan, China, which soon spread all over the world. The main hallmark of the disease includes fever, diarrhea, vomiting, and dry cough with dyspnea in half of the patients and acute respiratory distress syndrome (ARDS). Currently, no definitive treatment or prevention therapy exists for COVID-19 but scientists and researchers all over the world are relentlessly working to understand COVID-19 to discover novel therapeutic tools and vaccines. Today, photodynamic therapy (PDT) has been investigated as a noninvasive therapy for the treatment of this pandemic and was able to increase the healing process with the help of appropriate photosensitizers by targeting the pathogen inside the patient's body.

Relationship of clinical symptoms, comorbidities and treatment options along with disease outcomes in individuals tested for COVID-19 in Pakistan: a national survey

Background: This web-based survey is done to collect and assess data from people tested for COVID-19 with PCR in Pakistan. Methods: This 3-month study is a cross-sectional online survey, conducted by Pakistan Islamic Medical Association (PIMA), Health Research Advisory Board (HealthRAB) and National Institute of Health (NIH). Data collection was done using Google Forms. People who were tested for COVID-19 using Polymerase Chain Reaction (PCR) were included in the study. The sample size of the study was 1,537. SPSS version 22 was used for data analysis. Results: Majority of the respondents belonged to the age group 20 - 39 years. The most common symptoms found were fever 633 (41%), cough 534 (34%), generalized body aches 432 (28%) and sore throat 392 (25%). The mean COVID-19 mental health score was 3.59 (SD: 5.808, range: 0-18). Treatment with antibiotics and painkillers had a strong correlation (p-value < 0.05) with the disease outcomes. The disease outcomes had moderate correlation (p-value < 0.05) with anti-allergy, steroids, plasma and oxygen therapy, and weak correlation (p-value < 0.05) with Antiviral and Antimalarial therapy. Out of the total respondents, 561 (36.1%) were cured from COVID-19, 14 (0.9%) were expired during/after hospitalization, 15 (1%) were still infected and 962 (62%) were not infected. Conclusion: Pakistani population has a better cure rate than some of its neighboring countries. However, further research in this area is required to draw a definite conclusion.

Granulomatous Hepatitis as Primary Manifestation of Disseminated Histoplasmosis in an Immunocompetent Host Diagnosed on EUS FNA and Liver Biopsy

Introduction: Disseminated histoplasmosis (DH) presents as primarily lung manifestations with extrapulmonary involvement in immunocompromised hosts. Granulomatous hepatitis as first presentation of DH in an immunocompetent host is uncommon. Case Description/Methods: 25-year-old female presented with one month of fever, fatigue, myalgias, 30-pound weight loss, cough, nausea, vomiting, and epigastric pain. She has lived in the Midwest and southwestern US. Presenting labs: TB 1.9 mg/dL, AP 161 U/L, AST 172 U/L, ALT 463 U/L. Workup was negative for COVID, viral/autoimmune hepatitis, sarcoidosis, tuberculosis, and HIV. CT scan showed suspected gallstones and 9 mm left lower lobe noncalcified nodule. EUS showed a normal common bile duct, gallbladder sludge and enlarged porta hepatis lymph nodes which underwent fine needle aspiration (FNA). She was diagnosed with biliary colic and underwent cholecystectomy, with white plaques noted on the liver surface (A). Liver biopsy/FNA showed necrotizing granulomas (B) and fungal yeast on GMS stain (C). Although histoplasmosis urine and blood antigens were negative, histoplasmosis complement fixation was >1:256. She could not tolerate itraconazole for DH, requiring amphotericin B. She then transitioned to voriconazole, discontinued after 5 weeks due to increasing AP. However, her symptoms resolved with normal transaminases. At one year follow up, she is asymptomatic with normal liver function tests. Discussion(s): DH is a systemic granulomatous disease caused by Histoplasma capsulatum endemic to Ohio, Mississippi River Valley, and southeastern US. DH more commonly affects immunocompromised hosts with AIDS, immunosuppressants, and organ transplant. Gastrointestinal involvement is common in DH (70-90%) with liver involvement in 90%. However, granulomatous hepatitis as primary manifestation of DH is rare (4% of liver biopsies). Hepatic granulomas are seen in < 20%. Patients may present with nonspecific systemic symptoms. Serum/urine antigens may be negative. Gold standard for diagnosis is identifying yeast on tissue stains. Recommended treatment is amphotericin B followed by 1 year of itraconazole. However, shorter treatment duration may be effective in immunocompetent hosts. This case is unique in that granulomatous hepatitis was the first presentation of DH in our immunocompetent patient diagnosed on EUS FNA and liver biopsy. Clinicians must have a high degree of suspicion for DH in patients with fever of unknown origin especially in endemic areas regardless of immunologic status. (Table Presented).

Correlation between laboratory findings and clinical severity among the COVID-19 patients in the tertiary care centre

Background: Coronavirus is a highly infectious novel virus we are in urge to know more about their clinical characteristics and laboratory findings for the characterization and selection of treatment protocol. Methods: Prospective, single centre study. Two months data was collected, clinical characteristics data from patient case sheet and the laboratoryvalues from the Hospital Information System (HIS) for the month of July and August 2020. Results: Of 462 patients, 55 (11.9%) are falls under asymptomatic category, 194 (42%) are in mild category, 167 (36.1%) are in moderate category and 46 (10%) in severe category. Fever 230 (49.8%) and cough 211 (45.7%) was most common clinical symptom with p value < 0.01. Non-severe vs severe, 340 (73.6%) and 201 (43.5%) showed decreased in eosinophil count and absolute eosinophil count, 125 (27.1%) and 80 (17.3%) patient showed decrease in lymphocyte count and absolute lymphocyte count, 200 (43.3%) showed increase in neutrophil count with a significance of p value >0.05.186 (40.3%) patients had one or more co-morbidities. Laboratory findings between Asymptomatic VS symptomatic, showed significance changes in neutrophil, lymphocyte, Aspartate aminotransferase, Alkaline phosphatase, globulin values (p value <0.05). Conclusion: Clinical severity categorization at the time of admission was very helpful for the treating doctors in proper understanding of disease progression and appropriate treatment of the patient. Presence of co-morbidity, abnormal laboratory values, old age group patients, higher Computed Tomography score, higher mortality rate are seen more in patients who were in clinical severity grade severe category than in non-severe category patients.

Analysis on traditional Chinese medicine syndrome characteristics of patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant in a shelter hospital in Shanghai

Objective: To analyze the characteristics of traditional Chinese medicine (TCM) syndromes of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in a shelter hospital in Shanghai. Methods: A total of 621 patients infected with SARS-CoV-2 omicron variant from Apr. 4 to May 24, 2022 in a shelter hospital in Shanghai were enrolled. The data of the patients, including the general information and common clinical syndromes (such as fever, headache, stuffy nose, runny nose, cough, and sputum), were collected on admission by TCM syndrome electronic scale, and core syndrome characteristics were analyzed base on the proportion of each symptom. The syndromes were divided according to the symptom score of patients, and the differences of disease course among the syndromes were compared. Results: The proportion of patients aged 30 to 49 years old was the highest among 621 patients infected with omicron variant (49.76%, 309/621). The most prominent symptoms were cough and expectoration, accounting for 62.32% (387/621) and 68.12% (423/621), respectively. The more common symptoms included sore throat, stuffy nose, runny nose, fatigue, muscle pain, and headache. White sputum was mostly seen in the expectoration and clear mucus was mostly seen in runny nose. According to the clinical symptoms, the core syndrome characteristic of patients infected with omicron variant was cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome was plague invading the defensive exterior, accounting for 40.10% (249/621). The second and third ones were heat toxin attacking the lung syndrome (29.95%, 186/621) and dampness obstructing (17.55%, 109/621), while the least common syndrome was deficiency of qi and yin (7.73%, 48/621). The course of qi and yin deficiency was longer than the other 3 syndromes (P < 0.05). Conclusion: The core TCM syndrome characteristic of patients infected with SARS-CoV-2 omicron variant is cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome is plague invading the defensive exterior. The pattern tends to convert into qi and yin deficiency along the long course.

Surveillance of SARS CoV-2 and other respiratory viruses in 2020-2021 winter season

Aim: The global COVID-19 pandemic and new variants continue to seriously threaten society. In this study;It was aimed to investigate surveillance of SARS CoV-2 and other respiratory viruses in respiratory tract samples in the winter season of 2020-2021 in Sakarya province. Material and Method: The study was carried out at Sakarya Training and Research Hospital between 2020-2021. e study was carried out with respiratory tract samples (Nasopharyngeal swab) stored in the laboratory. Clinical samples included in study were stored in a Bio-SpeedyRvNATRtransfer tube (Bioeksen,Turkey) and no extraction was performed in accordance with manufacturer's instructions. All analyzes were recorded on BIO-RAD CFX-96C1000 Touch Real-time system device using Diagnovital influenza A/B, SARS CoV-2, RSV multiplex Real Time PCR amplification kit. Results: Of the 200 patients diagnosed with URTI/LRTI, 54.5% were male and 45.5% female. e most common clinical symptoms;sore throat 74%, cough 73.5%, fatigue 71%, fever 57%, runny nose 56%, headache 48.5%, sneezing 41.5%, loss of smell / taste 39.5%, diarrhea 36%, dyspnea was 31.5% and myalgia was 23.5%. PCR positivity rates of samples were analyzed as 28.5% for SARS COV-2 and 1.5% for RSV, respectively. PCR positivity for influenza A/B was not defined in the study. Considering the statistical significance between PCR results and COVID-19 symptoms in patients;symptoms of dyspnea (n=63), fever(n= 62) and sneezing(n=56), respectively, were statistically significant(p<0.05). Conclusion: Due to the circumstances, only three main viral agents could be investigated in the study. RSV was frequently identified as an important factor in pediatric patients, whereas influenza-which may be related to social and individual measures (mask,distance,hygiene)- was not detected in any sample. More comprehensive scientific studies are needed to support the data.

The different clinical characteristics of COVID-19 patients between pediatric and adults

Background: In December 2019, a novel coronavirus (a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) emerged in Wuhan, China. Objectives: The current research aimed to evaluate the clinical features of COVID-19 infection in pediatric patients and compare them with those of adult patients in Sanandaj, Iran. Methods: Retrospectively, 56 hospitalized cases, including 32 adult and 24 pediatric patients with COVID-19 from March 7th, 2020, to June 5th, 2020, were enrolled in this study. The clinical and laboratory findings of the pediatric patients with COVID-19 infection were analyzed and compared with those of the adult patients. Results: The average number of fever days in adults was higher than that of pediatric patients (P = 0.04). Cough was more severe in adults than in pediatric patients (P = 0.03). Diarrhea was not statistically different between the two groups. Dizziness was far more common in adults than pediatric patients (P = 0.01). The percentage of blood oxygen saturation decreased in both groups, but there was no statistically significant difference between the two groups. C-reactive protein (CRP) was positive in many patients in both groups;however, there was no difference between the pediatric and adult patients. Lymphopenia was significantly higher in adults than in pediatric patients (P = 0.02). As in pediatric patients, an increase in liver enzymes was seen in adults. However, there was no statistically significant difference between the two groups. Conclusions: The present study showed that pediatric patients with COVID-19 infection have milder clinical symptoms than adults. However, according to the laboratory findings, pediatric patients need to be followed up as well as adult patients.

The general characteristics of hospitalized patients with the diagnosis of COVID-19, and the relationship between presenting symptoms and clinical course: a single center experience

Objective: In this study, it was aimed to reveal the relationship between the clinical features, presenting symptoms, and prognosis of COVID-19 patients who were hospitalized in our center. Materials and Methods: 499 patients with the diagno-sis of COVID-19 followed in the service and intensive care units of Sakarya University Training and Research Hospital between March 2020 and January 2021 were included in the study. The clinical and demographical data of the patients were obtained from the patient files and hospital automation system. The obtained data were ana-lyzed statistically. Results: Of 499 patients, 171 were followed up in the ward and 328 in the intensive care unit. Follow-up of 230 patients resulted in death, while 269 patients were dis-charged. Comorbid diseases were found to be more fre-quently seen in the mortal group (p< 0.05). Mean leuko-cyte, neutrophil, c-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, d-dimer, and troponin values were higher in the mortal group;whereas mean lymphocyte value was found to be lower (p< 0.05). While fever, cough, and other less common symptoms (diarrhea, nausea, muscle weakness, etc.) were more frequently seen in the non-mortal group (p=0.022, p=0.038, and p=0.000 respectively), shortness of breath was significantly more common in the mortal group (p=0.000). The frequency of symptoms such as sputum, fatigue, sore throat, and the headache were found to be similar in both groups (p >0.05). Conclusion: It was concluded that the clinical course of patients with dyspnea at admission may be more severe and these patients should be followed more closely.

Evaluation of stroke frequency in COVID-19 patients

Objective: Neurological symptoms occur due to central and peripheral nervous system involvement with different mechanisms in coronavirus disease 2019 (COVID-19). Microvascular thrombosis develops with prothrombotic activation along with the increase in cytokines in COVID-19 infection. We aimed to investigate the incidence of cerebrovascular disease and concomitant risk factors in COVID-19 positive patients. Materials and Methods: Acute and temporally related cerebrovascular diseases with a diagnosis of COVID-19 were evaluated. Cerebrovascular events were assessed in 4 groups as ischemic and hemorrhagic events, transient ischemic attacks, and cerebral venous thrombosis. Risk factors for cerebrovascular disease in these patients were also assessed, and which risk factors for cerebrovascular diseases in COVID-19 patients are high risk were examined. Results: Of the 1000 patients with COVID-19 disease were evaluated. Ischemic cerebrovascular disease and/or transient ischemic attack were found in 14 patients (1.4%). The most common symptoms related to COVID-19 were fever and respiratory distress in 14 patients with acute ischemic stroke diagnosed with COVID-19. Conclusion: COVID-19 increases the risk of stroke in patients with multiple risk factors. Close follow-up should be performed more carefully, especially in patients with pulmonary involvement and acute ischemic stroke, because mortality is likely to be higher.

Oral manifestations in COVID-19 patients among the Bangladeshi population: a cross-sectional study

Background: COVID-19 is a multi-system all-pervasive disease with protean manifestations, and its major signs and symptoms, such as incessant dry cough, fever, and pneumonia, are well known. Yet, its mucocutaneous manifestations, particularly those of the oral cavity, appear to be little recognized. This may be due either to the rarity of oral manifestations of COVID-19, or poor detection of such symptoms by attending physicians who may do only a cursory examination of the oral mucosa because of the overwhelming gravity of the other major systemic presentations. Nevertheless, there are now a considerable number of reports, including systematic reviews, on oral manifestations of COVID-19 in the literature. This observational study was performed to determine the oral manifestations among COVID-19 patients. Material & Methods: A cross-sectional study was carried out among COVID-19 recovered patients. 120 Covid 19 recovered patients were purposively selected as study samples. All the samples diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria. Results: The study comprised the majority of males (68%) where females represent (32%) of the study population and the mean age was 39.3+or-12.4. Oral manifestations among study subjects during and after the disease illness including loss of taste being the commonest symptom (40%), followed by erythema and coated tongue (7.5%), mouth ulcerations (6.7%) and dry mouth (1.7%). The study revealed that the 41-60 age group subjects represented the highest (43%) oral manifestations. Conclusions: Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.

A Preliminary Study of Mild Heat Stress on Inflammasome Activation in Murine Macrophages.

Inflammation and mitochondrial-dependent oxidative stress are interrelated processes implicated in multiple neuroinflammatory disorders, including Alzheimer's disease (AD) and depression. Exposure to elevated temperature (hyperthermia) is proposed as a non-pharmacological, anti-inflammatory treatment for these disorders; however, the underlying mechanisms are not fully understood. Here we asked if the inflammasome, a protein complex essential for orchestrating the inflammatory response and linked to mitochondrial stress, might be modulated by elevated temperatures. To test this, in preliminary studies, immortalized bone-marrow-derived murine macrophages (iBMM) were primed with inflammatory stimuli, exposed to a range of temperatures (37-41.5 °C), and examined for markers of inflammasome and mitochondrial activity. We found that exposure to mild heat stress (39 °C for 15 min) rapidly inhibited iBMM inflammasome activity. Furthermore, heat exposure led to decreased ASC speck formation and increased numbers of polarized mitochondria. These results suggest that mild hyperthermia inhibits inflammasome activity in the iBMM, limiting potentially harmful inflammation and mitigating mitochondrial stress. Our findings suggest an additional potential mechanism by which hyperthermia may exert its beneficial effects on inflammatory diseases.

Clinical-epidemiological particularities of COVID-19-affected workers from "Eduardo Agramonte Pina" Hospital of Camaguey

Introduction: The health workers are one of the most prone to becoming infected with COVID-19, due to their exposure during their relationship with patients. Background: To determine the clinical and epidemiological characteristics of COVID-19 in workers of the Pediatric Hospital of Camaguey in the period from January to December 2021. Methods: A descriptive and cross-sectional study was carried out in a universe of 238 workers with a polymerase chain reaction-confirmed diagnosis during the aforementioned period;registered in a database. The variables studied included age group, sex, occupational category, service of origin, clinical manifestations, quarter of the year, and possible source of infection. The data were processed using the statistical program SPSS (Statistical Package for Social Sciences), version 25.0, on a Pentium IV computer. Informed consent and the bioethical principles of confidentiality of information were taken into account in the research. Results: The female sex predominated (54.7%) at ages 50-59 years. They were mostly nursing staff (29.4%), infected during the third trimester (39.9%) in the community (59.3%), presenting symptoms such as nasal discharge (32.8%) and fever (17.6%), working in the pediatric medicine wards (28.2%). Conclusions: Despite the difficult epidemiological situation, the main source of infection was the community. There were no institutional transmission events and there were no deaths.

Anti-fibrotic agents could be the game-changer for post-COVID-19 pulmonary fibrosis treatment

More than 220 countries and territories are globally affected by the recent pandemic COVID-19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is possibility of third wave of this pandemic as per epidemiological and public health experts. Besides that post-COVID-19 complications are alarming matter to look upon. Post-COVID-19 complications include several symptoms like as persistent fever;cough;fatigue;headache;attention disorder;dyspnea;anosmia;ageusia;chest pain discomfort;various respiratory illness;acute respiratory distress syndrome (ARDS) etc., and here the things to worry about is the development of pulmonary fibrosis after COVID-19. In some COVID-19 patients, hyper-inflammation in the form of 'cytokine storm' along with dysregulated immune response, alveolar epithelial tissue injury and wound repair collectively cause this secondary pulmonary fibrosis. Therefore, using anti-fibrotic agents e.g. pirfenidone, nintedanib and other natural compounds could be meaningful in these circumstances although their efficacy in treating COVID-19 is subject to more detailed laboratory research works. In this review article, we have discussed the progression of pulmonary fibrosis development which is triggered by COVID-19;probable solutions with anti-fibrotic agents including anti-fibrotic drugs, some well-known natural compounds, combined anti-fibrotic therapies;and the current challenges of this field.

Effect of aqueous extract of violet on fever in patients with COVID-19: a randomized clinical trial

Background and purpose: Violet is a plant that has received interest in complementary medicine due to its anti-inflammatory, antipyretic, and antimicrobial effects. Fever is one of the major symptoms of COVID-19. This study was conducted to determine the effect of violet extract in the form of syrup on fever in patients with COVID-19. Materials and methods: In this randomized clinical trial, 52 patients with COVID-19 were studied in Intensive Care Unit in Amol Imam Khomeini Hospital (2021). In intervention group in addition to an injection of acetaminophen, 5 cc of violet extract syrup prepared from the aqueous extract of the plant was taken. The temperature was recorded after 30 and 60 minutes and four hours. The follow-up of the patients continued for three days and the temperature was recorded every six hours. Results: There was a significant difference between the intervention group (36.84..0.37) and control group (37.13..0.62) in mean temperature at second time in second day of follow-up (P=0.04). Also, the mean temperature was found to be significantly different between the two groups at 30 (P=0.001) and 60 minutes (P=0.05) after the intervention. At other groups, there was no significant difference between the intervention and control groups. Conclusion: The aqueous extract of violet plant in the form of syrup reduces fever in patients with COVID-19 causing no complication. Due to the ease of access to this herbal product, it can be used to prevent problems caused by fever.

Observational study on prevalence of adverse effects of COVID vaccination among general population in South India

Introduction: COVID-19 is a viral disease due to the Severe Acute Respiratory Syndrome Coronavirus 2. The patients show flu-like symptoms with a dry cough, sore throat, high fever, and breathing problems. This was conducted to assess the adverse effects after taking Covid 19 vaccines in general population of Kerala state. Methodology: About 353 participants were enrolled in the study according to inclusion and exclusion criteria for a period of November 2021 to April 2022. Data collection was done with structured questionnaire in google form. The data were analysed and reported using tables, pie diagram, bar diagrams and different charts forms. Results: Majority of patients enrolled in the study were vaccinated with 2 dosed of Covid vaccines. From 351 participants vaccinated with Covid 19 vaccine 249 experienced an AEFI. The most reported AEFI was fever, body pain and injection site reactions. From the results it was found that females had experienced more AEFI than males. Most of the participants from our study were vaccinated with Covishield and all participants taken Sputnik vaccine had experienced some adverse effects. Conclusion: The present study reveal that majority of people vaccinated by Covid 19 vaccines had experienced any kind of AEFIs. Majority of patients enrolled in the study were vaccinated with 2 dosed of Covid vaccines. The most reported AEFI was fever, body pain and injection site reactions. From the results it was found that females had experienced more AEFI than males.

Clinical presentation of Iranian patients affected with COVID-19: a thousand faces disease

The coronavirus disease 2019 (COVID-19) pandemic in Iran is part of the worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present study aimed to demonstrate the clinical characteristics of patients affected by COVID-19, in our tertiary teaching hospital. Medical records and compiled data of 668 patients with suspected COVID-19 were obtained retrospectively between January to April 2020. The present study outcomes included demographic features of infected patients, underlying diseases and conditions, the relationship between the results of reverse transcription-polymerase chain reaction (RT-PCR) or CT-scan with the manifestations of the disease, mortality rate, and age distribution of fatalities among men and women. The median age of hospitalized patients was 63 years old (from 18 to 94). The patients' chief complaints in the admission time were cough, dyspnea, fever, and gastrointestinal problems, respectively. Hospitalized patients' common comorbidities were hypertension (HTN), and cardiovascular disease (CVD) (24%), diabetes mellitus (DM) (21.5%), asthma, or chronic obstructive pulmonary disease (COPD) (6%), or other underlying diseases (15.5%). One-third of patients had no comorbidity according to the data of medical records. In hospitalized patients, 169 (84.5%) had positive RT-PCR, and 156 (78%) had positive chest CT findings. The mortality rate of males was higher than females (66.3% vs. 33.3%) and in patients with positive RT-PCR compared to patients with positive chest CT-scan findings. The majority of deaths had a history of DM or HTN/CVD in their medical records. The chief complaint of patients was cough. DM and HTN or CVD were the common underlying disease related to death in hospitalized cases. Besides, the hospitalization and mortality rate in males was higher than in females. About 87% of dead hospitalized cases had positive RT-PCR results, and this rate was 82% for chest CT results.

Title- to study the clinical profile of patients infected with dengue in a tertiary care center in COVID pandemic era

Dengue infection has always been a major challenge to the public health and in the absence of specific treatment and availability of effective vaccine, this infection has been able to cause repeated outbreaks in different parts of the world for the past many years. This study was planned to analyse the symptoms and complications of dengue positive patients in the backdrop of Covid -19 pandemic. METHODS- A retrospective observational analysis was done on 87 patients presenting to a tertiary care center in northern India by taking into account of their presenting symptoms, haematological parameters and complications. RESULTS- Out of 87 patients 59 (67%) were males and 28 (32%) were females with maximum (36%) belonging to the age group of 18-30 years. 69% patients were from village areas. Fever, headache were the most common symptoms and thrombocytopenia (99%) was the most common haematological complication followed by liver dysfunction (88%). Respiratory symptoms were seen in 18% and skin manifestations were seen in 12% patients. CONCLUSION- Dengue infection continues to be a major cause of morbidity and mortality in many parts of the world. The early recognition of symptoms and signs is imperative to the successful management of disease. With the existence of Covid 19 infection it becomes more important to carefully observe and differentiate between the two viral illnesses as both can have overlapping symptoms.