RESUMEN
Immunosuppressant drugs like Etanercept, Mycophenolate mofetil, Sirolimus, Cyclos-porine, and Rituximab can weaken the immune system and make patients susceptible to SARS nCoV-2 virus. These drugs make immunocompromised persons more vulnerable to complications associated with COVID-19. Moreover, it can also increase mortality and morbidity, as a weakened immune system can lead to a longer duration of infection. This study discusses the guidelines on immunosuppressant drugs and their associated risk factors with COVID-19, issued by the U.S CDC (Centers for Disease Control and Prevention), WHO (World Health Organization), U.S FDA (Food and Drug Administration), and other accredited global health organizations. Moreover, it also includes information about pharmaceutical properties, mechanism of action, COVID-19 associated risk factors, adverse drug reactions, contraindications, and drug-drug interactions. Our study will help government partners and international health organizations to understand COVID-19 health risks associated with immunosuppressants. Increased public awareness about effective drug therapy for autoimmune diseases, cancer treatment, immunocompromised, and organ transplant patients will help lower the mortality and morbidity associated with the disease amid the COVID-19 pandemic.Copyright © 2021 Bentham Science Publishers.
RESUMEN
Objective- The aim of this study was to assess whether major blood inflammatory parameters like neutrophil/lymphocyte ratio (NLR), interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) levels are associated with left ventricular remodeling parameters, New York heart association (NYHA) functional classes and pro-B- type natriuretic peptide (pro-BNP) levels in patients with idiopathic DCM. Methodology-59 patients with DCM were initially screened and categorized as idiopathic DCM and 22 were included for further analyses due to COVID-19 restrictions and positive cases were eliminated from the study. Biochemical assessment and echocardiographic investigations were done to assess cardiac structure and function. Results- There was a statistically significant correlation found between NLR and NYHA functional class (r=0.48, p<0.001), pro-BNP level (r=0.61, P<0.001) and left ventricular (LV) systolic parameters. Similar correlation was observed for IL-6 (with NYHA, r=0.40, P=0.011 and with pro-BNP, r=0.55, P=0.002). hs-CRP showed low to moderate correlation with the cardiac markers. NLR was also significantly higher in NYHA functional class III-IV patients (n=11) compared to NYHA class I-II (n=11), (3.1±0.5 vs 3.8±0.8, P=0.045). IL-6 showed similar significant difference between NYHA class I-II and III-IV (10.0±2.6 vs 20.0±11.2, P=0.045). NLR and IL-6 also found to be independent positive predictors of heart failure progression in NYHA class III-IV (P=0.019 and 0.015 respectively). Conclusion- Our findings clearly exhibit the efficacy of NLR and IL-6 in predicting severity of chronic heart failure in IDCM patients.
RESUMEN
The emergence and global spread of COVID-19 has disrupted the traditional mechanisms of education throughout the world. Institutions of learning were caught unprepared and this jeopardised the face-to-face method of curriculum delivery and assessment. Teaching institutions have shifted to an asynchronous mode whilst attempting to preserve the principles of integrity, equity, inclusiveness, fairness, ethics, and safety. A framework of assessment that enables educators to utilise appropriate methods in measuring a student's progress is crucial for the success of teaching and learning, especially in health education that demands high standards and comprises consistent scientific content. Within such a framework, this paper aims to present a narrative review of the currently utilised methods of assessment in health education and recommend selected modalities that could be administered in an asynchronous mode during the COVID-19 pandemic. Assessment methods such as open-ended short answer questions, problem-based questions, oral exams, and recorded objective structured clinical exams (OSCE) would be appropriate for use in an asynchronous environment to assess the knowledge and competence of health professional students during COVID-19. Fairness and integrity can be ensured by using technological tools such as video and audio recording surveillance.