ABSTRACT
BackgroundCoronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are at high risk of exposure, the standard of care is personal protection from getting infected. Whether Ayurvedic rasayana drug like Chyawanprash can prevent symptomatic infection in frontline health care workers is unknown. ObjectiveTo evaluate the effect of the combination of Chyawanprash and Standard Preventive Regimen compared to the use of Standard Preventive Regimen alone on the proportion of RT-PCR confirmed COVID-19 infections among frontline healthcare workers (HCWs). MethodsAn open-label randomized controlled trial was conducted in the HCWs between 25 to 60 years age currently working in an environment with chance of direct exposure to COVID-19 cases. The interventions to be compared in this trial were Standard Preventive Regimen as per institutional guidelines and based on their roles (Group I) and Ayurvedic Intervention viz., Chyawanprash 12 g twice for 30 days from day of randomization plus Standard Preventive Regimen (Group II). The incidence of RT PCR confirmed COVID-19 cases in both groups, was the primary outcome measure. Evaluation of the safety of the study drug (by any statistically significant change in various biochemical and hematological parameters and occurrence of any adverse drug reactions); incidence of any other infective diseases (bacterial /viral/ fungal / etc.) like upper respiratory tract illness during the study period and any change in the immunoglobulins like IgG, IgM and IgE and inflammatory markers like TNF alpha, IL-6 and IL-10 were the secondary outcome measures. ResultsOut of 193 participants who completed the study, no participant in both groups was COVID-19 positive at the end of one month. In post intervention follow-up, 4 subjects in Group I and 2 subjects in Group II were COVID-19 positive. No adverse drug reaction or any serious adverse event was reported during the study. No clinically significant change in the safety parameters was observed before and after the study. Statistically significant rise in Serum IgG level was seen in Group II but other inflammatory and immune markers did not show statistically significant difference. ConclusionChyawanprash was well tolerated by all the participants in the intervention group but to prove its adaptogenic effect and efficacy as an add-on to the standard care in preventing the occurrence of COVID-19, clinical trial for longer duration with larger sample size is needed. Trial registrationClinical Trials Registry of India vide CTRI/2020/05/025275 dated 20/05/2020 Date of IEC approval19.5.2020
ABSTRACT
Four patients with shoulder problems that were traumatic in etiology presented to us with delays in seeking care ranging from 6 to 12 weeks due to the coronavirus disease 2019 (COVID-19) lockdown. The care of three cases (a 3-month-old neglected anterior shoulder dislocation with a greater tuberosity fracture in a 30-year old man, a 3-month-old neglected anterior shoulder dislocation in a 17-year old boy, and a 2-month-old neglected greater tuberosity fracture in a 31-year old man) was delayed due to the lockdown and the ensuing travel restrictions, while that of one case (a 6-week-old fracture–dislocation of the proximal humerus in a 55-year-old woman) was delayed because the patient was undergoing treatment for COVID-19 at the time of injury. This report intends to present the exceptional circumstances around these cases. The unique treatment challenges and their outcomes are also described to advise the surgeons of the nuances and difficulties in treating these injuries.
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BackgroundThe vast variation in COVID 19 mortality across the globe draws attention to potential risk factors other than the patient characteristics that determine COVID-19 mortality. Subjects and MethodsWe have quantified and analyzed one of the broadest set of clinical factors associated with COVID-19-related death, ranging from disease related co-morbities, socioeconomic factors, healthcare capacity and government policy and interventions. Data for population, total cases, total COVID mortality, tests done, and GDP per capita were extracted from the worldometers database. Datasets for health expenditure by government, hospital beds, rural population, prevalence of smoking, prevalence of overweight population, deaths due to communicable disease and incidence of malaria were extracted from the World Bank website. Prevalence of diabetes was retrieved from the indexmundi rankings. The average population age, 60+ population, delay in lockdown, population density and BCG data were also included for analysis. The COVID-19 mortality per million and its associated factors were retrieved for 56 countries across the globe. Quantitative analysis was done at the global as well as continent level. All the countries included in the study were categorized continent and region wise for comparative analysis determining the correlation between COVID 19 mortality and the aforementioned factors. ResultsThere was significant association found between mortality per million and 60+ population of country, average age, prevalence of diabetes mellitus, and case fatality rate with correlation and p value (p) of 0.422 (p 0.009), 0.386 (p 0.0186), -0.384 (p 0.019) and 0.753 (p 0.000) respectively at 95% CI. ConclusionThe study observations will serve as a evidence based management strategy for generating predictive model for COVID-19 infection and mortality rate.
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Due to the increasing use of preclinical targeted radionuclide therapy (TRT) studies for the development of novel theranosticagents, several studies have been performed to accurately estimate absorbed doses to mice at the voxel level using referencemouse phantoms and Monte Carlo (MC) simulations. Accurate dosimetry is important in preclinical theranostics to interpretradiobiological dose-response relationships and to translate results for clinical use. Direct MC (DMC) simulation is believed toproduce more realistic voxel-level dose distribution with high precision because tissue heterogeneities and nonuniform sourcedistributions in patients or animals are considered. Although MC simulation is considered to be an accurate method for voxelbasedabsorbed dose calculations, it is time-consuming, computationally demanding, and often impractical in daily practice. Inthis review, we focus on the current status of voxel-based dosimetry methods applied in preclinical theranostics and discuss theneed for accurate and fast voxel-based dosimetry methods for pretherapy absorbed dose calculations to optimize the dosecomputation time in preclinical TRT.
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OBJECTIVE: Portal vein thrombosis is considered a relative contraindication for transarterial chemoembolization (TACE) in hepatocellular carcinoma. The purpose of our study was to evaluate the efficacy of TACE treatment in patients with hepatocellular carcinoma with portal vein (PV) thrombosis. METHODS: From April 2011 to June 2013, 17 patients with unresectable hepatocellular carcinoma with PV thrombosis were studied. Patients were assessed for tumor response by imaging at regular intervals and the data compared with the baseline laboratory and imaging characteristics obtained before treatment. Univariate analysis was used to assess the treatments impact on patient survival. Survival analysis was performed using Kaplan-Meier estimations. RESULTS: Overall survival rates at three, six and 12 months were 82%, 71%, and 47%, respectively, with a median of 10 months. Patients in Child-Pugh class A had a median survival of 15 months compared to five months for those patients in Child-Pugh class B. The median survival period of patients responsive to treatment was 13 months while that of non-responders was five months. Patients with ascites at the time of presentation had median survival period of six months while those who did not had a median survival period of 13 months. In univariate analysis, response to chemoembolization (p<0.001), ascites (p<0.050) and Child-Pugh class at diagnosis (p<0.050) were found to be significant prognostic factors. CONCLUSION: TACE is a promising procedure in unresectable hepatocellular carcinoma with PV thrombosis. Response to chemoembolization, ascites and Child-Pugh class were the most important determining factors of survival.
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This review article discusses the current scenario of the national and international burden due to lymphatic filariasis (LF) and describes the active elimination programmes for LF and their achievements to eradicate this most debilitating disease from the earth. Since, bioinformatics is a rapidly growing field of biological study, and it has an increasingly significant role in various fields of biology. We have reviewed its leading involvement in the filarial research using different approaches of bioinformatics and have summarized available existing drugs and their targets to re-examine and to keep away from the resisting conditions. Moreover, some of the novel drug targets have been assembled for further study to design fresh and better pharmacological therapeutics. Various bioinformatics-based web resources, and databases have been discussed, which may enrich the filarial research.
