ABSTRACT
BACKGROUND: The pathogenesis of COVID-19 includes an integrated immune-inflammatory response. Modulation of host immune responses against the SARS-CoV-2 virus might be effective therapeutic management. Various Unani formulations have an immunomodulatory effect. OBJECTIVE: To explore the immunomodulatory effect and safety of Unani polyherbal drug (Tiryaq Wabai) in COVID-19 patients. MATERIALS AND METHODS: The current study was a randomized placebo-controlled clinical trial that included 92 mild to moderate COVID-19 patients randomized into two groups. The Unani formulation Tiryaq Wabai (2 gm orally once a day) was used as an intervention for 45 days, while the control group received a placebo. Both groups received standard care treatment. The primary outcome was 50% increment in absolute lymphocyte count (ALC). The secondary outcome was 50% increment in mean lymphocyte percentage, CD4 cells, and CD8 cell count. The mean increase in all the above parameters has also been studied. Relevant statistical tests were used to analyze the effect. RESULTS: A statistically significant improvement in a 50% increase in ALC (p-value, 0.004), lymphocyte percentage (p-value, 0.056), CD4 (p-value, 0.005), and CD8 cell count (p-value, 0.050) was reported. Also, a significant improvement in the mean value of the lymphocyte percentage (p-value 0.0007), ALC (p-value 0.0022), CD4 cell count (p-value 0.0025), and CD8 cell count (p-value 0.0093) was observed after the treatment. One adverse event of mild grade was reported in the placebo group. The analysis of safety parameters (LFT and KFT) was normal for both groups. CONCLUSION: In mild to moderate COVID-19 patients, Tiryaq Wabai effectively showed immunomodulatory activity by improving ALC count, lymphocyte percentage, CD4, and CD8 cell count.
ABSTRACT
Purpose: To study the efficacy of Colchicine in the management of Oral Sub mucous Fibrosis (OSMF) through systematic review and meta-analysis. Methods:An extensive literature search was conducted on databases such as PubMed, Cochrane Library database, LILACS, Google Scholar, CTRI, and Google search engine. The search comprises all articles published from 2013 to 2022. A total of 10 randomized control trial studies involving colchicine as one of the interventions were included. [CRD42022377674] Results:10 randomized control comprising 456 subjects were included. 3 studies are included in the meta-analysis comprising 90 subjects. All three studies show that there are significant differences between colchicine and other intervention regarding mouth opening and burning sensation. It indicates that Colchicine is significantly more effective in the reduction of burning sensation than other interventions used as a control in OSMF. Conclusion: The evidence generated through this systemic review and meta-analysis suggest that the use of an oral form of colchicine is an effective measure in the management of OSMF, especially the subjective symptom such as burning sensation where as it is not found to be much effective in case of mouth opening. If colchicine is used as co drug along with conventional injection therapy better will the result. However there is marked diversity among the studies reviewed; therefore, the results of this review should be interpreted very carefully.
ABSTRACT
Oxidative stress is a recognized factor that poses a significant risk for the development of Oral Squamous Cell Carcinoma (OSCC) and Oral Submucous Fibrosis (OSMF), as it leads to the generation of Reactive Oxygen Species. In recent years, there has been significant research on the enzymes MDA (malondialdehyde) and SOD (superoxide dismutase), investigating their potential role in the development of OPMD and OSCC. These enzymes have emerged as promising biomarkers due to their ability to provide a less invasive, cost-effective, and objective diagnostic method. Furthermore, they can be used to monitor disease progression and assess the effectiveness of therapy. The aim of this study was to assess the levels of MDA and SOD in the serum of patients diagnosed with OSCC and OSMF. Study group comprised of 60 patients, out of which 20 cases of clinically diagnosed OSCC patients and 20 cases of OSMF and 20 cases pf control comprising of healthy patients were recruited. Estimation MDA and SOD was done by ELISA. The statistical analysis was done using SPSS analysis. When comparing the levels of MDA and SOD between the OSCC and OSMF groups and the control group, statistically significant findings indicated elevated levels of malondialdehyde and reduced levels of superoxide dismutase in both the OSCC and OSMF groups. In this study, the assessment of lipid peroxidation through MDA levels revealed elevated concentrations in both the OSCC and OSMF groups when compared to the control group. Specifically, the order of MDA levels was observed as OSCC > OSMF > Control. Conversely, antioxidant enzyme levels, such as SOD, exhibited decreased concentrations in the OSCC and OSMF groups compared to the control group, with the order of SOD levels being Control > OSMF > OSCC. Consequently, the findings suggest that MDA and SOD can be considered potential biomarkers for identifying and monitoring OSCC and OSMF diseases.
ABSTRACT
Background: Tobacco consumption causes altered immune and inflammatory responses which lead to various respiratory diseases such as asthma and chronic obstructive pulmonary disease, as well as cardiovascular and cerebrovascular disorders. Studies have only confirmed the harmful effects of tobacco consumption on the severity of COVID-19. The present study aimed to explore the association between tobacco consumption and the initiation of COVID-19. Methods: This retrospective cohort study was conducted to explore the relationship between tobacco consumption and COVID-19. A brief closed-ended, self-structured questionnaire was prepared to record participants' responses. The Participants included the individuals who visited Rajendra Institute of Medical Sciences (RIMS), Ranchi, India for the COVID-19 diagnostic test. The statistical analysis was performed using SPSS software (version 24). The chi-square test and logistic regression analysis were also used to predict the odds of getting infected with COVID-19. Findings: A total of 521 valid responses were obtained and subjected to analysis. Moreover, 256 participants (49.13%) were COVID-19 positive and 57 participants (10.94%) were tobacco users. The odds ratio of tobacco consumption was higher in COVID-19-positive patients compared to COVID-19-negatives (OR=1.78; 95% CI 1.01, 3.13). The current tobacco users had a higher risk of developing COVID-19 as compared to the former users (OR=4.8; 95% CI 1.39, 16.61). The frequency and duration of tobacco use also affected the COVID-19 infectivity rate but these were statistically insignificant. Conclusion: The COVID-19 positivity rate was significantly higher in tobacco users, especially in current tobacco users as compared to former users. Nevertheless, gender and occupation had no significant effect on COVID-19 incidence in this study.
ABSTRACT
Background Periarthritis or frozen shoulder, also called adhesive capsulitis, is characterized by stiffness and pain along with gradual loss of active and passive movement in the glenohumeral joint. More than 2-5% of the population suffers from periarthritis with a higher incidence in the age group of 40-60 years. The various treatment modalities used for its management include simple physiotherapy, short-wave therapy, ultrasonic therapy, transcutaneous electrical nerve stimulation, hydrotherapy, analgesics, intra-articular injections, manipulation under general anesthesia (MUA), and surgical management. The application of intra-articular steroid injection has been a common and efficacious option in rapidly diminishing shoulder pain and disability. Some recent studies reported a better outcome using platelet-rich plasma (PRP) injections in frozen shoulder cases. Hence, this randomized controlled trial was conducted to compare the efficacy of intra-articular injections of PRP and triamcinolone in patients of shoulder periarthritis in a population from the eastern region of India Methodology A total of 60 patients with periarthritis shoulder were allocated into two groups after randomization. Group A received 2 mL autologous PRP, and Group B received 2 mL of triamcinolone (40 mg/mL) intra-articular injection. Patients were followed up on the 4th week, 12th week, and 24th week. The assessment of pain and function using the visual analog scale (VAS) score and the Disabilities of Arm, Shoulder, and Hand (DASH) score, respectively, was done at each follow-up. The primary analyses of both primary and secondary outcomes were conducted in the intention-to-treat (ITT) population. SPSS version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis. Results The mean VAS score in the PRP and triamcinolone groups was 14.33 ± 3.79 and 31.63 ± 7.62, respectively (p = 0.0001) after 24 weeks. The mean DASH score in the PRP and triamcinolone groups was 18.08 ± 8.08 and 31.76 ± 3.63, respectively (p = 0.0001), which shows significant improvement in both pain and disability scores in the PRP group after 24 weeks. Conclusions The triamcinolone group showed better short-term outcomes whereas PRP showed better long-term outcomes in reducing pain and disability scores in terms of VAS and DASH scores.
ABSTRACT
BACKGROUND AND AIM: The management of the worldwide spreading COVID-19 consists of amelioration of its symptoms but no cure is yet available. Herbal medicines supplemented with the Western medicine have been applied for COVID-19 treatment in India, China, Iran, and other countries. This systematic review and meta-analysis of RCTs evaluates the effect and safety of herbal intervention in the management of COVID-19. EXPERIMENTAL PROCEDURE: RCTs from databases like PubMed, Cochrane Library, ScienceDirect, Google Scholar, Science Direct, CTRI, AYUSH Research Portal, India, were reviewed and the data were extracted for study sample demographics, intervention details, clinical effect, inflammatory markers and safety monitoring. Outcomes were expressed as Risk-ratio (RR) with 95% CI for dichotomous data, and Mean-Difference (MD) with 95% CI for continuous data. RESULT AND CONCLUSION: From the 32 eligible studies, a total of 3177 COVID-19 patients were included in the review. Herbal intervention as an adjuvant to Western medicine causes significantly higher improvement compared to Western medicine alone [Fever (RR = 1.09 CI 1.03, 1.15), Cough (Risk-Ratio = 1.22 CI 1.08, 1.37), Fatigue (Risk-Ratio = 1.27 CI 1.11, 1.44), Chest CT Improvement (Risk-Ratio = 1.15 CI 1.08, 1.23)]. The laboratory parameters were also better in the herbal medicine group compared to standard care group only WBC (MD = 0.36 CI 0.16, 0.55), Lymphocyte percentage (MD = 5.48 CI 3.05, 7.92), Absolute lymphocyte count (MD = 0.23 CI 0.07, 0.39), CRP (MD = -5.66 CI -7.96, -3.37). However, duration of hospital stays (MD = -1.82 CI -3.84, 0.21); IL-6 (MD = -3.67 CI -8.76, 1.43), ESR Level (MD = -10.38 CI -25.96, 5.21) were statistically insignificant. No significant adverse events for herbal medications were noted in the included RCTs, during the time of the studies. (n = 665, RR 0.93; 95% CI 0.76, 1.14).
ABSTRACT
A femoral neck fracture is a very common injury in the elderly. However, its incidence is low among young adults, usually presenting as an emergency. In young adults, implant choice is one of the important factors. This systematic review aims to analyze the femoral neck system (FNS) versus cannulated cancellous (CC) screw for the fixation of femoral neck fractures in young adults through well-defined objectives. A comprehensive search from the electronic database (PubMed, Google Scholar, Web of Science, Cochrane Library) was conducted from the beginning till February 18, 2022. The data regarding study type, authors, year of publication, country, union time, Harris hip score, intraoperative blood loss, operating time, neck shortening, and hospital stay were extracted from the selected articles and analyzed using RevMan 5.4.1 software. For continuous data, e.g., healing time, intraoperative blood loss, operation time, Harris hip score, neck shortening, and hospital stay, the mean difference (MD), either weighted mean difference (WMD) or standardized mean difference (SMD), with a 95% confidence interval (CI) was recorded. A p-value less than 0.05 was taken as statistically significant. The Newcastle Ottawa scale was used for the risk of bias assessment. Six retrospective cohort studies including 427 patients were selected for the meta-analysis. There was significantly less healing time (WMD= -1.10, 95% CI: -1.73 to -0.47), shorter operation duration (WMD=7.70, 95% CI: -0.06 to 15.46), and better Harris hip score (WMD=4.79, 95% CI: 2.12-7.46) in the FNS than CC screw fixation method. However, intraoperative blood loss was significantly less in the CC screw system (WMD=21.27, 95% CI: 8.20-34.35). There was no significant difference between the two approaches in-hospital stay duration and femoral neck shortening. This can be concluded that FNS is better than CC screw fixation for treating neck of femur fractures in adults on the outcome basis of union time, less operation time, and better Harris hip score (HHS) with significant heterogeneity.
