Vaccination saves lives: How do patients with chronic diseases and severe COVID-19 fare? Analysis from Indias National Clinical registry for COVID-19

ObjectivesThis study aims to describe the demographic and clinical profile and ascertain the determinants of outcome among hospitalised COVID-19 adult patients enrolled in the National Clinical Registry for COVID-19 (NCRC). MethodsNCRC is an on-going data collection platform operational in 42 hospitals across India. Data of hospitalized COVID-19 patients enrolled in NCRC between 1st September 2020 to 26th October 2021 were examined. ResultsAnalysis of 29,509 hospitalised, adult COVID-19 patients [mean (SD) age: 51.1 (16.2) year; male: 18752 (63.6%)] showed that 15678 (53.1%) had at least one comorbidity. Among 25715 (87.1%) symptomatic patients, fever was the commonest symptom (72.3%) followed by shortness of breath (48.9%) and dry cough (45.5%). In-hospital mortality was 14.5% (n=3957). Adjusted odds of dying were significantly higher in age-group [≥]60 years, males, with diabetes, chronic kidney diseases, chronic liver disease, malignancy, and tuberculosis, presenting with dyspnea and neurological symptoms. WHO ordinal scale 4 or above at admission carried the highest odds of dying [5.6 (95% CI: 4.6, 7.0)]. Patients receiving one [OR: 0.5 (95% CI: 0.4, 0.7)] or two doses of anti-SARS CoV-2 vaccine [OR: 0.4 (95% CI: 0.3, 0.7)] were protected from in-hospital mortality. ConclusionsWHO ordinal scale at admission is the most important independent predictor for in-hospital death in COVID-19 patients. Anti-SARS-CoV2 vaccination provides significant protection against mortality.

The impact of patient information leaflets to prevent hypoglycemia in out-patients with type 2 diabetes mellitus / El impacto de los folletos de información al paciente para prevenir la hipoglucemia en pacientes ambulatorios con diabetes mellitus tipo 2

Hypoglycemia is a significant complication of intensive diabetes therapy, a true medical emergency, which requires prompt recognition and treatment to prevent organ and brain damage. Therefore, knowledge about diabetes can play an important role in maintaining glycemia control and prevent hypoglycemic complications. Aim: The aim of the study is to develop and assess the impact of patient information leaflets to prevent hypoglycemia in outpatients with type 2 diabetes mellitus and to study the effect of prescribed drugs pattern in patients. Material & Methods: This open labelled, interventional study was conducted in the endocrinology Out Patient Department (OPD) in a tertiary care hospital over a period of 9 months in 55 patients. The information was provided to patients through a developed patient information leaflet and their awareness and glycemic status were assessed by an internally institution developed vernacular language based validated questionnaire. The questionnaire with four different dimensions patient knowledge, glycemic control, compliance and life style was quantified in the study. Results: The study showed statistically significant (P<0.05) improvement in knowledge and glycemic control in male patients and in knowledge, compliance, and glycemic control for female patients. Literate patients showed more significant improvement in knowledge, compliance, life style, and glycemic control than illiterate patients. Conclusions: Results of the study suggested that pharmacist provided patient education and awareness helped type 2 diabetic hypoglycemic patients to improve knowledge and glycaemic control

La hipoglucemia es una complicación importante de la terapia intensiva de la diabetes, una verdadera emergencia médica, que requiere un reconocimiento y tratamiento rápidos para prevenir el daño cerebral y de órganos. Por lo tanto, el conocimiento sobre la diabetes puede desempeñar un papel importante en el mantenimiento del control de la glucemia y prevenir las complicaciones hipoglucémicas. Objetivo: el objetivo del estudio es desarrollar y evaluar el impacto de los folletos de información al paciente para prevenir la hipoglucemia en pacientes ambulatorios con diabetes mellitus tipo 2 y estudiar el efecto del patrón de medicamentos recetados en los pacientes. Material y métodos: Este estudio abierto de intervención abierta se realizó en el Departamento de pacientes ambulatorios (OPD) de endocrinología en un hospital de atención terciaria durante un período de 9 meses en 55 pacientes. La información se proporcionó a los pacientes a través de un folleto de información al paciente y su conocimiento y estado glucémico se evaluaron mediante un cuestionario validado basado en el lenguaje vernáculo desarrollado internamente en una institución. El cuestionario con cuatro dimensiones diferentes de conocimiento del paciente, control glucémico, cumplimiento y estilo de vida se cuantificó en el estudio. Resultados: El estudio mostró una mejora, estadísticamente significativa (P <0,05), en el conocimiento y el control glucémico en pacientes masculinos y en el conocimiento, el cumplimiento y el control glucémico en pacientes femeninos. Los pacientes alfabetizados mostraron una mejora más significativa en el conocimiento, el cumplimiento, el estilo de vida y el control glucémico que los pacientes analfabetos. Conclusiones: Los resultados del estudio sugirieron que el farmacéutico brindó a los pacientes con hipoglucemia diabética tipo 2 información y conciencia para mejorar el conocimiento y el control glucémico

Expression and function of microRNA-9 in the mid-hindbrain area of embryonic chick.

BACKGROUND: MiR-9 is a small non-coding RNA that is highly conserved between species and primarily expressed in the central nervous system (CNS). It is known to influence proliferation and neuronal differentiation in the brain and spinal cord of different vertebrates. Different studies have pointed to regional and species-specific differences in the response of neural progenitors to miR-9. METHODS: In ovo and ex ovo electroporation was used to overexpress or reduce miR-9 followed by mRNA in situ hybridisation and immunofluorescent stainings to evaluate miR- expression and the effect of changed miR-9 expression. RESULTS: We have investigated the expression and function of miR-9 during early development of the mid-hindbrain region (MH) in chick. Our analysis reveals a closer relationship of chick miR-9 to mammalian miR-9 than to fish and a dynamic expression pattern in the chick neural tube. Early in development, miR-9 is diffusely expressed in the entire brain, bar the forebrain, and it becomes more restricted to specific areas of the CNS at later stages. MiR-9 overexpression at HH9-10 results in a reduction of FGF8 expression and premature neuronal differentiation in the mid-hindbrain boundary (MHB). Within the midbrain miR-9 does not cause premature neuronal differentiation it rather reduces proliferation in the midbrain. CONCLUSION: Our findings indicate that miR-9 has regional specific effects in the developing mid-hindbrain region with a divergence of response of regional progenitors.

Isoniazid-induced cerebellitis: a disguised presentation

Cerebellitis is a rarely encountered complication of isoniazid therapy. Its occurrence is usually associated with concomitant renal disease and haemodialysis. Herein, we report the case of a patient with this complication who presented with isolated bilateral symmetrical dentate nucleus T2 hyperintensities on magnetic resonance imaging. Isoniazid neurotoxicity has never been reported to cause bilateral dentate hyperintensities, for which the differentials are few and include metronidazole toxicity.

MEDDB: a medicinal plant database developed with the information gathered from tribal people in and around Madurai, Tamil Nadu.

Tribal peoples are endowed with enriched traditional wisdom to use available nature resources around them. They are well versed in the usage of plant for treating various diseases. They have used powder or extract or paste form of the plant parts such as root, shoot, whole plant, fruits and leaves etc. The recipe known by the tribal people was passed on only to their family members and community through mouth to mouth practice. Hence, the knowledge is confined to particular people alone. It is always expedient to store information in the database, so that it will be accessible by everyone from everywhere. To achieve this, MEDDB has been developed, which stores the details of 110 plant species that are commonly used by tribes for fever, asthma, cold, cough, diabetes, diarrhea, dysentery, eye infections, stomach ache, wounds and snake bite. The details of each plant were collected from the literature and through web search to give comprehensive and exhaustive information. Each plant entry is compiled under the subheadings viz., common name, classification, physical characteristics, medicinal uses, active constituents, and references.

Lipoprotein(a) as a risk factor for diabetic retinopathy in patients with type 2 diabetes mellitus.

AIMS: To estimate serum lipoprotein(a) [Lp(a)] levels in patients with type 2 diabetes mellitus with and without diabetic retinopathy and to determine the correlation, if any, between serum Lp(a) levels and severity of diabetic retinopathy. MATERIALS AND METHODS: The study included a total of 200 patients of type 2 diabetes mellitus out of which 100 patients who had no retinopathy served as the control group and 100 patients with diabetic retinopathy formed the study group. A detailed fundus examination was done with dilated pupil. The Lp(a) levels were measured quantitatively in fasting venous samples by an immunoturbidimetric method using commercially available kits (Clonital). STATISTICAL ANALYSIS USED: Group comparisons involving qualitative measures were carried out using Chi square test. ANOVA procedure was applied for comparing group means. Logistic regression analysis was performed for independent factors associated with diabetic retinopathy. RESULTS: The average Lp(a) levels in the study group (68.5 mg/dl) were significantly higher than in the control group (25.1 mg/dl) (P 0.001). The Lp(a) levels were found to increase with increasing severity of diabetic retinopathy. CONCLUSIONS: Serum Lp(a) levels are significantly raised in patients with diabetic retinopathy as compared to those with no retinopathy.