ABSTRACT
We have entered the third year of the coronavirus disease 2019 (COVID-19) pandemic. If we look back, we can see how this pandemic caused a wide spectrum of disabilities and death worldwide. Moreover, COVID-19 is notorious for affecting multiple systems of our body leading to what we call "long-COVID". Many people are still suffering from persistent symptoms of long-COVID. Apart from respiratory complications, it is causing cardiac issues, renal failure, stroke, etc. Due to such multiple complications, the rate of disability and functional impairments has increased in the past two years following the beginning of this pandemic. Thus, an infectious disease/communicable disease such as COVID-19 is indirectly leading to increased incidence of several non-communicable diseases (cardiac, renal, neurological, etc.). In this scenario, urgent preparedness in all aspects is warranted to control such a situation.
ABSTRACT
A 28-year-old female developed gum hypertrophy after five months of Bell's palsy (BP). The vitamin C level was severely low. After vitamin C supplementation for one month, gingival hypertrophy was completely resolved. Facial deviation also improved following rehabilitation. Vitamin C is commonly considered as an antioxidant, anti-inflammatory, and immunomodulator, and it hastens recovery of neuritis caused by herpes (cause of BP). BP too has an immune-inflammatory background. To the best of our knowledge, for the first time, vitamin C deficiency has been reported as a cause or triggering/risk factor for Bell's palsy and at the same time immune-inflammation triggered in BP also may lead to vitamin C deficiency as existing vitamin C in the body starts scavenging free radicals to prevent oxidative damage. Vitamin C levels must be checked in all cases of BP, and intake of vitamin C-rich food should be encouraged in people who are at risk of developing BP.
ABSTRACT
INTRODUCTION/AIMS: Corticosteroids prolong ambulation and improve muscle power among boys with Duchenne muscular dystrophy (DMD). However, the optimal steroid regimen remains unclear. Hence, this study was undertaken to compare the efficacy of daily- versus intermittent-steroid regimens in ambulatory boys with DMD. METHODS: In this single-center, open-label randomized trial, 72 children were randomized to receive either daily prednisolone (0.75 mg/kg/day) or intermittent prednisolone (0.75 mg/kg/day, for first 10 days of every month). The primary outcome measure was the difference in average score on manual muscle testing (MMT) at baseline and after 6 mo of steroids. A difference of >0.2 was hypothesized to be significant. Secondary outcomes included changes in timed functions, muscular dystrophy-specific functional-rating scale score, peak torque, average power, and pulmonary function. RESULTS: In the intention-to-treat analysis, the mean (SD) change in MMT scores was 0.17 (0.15) and 0.08 (0.10) for the daily and intermittent steroid groups, respectively. The mean difference between the two interventions was 0.10 (95% confidence interval [CI] = 0.04-0.16; P = .003), which although significant was less than the predefined value of 0.2. Statistically significantly improvements were observed with daily-steroid regimen in the Gowers time (P = .01), nine-metre walk test (P = .02) and average power (P = .02) as compared to intermittent-steroid regimen. A total of 19/32 (52.8%) children in the daily-steroid group and 8/29 (27%) children in the intermittent-steroid group experienced some form of adverse effect (P = .02). DISCUSSION: Over a short-term period, the intermittent-steroid regimen was non-inferior to the daily-steroid regime in preserving muscle strength among children with DMD. However, better improvement of functional measures was observed with daily-steroid administration. The frequency of individual side effects was similar between the two groups.
