Comparative Analyses of Clinical, Laboratory, and Radiological Findings between COVID-19 Deceased and Recovered Patients.

Background Understanding the coronavirus disease 2019 (COVID-19)-specific indices has become important with increasing cases of COVID-related in-hospital mortality. Objective This case-control study compared clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients and identified the significant biomarkers associated with deceased patients. Method An analysis of clinical, laboratory, and radiological findings of COVID-19 patients admitted to the COVID-dedicated wards of Nepal Armed Police Force Hospital between March and December 2021 was performed using SPSS version 17.0, with statistical significance considered at p < 0.05. Result A total of 187 COVID-19 patients, comprising deceased [n=95, median (interquartile range, IQR) age: 66 (53-76) years, male: 61 (64.2%) (p=0.024)] and recovered [n=92, median (IQR) age: 51 (38-61) years, male: 44 (47.8%)], were included in the study. Compared to recovered COVID-19 patients, deceased patients had increased median respiratory (20 versus 29.5 breaths/minute) and pulse (83 vs. 86 beats/minute) rates; multiple co-morbidities (≥ 2) (11.9% vs. 32.6%) (p < 0.001); significantly (p < 0.05) lowered alkaline phosphatase (ALP), total protein (TP), albumin, lymphocytes, monocytes, eosinophil, hemoglobin and significantly (p < 0.05) elevated glucose, lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate aminotransferase (AST), leucocytes, neutrophils, D-dimer and C-reactive protein (CRP); and chest abnormalities including bilateral (p < 0.001), peripheral (p < 0.001) interstitial (p < 0.001) and ground glass opacity (GGO) (p=0.002). Conclusion Elderly, male sex, increased respiratory and pulse rate, presence of multiple comorbidities, lowered levels of ALP, TP, albumin, lymphocytes, monocytes, eosinophils, hemoglobin, elevated levels of glucose, LDH, ALT, AST, leucocytes, neutrophils, D-dimer, CRP, and chest X-rays showing bilateral, peripheral interstitial and GGO abnormalities were the significant indices associated with deceased COVID-19 patients.

Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu.

INTRODUCTION: Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal. OBJECTIVES: The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients. MATERIALS AND METHODS: A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients' detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria. MAIN OUTCOME MEASURES: The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed. RESULTS: A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004). CONCLUSION: The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.

Some aspects of changing behaviour of malaria vectors in tribal areas of India.

The field entomological studies and surveys carried out in 72 tribal districts out of 100 in seven penninsular States namely, Andhra Pradesh, Bihar, Gujarat, Madhya Pradesh, Maharashtra, Orissa and Rajasthan indicated that in most of the areas the vector mosquitoes encountered during the present study were almost the same as recorded by the earlier workers except that Anopheles fluviatilis James, 1902 was recorded in the areas of district Raipur, Durg, Bilaspur, Raigarh, Shahdol, Rajnandgaon, Barwani and Janjgir of Madhya Pradesh, and Sundergarh of Orissa during the present survey. This vector was not recorded in earlier studies by other workers. An. culicifacies Giles, 1901 was not found in present survey in East Godavari and Vishakhapatnam of Andhra Pradesh and Ganjam and Koraput of Orissa where this mosquito was found in collections earlier. Similarly, An. fluviatilis was not encountered during the present field study in Bhilwara of Rajasthan, Phulbani and Kalahandi of Orissa, Thane, Nanded and Nasik of Maharashtra and Bharuch of Gujarat state. During this study An. fluviatilis was noted to be mostly endophilic whereas earlier workers noted this mosquito to be exophilic in a large number of districts. The majority of the tribal districts seem to be under the influence of two malaria vectors, An. culicifacies and An. fluviatilis and these tribal districts are maintaining a high malaria endemicity with predominance of Plasmodium falciparum infection. In the present study, the transmission seasons were noted to be longer than recorded earlier in the districts of Andhra Pradesh, Gujarat, Rajasthan and Orissa. In the remaining states it is almost similar as recorded earlier.

Impact of deltamethrin spraying on malaria transmission in Rameshwaram Island, Tamil Nadu State - India.

The impact of spraying Deltamethrin 2.5% w.d.p. @ 20 mg/m2 and its comparison with Malathion 25% w.d.p. @ 2 gr./m2 was assessed in Rameshwaram Island, Tamil Nadu. Monitoring of entomological and parasitological indices revealed that due to deltamethrin spray malaria transmission could be effectively interrupted and a significant reduction in malaria cases was achieved. P. falciparum cases also showed a significant reduction whereas in the comparison malathion areas reduction in malaria cases or in pf cases was not recorded.

Efficacy of diethylcarbamazine medicated salt in interrupting Brugia malayi transmission in hill tribe settlements in Kerala State.

A filariasis survey carried out about eight years after achieving zero microfilaria (mf) rates following administration of diethylcarbamazine (DEC) medicated salt in the Kani hill tribe settlements in Quilon and Thiruvananthapuram districts of Kerala State revealed that there was no reappearance of Brugia malayi infection in the experimental areas. Mf rates were maintained at zero level in the experimental villages, while in the control villages, 2.9 per cent mf positives were observed. Mansonia (Mansonioides) uniformis dissected did not reveal filarial infection. It is concluded that DEC medicated salt regime in the experimental areas of Kani hill tribe settlements has been successful in effectively interrupting B. malayi transmission. Pilot studies in other B. malayi endemic areas of India using DEC medicated salt regime with the objective of eliminating B. malayi transmission are advocated, since the parasite has a restricted distribution in India and is already showing a declining trend.

Filaria situation in the Union Territory of Dadra & Nagar Haveli.

A resurvey conducted 8 years later in the Union Territory of Dadra & Nagar Haveli revealed the persistence of filariasis amongst its residents. Though no control measures have been in operation since the detection of filariasis in Dadra and Nagar Haveli in 1982, the parasitological indices, microfilaria (mf) and disease rates as well as mf count have remained static. The entomological studies revealed five times increase in density of Culex quinquefasciatus both in Silvassa and Naroli towns.

Man vector contact in microfilaraemic and amicrofilaraemic human population--a case control study.

A case control study was undertaken in rural areas of Varanasi, U.P., to study the relationship of Culex quinquefasciatus landing on microfilaria--carriers and amicrofilaraemic controls. No statistically significant difference was observed in the vector landing in these two groups.

Persistence of Vibrio cholerae in inter epidemic period--preliminary observations on analysis of water.

Out of the 61 water samples collected from hand pumps and wells from cholera endemic areas of Varanasi City, Vibrio cholerae non 01 was detected in only one sample. However, seven (18.9 per cent) samples out of 37 samples of river water were positive for V. cholerae non 01. None of the samples showed Vibrio cholerae. These observations indicate transmission and dilution of Vibrio cholerae bacillus in environment.

Epidemiology of Brugia malayi infection and its co-existence with Wuchereria bancrofti in and around Sillaberia PHC, District Midnapur, West Bengal.

Of 2186 persons investigated in thirteen villages of Sillaberia PHC, 19 were found to be infected with Brugia malayi and only one person harboured microfilaria (mf) of Wuchereria bancrofti. Similarly 41 persons exhibited signs and symptoms of chronic filariasis. The mf and disease rates percent worked out to be 0.914 and 1.87 respectively. The earliest ages showing mf and disease manifestations were 3 and 11 respectively. The mean mf density ranged from 2 to 12.2 per 20 cumm of blood. The male and female ratio in terms of mf carriers and chronic cases worked out to be 1.4:1 and 1:2 respectively. The entomological collections revealed a high ten man hour density (163.20) in case of Culex quinquefasciatus and comparatively much lower in case of Mansonia (Mansonioides) annulifera (47.51) and Mansonia (Mansoni oides) uniformis (23.83) respectively. The infection and infectivity rates in case of Mansonia (Mansonioides) annulifera were 6.1 and 1.2 per cent respectively.

Larvivorous fishes in controlling mosquito breeding from draw wells.

Culex quinquefasciatus have been found to breed in about 29 per cent of the wells in semi-urban area and 14 per cent of the wells in rural areas of Varanasi at one time or other. Majority of such wells are used-ones. Effectiveness of Poecillia reticulata, Esomus danrica and Trichogaster fasciatus in controlling well breeding is evaluated in the present study with successful results.

An action research in the delivery of primary health care through community based distribution.

PIP: In adhering to the spirit of primary health care (PHC), the Varanasi District in India began its community based distribution (CBD) project of oral rehydration solution (ORS) packets in Chiraigaon block in 1979. The CBD later included Cholapur, Kashi Vidyapith, Sewapuri, Araijiline, Haurah, Pindra, and Niyamatabad during 1980-1981. In 1989, an honorary project director headed the project and its cadre of regular paid staff. At the main office, staff included a project coordinator, technical consultant medical officer, field supervisors, and field assistants. 754 depot holders or kendra kalyan sanjojak (KKS) worked at the community level. They came from all segments of the society, e.g., farmers, teachers, individuals in business, etc. The KKS implemented the CBD and its policies. Individuals at the headquarters prepared ORS packets using the standard WHO formula. They included health information brochures about ORS written in the local language in each packet. Field assistants delivered these packets to the KKS each month at a no profit no loss cost. The depot holders then sold the packets at a marginal profit. From 1980-1983, the number of packets increased from 1725-9660. From 1980-1985, CBD workers distributed a total of 29.862 packets to all 8 blocks. Rigid social marketing criteria adopted in 1984 brought about a downturn in distribution, however. The number of families trained in ORS preparation varied from 80 in 1980 to 1688 in 1985. The number of families totaled 6919. Health education activities, such as group discussion and individual contracts, flourished at the community level which stimulated demand for ORS packets.^ieng

Clinico-epidemiological profiles of post-kala-azar dermal leishmaniasis in Varanasi.

Twenty-seven cases of Post Kala-Azar Dermal Leishmaniasis (P. K. D. L.) were detected in an endemic focus of Kala-azar in Sujabad village in Varanasi Distt. Male-Female ratio of cases was 4.4:1. Majority (66.6 per cent) of cases had macular lesions. Histopathology of one case showed Leishmania donovani (L. D.) bodies. Densities of sand fly were more in pockets where P. K. D. L. cases were detected. All the 13 cases, which were treated with sodium antimony gluconate, responded well to therapy.