RESUMO
Background As of November 14, 2021, coronavirus disease 2019 (COVID-19 has affected more than 3,44,00,000 individuals in India and resulted in more than 4,60,000 deaths in India.Symptoms of COVID-19 include cough, fever, dyspnea, diarrhea, fatigue, expectoration, myalgia, hemoptysis, abdominal pain, and anorexia.Associated comorbidities such as hypertension, diabetes, cardiovascular illness, and respiratory sicknesses influence the severity and prognosis of the COVID-19. Therefore, this study was conducted to determine the factors associated with the severity and outcome of elderly Indian people diagnosed with COVID-19. Methodology This hospital-based descriptive cross-sectional study was conducted among elderly patients with confirmed COVID-19 who were admitted to Gauhati Medical College Hospital from July 21, 2020, to January 15, 2021. The demographic data, exposure history, clinical symptoms and signs, underlying comorbidity, severity of COVID-19, and outcome data of each elderly patient were obtained and analyzed using SPSS software (Version 25.0, IBM Corp., Armonk, NY). The Fisher exact test, chi-square test, and binary logistic regression analysis were used for different study variables. Result A total of 165 hospitalized COVID-19 elderly patients were included in this study, and their mean age was 68.4 years. The most common symptoms were cough (34.5%), fever (28%), breathing difficulty (22%), weakness (13.1%), and chest pain (3.6%). Those with breathing difficulty (adjusted OR [aOR]: 7.293, 95% CI: 2.229-23.860, p=0.001), loose stool (aOR: 12.142, 95% CI: 1.052-140.209, p=0.045), hypertension (aOR: 2.703, 95% CI: 1.023-7.139, p=0.045), and severity of COVID-19 (aOR: 7.691, 95% CI: 2.870-20.607, P<0.001) had increased risk of poor outcome among the COVID-19 elderly. Being hypertensive (aOR: 2.474, 95% CI: 1.060-5.774, p=0.036) had an increased risk of severity of COVID-19. Conclusion The most common symptoms of COVID-19 elderly patients were fever, cough, and breathing difficulty. In elderly COVID-19 patients, hypertension played a crucial role in determining the severity of COVID-19, whereas breathing difficulty, loose stool, hypertension, and moderate-to-severe COVID-19 elderly patients had a poor outcome.
RESUMO
The potential gastrointestinal disorders associated with oral administration of rofecoxib can be avoided by delivering the drug to the inflammation site at a sustained, concentrated level over an extended period of time. Hydroxypropylmethylcellulose (HPMC), sodium alginate and Carbopol 940 were used in an attempt to develop topical gel formulations of rofecoxib. The effects of polymer composition on the rate of drug release from the gel formulations were examined through cellulose membrane mounting on a Keshary-Chien diffusion cell. The effects of initial drug concentration and viscosity on the permeation rate of rofecoxib from the gel formulations were evaluated using rat epidermis at 37 +/- 0.5 degrees C. The anti-inflammatory activity of the rofecoxib gel formulation was evaluated using the rat hind paw edema model. The gel formulation consisting of 4% w/w sodium alginate-Carbopol 940 at 3:1 ratio was found to be suitable for topical application based on in vitro evaluation and ex vivo permeation studies. The drug permeation rate increased with an increase of the initial drug concentration in gels up to 25% w/w. An inverse relationship was observed between the in vitro drug release rate/ex vivo permeation rate and viscosity of the gel formulations. The anti-inflammatory activity of 4% w/w sodium alginate-Carbopol 940 gel containing 25% w/w rofecoxib in the rat hind paw edema model reveals that the drug was delivered to the inflammation site at a controlled level over a period of 6 h. These results suggest the feasibility of the topical gel formulation of rofecoxib.
