scholarly journals Early high antibody-titre convalescent plasma for hospitalised COVID-19 patients: DAWn-plasma

2021 ◽  
pp. 2101724 ◽  
Author(s):  
Timothy Devos ◽  
Quentin Van Thillo ◽  
Veerle Compernolle ◽  
Tomé Najdovski ◽  
Marta Romano ◽  
...  

BackgroundSeveral randomised clinical trials have studied convalescent plasma (CP) for COVID-19 using different protocols, with different SARS-CoV-2 neutralising-antibody-titres, at different time-points and severities of illness.MethodsIn the prospective multicentre DAWN-plasma trial, adult patients hospitalised with COVID-19 were randomised to 4 units of open-label convalescent plasma combined with standard of care (intervention group) or standard of care alone (control group). Plasma from donors with neutralising-antibody-titres (NT50) ≥1/320 was the product of choice for the study.ResultsBetween May 2nd, 2020 and January 26th, 2021, 320 patients were randomised to convalescent plasma and 163 patients to the control group according to a 2:1 allocation scheme. A median volume of 884 mL convalescent plasma (IQR 806–906 mL) was administered, and 80.68% of the units came from donors with neutralising-antibody-titres (NT50) ≥1/320. Median time from onset of symptoms to randomisation was 7 days. The proportion of patients alive and free of mechanical ventilation on Day 15 was not different between both groups (convalescent plasma: 83.74% (n=267) versus control: 84.05% (n=137) – Odds ratio 0.99 (0.59–1.66) – p-value=0.9772). The intervention did not change the natural course of antibody titres. The number of serious or severe adverse events was similar in both study arms, and transfusion-related side effects were reported in 19/320 patients in the intervention group (5.94%).ConclusionsTransfusion of 4 units of convalescent plasma with high neutralising-antibody-titres early in hospitalised COVID-19 patients did not result in a significant improvement of the clinical status, or a reduced mortality.

2021 ◽  
Vol p6 (1) ◽  
pp. 3179-3185
Author(s):  
Roopa M.R ◽  
Vasudev A Chate ◽  
Shreevathsa Shreevathsa ◽  
Mohan Kumar G

Introduction: Shwasa is said as Shigrapranahara Roga. It occurs as the main disease and also a symptom in various diseases. Shwasakruchrata is a common symptom that occurs in Hrudroga. Acharya Charaka mentioned the unique classification of drugs based on their action. Shwasahara Dashemani is one among them. It is containing 10 herbal drugs which are specially indicated in Shwasa Roga. Hence to evaluate the efficacy of Shwasahara Dashemani in Lakshana Roopi Shwasa in L.V.F (Cardiac Asthma) has taken for the study. Aim and Objective: The objective is to assess the efficacy of Shwasahara Dashemani in L.V.F with dyspnea (Cardiac Asthma). Method: The present study is a controlled comparative, open-label, clinical trial with pre and post-test design. A total of 40 subjects of a diagnosed case of L.V.F with dyspnea (Cardiac Asthma) were selected by using a simple random sampling method. Control group subjects were intervened with standard treatment of L.V.F and intervention group subjects were intervened with standard treatment of L.V.F along with Shwasahara Dashemani Ghana Vati, for the duration of 30 days. Its efficacy was assessed before treatment (0th day) and after treatment (31st day) by using BDI (Baseline Dyspnea Index Scale). Results: The P-value of dyspnea of the control group is 1.000 and the P-value of dyspnea of the intervention group is 0.105. This shows that the results of both groups are statistically not significant. But as compared to the control group, the intervention group is clinically significant because after the intervention 35% of subjects had shown improvement in the intervention group. Conclusion: As compared to the control group, in the intervention group Shwasahara Dashemani Ghanavati is clinically significant in relieving cardiac asthma when used with standard treatment of L.V.F. Keyword: Shwasahara Dashemani. Cardiac Asthma, L.V.F, Dyspnea


Author(s):  
A. Gopal Rao ◽  
Shankar Achar Somashekar ◽  
Poorna Prasad ◽  
Manjunath Reddy Lekkala ◽  
Sreenivasa Hanumanthaiah ◽  
...  

Background: COVID-19 patients experience cytokine storm which cause pulmonary and extra-pulmonary complications. Effective antiviral and immune boosters are need of hour to treat COVID-19 as well as post COVID complications.Methods: In this study involving mild COVID-19 we randomized 40 patients to receive a Herbovir syrup along with standard of care (SOC) or SOC alone in 1:1 ratio. We evaluated the benefits of Herbovir syrup by assessing clinical outcomes and improvement in immune markers (LDH, CRP, D-dimer).Results: At the end of the study the immune markers in Herbovir group improved significant compared to control group. In patients who received Herbovir, LDH decreased from 334 U/l at baseline to 254 U/l at the end of treatment (p value <0.009), CRP decreased from 7.4 mg/l to 3.1 mg/l (p value=0.0171) and D-dimer decreased from 0.610 mg/l at baseline to 318 mg/l at the end of study (p value=0.001). TLC values did not go below normal range in Herbovir group whereas 8 patients in control group had low TLC at the end of study. Early recovery from COVID 19 symptoms was observed in >75% patients in Herbovir treated group.Conclusions: Herbovir accelerated recovery of COVID-19 patients by early improvement in clinical symptoms and immune markers in this study and results clearly indicates that Herbovir syrup has antiviral, immune booster activity and has definitive role in the management of mild COVID-19 patients along with standard of care. (Funded by Venkat pharma. CTRI no. CTRI/2020/08/027041).


2020 ◽  
Vol 7 (7) ◽  
pp. 1463
Author(s):  
Magesh Kumar ◽  
V. Venkateshwar

Background: Immunization is a necessary aspect of health care of children and injections are there for unavoidable. Many factors affect injection pain during immunization in infants. This study aims to see the effect of use of local anesthetics delivered by various modes for attenuation of vaccine related injection pain in infants and to compare them.Methods: An Open Label Four-Arm Randomized Control Trial of 300 healthy infants of age group 6 weeks to 6 months reported to immunization clinic for immunization with DPT-HiB-Hepatitis B combination vaccine were taken for study. The enrolled subjects were allocated into control group and intervention group (who were applied some form of local anesthesia).Results: Among the four groups of the patients studied we observed a statistical difference in the mean pain scores of the patients recorded at 15 second, 60 second and 5 min after vaccine injection (p value 0.0024 - 0.000). Group A (Infants with topical occlusive LA cream) showed minimum pain scores values at 15 second, 60 second and 5 min after vaccine injection, followed by Group C (Infants with topical LA spray with vapocoolant) whereas Control group (Infants not received any local anaesthesia) and Group B (Infants with topical LA spray without vapocoolant) exhibited the maximum pain scores.Conclusions: Topical occlusive local anesthetic cream and topical LA spray with vapocoolent, were found to be better than topical LA spray without vapocoolant or no topical anesthetic. Use of topical occlusive LA cream led to a lowest pain score. There was no significant difference in the profile of side effects following injection in the four group.


2020 ◽  
Vol 6 (01) ◽  
pp. 03-09 ◽  
Author(s):  
Frederic Ivan Ting ◽  
Sachiko Estreller ◽  
Heinrik Martin Jude Strebel

Abstract Introduction Fan therapy has been suggested by some studies as one of the nonpharmacological supportive interventions to alleviate breathlessness for dyspneic patients with terminal cancer. Unfortunately, data among Asians are limited and there are currently no published data showing that this intervention works among Filipinos—thus this study. Study Design This study was an open-label, randomized, placebo-controlled, crossover Phase 2 trial. The experimental group had a fan blowing air directly to the patient’s face for 5 minutes, and the control group had a fan blowing air to the patient’s legs. Treatment crossover was done after a washout period of 1 hour. The primary outcome, which is dyspnea, was measured subjectively using the Modified Borg Scale (MBS). Differences in the patient’s respiratory rate (RR) and oxygen saturation were also measured. Results A total of 48 patients were enrolled in this trial. The mean age of the patients enrolled was 51 years, and the most common primary tumor was lung cancer (21%). In the control group, results showed that the mean difference before and after intervention in the MBS was 0.15, and the mean difference in RR was 0.25. On the other hand, the intervention group showed a statistically significant decrease in the patient’s dyspnea as evidenced by a mean MBS decrease of 2.79 (p < 0.0001), and a mean RR decrease of 1.88 (p < 0.0001). Conclusion The results of this study reveal that fan on face (FAFA) therapy in terminally ill Filipino cancer patients in addition to the prescribed standard of care can significantly alleviate their level of dyspnea. Thus, FAFA therapy should be considered as an adjunct to standard of care for these patients.


2019 ◽  
Vol 33 (6) ◽  
pp. 832-837 ◽  
Author(s):  
Samuel K. Peasah ◽  
Kathryn Granitz ◽  
Michelle Vu ◽  
Bobby Jacob

Objective:To evaluate the effectiveness of a student pharmacist–led telephone follow-up intervention to improve hemoglobin A1c(HbA1c) in diabetic patients.Methods:This was a prospective, randomized, pilot study to implement a telephone follow-up intervention for diabetic patients with HbA1c≥7%. Patients were recruited and randomized into intervention and control groups. All patients received standard of care. Patients in the intervention group additionally received weekly phone calls from a student pharmacist for 12 weeks to encourage medication adherence. HbA1cat baseline and end of study were measured and the data were analyzed using SAS version 9.4. Analysis included descriptive statistics and a multiple regression model to assess the association between the end of study and baseline HbA1cwhile controlling for demographics.Results:Seventy-eight patients participated and the average age was 62 (±11) years. Baseline HbA1cwas 8.2% (±1.4%) in the intervention group and 7.9% (±1.3%) in the control group. HbA1cdecreased by 0.35% in the intervention group ( P = .027) and increased by 0.338% in the control group ( P = .013). The end of study HbA1cwere higher in the control group even after controlling for baseline HbA1cs (0.5547, P value .002) in the regression model.Conclusion:Incorporating student pharmacists in physician offices to provide clinical care services could lead to improved patient outcomes and students’ clinical and research skills.


2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
T Teo ◽  
J Yap ◽  
P Fong ◽  
N Hussin ◽  
H Wang ◽  
...  

Abstract Introduction  Coronary angiography and angioplasty is widely used in the diagnosis and treatment of coronary artery disease. Limited time to explain the procedure to patients in busy clinical settings may lead to increased adverse outcomes.  Purpose To evaluate the effectiveness of a portable patient education video in improving knowledge and allaying patient"s anxiety prior to coronary angiography and angioplasty. Methods  Consecutive patients undergoing coronary angiography and angioplasty were prospectively recruited over 1 year from June 2016 to May 2017 from a tertiary cardiac institution. We developed a 3 minute animated patient education video on the procedure. Patients were randomised 1:3 into a control group (receiving routine standard of care) and intervention group (watched video plus routine standard of care). Before the procedure, a self-administered written survey was conducted in the control group, pre-video in the intervention group, and post-video in the intervention group. Demographic data, knowledge and State Trait Anxiety Inventory (STAI) scores were gathered. Figure 1 shows excerpts of the video. Results We recruited 332 patients- 80 controls (80% males, mean age 59.6 ± 11.5, 51% previous procedures) and 252 intervention group (86% males, mean age 59.0 ± 9.4, 52% previous procedure). Compared to the control group, the intervention group had lower overall baseline knowledge scores (7.6vs8.5, p = 0.022) and similar anxiety scores (94vs92, p = 0.323); but significantly higher overall knowledge scores (10.3vs8.5, p= &lt;0.001) and lower anxiety scores (75vs92, p= &lt;0.001) after watching the video. Within the intervention group, there was a significant increase in overall knowledge scores (7.6vs10.3, p= &lt;0.001) and reduction in anxiety scores (94vs 75, p= &lt;0.001) before versus after watching the video. See Table 1. Subjectively, after watching the video, 98% of the patients reported benefit, 96% were more prepared and 85% less worried. There was significant improvement in knowledge scores and reduction in anxiety scores (p &lt; 0.001) in the subset of patients who had previously underwent a similar procedure (n = 131). Conclusion The video improved knowledge and reduced anxiety in patients undergoing coronary angiography and angioplasty. This is a useful adjunct to incorporate into existing workflows to improve patient care. Table 1 Total scores* Procedural events - Sedation Procedural events - Access site Procedural events-Contrast Procedural events-Stent Complications-General risk Complications-Bleeding Complications-Myocardial infarction Complications-Stroke Complications-Re-stenosis Anxiety-STAI# P-value comparing pre and post amongst cases (n = 252) &lt;0.001 &lt;0.001 &lt;0.001 &lt;0.001 &lt;0.001 0.094 &lt;0.001 &lt;0.001 &lt;0.001 &lt;0.001 &lt;0.001 P-value comparing cases (post) and controls (n = 80) &lt;0.001 0.042 0.005 0.006 0.131 0.021 &lt;0.001 &lt;0.001 &lt;0.001 &lt;0.001 &lt;0.001 * Range from 0-12 # State-Trait Anxiety Inventory (STAI), 40 questions, score range from 40-160 Abstract P205 Figure 1


2019 ◽  
Vol 9 (2) ◽  
pp. 63-72
Author(s):  
Nova Nurwinda Sari ◽  
Herlina Herlina

Diabetes mellitus dapat menyebabkan cukup banyak komplikasi seperti kelainan mata, kelainan ginjal, kelainan pembuluh darah dan kelainan pada kaki. Penderita diabetes mellitus yang mengalami komplikasi kronis perlu diberikan upaya preventif untuk mencegah komplikasi, salah satunya adalah kemampuan perawatan kaki. Penelitian ini dilakukan untuk menguji efektivitas supportive educative system dalam meningkatkan kemandirian perawatan kaki pada pasien dengan diabetes mellitus Tipe II di Puskesmas Permata Sukarame, Bandar Lampung. Penelitian ini menggunakan metode quasy eksperimen dengan desain pretest-posttest with control group dengan total masing-masing kelompok sebanyak 18 responden. Pengumpulan data dilakukan dengan menyebarkan kuesioner kepada responden yang memenuhi kriteria inklusi penelitian. Penelitian ini diuji menggunakan analisis univariat, bivariat dan uji T-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan rata-rata dalam kemandirian perawatan kaki pada kelompok intervensi dan kelompok kontrol dengan p-value 0,000. Pendidikan dan praktik perawatan kaki harus diberikan sejak dini sebagai upaya pencegahan untuk komplikasi.   Kata kunci : Supportive educative system, kemandirian perawatan kaki   SUPPORTIVE EDUCATIVE SYSTEM IN IMPROVING INDEPENDENCE OF FOOT CARE IN PATIENTS WITH DIABETES MELLITUS TYPE II   ABSTRACT Diabetes mellitus can cause quite a lot of complications such as eye disorders, kidney disorders, vascular disorders and abnormalities in the legs. Patients with diabetes mellitus who have chronic complications need to be given a preventive effort to prevent complications, one of which is foot care ability. This research was conducted to examine the effectiveness of supportive educative systems in increasing the independence of foot care in patients with Type II diabetes mellitus in the Permata Sukarame Health Center Bandar Lampung Working Area. This study used a quasi-experimental method with pretest-posttest with control group design with a total of 18 respondents each. Data collection is done by distributing questionnaires to respondents who meet the research inclusion criteria. This study was tested using univariate, bivariate, T-Test analysis. The results showed that the mean differences in the independence of foot care in the intervention group and the control group in the Permata Sukarame Community Health Center work area with a p-value of 0,000. Education and practice of foot care should be given early as a preventative effort for complications.   Keywords: Supportive educative system, independence of foot care


2020 ◽  
Vol 4 (1) ◽  
pp. 67-77
Author(s):  
Rohimah Ismail ◽  
Chong Mei Chan ◽  
Wan Muhammad Azly W. Zulkafli ◽  
Hasnah Zani ◽  
Zainab Mohd Shafie

                The evolution of information technology has exerted great influence on nursing education via new pedagogy of knowledge delivery without time and place restriction. Mobile technology revolutionises nursing education and clinical practice via empowering skills of critical thinking and clinical decision-making through learning. The aim of this study is to evaluate the effectiveness of using mobile messenger (Whatsapp) as an educational supporting tool among nursing students. The study design used is a Cluster Randomized Control Trail. Two nursing colleges were selected. Sample size was 93 participants, 48 from the Kuala Terengganu Nursing College Kuala Terengganu as the intervention group while the control group were recruited among 45 participants from UniSZA Nursing College. There is a significant difference in the level of knowledge between pre and posttest among intervention group (mean difference was -8.70 with a standard deviation 8.42, p-value< 0.001) and 93.8 percent of the respondents perceived the usefulness of using WhatsApp mobile messenger to enhance learning. This demonstrates that learning through mobile messenger (WhatsApp) enhances learning and is well received as a new method of learning by almost all students.   Keywords: Mobile learning, WhatsApp messenger, Social Interaction


2018 ◽  
Vol 3 (3) ◽  
pp. 556
Author(s):  
Mulyanti Roberto Muliantino ◽  
Tuti Herawati ◽  
Masfuri Masfuri

<p><em>Coronary Arterial Disease (CAD) is one of cardiovaskular disease that remain leading cause death and disability. Short sleep duration is the major symptoms in patients with CAD, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to increase sleep duration, </em><em>however few studies related to this</em><em> technique in planned</em><em> intervention</em><em>.</em><em> This study was to measured the effectiveness of Benson’s relaxation in short sleep duration of CAD patients during cardiac rehabilitation. It was a </em><em>quasi experimental pretest posttest control group design.</em><em> This study included 29 respondens in Dr.M.Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). </em><em>Benson’s relaxation </em><em>technique</em><em> was administered for 5 days 2 times a day, each 20 minutes to intervention group.</em><em> Short sleep duration was measured using </em><em>sleep diary (self report).</em><em> The result indicated significant increasing in mean of  sleep duration  before and after Benson’s relaxation in intervention group </em><em>(p value &lt; 0,001). </em><em>The study concluded that </em><em>Benson’s relaxation </em><em>technique is an effective non-pharmacological intervention to increase sleep duration in CAD patients.</em></p><p><em><br /></em></p><p>Penyakit jantung koroner menjadi masalah kardiovaskular yang mengakibatkan angka mortalitas yang tinggi. Durasi tidur pendek termasuk salah satu keluhan utama pasien penyakit jantung koroner pada masa recovery setelah serangan dan menjalani rehabilitasi fase 2. Relaksasi Benson merupakan teknik relaksasi sebagai terapi modalitas untuk mengurangi keluhan durasi tidur pendek, namum belum banyak penelitian terkait intervensi ini. Penelitian ini bertujuan untuk mengidentifikasi pengaruh relaksasi Benson terhadap durasi tidur pasien penyakit jantung koroner yang menjalani rehabilitasi fase 2. Penelitian ini menggunakan desain Quasi Eksperimen dengan pendekatan <em>control group pretest posttest design</em> pada 29 responden di RSUP. Dr.M.Djamil Padang yang dibagi dalam dua kelompok (kelompok intervensi dan kelompok kontrol). Hasil penelitian menunjukan ada perbedaan rerata durasi tidur yang signifikan antara sebelum dan setelah dilakukan intervensi relaksasi Benson pada kelompok intervensi (p value &lt; 0,001). Simpulan hasil penelitian ini dapat menjadi salah satu terapi modalitas bagi perawat untuk mengatasi masalah durasi tidur pendek pada pasien penyakit jantung koroner.</p><p><em><br /></em></p>


Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 86
Author(s):  
Fauna Herawati ◽  
Yuni Megawati ◽  
Aslichah ◽  
Retnosari Andrajati ◽  
Rika Yulia

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.


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