scholarly journals The Use of Hydroxyurea in the Treatment of COVID-19

2021 ◽  
Vol 7 (4) ◽  
pp. 312-317
Author(s):  
Melissa Robin Bowman Foster ◽  
Ali Atef Hijazi ◽  
Rebecca Opoku ◽  
Priya Varghese ◽  
Chun Li
Keyword(s):  
Sickle Cell ◽  
Respiratory Health ◽  
Treatment Protocol ◽  
Clinical Findings ◽  
Care Hospital ◽  
Care Providers ◽  
Treatment Protocols ◽  
Unsuccessful Treatment ◽  
Significant Difference ◽  
Specialized Care

Abstract Introduction The rapid worldwide spread of COVID-19 motivated medical professionals to pursue and authenticate appropriate remedies and treatment protocols. This article aims to analyze the potential benefits of one treatment protocol developed by a group of care providers caring for severe COVID-19 patients. Methods The clinical findings of COVID-19 patients who were transferred to a specialized care hospital after unsuccessful treatment in previous institutions, were analyzed. The specialized care hospital used a treatment protocol including hydroxyurea, a medication commonly used for sickle cell treatment, to improve respiratory distress in the COVID-19 patients. None of the COVID-19 patients included in the analyzed data were diagnosed with sickle cell, and none had previously taken hydroxyurea for any other conditions. Results In all presented cases, patients reverted to their baseline respiratory health after treatment with the hydroxyurea protocol. There was no significant difference in the correlation between COVID-19 and hydroxyurea. However, deaths were extremely low for those taking hydroxyurea. Conclusions Fatality numbers were extremely low for those taking hydroxyurea; death could be attributed to other underlying issues.

scholarly journals Challenges in Steroid and Anticoagulant Therapy in Severe COVID-19 Pneumonia: A Prospective Study

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1214
Author(s):  
Alaa Thabet Hassan ◽  
Alaa E. Abd Elmoniem ◽  
Marwa Mahmoud Abdelrady ◽  
Mona Embarek Mohamed ◽  
Mohamed A. Mokhtar ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Severe Pneumonia ◽  
High Risk Group ◽  
University Hospital ◽  
Treatment Protocols ◽  
Neutrophil Lymphocyte Ratio ◽  
Treatment Type ◽  
Acute Kidney Disease ◽  
Significant Difference ◽  
Group B

Background: As COVID-19 has neither a standard treatment protocol nor guidelines, there are many treatment protocols for anti-inflammatory corticosteroids and anti-coagulations for severe COVID-19 pneumonia patients. This study aimed to assess the most suitable modality in this high-risk group. Methods: A prospective, experimental study design was adopted that included 123 severe COVID-19 pneumonia patients admitted at Assiut University Hospital. Patients were divided into three groups according to a combined corticosteroid and anticoagulants therapy protocol. Group A included 32 patients, group B included 45 patients, and group C included 46 patients. Assessment of cases was conducted according to the treatment type and duration, weaning duration from oxygen therapy, length of hospital and ICU stay, and complications during treatment. Three months follow-up after discharge was performed. Results: the three patient groups showed significant differences regarding the 3-month outcome, whereas Group C showed the highest cure rate, lowest lung fibrosis, and lowest mortality rate over the other two groups. The in-hospital outcome, the development of pulmonary embolism, bleeding, hematoma, acute kidney disease, and myocardial infarction showed a significant difference between groups (p values < 0.05). Mortality predictors among severe COVID-19 patients by multivariable Cox hazard regression included treatment modality, history of comorbid diseases, increased C reactive protein, high neutrophil-lymphocyte ratio, and shorter ICU and hospital stay. Conclusion: the use of combined methylprednisolone and therapeutic Enoxaparin, according to a flexible protocol for COVID-19 patients with severe pneumonia, had two benefits; the prevention of disease complications and improved clinical outcome.

scholarly journals Clinical and therapeutic aspects of an outbreak of canine trypanosomiasis

2019 ◽  
Vol 28 (2) ◽  
pp. 320-324 ◽  
Author(s):  
Jessica Teles Echeverria ◽  
Rodrigo Leite Soares ◽  
Beatriz Aléssio Crepaldi ◽  
Gustavo Gomes de Oliveira ◽  
Polyana Mayume Pereira da Silva ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Trypanosoma Evansi ◽  
Clinical Findings ◽  
Microcytic Anemia ◽  
Pcr Analysis ◽  
Treatment Protocols ◽  
Hypochromic Microcytic Anemia ◽  
Clinical Recovery ◽  
Therapeutic Protocol ◽  
Blood Smears

Abstract Trypanosomiasis caused by Trypanosoma evansi can seriously affect both domestic and wild animals. This article reports on an outbreak of canine trypanosomiasis on a farm in the Pantanal region of Brazil. The farm had 38 dogs, 20 of which died before receiving veterinary care. The remaining 18 dogs were underwent anamnesisn, clinical examination, hematological and biochemical evaluations. Blood smears and PCR analysis were performed for the diagnosis. The treatment protocols used according to the clinical recovery or parasitological cure of the dogs, using diminazene diaceturate, isometamidium chloride or quinapyramine sulfate. Post-treatment parasitological evaluation was performed by the microhematocrit technique. 7/18 dogs were PCR positive for T. evansi (confirmed by sequencing). There was clinical findings, which were consistent with both the acute and chronic stages of the disease in dogs. The infected dogs all exhibited at least one clinical sign of the disease. The hematological findings were compatible with trypanosomiasis, highlighting the hypochromic microcytic anemia as the main outcome. No treatment protocol was fully effective and the prolonged use of diminazene diaceturate caused the death of an animal. The trypanosomiasis can cause high rates of morbidity and mortality in dogs and difficulty in establishment an effective and safe therapeutic protocol.

Detection of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia by 4color Cytometry in International Multicenter Trial Minimini.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1092-1092
Author(s):  
Ester Mejstrikova ◽  
Drago Batinic ◽  
Dubravcic Klara ◽  
Margareth Ng ◽  
Yonna Leung ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Residual Disease ◽  
Lymphoblastic Leukemia ◽  
Treatment Protocol ◽  
Multicenter Trial ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Leukemic Cells ◽  
Treatment Protocols ◽  
Significant Difference ◽  
B Lineage

Abstract FC is still not employed in MRD based treatment protocols. One problem is lack of standardization suitable for prospective trials involving multiple clinical centers and FC laboratories. Therefore, we established a MiniMini Project, an international collateral study within the ALL IC BFM 2002 treatment protocol for childhood acute lymphoblastic leukemia (ALL). The MiniMini Project provides a mainframe of minimal panel of monoclonal antibody combinations to evaluate MRD by FC. Patients (pts) are stratified according non-MRD criteria (prednisone response at day 8 in peripheral blood (PB), percentage of blasts at day 15 and day 33 in bone marrow (BM), leukocytosis, and age at diagnosis and presence of BCR/ABL or MLL/AF4 fusions). Identical immunophenotypic populations are reported in all pts regardless presenting phenotype. Each laboratory investigates at least 2 pts with B lineage ALL by the T ALL combinations and vice versa. These “cross-lineage controls” together with data on subpopulations that are negative at diagnosis were used to set the specificity cutoff values at each time point (diagnosis, day 8 BM and PB, day 15, day 33 day 52 BM). MRD levels obtained by Ig/TCR rearrangements RQ-PCR in 32 pts (24 pts BCP ALL, 8 pts T ALL) were used to define specificity thresholds. 185 pts were investigated in the participating laboratories. We used data from first Czech cohort of pts (92 pts in total, 16 pts T lineage, 74 pts B lineage, in standard risk group (SRG), n=36, IRG, n=40 and HRG, n=16) in whom clinical data as well as standard FC analysis results were available. We compared morphological percentage of blasts (used for stratification) to a level of residual disease by FC. There was high concordance in SRG of both methods, except 1 patient redirected into IRG group (M3 BM vs. only 14% of blasts by FC). In IRG, concordance was in 92.5% of pts, 3 pts should be placed in HRG group according FC. 98.9% of pts morphologically in complete remission at day 33 were confirmed by FC. Although FC data confirm a significant difference between PGR and PPR in PB specimens at day 8 (p=0.0014), there is an overlap in percentage of leukemic cells between these categories. In total, MRD level above 0.1% was observed in BM of 100, 99, 84, 32 and 3.5 % pts in days 0, 8, 15, 33 and 52, respectively and in PB of 95% pts at day 8. Our first results show feasibility of FC standardization. The choice of subpopulations and the cutoff points will be validated in an independent cohort within the same Project.

Evaluation of Mirror Therapy for Upper Limb Rehabilitation in Stroke

2013 ◽  
Vol 24 (3) ◽  
pp. 63-69 ◽  
Author(s):  
Laisram Nonica ◽  
Muzaffar Tufail ◽  
RK Wadhwa ◽  
Borah Diganta ◽  
SY Kothari
Keyword(s):  
Upper Extremity ◽  
Tertiary Care ◽  
Self Care ◽  
Motor Recovery ◽  
Control Group ◽  
Care Hospital ◽  
Mirror Therapy ◽  
Treatment Protocols ◽  
Upper Limb Rehabilitation ◽  
Significant Difference

Abstract Trials have shown modest clinical improvement in disabilities after stroke with the use of different techniques; however most of the treatment protocols for the paretic upper extremity are either expensive or labour intensive, which makes the provision of intensive treatment for many patients difficult. It has been suggested that mirror therapy is a simple, inexpensive and, most importantly patient-directed treatment that may improve upper extremity function. A prospective randomised case control study was done on 60 patients of both the sexes in the age group of 19 to 82 years having stroke for the first time. This study was conducted in the Department of Physical Medicine and Rehabilitation of a tertiary care hospital. All the patients who fulfilled the criteria were enrolled for study; patients were randomly allotted to the study or control group. Study group was given mirror therapy in addition to the conventional stroke rehabilitation programme. Patients were assessed in terms of motor recovery (Brunnstrom stages), spasticity (modified Ashworth Scale), and the self-care items of the Barthel index. These indices were measured at 0 month (pretreatment), 1 month (post-treatment), and 6 months (follow-up). There was a statistically significant difference in spasticity improvement between the study and control groups; however no significant difference was seen in motor recovery and self care items between the groups. The patients had significant improvements within the groups after the therapy for one month. Mirror therapy can be a useful intervention supplement in rehabilitation of patients; it provides a simple and cost effective therapy for recovery of hand function.

scholarly journals Therapeutic study of onychomycosis in a tertiary care center

2019 ◽  
Vol 5 (3) ◽  
pp. 517
Author(s):  
Geetha K. ◽  
Muthubharathi S.
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Nail Plate ◽  
Care Hospital ◽  
Open Label ◽  
Treatment Protocols ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Group A ◽  
Oral Terbinafine

<p class="abstract"><strong>Background:</strong> Onychomycosis is the fungal infection of nail unit and require long-term treatment to achieve complete cure. This study aims to know the effectiveness of various treatment protocols for onychomycosis.</p><p class="abstract"><strong>Methods:</strong> This randomized uncontrolled open label study was undertaken in a tertiary care hospital. Patients with onychomycosis were included. Patients who received systemic or topical antifungal therapy in last six months were excluded. After obtaining ethical approval they were subjected to KOH mount and culture from nail clippings. Patients were selected randomly with both KOH and culture positive. Patients were divided into 3 groups. Group-A received oral terbinafine, Group-B received oral terbinafine and topical amorolfine, Group-C received oral itraconazole and topical amorolfine for 6 months. The patients were evaluated and assessed for the growth of the nail plate and were inquired for any adverse effects due to the drugs, at 6, 12 and 24 weeks. The results were recorded and detailed statistical analysis was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the course of study 9 patients were lost in follow up and were excluded from the analysis of results. Mycological cure with negative KOH microscopy and culture were obtained in 56.6%, 73.3% and 70% in groups A, B and C. Clinical cure was observed in 60%, 76.6%, and 73.3% patients in group A, B and C respectively.</p><p class="abstract"><strong>Conclusions:</strong> There was no statistically significant difference in cure rate among the different treatment groups. Combination therapy achieved better results compared to monotherapy.</p>

scholarly journals A study of clinical and hematological profile of children with sickle cell disease in a tertiary care hospital, Valsad, India

2017 ◽  
Vol 4 (4) ◽  
pp. 1317 ◽  
Author(s):  
Kinjal G. Patel ◽  
Chintu Chaudhari ◽  
Diwakar Sharma
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Age Group ◽  
Cell Disease ◽  
Significant Difference ◽  
The Common

Background: Sickle cell disease is commonly seen in rural population of south part of Gujarat in India. It is one of the common causes of recurrent hospitalization, morbidity and mortality in pediatric population. This study was therefore undertaken to evaluate the clinical profile of sickle cell disease in a tertiary care hospital.Methods: This was the prospective observational study done from November 2015 to October 2016. All the hospitalized diagnosed case of sickle cell disease and trait in age group of 6 months to 14 years were taken in this study. Sickle cell disease with some genetic or metabolic disease and sickle-beta-thalassemia patients were not included in this study.Results: Total 61 patients were admitted over a one year of study period, out of which 47 were sickle cell disease and 14 sickle cell trait patients. Morbidity events were commonly observed in 5-12 years of age groups (68.85%). Seasonal variation also observed, 47.54% of total cases are seen in winter season. Pain (60.65%) was the most common presenting symptom. Severe pallor (39.34%) and splenomegaly (24.59%) was the most common sign in both groups. Vaso-occlusive crisis (59.01%) was the most common morbidity event observed, of which abdominal pain was the most common site of pain involvement. On laboratory analysis, there was statistically significant difference observed in disease and trait. In patients with sickle cell disease acute painful crisis (59.57%) was the common morbidity event observed while in sickle cell trait patients acute febrile illness (71.42%) observed.Conclusions: Vaso-occlusive crisis is the commonest manifestation in pediatric age group. Comprehensive medical care and management is required to decrease the morbidity and mortality. 

scholarly journals Physicians’ Adherence to Asthma Guidelines: A Prospective Prescription Review from Tertiary Care Hospital, Malaysia

2018 ◽  
Vol 5 (1) ◽  
pp. 13-19
Author(s):  
Raja Ahsan Aftab ◽  
Amer Hayat Khan ◽  
Syed Azhar Syed Sulaiman ◽  
Irfhan Ali
Keyword(s):  
Treatment Outcome ◽  
Lung Function ◽  
Treatment Outcomes ◽  
Tertiary Care ◽  
Care Hospital ◽  
Asthma Treatment ◽  
Unsuccessful Treatment ◽  
Significant Difference ◽  
Asthma Patients ◽  
The Cost

Aims and objective: The aim of the current study is to evaluate adherence clinical practice guideline of asthma, to assess treatment outcomes of guideline adhering to pharmacotherapy and to calculate the cost of asthma treatment. Methods: A prospective record viewing study was conducted at the respiratory clinic of Hospital Pulau Pinang, Penang, Malaysia from December 2012 to June 2013. A total of 180 prescriptions of patients from 6 doctors (30 prescriptions by each doctor) were evaluated against global initiative of asthma (GINA) guidelines. Treatment outcomes of asthma patients were evaluated based on lung function values. Direct assessment of cost was compared between the guidelines adhered and non-adhered scripts. Results: Of the total 180 asthmatic patients, 143 (78.9%) received guideline-adhered pharmacotherapy. A total of 158 (87.7%) patients reported successful treatment outcome, out of which, 124 (78.4%) patients received guideline-adhered pharmacotherapy. A statistical significant difference (p < 0.001) was observed among lung function values after patients’ first and second visit. An analysis indicated that patients aged > 46 years were found to have a significant association with treatment outcomes (OR=3.77, p=0.03). While comparing the cost of asthma treatment outcome, it was observed that the average cost of successfully treated patients who received guideline-adhered pharmacotherapy was RM 70.00 per patient (1US$ = RM 3.20) while patients reporting unsuccessful treatment outcome was RM 75.47 per patient. Conclusion: A majority of asthma patients received guideline-adhered pharmacotherapy.

scholarly journals Hormonal status in patients with advanced prostatic cancer on the therapy with androgen blockade

2011 ◽  
Vol 68 (4) ◽  
pp. 321-326
Author(s):  
Sasa Vojinov ◽  
Ivan Levakov ◽  
Dimitrije Jeremic ◽  
Srdjan Zivojinov ◽  
Goran Marusic
Keyword(s):  
Prostatic Cancer ◽  
Locally Advanced ◽  
Treatment Protocol ◽  
Control Group ◽  
Treatment Protocols ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Lh Rh ◽  
Androgen Blockade

Background/Aim. Hormone suppression therapy is used in men with advanced prostate cancer improving chances of longer survival. The aim of this study was to investigate the influence of androgen blockades on testosterone and luteinizing hormone (LH) values in patients with locally advanced and metastatic prostatic cancer. Methods. The study included a total of 60 patients out of which 45 with prostatic cancer divided into 3 subgroups based on the type of the applied treatment protocol: 15 patients on monotherapy with luteinizing-releasing hormone (LH-RH) agonists (group I), 15 patients on total androgen blockade (group II) and 15 patients on monotherapy with antiandrogen (group III)). The control group consisted of 15 patients with benign prostatic hyperplasia. In all the patients, values of testosteron, LH and prostatespecific antigen (PSA) were monitored initially, as well as 3 and 6 months after the treatment protocol introduction. Results. In the patients of the groups I, II and III, values of testosterone decreased after three months by 95.58%, 95.72%, and 67%, respectively. The difference was significant (p < 0.01). Between the values after three and six months there was no significant difference in these groups of participants. Testosterone values were significantly higher in the patients of the group III in both analyses. Comparing the values between the groups III and I, as well as those of the groups III and II, a significant difference was found after three and six months of the therapy (p < 0.01). There was a difference in testosterone values between the groups I and II after 3 and 6 months, but not significant. All types of the applied treatment protocols in the therapy of prostatic cancer significantly decreased the values of LH compared to the basal ones. Conclusion. Total androgen blockade and LH-RH agonists are more effective in lowering testosterone values (to castration values) compared to the antiandrogen monotherapy, where testosterone values stay above the castration level. This therapy approach has advantages, since it decreases testosterone values providing better therapy response. There is a difference in testosterone values, but not significant, when total androgen blockade and monotherapy with LH-RH agonists are administered. Registered lower basal values of LH in all patients with prostatic cancer open the possibility to introduce LH as a new additional, significant marker in diagnosis of this neoplasm.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Effectiveness of Ayurvedic intervention in Primary Open Angle Glaucoma (Kaphaja Adhimantha) - A Case Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Ratheesh P. ◽  
Dr. Abhayadev A. ◽  
Dr. Varsha Sumedhan ◽  
Dr. Meghna P P. ◽  
Dr. Srinivasan M ◽  
...  
Keyword(s):  
Visual Field ◽  
Structural Changes ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Treatment Protocol ◽  
Clinical Findings ◽  
Field Analysis ◽  
Open Angle ◽  
Remarkable Change ◽  
Related Disorder

Glaucoma is a diverse group of disorders affecting the eye with a common characteristic potentially progressive optic neuropathy that is determined by both structural changes and functional deficit in which IOP is a key modifiable factor. In Primary Open Angle Glaucoma (POAG), IOP independent mechanisms of glaucomatous nerve damage and visual field loss with unobstructed angle of anterior chamber is observed. The patient has reported gradual diminution of peripheral aspect of visual field (Rt. eye - 6/12 and Lt. eye - 6/12 on Snellen’s distant vision chart) in both eyes for 2 years. There was marked peripheral field defect on both confrontation test and perimetry visual field analysis test. The disease shows clinical similarity with Kaphaja Adhimantha, a disease affecting the whole eye mentioned in Susruta Samhita and Ashtanga Hrudaya. It is a chronic disease comes under life style related disorder. Dukhena Roopam Pasyathi (distorted image or constricted visual field), Sirodukha (headache), Srava (watering), Kandu (itching), Pamsupoornatha (foreign body sensation), Aviladarsana (diminished vision) and Gourava (heaviness of eye and head) are the clinical findings explained in the context of Kaphaja Adhimantha. These clinical finding mentioned in classical literature shows resemblance with POAG. The meticulous deployment of kaphaja Abhisyandha- Adhimantha treatment protocol can be used to prevent the progression of ganglionic damage and preservation of eye sight. The logical interpretation on the basis of both subjective and objective clinical findings concluded the diagnosis as Kaphaja Adhimantha and treatment principle adopted was Apatharpana, Kaphahara, Abhisyandhahara and Srothovisodhana. After treatment his vision has improved as 6/6 (Rt. Eye) and 6/6 (Lt. Eye) and remarkable change in field analysis. The study discusses about the effectiveness of Ayurvedic management in POAG.

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