scholarly journals EFFICACY AND SAFETY OF REMDESIVIR IN THE TREATMENT OF COVID 19: A RETROSPECTIVE STUDY

2020 ◽  
pp. 1-4
Author(s):  
Hetal Pandya ◽  
Keyur Patel ◽  
Pradeep Reddy ◽  
Pramod Jha
Keyword(s):  
Clinical Laboratory ◽  
Antiviral Drug ◽  
P Value ◽  
Retrospective Case ◽  
Case Record ◽  
Laboratory Parameters ◽  
Icu Stay ◽  
Ventilator Therapy ◽  
Antiviral Activities ◽  
Group B

Background: No specic antiviral drug has been proven effective for treatment of patients with severe coronavirus disease 2019 (COVID-19).The aim of this study was to summarize the antiviral activities of remdesivir against SARS-CoV-2, the causative agent of COVID-19. We present our observations on remdesivir use. Methods: In a retrospective case control study total 74 patients of moderate to severe covid 19 infection admitted to Dhiraj hospital were enrolled. Out of total 74 patients, 37 were given remdesivir assigned as group A and 37 patients were not given remdesivir assigned as group B. Data was collected from the case record form and analyzed with respect to inammatory markers, mortality, length of ICU stay and days on ventilator support. Results: Out of 74 moderate to severe RT PCR positive Covid 19 patients, 37 patients were in remdesivir group and others were in non remdesivir group. Mean age was 55.08 + 8.98 years and 22 were male in remdesivir group. Statistically signicant improvement was noted with ESR, CRP and Sr.LDH only. Other laboratory parameters (TLC, NLR, D-Dimer, and Sr.Ferrtin) showed minor improvement only (p value =>0.05).Less mortality was observed with remdesivir treatment, along with ICU stay and less days on ventilator therapy without any safety concerns. Conclusion: Remdesivir use along with standard therapy had showed signicant improvement in terms of clinical, laboratory parameters and recovery in patients with moderate to severe Covid 19 infection.

scholarly journals Comparative Study on Planned repeat Caesarean Section and Unplanned Repeat Caesarean Section

2016 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Jinnatun Nur ◽  
Rashida Khanom ◽  
Sumaya Akter
Keyword(s):  
Caesarean Section ◽  
Subsequent Pregnancy ◽  
T Test ◽  
P Value ◽  
Retrospective Case ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
First Time

Repeat Caesarean section always carries more risk than first time caesarian delivery. In our country, antenatal care is always neglected. When this negligence occurs during subsequent pregnancy who had already goes on Caesarean section for the first pregnancy. In our study, we try to compare between the planned and unplanned repeat Caesarean section. The study was carried out at Mymensingh Medical College Hospital, Mymensingh and Amina Nursing Home at Charpara Mymensingh. This was a retrospective case control study, There were 100 patients in Group: A, (Planned repeat Caesarean section), Group B was also consisted with 100 patients (Unplanned repeat Caesarean section). Odd ratio was measured. Odd ratio between group; A and Group: B was 2.8. The two groups were compared by their age and independent t test was carried out. Group: A. Mean ± SD 25.76 ± 4.461Group: B. Mean ± SD = 26.12 ± 5.513. By pair independent t test: P value: .076ns. So we can conclude that regular antenatal Check up is mandatory for those whose 1st delivery was conducted by Caesarean section irrespective of age and economical status.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 57-61

scholarly journals Intensive care unit delirium - does prolonged intensive care unit stay increase morbidity

2020 ◽  
Vol 6 (3) ◽  
pp. 477
Author(s):  
Niranjanan Raghavn Muralidharagopalan ◽  
Kamalakumar Karuppasamy ◽  
Somasundaram Subramanian
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Geriatric Patients ◽  
Neurological Recovery ◽  
Retrospective Case ◽  
Icu Stay ◽  
Group A ◽  
Group B ◽  
Icu Psychosis

<p class="abstract"><strong>Background:</strong> The term intensive care unit (ICU) delirium or ICU psychosis denotes the transient period of psychosis exhibited by the geriatric patients placed in long term ICU care. This condition can be mistaken for organic neurological deterioration and can result in improper treatment, delayed rehabilitation and longer ICU stay. The objective of the study was to analyse the outcome of early ward rehabilitation in post-surgical patients with ICU psychosis.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective case control study of 45 geriatric patients (above 60 years of age) who developed delirium or psychosis after long term ICU stay (&gt;4 days) following a major trauma and orthopaedic procedure. Of the 45 patients, 28 patients (group A) were shifted out of ICU after haemodynamic stability despite continued delirious episodes. The remaining 17 patients (group B) were those who were retained in the ICU for complete neurological recovery.<strong></strong></p><p class="abstract"><strong>Results:</strong> Significant positive difference was noted in patients who were shifted out of ICU early (group A) compared to group B. Group A patients had faster recovery, lesser delirious episodes (2.3±0.9 compared to 13.4±2.7) and fewer days of hospital stay (4.9±1.2 compared to 12.4±2.6) when compared to group B. None of the patients had any episodes of psychosis after discharge from the hospital when followed up for duration of 6 months.</p><p class="abstract"><strong>Conclusions:</strong> Post-operative geriatric patients diagnosed with ICU psychosis fare better with early out of ICU mobilisation. It is not essential to wait for full neurological recovery to shift these patients out of ICU though close ward monitoring may be essential in some cases.</p>

scholarly journals Association of ABO blood groups with dengue fever and its complications in a tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 265-269 ◽  
Author(s):  
Shivani Ravichandran ◽  
S. R. Ramya ◽  
Reba Kanungo
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Blood Group ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Blood Groups ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Case Record

Abstract CONTEXT: Dengue fever (DF) has been steadily increasing in India with outbreaks in certain areas taking the proportion of epidemics. Along with secondary dengue, several risk factors predispose to dengue hemorrhagic fever and dengue shock syndrome. Very few studies associating the relationship between dengue and its severity with ABO blood group have been documented. AIMS: The aim of this study was to determine the association between distribution of ABO Rh blood groups and DF and DF with thrombocytopenia. SETTINGS AND DESIGN: This was a retrospective descriptive study conducted at the clinical laboratory of the department of microbiology. MATERIALS AND METHODS: Dengue patients whose case record contained information on blood group were screened for details of blood group and confirmed dengue diagnosis. Randomly 384 case records were selected. These were divided into two groups; Group 1 included DF cases (platelet count >20,000) and Group 2 included DF cases with thrombocytopenia (platelet count <20,000). Control group consisted of patients other than dengue, whose blood grouping had been done; randomly 390 were selected and analyzed. STATISTICAL ANALYSIS USED: P value was calculated using the Chi-square test. Odds ratio were calculated using the Fisher's exact test. RESULTS: DF was higher in 23% of individuals with AB blood group as compared to 8.5% of controls (P = 0.0004), whereas patients with blood group O were significantly less affected with DF (P = 0.0048). Disease severity was not associated with any of the blood groups. CONCLUSIONS: Individuals with AB blood group are more prone to DF, whereas individuals with blood group O are less prone.

scholarly journals Evaluation of the use of Hypertonic Saline 3% Nebulizer versus Intravenous Hypertonic Saline 3% to Attenuate the Manifestations of Acute Respiratory Distress Syndrome

2020 ◽  
Vol 14 (1) ◽  
pp. 52-61
Author(s):  
Amr Sobhy ◽  
Abdelkarem Hussiny ◽  
Mohammed Kamal
Keyword(s):  
Mortality Rate ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Distress Syndrome ◽  
Control Group ◽  
P Value ◽  
Icu Stay ◽  
Group A ◽  
Group B ◽  
Group D

Background: A well-known disease, Acute Respiratory Distress Syndrome (ARDS) presents a daunting challenge to the medical community with alarmingly high mortality rates. Initiation of hypertonic saline (HTS) nebulization therapy for patients with early ARDS appears to be tolerable and may be beneficial. However, using a nebulizer is cumbersome and less efficient. This study aims to assess the efficacy of using HTS3% in a nebulizer in comparison with intravenously injecting it to attenuate the manifestation of ARDS. The study analyses factors such as the severity of the disease, need and duration of mechanical ventilation (MV), ICU stay, and mortality rate in the comparative analysis. Materials and Methods: The randomized, comparative, and controlled study included patients of both genders from an age bracket of 18-60 years. The patients fulfilled the Berlin definition of ARDS. Additionally, the whole sample was divided into four groups (26 patients each): Group A received standard pharmacotherapy [methylprednisolone 1mg/kg/day intravenously and salbutamol nebulizer 2.5 mg (1 ml) + 3 ml normal saline/8hr] and normal saline 0.9% (5ml) nebulizer /8hr: Group B received standard pharmacotherapy + HTS2.7% (5ml) nebulizer/8hr: Group C also received standard pharmacotherapy and 500ml normal saline intravenously over 24 hours: Group D received standard pharmacotherapy and 500 ml HTS 3% intravenously over 24 hours. The following parameters were recorded: Lung injury score (Murray Score, calculated every 24 hours), the incidence of the need for MV, duration of MV, length of ICU stay, and mortality rate. Results: Group B (HTS nebulizer group) and group D (HTS IV group) showed the most rapid improvement in the Murray score with a 50% decrease in the score from its initial value (D50%) by day 4 with P-values of 0.013 and 0.022 respectively. Subjects from Group D (HTS IV) and Group B (HTS Nebulizer) were the least in need of MV as only 38.5% needed MV with a P-value <0.001. In comparison, 69.2% subjects from group A (control) and 73.1% from group C required MV, with a P-value <0.001. The shortest duration of MV care was found in group D (median 3.12 days), followed by group B (median 4.21 days). The results were highly significant, with P-value 0.004 when compared with group A (control group) and group C. In addition, the longest duration of MV care was reported in group A (median 5.37 days). There was significant variation in all groups regarding the length of ICU stay: group D required the least number of days (median 6.76 days), followed by group B (median 7.08 days). The result was statistically significant, with a P-value of 0.004 when compared with the control group (median 9.1 days) and group C(longest duration of MV with a median of 10.13 days). However, no significant difference was found in the mortality rate (P-value >0.05). Conclusion: The use of hypertonic saline 3% intravenously has a comparable effect as the use of hypertonic saline 3% via nebulizer to attenuate the manifestations of (ARDS) and even superior in the mechanically ventilated patient.

scholarly journals Pattern of electrolytes in a cohort of critically ill COVID-19 patients

2020 ◽  
pp. 46-50
Author(s):  
Rozina Sultana ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Debasish Kumar Saha ◽  
...  
Keyword(s):  
Critically Ill ◽  
Disease Process ◽  
P Value ◽  
Base Line ◽  
Rt Pcr ◽  
Case Record ◽  
Icu Stay ◽  
Co Morbidity ◽  
Death Cases ◽  
Length Of Icu Stay

Background: Coronavirus disease 2019 (COVID-19) is a potentially fatal disease with multisystem involvement. Several studies have reported various electrolyte abnormalities at admission in patients who progress to the severe form of COVID-19. This study evaluated the electrolyte pattern in confirmed and critically ill COVID-19 patients. Methods: This cross sectional study was carried out in the department of critical care medicine of BIRDEM General Hospital, Dhaka, Bangladesh, from 1st July to 10th November, 2020. Total 70 RT-PCR positive, critically ill COVID-19 patients, were enrolled. Patients’ demographic profile, clinical features, admission electrolyte report, length of ICU stay and outcome were documented in case record forms. Results: In this cohort, total 70 RT-PCR positive COVID-19 cases (male 41, female 29, mean age 62.9 ± 13.3years) were enrolled. Fifty eight (82.85%) patients had different electrolytes abnormalities including hyponatraemia (54, 77.1%), hypokalaemia (35, 50%), hypocalcaemia (20, 28.6%) and hypomagnesaemia (11,15.7%). Regarding clinical symptoms, 98.6% (n=69) had respiratory distress, 97.1% (n=68) had cough, 94.3% (n= 66) had history of fever and 10.0 % (n=7) presented with unconsciousness. Diabetes mellitus (DM) was the most common co morbidity (94.3%).Mean length of ICU stay were 6.4 ± 3.4 days, where 48.57% (n=34) survived and 51.42% (n=36) died. Among 36 death cases, 33 patient (91.7%) had hyponatraemia (p value=0.003), which was statistically significant. Conclusion: In this study, we found that, hyponatraemia was the most predominant electrolyte abnormality. Among 36 death cases, around 92% had hyponatraemia. Like other studies, it showed that various electrolyte imbalances seem to have an impact on disease process. So, base line electrolyte assessment would be beneficial for evaluating the risk of severity of COVID-19. So, more study of electrolytes in COVID-19 cases with multi center approach is needed. Birdem Med J 2020; 10, COVID Supplement: 46-50

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

CONVENTIONAL VERSUS THREE-DIMENSIONAL CONFORMAL EXTERNAL RADIOTHERAPY IN CANCER CERVIX: A COMPARATIVE STUDY FOR COMPLIANCE, RESPONSE AND TOXICITY

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Richa Gupta ◽  
Piyush Kumar ◽  
D. P. Singh ◽  
Arvind Kumar Chauhan ◽  
Kamal Sahni
Keyword(s):  
Clinical Response ◽  
Three Dimensional ◽  
Common Side Effect ◽  
P Value ◽  
High Dose ◽  
Cancer Cervix ◽  
Conventional Radiotherapy ◽  
Radiation Fields ◽  
Group A ◽  
Group B

INTRODUCTION: Cervical cancer is the second most frequent cancer among Indian women. Radiotherapy is the cornerstone of treatment in all its stages. Three-dimensional conformal radiotherapy (3DCRT) combines multiple radiation fields to deliver precise dose of radiation to the affected area. Tailoring each of the radiation fields to focus on the tumor delivers a high dose of radiation to the tumor and avoids nearby healthy tissue. The present study is done to compare conventional radiotherapy versus 3DCRT in cancer cervix for compliance, clinical response and toxicity. MATERIAL AND METHODS: Fifty patients were enrolled and randomised into two radiotherapy plans with radical intent - Group A treated by conventional radiotherapy and group B treated by 3DCRT. Concurrent cisplatin was delivered on weekly (35mg/m2) or tri-weekly (75mg/m2) basis during external beam Radiotherapy and was followed by High Dose Radiotherapy Brachytherapy. Clinical response and complication assessment were evaluated.Collected data was analyzed using standard statistical methods and softwares to calculate level of significance using “p” value by chi square test. RESULTS: In this study mean age of the patients was 48 years (26-67 years). The anemia was the most common side effect seen in both groups (96% vs 88%, p=0.29). Neutropenia was more in group B (36% vs 44%, p= 0.56). Lower GI toxicity was seen only in patients in group A (20% vs 0%, p=0.018). In follow up there were no significant early rectal and bladder reactions in both groups and 2 patients in each group had late rectal reactions of grade I and II (p= 0.312). No significant skin, bladder and small intestinal toxicity were seen in both groups. CONCLUSION: Conventional radiotherapy gives equally efficacious response though accompanied by toxicities which were acceptable.

The effect of Gokshura Churna over Tilanalakshara Yoga in the management of Mutrashmari - A Randomized Comparative Clinical Study

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Anil M. Sanshi ◽  
Dr.Pallavi A. Hegde
Keyword(s):  
Abdominal Pain ◽  
Renal Calculi ◽  
Renal Calculus ◽  
P Value ◽  
Standard Group ◽  
Standard Drug ◽  
Female Ratio ◽  
Comparative Clinical Study ◽  
Group B ◽  
Trial Drug

Background: Mutrashmari is a stone like structure anywhere in the Mutravaha Srothas which can be compared with renal calculi and one among the Astamahagada, clinical features as renal angle pain, haematuria, pyuria and dysuria. Peak age is 3rd to 5th decade while majority of patients report regarding onset of disease in 2nd decade of life and male to female ratio is 3:1. Objectives: To compare the effect of Gokshura Churna over Tilanalakshara Yoga in the management of Mutrashmari with special reference to Renal calculi. Materials and Methods: 30 patients were selected on the basis of inclusion criteria and divided into 2 groups with 15 patients in each group by chit method. Group A was treated with standard drug Tilanalakshara Yoga and Group B was traeted with trial drug Gokshura Churna. Results: It was found that standard group reduced the abdominal pain by 85.1%, dysuria by 89.4%, renal angle tenderness 88.4%, haematuria 100%, pyuria 100%, size of renal calculus 41.9% by 21st day of treatment. In study group it was observed that abdominal pain reduced by 92%, dysuria 96.1%, renal angle tenderness 91.6%, haematuria 100%, pyuria 100% and size of renal calculus 48.5% by 21st day of treatment. Conclusion: This assessment showed Gokshura Churna had significant result over Tilanala Kshara Yoga in both subjective and objective parameters with P value less than 0.0001.

The silent presence of Mycoplasma hominis in patients with prostate cancer

2020 ◽  
Vol 78 (7) ◽  
Author(s):  
Saman Saadat ◽  
Pezhman Karami ◽  
Mohammad Jafari ◽  
Mahdi Kholoujini ◽  
Zahra Rikhtegaran Tehrani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Mycoplasma Hominis ◽  
Opportunistic Pathogen ◽  
Host Cells ◽  
Prostate Tissue ◽  
Control Group ◽  
P Value ◽  
Retrospective Case ◽  
Formalin Fixed Paraffin Embedded ◽  
Pcr Targeting

ABSTRACT Background Mycoplasma hominis, an opportunistic pathogen in human genitourinary tract, can cause chronic infection in the prostate. Intracellular survival of M. hominis leads to a prolonged presence in the host cells that can affect the cell's biological cycle. In the present study, we aimed to evaluate the frequency of M. hominis DNA in prostate tissue of Iranian patients with prostate cancer (PCa) in comparison to a control group with benign prostatic hyperplasia (BPH). Methods This research was a retrospective case-control study using 61 archived formalin-fixed paraffin-embedded (FFPE) blocks of prostate tissue from patients with PCa and 70 FFPE blocks of patients with BPH. Real-time PCR, targeting two different genes, 16S rRNA and yidC, in the M. hominis genome was performed for all specimens. Results Out of 61 blocks of prostate biopsy from patients with PCa, eight samples (13%) were positive for M. hominis, while the bacterium was not detected in any of the 70 blocks of patients with BPH (P value, 0.002). Conclusions The high frequency of M. hominis in patients with PCa likely shows a hidden role of the organism in prostate cancer during its chronic, apparently silent and asymptomatic colonization in prostate.

scholarly journals Integration of a Virtual Dispensing Simulator “MyDispense” in an Experiential Education Program to Prepare Students for Community Introductory Pharmacy Practice Experience

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 48
Author(s):  
Ashley E. Johnson ◽  
Jillian Barrack ◽  
Jill M. Fitzgerald ◽  
Diana M. Sobieraj ◽  
Lisa M. Holle
Keyword(s):  
Community Pharmacy ◽  
Experiential Education ◽  
Self Care ◽  
Pharmacy Practice ◽  
Pharmacy Education ◽  
P Value ◽  
Community Practice ◽  
Practice Experience ◽  
Group A ◽  
Group B

Background: Technology is increasingly used to enhance pharmacy education. We sought to evaluate student learning and preparedness for community introductory pharmacy practice experiences (IPPEs) after implementation of “MyDispense” into experiential education. Methods: Both first-year pharmacy students and assigned community IPPE preceptors were eligible. Students were stratified based on previous community pharmacy experience (< or ≥ 50 h), then randomized to complete MyDispense exercises before IPPE (group A) or after 24–32 h of IPPE (group B). We evaluated preceptors’ assessment of student readiness using a 6-item Likert scale survey and students’ readiness and opinion of MyDispense using an anonymous 9-item survey. Descriptive statistics were used to characterize data. The Mann–Whitney U test was used to compare groups and a p-value < 0.05 was considered statistically significant. Results: Of 177 eligible students, 155 were randomized and 56 completed study. Group A included 32 students; 56.3% had prior community practice experience. Group B included 24 students; 50% had prior community practice experience. Forty-eight preceptors were enrolled. Students who completed exercises before rotation received higher preceptor scores for patient counseling of self-care and of medications (p < 0.05 for both). Students self-assessed their counseling skills lower than all other skills; 30.4% and 42.9% of students felt mostly or always prepared to counsel for self-care and medications, respectively. Students found MyDispense straightforward, realistic, and appreciated the ability to practice in a safe, electronic, community pharmacy, patient-care environment. Conclusion: Simulation-based software, such as MyDispense, can enhance learner understanding of the prescription fill and counseling process in a community pharmacy practice setting.

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