scholarly journals Effect of Anticoagulants on the Survival Rate in Critically Ill COVID-19 Patients

2021 ◽  
pp. 6-11
Author(s):  
H. M. Akshay ◽  
Gayatri Vaidya ◽  
Sarika M. Shetty ◽  
Chandan Dharmashekara ◽  
Bhargav Shreevatsa ◽  
...  
Keyword(s):  
Survival Rate ◽  
Critically Ill ◽  
World Health ◽  
Female Ratio ◽  
Thrombotic Complications ◽  
Health Organization ◽  
Systemic Pathology ◽  
Complications And Mortality ◽  
Male To Female ◽  
Common Manifestation

Background: The World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19), as a pandemic in January 2020. The morbidity and mortality associated with the disease are enormous COVID-19, with a multi-systemic pathology, exhibits thrombosis as a common manifestation. Disseminated intravascular coagulation (DIC) and thrombotic lesions have been reported in >70% and >30% of patients, respectively, who have died due to the COVID-19 and therefore, heparin is included in the treatment of moderate to severe cases. This retrospective study was undertaken to check the effectiveness of prophylactic therapy with heparin at reducing mortality in critically ill COVID-19 patients. Methodology: The study included retrospective data from case records of 169 critically ill COVID-19 patients with or without comorbidities and an anticoagulant regimen. The data were thoroughly studied for demographic profile, comorbidities, type and dosage of anticoagulants, length of intensive care unit stay, and mortality rates. Results: The male to female ratio of the study subjects was 125/44 (76%/24%). Patients with comorbidities were critically ill as compared to those with none (140/29), and diabetes mellitus was the most common comorbidity, found in 99 patients. Mortality rate was significantly higher in patients who had not received any anticoagulant (p = 0.015) and in patients who had received unfractionated heparin (p =0.036) as compared to those who received low molecular weight heparin (LMWH). Conclusion: The prophylactic administration of heparin improves the survival rate of the critically ill covid 19 patients is more when compared with the patients who do not receive heparin. LMWH is very effective in reducing thrombotic complications and mortality in critically ill COVID-19 patients.

scholarly journals Two Hyperparasitaemic Plasmodium Falciparum Cases Successfully Treated with Artemisinin-based Combination Therapy

2020 ◽  
Author(s):  
Benudhar Mukhi ◽  
Anupkumar R. Anvikar ◽  
Bina Srivast ◽  
Himanshu Gupta ◽  
Susanta Kumar Ghosh
Keyword(s):  
Plasmodium Falciparum ◽  
Combination Therapy ◽  
Malaria Diagnosis ◽  
World Health ◽  
Host Responses ◽  
Reference Ranges ◽  
Female Ratio ◽  
Health Organization ◽  
Complications And Mortality ◽  
Male To Female

Abstract BackgroundHyperparasitaemia is an important event in a cascade of Plasmodium falciparum severe malaria (SM) but requires host responses to cause cerebral malaria (CM) leading to death, if left untreated. Here, we report two hyperparasitaemic patients with no CM.MethodsMalaria diagnosis was performed based on thick and thin smears examination, and immunochromatographic-based rapid diagnostic test assay. Parasitaemia was calculated following World Health Organization (WHO) protocol. Haematological and biochemical investigations were also performed. ResultsThe first patient had 42% parasitaemia (100% asexual parasites). The second one had 9.5% parasitaemia comprising 46% asexual, and 54% sexual stages with 1:1 male to female ratio. On the day of admission, both had presented abnormal haematological and biochemical parameters compared to the reference ranges. Remarkably, both the patients recovered successfully with oral artemisinin-based combination therapy (ACT) and a single dose of primaquine.ConclusionThe presence of hypergametocytaemia may hinder the elimination efforts, if not treated immediately. This report also signifies the need of accurately estimating the parasitaemia in malaria patients and their timely management to prevent complications and mortality.

scholarly journals Two hyperparasitaemic Plasmodium falciparum cases successfully treated with Artemisinin-based Combination Therapy

2020 ◽  
Author(s):  
Benudhar Mukhi ◽  
Anupkumar R. Anvikar ◽  
Bina Srivast ◽  
Himanshu Gupta ◽  
Susanta Kumar Ghosh
Keyword(s):  
Plasmodium Falciparum ◽  
Combination Therapy ◽  
Malaria Diagnosis ◽  
World Health ◽  
Host Responses ◽  
Reference Ranges ◽  
Female Ratio ◽  
Health Organization ◽  
Complications And Mortality ◽  
Male To Female

Abstract BackgroundHyperparasitaemia is an important event in a cascade of Plasmodium falciparum severe malaria (SM) but requires host responses to cause cerebral malaria (CM) leading to death, if left untreated. Here, we report two hyperparasitaemic patients with no CM.MethodsMalaria diagnosis was performed based on thick and thin smears examination, and immunochromatographic-based rapid diagnostic test assay. Parasitaemia was calculated following World Health Organization (WHO) protocol. Haematological and biochemical investigations were also performed.ResultsThe first patient had 42% parasitaemia (100% asexual parasites). The second one had 9.5% parasitaemia comprising 46% asexual, and 54% sexual stages with 1:1 male to female ratio. On the day of admission, both had presented abnormal haematological and biochemical parameters compared to the reference ranges. Remarkably, both the patients recovered successfully with oral artemisinin-based combination therapy (ACT) and a single dose of primaquine.ConclusionThe presence of hypergametocytaemia may hinder the elimination efforts, if not treated immediately. This report also signifies the need of accurately estimating the parasitaemia in malaria patients and their timely management to prevent complications and mortality.

scholarly journals Demographic and Clinical Characteristics of Early Travel-Associated COVID-19 Cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Reham M. Marei ◽  
Mohamed M. Emara ◽  
Omar M. Elsaied ◽  
Gheyath K. Nasrallah ◽  
Tawanda Chivese ◽  
...  
Keyword(s):  
Clinical Data ◽  
Clinical Symptoms ◽  
Age Groups ◽  
The Elderly ◽  
World Health ◽  
Female Ratio ◽  
Younger Age ◽  
The Mean ◽  
Health Organization ◽  
Male To Female

Background: SARS-CoV-2 continues to claim hundreds of thousands of people's lives. It mostly affects the elderly and those with chronic illness but can also be fatal in younger age groups. This article is the first comprehensive analysis of the epidemiological and clinical outcomes of the travel-associated SARS-CoV-2 cases until April 19, 2020.Methods: Demographic and clinical data of travel-associated SARS-CoV-2 cases were collected for the period between January 16, 2020 and April 19, 2020. More than one hundred and eighty databases were searched, including the World Health Organization (WHO) database, countries' ministries websites, and official media sites. Demographic and clinical data were extracted and analyzed.Results: A total of 1,186 cases from 144 countries meeting the inclusion criteria were reported and included in the analysis. The mean age of the cases was 44 years, with a male to female ratio of 1.6:1. Travel-associated cases originated from more than 40 countries, with China, Italy, and Iran reporting the highest numbers at 208, 225, and 155, respectively. Clinical symptoms varied between patients, with some reporting symptoms during the flights (117 cases; 9.87%). A total of 312 (26.31%) cases were hospitalized, of which 50 cases (4.22%) were fatal.Conclusion: Major gaps exist in the epidemiology and clinical spectrum of the COVID-19 travel-associated cases due to a lack of reporting and sharing data of many counties. The identification and implementation of methodologies for measuring traveler's risk to coronavirus would help in minimizing the spread of the virus, especially in the next waves.

scholarly journals Containing Coronavirus Disease 2019 (COVID-19) in Belize

2020 ◽  
Author(s):  
Kyle A. Habet ◽  
Diomne Habet ◽  
Gliselle Marin
Keyword(s):  
National Level ◽  
World Health ◽  
Contact Tracing ◽  
Female Ratio ◽  
Additional Information ◽  
First Case ◽  
Community Transmission ◽  
The Government ◽  
Health Organization ◽  
Male To Female

Abstract Objective: To demonstrate how Belize, a small country in Central America with limited resources, contained the spread of SARS-CoV-2 (COVID-19).Methods:Information was gathered from official press releases from the Government of Belize. Statistics were accessed from the Ministry of Health’s website. Additional information was acquired from internet searches on Pubmed and the World Health Organization.Results:Total Cases: 18; Male to female ratio: 1:1; Deaths: 2; Total Tests Done: 1,128; Percentage of positive tests: 1.59%, New cases per day since first case to plateau: 0.812.Conclusion: Early intervention on a national level was key to preventing importation of cases and subsequent community transmission. Limiting the conglomeration of people, curfews, closures of school and universities, government-mandated social distancing, and extensive contact tracing may have mitigated the exponential spread of COVID-19. Mandatory mask-wearing in public may have helped to prevent spread between asymptomatic carriers to susceptible individuals. A low population density may have also contributed to containing the virus.

Indeterminate Chagas’ disease: Trypanosoma cruzi strain and re-infection are factors involved in the progression of cardiopathy

2003 ◽  
Vol 104 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Juan M. BUSTAMANTE ◽  
Héctor W. RIVAROLA ◽  
Alicia R. FERNÁNDEZ ◽  
Julio E. ENDERS ◽  
Ricardo FRETES ◽  
...  
Keyword(s):  
Survival Rate ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Infected Group ◽  
World Health ◽  
Cardiac Lesions ◽  
Health Organization ◽  
Host Parasite ◽  
Β Adrenergic Receptors ◽  
First Time

Chagas' disease is caused by Trypanosoma cruzi, which is transmitted by reduviid bugs. The World Health Organization has estimated that about 16–18 million people in the Americas are infected, and that more than 100 million are at risk. In the present study we have used a murine model to analyse if particular T. cruzi strains (Tulahuen strain and SGO-Z12 isolate from a chronic patient) and/or re-infection may determine, during the indeterminate phase of experimental Chagas' disease, changes that could explain the different evolution of cardiac lesions. Re-infected mice reached higher parasitaemias than those infected for the first time. The survival in the indeterminate phase of mice infected with Tulahuen strain was 50.0%, while the SGO-Z12-infected group presented a significantly higher survival rate (77.1%; P<0.01). The SGO-Z12-re-infected group showed a survival rate (70.9%) significantly higher than that of the Tulahuen-re-infected group (37.0%; P<0.01). Electrocardiographic abnormalities were found in 66% of Tulahuen-infected mice, while in SGO-Z12-infected group such abnormalities were found in only 36% of animals (P<0.01). The two groups exhibited similar percentages of electrocardiographic dysfunction on re-infection, although intraventricular blocks were more frequent in Tulahuen-re-infected mice (P<0.01). Hearts from infected or re-infected mice with either parasite showed mononuclear infiltrates. The SGO-Z12-re-infected and Tulahuen-re-infected groups exhibited a significantly diminished affinity (P<0.05) and a significantly increased density (P<0.05) of cardiac β-adrenergic receptors compared with the infected and non-infected groups. The indeterminate phase of Chagas' disease is defined as a prolonged period that is clinically silent, but the present findings show that different T. cruzi strains and re-infection are able to alter the host–parasite equilibrium, and these factors may be responsible for inducing progressive cardiopathy.

scholarly journals Relationship of the high proportion of suicidal acts involving ingestion of pesticides to the low male-to-female ratio of suicide rates in China

2020 ◽  
Vol 29 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Yi Yin ◽  
Zhichao Lan
Keyword(s):  
Suicide Rate ◽  
Suicidal Behaviour ◽  
Case Fatality ◽  
World Health ◽  
Mortality Data ◽  
Female Ratio ◽  
Demographic Profile ◽  
Female Suicide ◽  
Suicide Rates ◽  
Male To Female

Abstract Aims The 2014 World Health Organization report on global suicide identified large differences in the male-to-female ratio of suicide rates between countries: most high-income countries (HICs) report ratios of 3:1 or higher while many low- and middle-income countries (LMICs) – including China and India – report ratios of less than 1.5:1. Most authors suggest that gender-based social-cultural factors lead to higher rates of suicidal behaviour among women in LMICs and, thus, to relatively high female suicide rates. We aim to test an alternative hypothesis: differences in the method and case-fatality of suicidal behaviour – not differences in the rates of suicidal behaviour – are the main determinants of higher female suicide rates in LMICs. Methods A prospective registry of suicide attempts treated in all 14 general hospitals in a rural county in China was established and data from the registry were integrated with population and mortality data from the same county from 2009 to 2014. Results There were 160 suicides and 1010 medically-treated suicidal attempts in the county; 84% of female suicides and 58% of male suicides ingested pesticides while 73% of female attempted suicides and 72% of male attempted suicides ingested pesticides. The suicide rate (per 100 000 person-years of exposure) was 8.4 in females and 9.1 in males (M:F ratio = 1.08:1) while the incidence of ‘serious suicidal acts’ (i.e. those that result in death or received treatment in a hospital) was 81.5 in females and 47.7 in males (M:F ratio = 0.59:1). The case-fatality of serious suicidal acts was higher in males than in females (19 v. 10%), increased with age, was highest for violent methods (92%), intermediate for pesticide ingestion (13%) and lowest for other methods (5%). Conclusions The incidence of medically serious suicidal behaviour among females in rural China was similar to that reported in HICs, but the case-fatality was much higher, primarily because most suicidal acts involved the ingestion of pesticides, which had a higher case-fatality than methods commonly used by women in HICs. These findings do not support sociological explanations for the relatively high female suicide rate in China but, rather, suggest that gender-specific method choice and the case-fatality of different methods are more important determinants of the demographic profile of suicide rates. Further research that involves ongoing monitoring of the changing incidence, demographic profile and case-fatality of different suicidal methods in urban and rural parts of both LMICs and HICs is needed to confirm this hypothesis.

scholarly journals Post-influenza neuromuscular complications

2018 ◽  
Vol 8 (2) ◽  
pp. 78-87
Author(s):  
Kamila Tuzim ◽  
Tomasz Tuzim ◽  
Magdalena Urbańczuk ◽  
Marcin Urbańczuk ◽  
Katarzyna Schab
Keyword(s):  
Respiratory Tract Infections ◽  
Influenza Viruses ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Health Organization ◽  
Tract Infections ◽  
Complications And Mortality ◽  
Neuromuscular Complications ◽  
Diagnostics And Therapy

According to the data of the World Health Organization, every year influenza develops in up to 1.575 billion people, and 1 million of them die. Although influenza viruses are the leading cause of the upper respiratory tract infections, severe neuromuscular complications occur as well, frequently leading to disability or even death. Children under five years of age and elderly people are at the highest risk of complications and mortality. The article discusses the selected neuromuscular complications of influenza, bringing particular attention to their etiology, symptomatology, diagnostics, and therapy.

scholarly journals Disease characteristics and clinical outcome in young adults with essential thrombocythemia versus early/prefibrotic primary myelofibrosis

Blood ◽  
2012 ◽  
Vol 120 (3) ◽  
pp. 569-571 ◽  
Author(s):  
Tiziano Barbui ◽  
Jürgen Thiele ◽  
Alessandra Carobbio ◽  
Francesco Passamonti ◽  
Elisa Rumi ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Adverse Events ◽  
Essential Thrombocythemia ◽  
Young Patients ◽  
Primary Myelofibrosis ◽  
World Health ◽  
Disease Characteristics ◽  
Thrombotic Complications ◽  
Health Organization

Abstract In the present study, we investigated disease characteristics and clinical outcome in young patients (< 40 years) with World Health Organization (WHO)–defined essential thrombocythemia (ET) compared with early/prefibrotic primary myelofibrosis (PMF) with presenting thrombocythemia. We recruited 213 young patients (median age, 33.6 years), ncluding 178 patients (84%) with WHO-defined ET and 35 patients (16%) showing early PMF. Median follow-up time was 7.5 years. A trend for more overall thrombotic complications, particularly arterial, was seen in early PMF compared with ET. Progression to overt myelofibrosis was 3% in ET and 9% in early PMF, but no transformation into acute leukemia was observed. Combining all adverse events (thrombosis, bleeding, and myelofibrosis), the rate was significantly different (1.29% vs 3.43% of patients/year, P = .01) in WHO-ET and early PMF, respectively. In multivariate analysis, early PMF and the JAK2V617F mutation emerged as independent factors predicting cumulative adverse events.

scholarly journals A Study of Prevalence and Predictors of Acute Ischemic CVA Patients Admitted to Manipal Teaching Hospital, Pokhara, Nepal

2020 ◽  
Vol 2 (1) ◽  
pp. 42-46
Author(s):  
Bishnu Jwarchan ◽  
Nikunja Yogi ◽  
Suman Adhikari ◽  
Prabin Bhandari ◽  
Subita Lalchan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Statistical Significance ◽  
World Health ◽  
Systemic Hypertension ◽  
Female Ratio ◽  
History Of ◽  
Artery Disease ◽  
Health Organization

 Background: According to the World Health Organization (WHO), 15 million people suffer stroke worldwide each year. Of these, 5 million die, and another 5 million are left permanently disabled. Materials and methods: A retrospective hospital based observational study was carried out in patients with ischemic CVA. Modified Ranking Scale (MRS) on the follow up on 30 days after discharge was obtained. MRS 0-2 was categorized and good outcome and MRS 3-6 was categorized as poor outcome. Results: Out of 56 patients studied 33.9 % were less than 60 years of age and 63.1% were greater than 60 years of age. Male to female ratio was 1.55. MCA territory infarct was the most common with the frequency of 76.8%. There was significant association of HTN, DM, coronary artery disease and other factors as well with the outcome of the patients. Conclusion: On regards to clinic-social demographic parameters there was statistical significance between the gender of the patient, history of systemic hypertension, history of diabetes mellitus and coronary artery disease and outcome of the patient in 30 days follow up.

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