Does COVID-19 infection increase the risk of pulmonary embolism in ambulatory patients with deep vein thrombosis

Objectives Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications including venous thromboembolism. This study compares the development of pulmonary embolism, post-thrombotic syndrome, and clinical outcomes of COVID-19 and non-COVID-19 patients with deep vein thrombosis (DVT). Methods One hundred and eight patients diagnosed with acute deep vein thrombosis (DVT) between June 2020 and February 2021 in our institution were included in this retrospective study. Thirty-nine patients had been previously diagnosed with COVID-19 and specified as the COVID-19 group. Sixty-nine patients did not have COVID-19 and specified as the non-COVID-19 group. Mean ages of both groups were 64.3 ± 15.8 and 60.1 ± 19.7 years, respectively ( p = .37). Results The median duration from the onset of the COVID-19 to diagnosis of DVT was 22 (2–120) days in the COVID-19 group. The patients of two groups were mostly treated outpatient at rates of 94.9% vs 94.2%, respectively ( p = .88). Pulmonary embolism was seen in six patients (15.4%) in the COVID-19 group and in three patients (4.3%) in the non-COVID-19 group ( p = .04). Kaplan–Meir curves showed that patients with COVİD-19 had significantly higher pulmonary embolism than those without COVID-19 ( p = .015). The recurrence rate of DVT was 2.6% in the COVID-19 group ( n = 1), and 4.3% in the non-COVID-19 group ( n = 3), indicating no statistically significant difference ( p = .63). Mortality was seen in six patients (15.4%) in the COVİD-19 group, and in seven patients (10.1%) in the non-COVID-19 group. According to the Kaplan–Meir method, 10 months survival rates were 73.9 ± 10% in the COVID-19 group, and 66.3 ± 12.8% in the non-COVID-19 group with no statistical significance ( p = .218). Conclusions Our data draw attention to the fact that deep vein thrombosis should not be considered a safe and self-limited condition. Efficient preventive measures such as mobilization and prophylactic drug use should be considered to prevent DVT during the management of COVID-19.

Montelukast and Coronavirus Disease 2019: A Scoping Review

Coronavirus disease 2019 (COVID-19) is an emerging worldwide issue, that has affected a large number of people around the world. So far, many studies have aimed to develop a therapeutic approach against COVID-19. Montelukast (MK) is a safe asthma controller drug, which is considered as a potential antiviral drug for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This review has a systematic approach to investigate the reports on the use of MK as a part of treatment or a prophylactic agent in COVID-19. The search was conducted in PubMed, Web of Science, and Scopus databases and yielded 35 studies containing the influence of MK on SARS-CoV-2. Ultimately, MK appears to be worth being used as an adjuvant therapeutic and prophylactic drug against SARS-CoV-2. Nevertheless, more clinical trials are required to accurately investigate its effectiveness.

Extended Spectrum Beta Lactamase (ESBL) Producing Neisseria meningitidis – Isolated from a Case of Pneumonia

Neisseria meningitidis (meningococci) is the most common cause of bacterial meningitis in all age groups. Invasive meningococcal disease manifesting as meningococcal pneumonia is a very rare clinical condition. Here we have a 72 year old male who presented with meningococcal pneumonia and sepsis following a flu like illness. It is notable that he did not develop the syndrome of meningococcemia or its associated complications. This patient was treated with injections of Piperacillin-Tazobactum and Azithromycin because of the unusual antibiotic resistance pattern of the organism. He recovered completely without any sequelae. The meningococci isolated was an ESBL (extended spectrum beta lactamase) producing strain, hence it was resistant to Penicillin and third generation Cephalosporins which are usually used for the treatment of meningococcal infections .This strain was also resistant to Ciprofloxacin .This poses a threat to the community as well, especially because Ciprofloxacin is used as a chemo prophylactic drug by the contacts of the patient and the laboratory workers dealing with the patient’s clinical samples.

Ginger (Zingiber Officinale)-derived nanoparticles in Schistosoma mansoni infected mice: Hepatoprotective and enhancer of etiological treatment

Background Nanotechnology has been manufactured from medicinal plants to develop safe, and effective antischistosmal alternatives to replace today’s therapies. The aim of the study is to evaluate the prophylactic effect of ginger-derived nanoparticles (GNPs), and the therapeutic effect of ginger aqueous extract, and GNPs on Schistosoma mansoni (S. mansoni) infected mice compared to praziquantel (PZQ), and mefloquine (MFQ). Methodology/principal findings Eighty four mice, divided into nine different groups, were sacrificed at 6th, 8th, and 10th week post-infection (PI), with assessment of parasitological, histopathological, and oxidative stress parameters, and scanning the worms by electron microscope. As a prophylactic drug, GNPs showed slight reduction in worm burden, egg density, and granuloma size and number. As a therapeutic drug, GNPs significantly reduced worm burden (59.9%), tissue egg load (64.9%), granuloma size, and number at 10th week PI, and altered adult worm tegumental architecture, added to antioxidant effect. Interestingly, combination of GNPs with PZQ or MFQ gave almost similar or sometimes better curative effects as obtained with each drug separately. The highest therapeutic effect was obtained when ½ dose GNPs combined with ½ dose MFQ which achieved 100% reduction in both the total worm burden, and ova tissue density as early as the 6th week PI, with absence of detected eggs or tissue granuloma, and preservation of liver architecture. Conclusions/significance GNPs have a schistosomicidal, antioxidant, and hepatoprotective role. GNPs have a strong synergistic effect when combined with etiological treatments (PZQ or MFQ), and significantly reduced therapeutic doses by 50%, which may mitigate side effects and resistance to etiological drugs, a hypothesis requiring further research. We recommend extending this study to humans.

Hydroxychloroquine Increased Anxiety-Like Behaviors and Disrupted the Expression of Some Related Genes in the Mouse Brain

Hydroxychloroquine (HCQ), which has been proposed as a therapeutic or prophylactic drug for COVID-19, has been administered to thousands of individuals with varying efficacy; however, our understanding of its adverse effects is insufficient. It was reported that HCQ induced psychiatric symptoms in a few patients with autoimmune diseases, but it is still uncertain whether HCQ poses a risk to mental health. Therefore, in this study, we treated healthy mice with two different doses of HCQ that are comparable to clinically administered doses for 7 days. Psychiatric-like behaviors and the expression of related molecules in the brain were evaluated at two time points, i.e., 24 h and 10 days after drug administration. We found that HCQ increased anxiety behavior at both 24 h and 10 days. Furthermore, HCQ decreased the mRNA expression of interleukin-1beta, corticotropin-releasing hormone (Crh), a serotonin transporter (Slc6a4), and a microglia maker (Aif1) in the hippocampus and decreased the mRNA expression of brain-derived neurotrophic factor (Bdnf) in both the hippocampus and amygdala. Lots of these behavioral and molecular changes were sustained beyond 10 days after drug administration, and some of them were dose-dependent. Although this animal study does not prove that HCQ has a similar effect in humans, it indicates that HCQ poses a significant risk to mental health and suggests that further clinical investigation is essential. According to our data, we recommend that HCQ be carefully used as a prophylactic drug in people who are susceptible to mental disorders.

Lisinopril as a prophylactic agent for migraine: a randomised double blind placebo controlled cross over prospective study in Kashmir

Background: Migraine is one of the commonest neurological disorder seen by neurologists. Many different medications are available to be used as prophylactic agent. We conducted this study to determine the efficacy of Lisinopril as a prophylactic drug for migraine in our region.Methods: Our study is a randomised double blind, placebo controlled, cross over, prospective study. 60 patients were included in this study. Treatment period of 12 weeks with one 10 mg lisinopril tablet once daily for one week then two 10 mg lisinopril tablets once daily for 11 weeks, followed by a two week wash out period. Second treatment period of one placebo tablet once daily for one week and then two placebo tablets for 11 weeks. Thirty participants followed this schedule, and 30 received placebo followed by lisinopril. Primary end points were number of hours with headache, number of days with headache, number of days with migraine.Results: Statistical analysis of data from 41 patients that completed this study revealed that hours with headache, days with headache, days with migraine, and headache severity index were significantly reduced by 16%, 16% , 23% and 17% , respectively, with lisinopril as compared to placebo.Conclusions: This study favours lisinopril as an effective prophylactic drug for migraine. The adverse effects of lisinopril, though of significant frequency, have been mild to moderate in severity but were well tolerated by even normotensive subjects.

Reduction of faecal shedding of parasites in West African dwarf bucks fed yeast and Lactobacillus acidophilus

Ruminants serve as reservoirs of pathogenic microorganisms and their faecal shedding forms the vehicle of entry into human food chain which in turn causes food borne diseases. Usually drugs and live vaccines are the main control measures; however, due to increasing concerns of resistance and residues in meat with prophylactic drug use and the high cost of vaccines, alternative control methods are needed. The aim of this study was to determine if administration of probiotics could influence the shedding of faecal pathogenic bacteria and parasites/helminthes from WAD goats. In a completely randomised design, thirty goats were allotted to six dietary treatments which were formulated using concentrate as: control (D1); antibiotic (D2); 2.5g bakers yeast (D3); 5.0g bakers yeast (D4); 2.5g yeast plus Lactobacilli (D5) and 5.0g yeast plus Lactobacilli (D6), where D5 and D6 were fortified with Lactobacillus acidophilus at 1.00x1012cfu/g each. Faecal samples (3g) were collected from bucks for faecal egg count reduction test (FECRT, %). Data obtained were subjected to descriptive statistics and ANOVA α0.05. The results showed that the FECRT (%) for the pathogenic bacteria revealed a significant (p<0.05) reduction in load at two weeks by 99.99 % in D6 while the least was seen in D2 with 98.98 %. The salmonella as at day 14 recorded significant percentage reduction which was high in D5 (90 %) and lowest in D6 (19.23 %). The parasitic shedding of coccidia at day 14 showed that the goats on D1 shed 400 egg per gram (epg) while those on D3 recorded 150 epg. The animals on D2, D4, D5 and D6 recorded no trace of coccidia eggs in their faeces while animals on D5 and D6 showed reductions of 5.60 and 50.00 % respectively in Ascaris. Tapeworm was identified only in faecal sample of D1. The result revealed that yeast combined with Lactobacillus acidophilus at 5g/day could serve as a potential alternative to anti-bacteria and anti-helminthes.

A facile synthesis of Co (II) doped cobalt oxide nanostructures; Application for the sensitive determination of prophylactic drug furazolidone

In this report, cobalt (II)-doped cobalt oxide (Co-Co2O4) rose-like nanostructures were synthesized via a facile one-step ultra-sonication method. The as-prepared nano Co-Co2O4 was utilized for the sensitive quantification of the...

Increased deep vein thrombosis cases during the COVID-19 quarantine

Objective The aim of this study was to compare the number of deep vein thrombosis (DVT) cases during the quarantine period for COVID-19 to that of the last year. Methods This study was conducted as a single-center and retrospective study. All hospital admissions during April 2020 and May 2020 were screened from the hospital records, and DVT cases were recorded. Likewise, all hospital admissions during April 2019 and May 2019 were screened, and DVT cases were noted. DVT cases of both years were compared. Results Among 480931 patients admitted to our hospital in April 2019 and May 2019, DVT was detected in 82 patients (0.017%) (47 males, 35 females) with a mean age of 56.99 ± 9.1 years (ranges 39 to 79 years). Besides, among 145101 patients admitted to our hospital in April 2020 and May 2020, DVT was detected in 123 patients (0.084%) (51 males, 72 females) with a mean age of 58.64 ± 8.9 years (ranges 40 to 83 years). Despite the decrease in the total number of patients admitted to the hospital, there was a significant increase in the number of DVT patients. Interestingly, there were only two symptomatic pulmonary-embolism cases in the 2019 period, whereas there were seven symptomatic pulmonary embolisms secondary to DVT in the 2020 period. Unfortunately, one patient died due to pulmonary embolism secondary to DVT in 2020. The previous history of DVT was remarkable in patients admitted during the COVID-19 confinement. Conclusion In conclusion, COVID-19 confinement seems to be associated with increased rates of DVT. Strict preventive measures such as exercise training or prophylactic drug use should be considered to prevent immobility-related DVT during the COVID-19 quarantine.