Notes

Helping the long-term reply to antidepressant medications by simply setting up a personalized platform according to variation and also chronotherapy.
such that patients with increasing TC,LDL,VLDL,TG levels had shorter COVID 19 onset to mucormycosis onset duration.

The study showed a positive correlation between serum lipid profile and staging of mucormycosis and negative correlation between lipid levels with duration between onset of COVID 19 to onset of mucormycosis. Hence serum lipid profile can be used as an excellent marker to predict the severity and prognosis of COVID 19 associated mucormycosis.
The study showed a positive correlation between serum lipid profile and staging of mucormycosis and negative correlation between lipid levels with duration between onset of COVID 19 to onset of mucormycosis. Hence serum lipid profile can be used as an excellent marker to predict the severity and prognosis of COVID 19 associated mucormycosis.The triaging of COVID 19 patients is of paramount importance to plan further management. There are several clinical and laboratory parameters that help in categorizing the disease severity, triaging, and prognostication. Little is known about the prognostic significance of eosinopenia in predicting the severity of COVID 19 from large hospital data especially from low- and middle-income countries. The objective of this study is to evaluate the level of eosinopenia as an early prognostic marker for assessing the outcomes in COVID 19 patients and to assess the superiority of eosinopenia as a prognostic marker for assessing the outcomes in COVID 19 patients compared to lymphopenia and neutrophil lymphocyte ratio (NLR).
The study was carried out in a tertiary care hospital. A retrospective longitudinal approach was adopted wherein the hospital records of COVID 19 patients were analysed. Two separate groups of patients were included for analysis to describe the association between initial eosinophil counts of the was found in 86 % whereas a high neutrophil lymphocyte ratio >17 was seen in only 25.6% of patients who died. Thus, implying that is eosinopenia is an important marker of disease severity in COVID 19.

Eosinopenia is an important parameter in the evaluation of COVID 19 and the presence of it should alert the clinicians regarding the further progression of the disease. It is not only an important marker but also an early marker for severe disease.
Eosinopenia is an important parameter in the evaluation of COVID 19 and the presence of it should alert the clinicians regarding the further progression of the disease. It is not only an important marker but also an early marker for severe disease.Dengue fever is the world's fastest growing vector borne viral disease. Dengue infection has high morbidity and mortality unless managed promptly and appropriately. Calcium regulates many physiological processes such as neuromuscular transmission, heart contractility, hormonal release, blood coagulation and is essential for cell function. Low calcium level is present in almost 80% of dengue cases and is more associated with severe cases. Hypocalcemia enhances the binding of the dengue virus to monocyte macrophages and cells of T cell and B cell lineages in dengue infection. However, there is scarcity of literature on calcium homeostasis in dengue infection, and current guidelines do not address the necessity to monitor or correct blood calcium levels in dengue patients. In present study, we evaluated serum calcium level in dengue patients and correlated it with disease severity.
The present observational cross-sectional study conducted in the Department of Medicine and Biochemistry, VMMC and Safdarjung Hospiengue infection but further studies are required to support this.Convalescent plasma therapy, a classic adaptive immunotherapy used in the treatment of SARS, MERS, and 2009 H1N1 pandemic with acceptable efficacy and safety in the past. Selleck I-191 Convalescent plasma therapy was taken into consideration in management of COVID 19 disease during the initial days of pandemic but was withdrawn later due to its doubtful beneficial role. This study aims to explore the beneficial role of convalescent plasma and to determine whether convalescent plasma therapy holds a second chance in treating SARS COV-2.
This cross-sectional observational study includes 82 cases of moderate to severely ill COVID 19 patients who received convalescent plasma therapy and 41 controls who didn't. Regular monitoring of TLC, P/F ratio, N/L ratio inflammatory markers, respiratory rate, oxygen saturation, ABG and radiological imaging was done for comparative analysis.

In case group 39 patients (47.56%) were on oxygen mask, 17 patients (20.73%) on NIV, 9 Patients on NRM (10.97%), 16 patients (19.51%) on room air, 1(1.21%) on HFNC initially. After 7th day of convalescent plasma therapy 49 patients (59.75%) were on room air which suggests significant improvement in mode of ventilation in case group as compared to control group. Mean respiratory rate in case group was 30.46 CPM initially and 24.7 CPM on day 7th of plasma therapy which is statistically significant.

Plasma therapy is effective if given in early stage of disease and convalescent plasma donors having adequate antibody titre.
Plasma therapy is effective if given in early stage of disease and convalescent plasma donors having adequate antibody titre.Since December 2019, an emerging coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) has been spreading worldwide. Older people and those with comorbidities are more likely to develop severe illness. Vaccines against coronavirus have been developed recently. In India, the two vaccine currently authorized to use are namely ChAdOx1 nCov, Covishield and Covaxin; both of which require 2 shots few weeks apart for adequate protection. Although COVID antibody test has not been done following vaccination in my subjects, it was observed that those who were vaccinated with one or two doses had less clinical severity compared to non vaccinated patients. In this study, we did a comparative analysis of the laboratory markers of severity in elderly COVID patients who were fully vaccinated, partially vaccinated and non vaccinatednon-vaccinated.
This study is conducted with COVID-19 patients in age group more than 65 years for duration of 6 months. Participants were divided in three group Fully Verence (p>0.05) was observed in terms of procalcitonin and NLR among the groups although the average values were found to increase from fully vaccinated to partially vaccinated to non-vaccinated groups.

Vaccination was associated with less severity when analysed in terms of laborotary parameters in COVID-19 elderly patients.
Vaccination was associated with less severity when analysed in terms of laborotary parameters in COVID-19 elderly patients.Tuberculosis may lead to adrenal insufficiency by direct glandular involvement, by extra glandular infection or as a by-product of Anti tuberculous therapy. Subclinical adrenal insufficiency becomes important in stressful situation which require increased release of ACTH to meet heightened metabolic demands. Our objective was to determine the adrenal reserve in patients with pulmonary tuberculosis and to determine the effect of ATT on adrenal function.
Prospective observational study was performed on 50 pulmonary tuberculosis patients. Blood sample for baseline serum cortisol is drawn between 800 and 830 a.m. with patients fasting overnight. Patients with serum cortisol level < 220 nmol/L will be followed up by ACTH stimulation by injecting 250μg of Cosyntropin intramuscularly and blood samples for serum cortisol is drawn at 30 and 60 minutes. Serum cortisol levels < 220 nmol/L, Post-ACTH <500 nmol/L or post ACTH increment <200 nmol/L are suggestive of adrenal insufficiency. Aftert manifestations of these conditions are however unusual. Incidence of adrenal insufficiency in pulmonary tuberculosis patients was high, and it was confirmed with ACTH stimulation test. This present study helps identifying cases at risk of fatal adrenal crisis and institute timely management, thus improving disease prognosis.COVID-19 is a highly infectious disease with varied presentation as well as outcome. Inflammation plays a major role in the outcome of COVID-19 infection. This study was aimed to evaluate the role of conventional feasible inflammatory markers in predicting the outcome of COVID-19 in hospitalized adult patients.
A total of 100 confirmed COVID-19 patients were included in the study. Clinical and demographic data were collected. Biochemical, hematological, and inflammatory markers were assessed in all the patients. Disease severity and primary outcome as survival and or mortality were recorded.

Hematological indices and inflammatory markers were significantly higher among the non-survivor. N/L (Neutrophil/Lymphocyte) ratio and CRP (C-reactive protein) can differentiate non-survivor from survivors with the sensitivity of 85.7%, 85.7%, and specificity of 96.8 %, 77.4% with a cut-off value of 6.44, 23.02 respectively in the receiver operator curve (ROC). N/L ratio and CRP were significantly increased among the patients with severe COVID-19 infection. Cox regression Survival analysis showed that an elevated N/L ratio and CRP were significantly associated with mortality with the Hazard ratio of 1.331 (P <0.001) and 1.014 (P <0.015) respectively.

The present study implicates that increased N/L ratio and CRP were significantly correlated with severity and mortality in COVID-19 patients. These conventional feasible markers can be useful in predicting the outcome of COVID-19 infection.
The present study implicates that increased N/L ratio and CRP were significantly correlated with severity and mortality in COVID-19 patients. These conventional feasible markers can be useful in predicting the outcome of COVID-19 infection.Drug repurposing is considered as a rapid strategy for COVID-19 drug discovery and many drugs have been tried for treatment of COVID-19. Antivirals like favipiravir and remdesivir have become part of the COVID-19 Management Protocol by Ministry of Health and Family Welfare (MOHFW) as well as Maharashtra State guidelines since beginning, after being approved by Drugs Controller General of India (DCGI). Although these drugs have shown promising results, their efficacy is still not proven completely and needs to be studied in large populations. The purpose of our study was to evaluate the clinical outcomes in hospitalised patients with COVID-19 treated with remdesivir and/or favipiravir.
Retrospective analysis of medical records of 914 adult COVID-19 patients hospitalized in a tertiary care center in Mumbai was conducted. We assessed the following outcomes severity of disease, need for oxygen supplementation, incidence of complications, discharge from hospital or death, oxygen requirement at the time of dischariravir only group, 7.04% in remdesivir plus favipiravir group and 10.47 % patients in control group needed oxygen support after discharge.

Majority of patients in our study got discharged under ICMR guidelines with higher proportion of patients in the treatment groups as compared to the control group. Also, lesser number of patients in the treatment groups required oxygen supplementation post discharge as compared to the control group.
Majority of patients in our study got discharged under ICMR guidelines with higher proportion of patients in the treatment groups as compared to the control group. Also, lesser number of patients in the treatment groups required oxygen supplementation post discharge as compared to the control group.
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