Abstract
Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) affects millions of people worldwide. The article aims to review the therapeutic perspective on natural antioxidants, their ...mechanism of action, pharmacokinetics in management and cure of COVID‐19/ SARS‐CoV‐2 infection. We conducted a literature search including World Health Organization and National Institute of Health guidelines and clinical trials registered with
ClinicalTrials.gov
limited to antioxidants in COVID‐19 management. Elderly, immunocompromised patients, and others with underlying health conditions or multiple comorbidities have a high mortality rate. Disrupted redox homeostasis and oxidative stress seem to be biological pathways that may increase personal vulnerability to infection. Antioxidants like vitamins C, D, E, epigallocatechin‐3 gallate, and morin have been reported to protect against COVID‐19 disease. Reactive oxygen species are immunological regulatory elements of viral replication. Natural antioxidants exhibit potential action in preventing inflammation and organ dysfunction during viral infection. They also increase glutathione level, oxygenation rate, and immunological responses in the treatment of sepsis and acute respiratory distress syndrome. No wonder the selection of prevention, treatment, and cure of COVID‐19 and SARS‐CoV‐2 mainly depends upon the antiviral and immunoregulatory activity which they possess. Yet, their efficacy against COVID‐19 is of great concern and demands extensive study.
Barraquer‐Simons syndrome is a rare entity characterized by progressive loss of subcutaneous tissue in the face and/or upper half of the body and can be associated with autoimmune conditions such as ...systemic lupus erythematosus. Close long‐term follow‐up is required to identify metabolic disturbances, potentially life‐threatening renal problems, and other associated diseases.
Barraquer‐Simons syndrome is a rare entity and can be associated with autoimmune conditions such as systemic lupus erythematosus. Close long‐term follow‐up is required to identify metabolic disturbances and potentially life‐threatening renal problems.
Introduction: Decompressive Craniectomy (DC) is a common neurosurgical procedure performed to reduce the intractable intracranial pressure in various neurosurgical diseases (infarction, hemorrhage, ...traumatic brain injury). The main aim of the study was to describe the demographic, clinical and operative characteristics of patients who underwent DC for different conditions and to correlate the outcome with various preoperative and intraoperative factors in our center.
Methods: This was a retrospective study of patients who underwent DC for various neurosurgical diseases from January 2019 to January 2021 in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The chart of the patients were retrieved from the medical records and additional information obtained via telephone.
Results: A total of 55 patients were enrolled in the study with a mean age of 43.0 + 17.3 years and male:female ratio of 1.5:1. There were 20 (36.4%) patients who presented with trauma and 35 (63.6%) patients with non traumatic origin. Among them, 28 (51%) patients presented with GCS<8 and 27 (49%) patients with GCS>8 and 37 (67.3%) patients with unequal pupil. At the end of six months follow up, the favorable outcome was seen in 23 (41.8%) patients. The only factor significantly associated with favorable outcome was the preoperative pupillary status.
Conclusion: In our cohort the preoperative pupillary status (bilateral equal and reactive pupil) was the variable significant for favourable outcome in patients undergoing DC.
Staghorn calculus usually fills the pelvis of the kidney, the infundibulum, and most of the calyces. It is a rarity for staghorn stones to be asymptomatic; in addition to that, the calculus discussed ...in this case report was of a very large size and was removed intact. Open pyelolithotomy, the procedure used, is one that comes with a wide range of complications but can be deemed effective in certain cases. In this scenario, it led to no impediments to normal physiology.
Here the authors report the case of a 45-years-old Nepalese male who presented with a large yet asymptomatic staghorn calculus. It was managed with an open pyelolithotomy, and the patient had no intraoperative or postoperative complications.
Staghorn stones can be complete or partial and often naturally progress to renal impairment. Thus, an aggressive therapeutic approach is crucial, with careful evaluation of the site and size of the stone, the patient's preference, and the institutional capacity. Ideally, staghorn calculi are completely removed, and it is imperative that the functions of the affected kidney are preserved as far as possible and when applicable. Although percutaneous nephrolithotomy is recommended for the removal of staghorn stones, several clinical, technical, and socioeconomic factors contributed to the use of open pyelolithotomy in the management of the case discussed here.
Open pyelolithotomy can prove highly effective in removing large stones intact and in a single setting, the importance of which was accentuated by its unique clinical presentation and pathological anomalies.
Introduction: Infectious diseases are one of the most frequent reasons for hospital admission for children and antimicrobials are commonly used to treat them. There is higher prevalence of irrational ...prescriptions of antimicrobials in such population. This study was conducted to survey the pattern of antimicrobial prescription in Paediatric inpatient.
Material and Methods: This was retrospective, descriptive, observational study. The data was collected from prescription records. The paediatric population included in the study was categorised into three age groups. A total of 87 prescriptions were studied and the information was recorded in performa. Data were recorded in MS Excel and Graph Pad Prism version 6 was used for analysis.
Results: The number of male child was outnumbered by female child. The average age of the patient on antimicrobial prescription was 5.34 ± 2.18 years. The mean duration of hospital stay was 6.17 ± 2.01 days. The common indications for antimicrobial prescriptions were upper respiratory tract infections, diarrhoeal illness, urinary tract infections, enteric fever, etc. The antimicrobials prescription rate was 1.33. Oral route was found to be commonly used than parenteral route. The generic prescription rate was 33.6%. The most common drug prescribed was ceftriaxone followed by amoxicillin + clavulanic acid, ciprofloxacin, metronidazole and amikacin. The 62.5% of antimicrobials were prescribed from National Essential List of Medicines.
Conclusion: This study highlights the prescription pattern of antimicrobial agents in hospitalised Paediatric population in a tertiary care hospital.
Pulmonary tuberculosis, caused by
is a significant public health issue, especially in developing countries, affecting millions of people every year. Despite the development of many antitubercular ...antibiotics and increased awareness of preventive methods, it is still a major cause of mortality worldwide. Vitamin D, a micronutrient known to have a major role in bone and calcium metabolism, has also shown its immunomodulatory effects to suppress mycobacterial growth. We conducted a systematic review and meta-analysis of the available evidence to explore the association between vitamin D levels and tuberculosis. We performed a systematic search for articles from inception to May 2021 in multiple databases. We included 26 studies in our qualitative synthesis and 12 studies in meta-analysis or quantitative synthesis. In our meta-analysis, we used a random-effect model to calculate the odds ratio (OR) of vitamin D deficiency in tuberculosis patients compared to the healthy controls. On pooled analysis, we found that the odds of the participants having vitamin D deficiency was 3.23 times more in tuberculosis patients compared to the healthy group (OR=3.23, CI = 1.91-5.45, p<0.0001). Thus, we concluded that there is an association between low levels of vitamin D and tuberculosis infections. We suggest conducting long-term prospective cohort studies in tuberculosis endemic countries to better understand the causal relationship between vitamin D deficiency and tuberculosis.
In the present study was to determine the anti-inflammatory activity of the aqueous extract of the bark and root of Myrica esculenta and their active phytoconstituents through in vitro and in silico ...studies. The bioactive phytoconstituent of Myrica esculenta was determined by GC-MS spectroscopy techniques. After that, total phenolic and flavonoid content of both bark and root extract was determined. Furthermore, in vitro anti-inflammatory activity was determined in both extracts. The molecular docking analysis determined the binding affinity of bioactive compounds against inflammatory proteins such as COX-1, COX-2, IL-10, and TNF-α. The present study revealed that bark extract of Myrica esculenta has the highest total phenolic and flavonoid content compared with root extract (553.44 ± 18.38 mg GAE/g equivalent and 336.02 ± 8.04 mg quercetin/g equivalent, respectively). Similarly, the bark extract showed good inhibitory activity with 5-LOX and HYA assay (IC50 11.26 ± 3.93 and 21.61 ± 8.27 µg/mL, respectively), but 15-Lox inhibitory assay root extract showed the highest inhibitory activity, IC50 16.95 ± 5.92 µg/mL. The docking result showed that myricetin, arjunolic acid, and myricanone have the highest binding affinity with all inflammatory proteins in respective order: myricetin > arjunolic acid > celecoxib > myricanone > myricitrin > 3-epi-ursonic acid. The MD simulation of COX-1 and myricetin showed the highest stability and low deviation at 310 K through RMSD values (1.07–2.3 Å) as compared with COX-1 and myricitrin (0.193–1.885 Å) and TNF-α and myricanone (1.377 to 3.457 Å), respectively, when analyzed at 100 ns time frame. The extracts and their active constituents showed good anti-inflammatory activity. Further study is essential to define their mechanism of action.
Introduction: Decompressive Craniectomy (DC) is a common neurosurgical procedure performed to reduce the intractable intracranial pressure in various neurosurgical diseases (infarction, hemorrhage, ...traumatic brain injury). The main aim of the study was to describe the demographic, clinical and operative characteristics of patients who underwent DC for different conditions and to correlate the outcome with various preoperative and intraoperative factors in our center. Methods: This was a retrospective study of patients who underwent DC for various neurosurgical diseases from January 2019 to January 2021 in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The chart of the patients were retrieved from the medical records and additional information obtained via telephone. Results: A total of 55 patients were enrolled in the study with a mean age of 43.0 + 17.3 years and male:female ratio of 1.5:1. There were 20 (36.4%) patients who presented with trauma and 35 (63.6%) patients with non traumatic origin. Among them, 28 (51%) patients presented with GCS<8 and 27 (49%) patients with GCS>8 and 37 (67.3%) patients with unequal pupil. At the end of six months follow up, the favorable outcome was seen in 23 (41.8%) patients. The only factor significantly associated with favorable outcome was the preoperative pupillary status. Conclusion: In our cohort the preoperative pupillary status (bilateral equal and reactive pupil) was the variable significant for favourable outcome in patients undergoing DC.
Staghorn calculus usually fills the pelvis of the kidney, the infundibulum, and most of the calyces. It is a rarity for staghorn stones to be asymptomatic; in addition to that, the calculus discussed ...in this case report was of a very large size and was removed intact. Open pyelolithotomy, the procedure used, is one that comes with a wide range of complications but can be deemed effective in certain cases. In this scenario, it led to no impediments to normal physiology. Case PresentationHere the authors report the case of a 45-years-old Nepalese male who presented with a large yet asymptomatic staghorn calculus. It was managed with an open pyelolithotomy, and the patient had no intraoperative or postoperative complications. DiscussionStaghorn stones can be complete or partial and often naturally progress to renal impairment. Thus, an aggressive therapeutic approach is crucial, with careful evaluation of the site and size of the stone, the patient's preference, and the institutional capacity. Ideally, staghorn calculi are completely removed, and it is imperative that the functions of the affected kidney are preserved as far as possible and when applicable. Although percutaneous nephrolithotomy is recommended for the removal of staghorn stones, several clinical, technical, and socioeconomic factors contributed to the use of open pyelolithotomy in the management of the case discussed here. ConclusionOpen pyelolithotomy can prove highly effective in removing large stones intact and in a single setting, the importance of which was accentuated by its unique clinical presentation and pathological anomalies.
PDF
