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An Insight into ACE2 Expression Associated Complexities of COVID-19 and the Possible Vaccine Strategies to Control Viral Entry into Host Cells
Khandaker Atkia Fariha,
Hasan Mahmud Syfuddin,
Shamim Ahmed
Issue:
Volume 9, Issue 2, March 2021
Pages:
58-69
Received:
25 January 2021
Accepted:
19 February 2021
Published:
4 March 2021
Abstract: The first detected COVID-19 virus in China in late December 2019, has now spread to over 200 countries and territories across the globe. As it is a novel virus, in course of time, new symptoms and new complexities in patients have arisen, which demand immediate attention. This ambiguous, fast mutating nature and strain variations of SARS CoV2 have hindered the way of vaccine development. However, recognizing this new virus as a member of coronavidae family and its similarity with previously prevailed SARS-Cov virus has advantages in order for its further characterization and identification of the route of entry. Hence, this review aims at providing an overview of the viral entry pathway and explaining the reasons behind the vulnerability of an individual based on his/her age, sex, weight, other existing diseases and genetic make-up. It will also try to explicate various newly emerged symptoms of COVID-19 from the perspective of cytokinin storm theory. Furthermore, it summarizes all the therapeutic strategies based on preventing virus entry, some of which are already developed or under trial or yet confined in theory using currently published literature, scientific reports and research articles about SARS-CoV2. This review will help better understand the COVID-19 complicacies with latest concepts on therapeutic strategies against SARS-CoV2.
Abstract: The first detected COVID-19 virus in China in late December 2019, has now spread to over 200 countries and territories across the globe. As it is a novel virus, in course of time, new symptoms and new complexities in patients have arisen, which demand immediate attention. This ambiguous, fast mutating nature and strain variations of SARS CoV2 have ...
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Philippine Normal Reference Values for Cardiopulmonary Exercise Testing
Lenora Fernandez,
Camilo Roa Jr,
Liza Llanes-Garcia,
Norman Maghuyop
Issue:
Volume 9, Issue 2, March 2021
Pages:
70-75
Received:
16 February 2021
Accepted:
2 March 2021
Published:
9 March 2021
Abstract: Performance on cardiopulmonary exercise test (CPET) is influenced by genetic, racial and environmental factors. This study aimed to establish the Maximum Working Capacity, Peak oxygen uptake (VO2), Peak carbon dioxide output (VCO2), Tidal Volume (TV) for normal Filipinos during exercise and derive prediction equation models for Maximum Working Capacity, Peak VO2, Peak VCO2 and maximum attained TV. The maximal cardiopulmonary responses were analyzed for one hundred eighteen healthy sedentary adult Filipino subjects who underwent CPET using a symptom limited incremental progressive cycle ergometer driven protocol. A Vista Mini-CPX Model 17670 was used. Models for predicting VO2 max, VCO2 peak, TV peak, and Work Max were derived with height, weight, age and sex being screened for significance as predictors. Linear and non-linear regression analyses were done. The maximum working capacity for males was 154.21±26.6 watts and 93.02±15.57 watts for females while the peak VO2 for males was 4.90±3.11 and 4.56±2.41 liters/minute for females. The predictive formulae derived from this study for maximum work capacity, peak VO2, VCO2 and tidal volume had acceptable correlation coefficients and performed as well as other published predictive equations based on Caucasian and Asian populations. Differences between races as to performance in exercise testing was confirmed in this study.
Abstract: Performance on cardiopulmonary exercise test (CPET) is influenced by genetic, racial and environmental factors. This study aimed to establish the Maximum Working Capacity, Peak oxygen uptake (VO2), Peak carbon dioxide output (VCO2), Tidal Volume (TV) for normal Filipinos during exercise and derive prediction equation models for Maximum Working Capa...
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Statins: The Backbone of Treatment of Dyslipidemia
Satyavir Yadav,
Sundeep Mishra,
Rajeev Agarwala
Issue:
Volume 9, Issue 2, March 2021
Pages:
76-82
Received:
23 September 2020
Accepted:
8 February 2021
Published:
9 March 2021
Abstract: Statins are a panacea for secondary prevention of atherosclerotic cardiovascular disease and primary prevention in high-risk individuals. They are very well tolerated and side effects like muscle toxicity and increased risk of new onset of diabetes are seen in a minority of cases. They are also recommended in diabetic patient because the benefit is many times more than the risk of diabetes. Statins reduce total cholesterol, LDL cholesterol, Apo B, non-HDL cholesterol, and triglycerides, and also increase high-density lipoprotein (HDL) cholesterol levels in most patients with hypercholesterolemia and combined hyperlipidemia. Statins are not indicated in individuals with Frederickson Class I and V hyperlipidemias. Extensive literature supports use of statins in coronary heart disease (CHD) patients for treatment of dyslipidemia and secondary prevention. It has also been recognized that in secondary prevention and ACS populations lower LDL may be better. Trials have compared moderate with more robust LDL-C reduction, using maximum doses of atorvastatin or simvastatin. Available statins differ in their ability to reduce atherogenic lipoproteins and raise the level of high-density lipoprotein (HDL) cholesterol. Depending on dose used and specific statin, LDL cholesterol reduction of 18% to 55% can be expected. Atorvastatin and rosuvastatin are the most potent statins for lowering LDL-C cholesterol levels, yielding average reductions that approach 50% for atorvastatin and exceed 50% for rosuvastatin at the highest dose. Reduction in triglycerides with statins ranges from 7% to 30%, and is higher in hypertriglyceridemic populations and at higher statin doses. HDL levels usually rise by 5% to 10%. No consistent dose response relationship between statin dose and degree of HDL increase is seen.
Abstract: Statins are a panacea for secondary prevention of atherosclerotic cardiovascular disease and primary prevention in high-risk individuals. They are very well tolerated and side effects like muscle toxicity and increased risk of new onset of diabetes are seen in a minority of cases. They are also recommended in diabetic patient because the benefit is...
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Profile of Vitamin D in Patients Attending at Tertiary Care Hospital, Bangladesh
Salma Sadiya,
Md. Masud Rana,
Mashud Parvez,
Mahmuda Monowara,
Afsana Habib Sheuly
Issue:
Volume 9, Issue 2, March 2021
Pages:
83-86
Received:
21 February 2021
Accepted:
17 March 2021
Published:
26 March 2021
Abstract: Introduction: Vitamin D deficiency is a common condition prevalent among both developed and developing countries where it is seen mostly in females. It has been linked to various skeletal and non-skeletal diseases. This study was done to find out the distribution of Vitamin D deficiency attending the outpatient department of a tertiary care hospital. Methods: This descriptive cross-sectional study was done among the patients attending the outpa¬tient department of a tertiary care hospital in Dhaka, Bangladesh. Methodology: The six months study was conducted from January 2019 to July 2019. The ethical approval was taken from the Institutional Review Committee of the institute where we conducted the study. Convenient sampling was done. The collected data was entered in Microsoft Excel and was analyzed in the Statistical Package for the Social Sciences (SPSS) version 23. Results: Out of 170 participants, the distribution of vitamin D deficiency was 24 (14.1%) and insufficient vitamin D in 59 (34.7%) of the patients. The mean serum vitamin D concentration by gender was 33.20±13.10ng/ml in males and 29.85±9.99 ng/ml in females. Mean age of deficient cases are 18.25±23.47 years and for sufficient cases mean age is 6.92±7.36 years. A total of 16 females and 8 males had vitamin D deficiency. Conclusions: Vitamin D deficiency was prevalent especially in girl child.
Abstract: Introduction: Vitamin D deficiency is a common condition prevalent among both developed and developing countries where it is seen mostly in females. It has been linked to various skeletal and non-skeletal diseases. This study was done to find out the distribution of Vitamin D deficiency attending the outpatient department of a tertiary care hospita...
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Mortality Among Lassa Fever Patients: A Systematic Review
Peter Ekpunobi Chime,
Ethel Nkechi Chime,
Uzoma Chukwunonso Okechukwu
Issue:
Volume 9, Issue 2, March 2021
Pages:
87-90
Received:
24 February 2021
Accepted:
8 March 2021
Published:
26 March 2021
Abstract: Background: Lassa fever is a disease of public health importance because of its morbidity and associated mortality and also because of its potential for residual morbidity such as hearing loss and social stigma. Knowledge of the mortality among Lassa fever patients is one way of assessing the effectiveness of the current strategies employed in Lassa fever management. This article is aimed at reviewing mortalities among Lassa fever patients. Methods: The relevant articles for the review were searched and obtained through the PubMed database. Data of interest were confirmed cases of Lassa fever, number of deaths and case fatality rates. Findings: All the studies reviewed were carried out in the Lassa fever endemic zone of West Africa. The case fatality rates in Lassa fever ranged from 24% to 61%, with a mean of 36%. More cases of Lassa fever and more deaths occurred during Lassa fever outbreaks. Patient’s age, co-existing medical conditions as well as complications arising from Lassa virus infection were the determinant factors for patients’ survival. Conclusion: The case fatality rate in Lassa fever was very high among hospitalized patients. Timely therapeutic intervention, infection prevention and control measures and well-coordinated response during Lassa fever outbreaks are necessary for favourable outcomes in Lassa fever management.
Abstract: Background: Lassa fever is a disease of public health importance because of its morbidity and associated mortality and also because of its potential for residual morbidity such as hearing loss and social stigma. Knowledge of the mortality among Lassa fever patients is one way of assessing the effectiveness of the current strategies employed in Lass...
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Correlation Between HBV Infection Status, Level of Surface Antigen-antibody and Phospholipid Metabolism, Insulin Resistance
Li Ting,
Chen Chan,
Liu Yonggang,
Yin Yan,
Li Pin
Issue:
Volume 9, Issue 2, March 2021
Pages:
91-95
Received:
20 February 2021
Accepted:
6 March 2021
Published:
26 March 2021
Abstract: Background: Chronic HBV infection has a continuous effect on blood sugar and blood phospholipid metabolism. Metabolic syndrome (MS) and insulin resistance (IR) are the main risk factor leading to diabetes and cardiovascular disease. At present, the relationship between chronic HBV infection and MS was still controversial. Objective: To explore the correlation between hepatitis B virus (HBV) infection status, level of surface antigen-antibody and phospholipid metabolism, insulin resistance (IR). Methods: A retrospective analysis was performed on the clinical data of 423 patients who underwent hepatitis B markers test in the hospital from January 2017 to June 2019. Among them, there were 95 cases with positive hepatitis B surface antigen (HBsAg) in the HBV infection positive group and 328 cases with negative HBsAg in the HBV infection negative group. The serum phospholipid fatty acid maps and IR related indexes were compared between the two groups. The correlation between the level of HBsAg antibody and phospholipid fatty acid maps, IR related indexes were analyzed by Spearman analysis. Results: The levels of saturated fatty acid (SFA) and u-6/u-3 polyunsaturated fatty acid (PUFA) in the HBV infection positive group were higher than those in the HBV infection negative group, while n-6PUFA, n-3PUFA, PUFA, and PUFA/SFA were all lower than those in HBV infection negative group (P<0.05). The levels of fasting blood glucose (FBG) and insulin resistance index (HOMA-IR) in the HBV infection positive group were higher than those in the HBV infection negative group, while fasting insulin (FINS) and islet sensitivity index (ISI) were lower than those in HBV infection negative group (P<0.05). Spearman correlation analysis showed that HBeAg level was positively correlated with SFA, n-6/n-3 PUFA, FBG and HOMA-IR (r=0.381, 0.369, 0.516, 0.453, P<0.001), while negatively correlated with n-3 PUFA, n-6 PUFA, PUFA, PUFA/SFA, FINS and ISI (r=-0.322, -0.306, -0.467, -0.482, -0.465, -0.356, P<0.001). Conclusion: HBV infection may cause changes in the composition of serum phospholipid fatty acid and IR.
Abstract: Background: Chronic HBV infection has a continuous effect on blood sugar and blood phospholipid metabolism. Metabolic syndrome (MS) and insulin resistance (IR) are the main risk factor leading to diabetes and cardiovascular disease. At present, the relationship between chronic HBV infection and MS was still controversial. Objective: To explore the ...
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Analysis and Countermeasures of 101 Inpatients with Falls in Internal Medicine Department
Xueyan Liu,
Jian Yu,
Shenling Hu,
Jinglan Luo,
Qingling Chen,
Jiewei Huang,
Yan Liu,
Meili Tang
Issue:
Volume 9, Issue 2, March 2021
Pages:
96-101
Received:
5 March 2021
Accepted:
22 March 2021
Published:
30 March 2021
Abstract: Falling of inpatients can cause serious injuries to patients, family members and caregivers. It damages patients’ physical and mental health, increases the remedy cost of medical institution, and affects the quality of nursing service in hospital. The aim of this study is to analyze the current situation of falls of inpatients in internal medicine department, so as to provide reference information for improving patient safety management and hospital quality control. With the help of the method of retrospective investigation, the number of inpatients with falls in the First Affiliated Hospital of Jinan University from January to December 2019 was reviewed, and the incidence, causes, time and nurse patient ratio were analyzed. There were total 101 falls of inpatients in internal medicine department in year 2019, accounting for 58% of the fall patients in the hospital, the fall rate of internal medicine department inpatients was 0.5‰. The injury rate of grade1 and above was 54.45%. The incidence of falls has three epidemiological characteristics, mainly for the elderly over 60 years old, accounting for 71.3%, the most commonplace to fall is the toilet, the high incidence period is 22:01-07:00. Drugs are one of the main factors leading to falls, with sedative-hypnoticdrugs (benzodiazepines) being the most common, followed by antidiabetic drugs, antihypertensive drugs and diuretics. Patients at high risk of falling, despite the presence of caregivers is 69.3%, had a higher incidence of falls. A nurse on duty attended to 10 to 50 patients in the falling event. From the above outcome, it is illustrated that the incidence of fall injury in medical inpatients is higher. The main population is the elderly and patients taking sedatives, sleeping pills or hypoglycemic drugs. Nurses need to keep an eye out for patients who take medications that can easily lead to falls. Hospital management departments should strengthen the training of nursing staff and new nurses, establish safety culture and improve nurses’ consciousness of fall prevention. Head nurses should take flexible shift system to effectively reduce the incidence of falls.
Abstract: Falling of inpatients can cause serious injuries to patients, family members and caregivers. It damages patients’ physical and mental health, increases the remedy cost of medical institution, and affects the quality of nursing service in hospital. The aim of this study is to analyze the current situation of falls of inpatients in internal medicine ...
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Amoxicillin-Induced Meningoencephalitis: Case Report and Review of the Literature
Lea Scherschinski,
Laura Baudier,
Marie-Luise Mono,
Lars Christian Huber,
Nora Christe
Issue:
Volume 9, Issue 2, March 2021
Pages:
102-106
Received:
17 March 2021
Accepted:
12 April 2021
Published:
26 April 2021
Abstract: Amoxicillin is one of the most frequently prescribed antibiotics for common bacterial infections in the primary care setting. Although being considered one of the safest drugs, amoxicillin can induce a rare hypersensitivity reaction with direct leptomeningeal irritation leading to drug-induced aseptic meningoencephalitis (DIAM). Given its rare incidence and poorly elucidated risk factors, amoxicillin-induced aseptic meningoencephalitis remains a diagnostic challenge. We report here the case of an 82-year-old male who presented to our emergency department with fever and cellulitis on the left foot. Antibiotic therapy with amoxicillin-clavulanate was established. Two days after admission, the patient developed frontal headaches, nausea, photophobia, and nuchal rigidity, while remaining febrile. In addition, intermittent episodes of amnesic aphasia, confusion, and agitation were observed. Cerebrospinal fluid (CSF) analysis revealed mononuclear-predominant pleocytosis, without detecting a causative pathogen by culture or PCR screening. Repeated and focused exploration of the patient's medical history unraveled a similar episode of severe cephalgia with mononuclear-predominant pleocytosis on CSF analysis after the intake of amoxicillin-clavulanate 15 years before the current presentation. The combination of clinical signs for leptomeningeal irritation following ingestion of a distinct medication and the lack of evidence for a causative pathogen on CSF analysis, were suggestive of DIAM. DIAM is most commonly caused by nonsteroidal anti-inflammatory drugs, antibiotics and intravenous immunoglobulins. DIAM remains a diagnosis of exclusion. Its pathomechanism is still not completely understood. Our illustrative case emphasizes the key points of this rare but important diagnosis. In the context of our report, we review all published cases of amoxicillin-induced meningoencephalitis. Our case report may increase the awareness of this challenging diagnosis.
Abstract: Amoxicillin is one of the most frequently prescribed antibiotics for common bacterial infections in the primary care setting. Although being considered one of the safest drugs, amoxicillin can induce a rare hypersensitivity reaction with direct leptomeningeal irritation leading to drug-induced aseptic meningoencephalitis (DIAM). Given its rare inci...
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