Evaluation of the Efficacy and Safety of Intravenous Immunoglobulin (IVIG) in Moderate-to-Severe Hospitalized COVID-19 Patients: A Randomized, Open-Label Parallel-Group Study.

Purpose: Since February 2020, the world has been overwhelmed by the SARS-CoV-2 outbreak, and several patients suffered interstitial pneumonia and respiratory failure requiring mechanical ventilation, threatening the capability of healthcare systems to handle this amount of critical cases. Intravenous immunoglobulins (IVIG) possess potential immunomodulatory properties beneficial for COVID-19 patients, yet evidence supporting IVIG as adjunctive therapy remains sparse. This study evaluated the outcomes of adjunctive IVIG with the standard of care (SoC) in moderate-to-severe COVID-19 patients.

Mercury air, urine monitoring and health effects on occupationally exposed dental healthcare workers in Delhi, India.

Background: Mercury (Hg) is a toxic heavy metal with multiple uses in various medical devices. Hg is used in dentistry as a restorative material. Such use creates significant exposure to dental practitioners.

Clinical profile of hospitalised moderate category COVID-19 patients: Short study from a Tertiary Care Centre in Delhi.

Background: The clinical profile of hospitalized moderate-category COVID-19 patients has been understudied globally and in India.

Aim: The present study was conducted to study the clinical profile and assess the proportions of patients who progressed to severe disease and its predictors among moderate COVID-19 patients.

Materials And Methods: In this single-center observational study, 100 moderate-category COVID-19 patients as per Ministry of Health and Family Welfare (MoHFW) criteria of age ≥18 years of either sex, excluding pregnant females from February to November 2021, were studied by analyzing their clinical profiles and assessing Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score 2 (NEWS-2), and chest computed-tomography severity score (CTSS) to predict progression to severe disease.

Systemic inflammatory response syndrome criteria (SIRS) and sepsis 3 criteria for assessing outcomes in sepsis: A prospective observational study.

Background: Sepsis is a major cause of death in hospitalised patients worldwide. Most studies for assessing outcomes in sepsis are from the western literature. Sparse data from Indian settings are available comparing the systemic inflammatory response syndrome (SIRS), Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) (sepsis 3 criteria) for assessing outcomes in sepsis.

A case report on uneventful anticoagulation and persistence of Type 1 Respiratory Failure post severe COVID-19 infection in a patient of Osler-Weber-Rendu syndrome.

The SARS-CoV-2 pandemic has led researchers worldwide to study the patterns of association of SARS-CoV-2 with different diseases, which have been a prime focus of medical literature. Osler-Weber-Rendu syndrome, also known as hereditary hemorrhagic telangiectasia (HHT), is a rare genetic disorder in which patients present with recurrent epistaxis, nostril manipulations, and multiple arteriovenous malformations (AVMs) along with telangiectasias involving internal organs and mucocutaneous areas. In addition, these AVMs are prone to bleeding or act as a nidus for thrombus formation, apart from other serious complications, such as chronic hypoxemia, anemia, pulmonary artery hypertension, heart failure, and cerebrovascular accidents.

Can Sublingual Nitrate Improve Visualization of Lower Limb Arteries on Computed Tomography Angiography?

Objective: The aim of the study is to evaluate the role of sublingual nitrate in improving vessel visualization on peripheral computed tomography angiography (CTA).

Methods: Fifty patients clinically diagnosed with peripheral arterial disease of the lower limb were prospectively included in this study: Twenty-five underwent CTA after sublingual nitrate administration (nitrate group) and 25 without (non-nitrate group). Two blinded observers qualitatively and quantitatively assessed the data thus generated.

Sewer gas poisoning causing transient and focal ST-segment elevation in the ECG: Case report.

In India, a large number of sanitary care workers are involved in manual scavenging. This exposes them to sewer gas mainly consisting of hydrogen sulphide. Sewer gas toxicity primarily causes neurological injury, followed by cardiac and respiratory involvement.

Human Health Risk Assessment due to Heavy Metals in Ground and Surface Water and Association of Diseases With Drinking Water Sources: A Study From Maharashtra, India.

Background: Contamination of freshwater sources can be caused by both anthropogenic and natural processes. According to Central Pollution Control Board, Maharashtra along with 2 other states, contribute 80% of hazardous waste generated in India, including heavy metal pollution. Hence, it is important to quantify heavy metal concentrations in drinking water sources in such areas.

Role of cardiovascular magnetic resonance imaging in COVID-19 recovered patients: A short-term follow-up study.

Objective: Cardiac involvement in recovered COVID-19 patients assessed by cardiac magnetic resonance imaging (MRI).

Methods: Subjects recently recovered from COVID-19 and with an abnormal left ventricular global longitudinal strain were enrolled. Cardiac MRI in all the enrolled subjects was done at baseline (within 30-90 days following recovery from COVID-19) with a follow-up scan at 6 months in individuals with an abnormal baseline scan.

Heavy Metal Accumulation in Fruits and Vegetables and Human Health Risk Assessment: Findings From Maharashtra, India.

Background: Vegetables are consumed enormously by humans all over the world. Consumption of contaminated fruits and vegetables is the most likely route of heavy metal exposure. Hence, it is important to quantify heavy metal concentration in frequently consumed fruits and vegetables.

Effect of Supplementation of Vitamin C and Thiamine on the Outcome in Sepsis: South East Asian Region.

Introduction: The global burden of sepsis is overwhelming and novel therapeutic agents is the need of the hour. The present study was designed to understand the role of Malondialdehyde as a marker of the oxidative stress in sepsis, as well as the effect of supplementation of Vitamin C and Thiamine in patients of sepsis.

Methods: 80 patients of sepsis were randomly divided into 4 groups of 20 each.

Lactate enhanced-quick Sequential Organ Failure Assessment 2 (LqSOFA2): A new score for bedside prognostication of patients with sepsis.

Background & Objectives: Early diagnosis and prompt treatment remain a challenge in sepsis. To study the role of quick Sequential Organ Failure Assessment (qSOFA), blood lactate levels and a new score Lactate - Enhanced-qSOFA 2 (LqSOFA2) in predicting outcome in patients with sepsis and their association with established severity scores.

Methods: This was a prospective, observational study in patients admitted to ICU of a tertiary care hospital in north India.

Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19.

Introduction: There is strong evidence for the use of corticosteroid in the management of severe coronavirus disease-2019 (COVID-19). However, there is still uncertainty about the timing of corticosteroids. We undertook a modified Delphi study to develop expert consensus statements on the early identification of a subset of patients from non-severe COVID-19 who may benefit from using corticosteroids.

Massive hemoptysis causing mortality in a post COVID-19 infected Asian male patient: Presenting as pulmonary mucormycosis, pulmonary tuberculosis and later sino-nasal mucormycosis.

While the developed nations are discussing giving a third dose of the COVID-19 vaccine to immunocompromised individuals, there are still challenges that are of global concern, especially in developing countries. The Delta variant which is predominantly responsible for the disease burden has now been reported in over 148 countries. The catastrophe caused in the Indian subcontinent has highlighted some associations, most notable being the unprecedented rise in the cases of mucormycosis in COVID-19 patients referred to as CAM (COVID-19 associated mucormycosis).

Leishmaniasis.

Leishmaniasis is one of the chronic debilitating vector-borne diseases caused by obligate intracellular protozoa. The global burden of disease although not increasing but potential risk of spread is there. At least 20 species of Leishmania are pathogenic to human beings.

Adrenomedullin and Its Possible Role in Improved Survival in Female Patients with Sepsis: A Study in the South East Asian Region.

Aims And Objectives: Serum adrenomedullin (ADM) as a prognostic biomarker to study the gender-related differences in mortality pattern and its correlation with the sequential organ failure assessment (SOFA) and acute physiologic assessment and chronic health evaluation II (APACHE II) scores in patients of sepsis.

Measurements And Main Results: Eighty patients of sepsis of which 36 were males and 44 were females, were taken in the study as per sepsis III guidelines. They were followed up for a period of 28 days.

Drug utilization, rationality, and cost analysis of antimicrobial medicines in a tertiary care teaching hospital of Northern India: A prospective, observational study.

Background: The burden of bacterial infections is huge and grossly under-represented in the current health-care system. Inappropriate use of antimicrobial medicines (AMMs) poses a potential hazard to patients by causing antibiotic resistance. This study was conducted to assess the: (i) AMM consumption and use patterns in patients attending the outpatients and inpatients of Medicine and Surgery departments of the hospital.

Critical care practice in India: Results of the intensive care unit need assessment survey (ININ2018).

Background: A diverse country like India may have variable intensive care units (ICUs) practices at state and city levels.

Aim: To gain insight into clinical services and processes of care in ICUs in India, this would help plan for potential educational and quality improvement interventions.

Methods: The Indian ICU needs assessment research group of diverse-skilled individuals was formed.

Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial.

Importance: Previous research suggested that soluble human recombinant thrombomodulin may reduce mortality among patients with sepsis-associated coagulopathy.

Objective: To determine the effect of human recombinant thrombomodulin vs placebo on 28-day all-cause mortality among patients with sepsis-associated coagulopathy.

Design, Setting, And Participants: The SCARLET trial was a randomized, double-blind, placebo-controlled, multinational, multicenter phase 3 study conducted in intensive care units at 159 sites in 26 countries.

Correlation of chronic obstructive pulmonary disease assessment test and clinical chronic obstructive pulmonary disease questionnaire score with BODE index in patients of stable chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease (COPD) has a major impact on health status in accordance with disease severity. It is usually assessed by the various quality of life questionnaires.

Objectives: The aim of this study is to assess the disease severity and health status in stable patients of COPD using COPD assessment test (CAT) and clinical COPD questionnaire (CCQ) scores and to correlate with BODE index and its components.

Role of oestrogen and its receptors in HEV-associated feto-maternal outcomes.

Background: Pregnant women infected with HEV develops adverse pregnancy outcomes like, abortions, intrauterine fetal death, still births, neonatal deaths, preterm delivery and maternal mortality.

Aim: To correlate oestrogen and its receptors ESR1α and ESR2β levels with HEV-associated feto-maternal outcomes.

Material & Methods: A total of 142 pregnant women with HEV infection and 142 pregnant controls were included in study from Department of Obstetrics & Gynaecology and Department of Medicine, Maulana Azad Medical College (MAMC) and associated Lok Nayak Hospital (LNH), New Delhi.

Corticosteroid-induced cryptococcal meningitis in patient without HIV.

Cryptococcus neoformans is the most frequent cause of fungal meningitis in humans. Cryptococcus affects people of all ages and has a worldwide distribution. It is the fourth most common infection in AIDS (CD4 counts <100/mm).

The Effect of Folic Acid Supplementation on Hyperhomocysteinemia and Pulmonary Function Parameters in Chronic Obstructive Pulmonary Disease: A Pilot Study.

Introduction: Preliminary studies have established the elevated plasma total Homocysteine (tHcy) levels as a risk factor for Chronic Obstructive Pulmonary Disease (COPD). However, studies describing plasma tHcy levels and their relationship to folic acid supplementation and Forced Expiratory Volume in 1 Second (FEV1) status in COPD patients are still lacking.

Aim: We investigated the role of hyperhomocysteinemia in COPD and then prospectively examined the relationship between plasma tHcy concentration and effect of folic acid supplementation on FEV1 status in COPD patients.

Evaluation of BODE index and its relationship with systemic inflammation mediated by proinflammatory biomarkers in patients with COPD.

Introduction: BODE index, a multidimensional grading system which is based on Body mass index, airway Obstruction, Dyspnea scale, and Exercise capacity, has been increasingly used for the evaluation of chronic obstructive pulmonary disease (COPD). Many of the systemic manifestations of COPD are shown to be mediated by elevated levels of proinflammatory biomarkers.

Objective: We aimed to investigate the relationship between the BODE index, its components, disease severity, and proinflammatory biomarkers like C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-6.

Ruptured Sinus of Valsalva with Infective Endocarditis Complicated with Post-Infectious Acute Glomerulonephritis: A Rare Case Presentation.

Ruptured Sinus of Valsalva (RSOV) is a rarely seen disease condition. RSOV can have varied presentations from being asymptomatic with just a cardiac murmur to profound hypotension. There has been simultaneous occurrence of RSOV with Infective Endocarditis (IE) in literature.