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   Table of Contents - Current issue
May-August 2021
Volume 2 | Issue 2
Page Nos. 25-60

Online since Monday, July 12, 2021

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Neglected Diseases in the era of COVID-19 pandemic: It's the right time to act together p. 25
Sudip Bhattacharya, Sheikh Mohd Saleem
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Insights into the mechanisms of action of chloroquine and hydroxychloroquine and its use in COVID-19 for chemoprophylaxis p. 27
Monalisa Sahu, Arvind Kumar, Sujay Halkur Shankar, Diksha Patidar, Vishal Kumar Vishwakarma, Pradipt Sahoo, Naveet Wig
The global outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/2019-nCoV) has put forth a serious threat to international public health and has ruined the global economy. Till date, no drugs have been approved for coronavirus disease-2019 (COVID-19), although the use of some drugs in the trial phase has been attempted. The drugs being used for the management of COVID-19 disease include chloroquine (CQ), hydroxychloroquine (HCQ), and remdesivir. In this article, we have aimed to review existing literature and mechanism by which CQ and HCQ have an effect on COVID-19, most importantly by interfering with autophagy, lysosomal activity, receptor binding, and membrane fusion. We have systematically searched the PubMed database up to April 2020 and analyzed all the articles published on CQ, HCQ, and COVID-19. The available data provide insights into the immunomodulatory potency of HCQ, along with the molecular mechanism of action of the drug on the SARS-CoV-2.
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Renin-angiotensin system in the pathogenesis of COVID-19 and possible drug targets p. 33
Sujay Halkur Shankar, Arvind Kumar, Diksha Patidar, Sai Krishna Kanukuntla, Naveet Wig
Coronavirus disease 2019 (COVID-19) is characterized by fever, cough, shortness of breath, myalgia, and headache. The disease also takes a more severe form with life-threatening manifestations of acute respiratory distress syndrome, acute cardiac injury, acute kidney injury, disseminated intravascular coagulopathy, and cytokine storm. It has been elucidated that like its predecessor, the SARS CoV, the SARS CoV-2 utilizes the angiotensin-converting enzyme 2 receptor to enter cells. This knowledge brought into speculation the effects of a dysregulated renin-angiotensin system (RAS) in the pathogenesis of COVID-19. It has been proposed that the effects of a dysregulated RAS would lead to an inflammatory cascade and contribute to the cytokine storm that is central to the disease. This paper looks at the RAS pathway and hypothesizes the possibility of a positive RAS feedback loop in the pathogenesis of COVID-19.
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Evidence-based yoga and ayurveda lifestyle practices for the geriatric population during Coronavirus Disease 2019 pandemic: A narrative p. 38
Praag Bhardwaj, Nitish Pathania, Monika Pathania, Vyas Kumar Rathaur
Coronavirus disease 2019 has had a devastating impact on global health-care systems and the economy. Scientists and medical professionals worldwide are striving to provide for vaccine cures, while the deadly virus continuously mutates and thrives. Immunity being directly co-related to multiple factors such as diet, sleep, lifestyle, and stress; elderly people are at high risk due to factors such as immunosenescence, weakened metabolism, micro-nutrient deficiency, immobility, chronic stress, and comorbidities. The elderly has had the highest morbidity and mortality rates during the pandemic and is the most neglected in general. Holistic and integrative approaches need to be researched for finding safe and risk-free ways that may help counter immune suppression and prevent the vulnerable from getting infected. Yoga and Ayurveda have shown promising results in this regard, although among populations varying in age and health status. However, good-quality clinical trials are needed to strengthen the evidence of yoga for geriatric immunity as online databases of PubMed, Cochrane Library, and Embase showed a paucity of studies when searched for related keywords. Similarly, several aspects of Ayurveda, especially Ahara/food, have vast yet unexplored applications in immune strengthening and developing physical and mental resilience. Primary care physicians can utilize these time-tested techniques as lifestyle modifications along with the standard pharmacological treatment for fulfilling the health-care needs of their patients, especially for the vulnerable elderly, which is the pressing need during this pandemic.
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A cross-sectional study to assess the risk factors for the presence and severity of obstructive sleep apnea among patients with type 2 diabetes mellitus at a tertiary care hospital, Gangtok p. 48
Divij Sharma, Bidita Khandelwal, Sumit Kar
Background and Objectives: Diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are common disorders that not only often coexist but also have a bidirectional association where each condition exacerbates the other. The present study was performed to ascertain the occurrence and predictors of risk factors of OSA in patients with type 2DM. Materials and Methods: A cross-sectional hospital-based study recruiting 164 patients for over 2 months was conducted, in which each diabetic patient was assigned to complete a questionnaire on various variables followed by a general physical examination for associated comorbidities diabetic complications (neuropathy, nephropathy, and retinopathy). Their fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded, following which they were administered and assessed using Berlin Questionnaire and Epworth Sleepiness Score for risk category and daytime sleepiness. Patients with already diagnosed OSA including ones receiving treatment for it were excluded from the study. Results: Of the 164 diabetic patients recruited in the study, 64 (39%) were at high risk for OSA in contrast to the 100 (61%) who were at low risk for OSA. Neck circumference, waist circumference, presence of hypertension and more than one comorbidities along with patients who experienced witnessed apnea at least three times a week, excessive daytime sleepiness, and habitual snorers found to be significant risk factors and practices in posing DM patients at a higher risk for OSA. Patients with body mass index ≥25 were more likely to have a high risk of OSA. FBG and HbA1c were not significant risk factors for OSA. Conclusions: OSA has a high prevalence in subjects with T2DM which reinforces the clinicians to remain observant for signs and symptoms of OSA in diabetic patients and monitor their compliance in terms of weight management, diet control, and medication adherence.
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Impact on mental health among patients with COVID-19: A study from central India p. 55
Arvind Sharma, Aditi Bharti, Tej Pratap Singh, Richa Sharma, Deepali Soni, Priyanka Dubey
Objective: The objective of the study is to assess mental health status and the severity of the depression in patients of COVID-19 admitted to a tertiary care hospital in Jabalpur district. Settings and Design: This cross-sectional study was conducted over a period from April to June 2020 at the NSCB Medical College and Hospital, Jabalpur. Methodology: Out of 150 participants, 135 participants responded whereas 15 patients did not respond as some of them did not answer the calls and remaining did not give their consent. Participants included confirmed COVID-19 cases admitted at a tertiary care hospital, aged 18 years and above. The Patient Health Questionnaire-9 was used to determine depression and was completed through telephonic platform survey. Statistical Analysis Used: SPSS statistical software was used to analyze the data. P <0.05 and <0.001 with 95% confidence interval was considered statistically significant. Results: Among 135 participants, overall depression was found to be 50.4%, out of which, 29.6% were in mild depression, 8.9% were in moderate depression and 11.8% were in moderately severe to severe depression. Females had approximately four times higher risk for depressive symptoms (P <0.001), and for an age group, more than 45 was found to be significantly associated with depression. Conclusion: The present study suggested that about 50% of the people experienced depression. The significant factors found may reveal that more attention should be given to the mental health of the patients with COVID-19, imperatively with psychological care in the treatment protocol to subdue the effects of the pandemic.
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