RESUMO
BACKGROUND AND OBJECTIVES: Assessing the co-infections with COVID-19 is crucial to delineate its true clinical impact. Pediatric information in this aspect is limited. Our study aims to analyze the spectrum of co-infections in pediatric COVID-19 patients and determine the clinical as well as laboratory parameters predicting co-infection. METHODOLOGY: In this prospective observational study conducted from June to December 2020 in a single tertiary care institution, data pertaining to demographic, illness and treatment-related variables were analyzed among two subsets of pediatric patients of age 1 month-12 years with RT-PCR-confirmed COVID-19 infection-Group A: those with confirmed co-infection and Group B: moderate to severe disease without co-infection. Among Group A, etiology of co-infection was characterized through relevant microbiological examination within 48 h admission. RESULT: Among our study population, 15.03% and 20.6% had co-infections and moderate to severe disease respectively. Among those with confirmed co-infection, 32.5%, 11.6% and 6.97% recorded blood culture, respiratory secretion and CSF growth, respectively, the picture being dominated by Methicillin resistant and sensitive Staphylococcus aureus. Serum serology demonstrated Scrub typhus infection to be most prevalent. Concurrent respiratory viral infections were seen in 11.6%. Children with co-infection had significantly higher morbidity and need for supportive therapy. Predictors of co-infection were localization of infection, Neutrophil count ≥10×109, age-specific lymphopenia, CRP > 100 mg/dl and hyperferritinemia. CONCLUSION: Co-infections are an important factor prognosticating pediatric COVID infection. Their early detection, prompt and appropriate treatment is of paramount importance.
Assuntos
COVID-19 , Coinfecção , Infecções Estafilocócicas , Criança , Coinfecção/epidemiologia , Humanos , Estudos Prospectivos , SARS-CoV-2 , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologiaRESUMO
The objective of this study was to describe clinico-laboratory parameters, outcome and predictors of scrub typhus co- infection in COVID-19 affected children. Ours was a retrospective analysis done in a tertiary care pediatric COVID facility. COVID-19 positive children in the age group of 1 month to 12 years who were tested for scrub typhus co-infection between May to August 2020 were included in the study. In all positive cases, clinical, laboratory, treatment and outcome data were analyzed. Relevant data were compared between scrub typhus confirmed, and suspected but negative patients. All six patients with co-infection had fever for >5 days and four had features of cerebral involvement. These had lymphocytic pleocytosis in cerebrospinal fluid (CSF) analysis and two had eschar. Screening for scrub typhus in persistently febrile children residing in highly endemic areas is highly recommended.
Assuntos
COVID-19 , Coinfecção , Tifo por Ácaros , Humanos , Criança , COVID-19/diagnóstico , Coinfecção/diagnóstico , Coinfecção/epidemiologia , Estudos Retrospectivos , Tifo por Ácaros/complicações , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/tratamento farmacológico , Febre/diagnóstico , Febre/etiologiaRESUMO
CONTEXT: Pre-hypertension remains a significant public health challenge and appropriate intervention is required to stop its progression to hypertension and/or cardiovascular diseases. OBJECTIVE: To study the effects of individualized homeopathic medicines (IH) against placebo in intervening with the progression of pre-hypertension to hypertension. DESIGN: Double-blind, randomized, two parallel arms, placebo-controlled trial. SETTING: Outpatient departments of D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India. PATIENTS: Ninety-two patients suffering from pre-hypertension; randomized to receive either IH (n = 46) or identical-looking placebo (n = 46). INTERVENTIONS: IH or placebo in the mutual context of lifestyle modification (LSM) advices including dietary approaches to stop hypertension (DASH) and brisk exercises. MAIN OUTCOME MEASURES: Primary - systolic and diastolic blood pressure (SBP and DBP); secondary - Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2) scores; all measured at baseline, and every month, up to 3 months. RESULTS: After 3 months of intervention, the number of patients having progression from pre-hypertension to hypertension between groups were similar without any significant differences in between (all P>0.05). Reduction in BP and MYMOP-2 scores were non-significantly higher (all P>0.05) in the IH group than placebo with small effect sizes. Lycopodium clavatum, Thuja occidentalis and Natrum muriaticum were the most frequently prescribed medicines. No harms or serious adverse events were reported from either group. Thus, there was a small, but non-significant direction of effect favoring homeopathy, which ultimately rendered the trial as inconclusive. [Trial registration: CTRI/2018/10/016,026; UTN: U1111-1221-8251].
Assuntos
Homeopatia , Hipertensão , Materia Medica , Pré-Hipertensão , Método Duplo-Cego , Humanos , Hipertensão/tratamento farmacológico , Materia Medica/uso terapêutico , Pré-Hipertensão/tratamento farmacológico , Resultado do TratamentoRESUMO
The emergence of organic-inorganic hybrid perovskites (OHPs) has revolutionised the potential performance of optoelectronic devices; most perovskites are opaque and hence incompatible with transparent optoelectronics and sensitive to environmental degradation. Here, we have reported a single-step fabrication of ultra-long MAPbI3 perovskite microwire arrays over a large area using stencil lithography based on sequential vacuum sublimation. The environmental stability of MAPbI3 is empowered with a newly designed and synthesized transparent supramolecular self-assembly based on a mixture of two tripodal l-Phe-C11H23/C7F15 molecules, which showed a contact angle of 105° and served as ultra-hydrophobic passivation layers for more than 45 days in an ambient atmosphere. The MAPbI3 microwire arrays passivated with the supramolecular self-assembly demonstrated for the first time both excellent transparency of â¼89% at 550 nm and a remarkable photoresponse with a photo-switching ratio of â¼104, responsivity of 789 A W-1, detectivity of 1014 Jones, linear dynamic range of â¼122 dB, and rise time of 432 µs. Furthermore, the photodetector fabricated on a flexible PET substrate demonstrated robust mechanical flexibility even beyond 1200 bending cycles. Therefore, the scalable stencil lithography and supramolecular passivation approaches have the potential to deliver next-generation transparent, flexible, and stable optoelectronic devices.