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Background: Antimicrobial resistance (AMR) has evolved into a severe public health issue that defies all current control strategies and needs multidisciplinary, creative solutions. Antimicrobial stewardship (AMS) activities demand a set of tools and abilities that can be used by health systems. In view of the growing AMR and the difficulty for the surveillance of it in the developing country, this study was conducted to incorporate pharmacovigilance (PV) in the AMS program. Materials and Methods: A cross-sectional pilot study was conducted to collect the PV database of antimicrobials induced adverse drug reactions (ADR) from the Adverse Drug Reactions Monitoring Center (AMC) of the institute for a period of 2 months from August 2022 to September 2022. The information from the database was analyzed to estimate the usage of antibiotics from the PV database from AMC and classified it under the Anatomical Therapeutic Chemical, to assess the rationality of the antimicrobial's usage based on "Access," "Watch," and "Reserve" (AWaRe) classification, and to assess the ADR of the antibiotics. The analysis was done by using the SPSS version 20.0 for Windows. Results: The results showed that the prevalence of ADRs were more in adults' population with preponderance in female. The antibiotics usage was as per with World Health Organization standard and most of the antibiotics used were from the Access group of AWaRe classifications. Tetracyclines and penicillins were the most used antibiotic group of drugs. The number of patients included in the study was 70. Most of the causality assessment was "possible" (62.85%). In the study, almost 90% of the drug was withdrawn and 70% of the patients were in the recovering stage. Conclusion: Using existing PV approaches to address usage of antibiotics and AMR issues would allow PV to progress as a field, and governments will get a stronger return on their PV investments.
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Retroperitoneal spindle cell neoplasms are diagnostically challenging. Malignant peripheral nerve sheath tumours (MPNSTs) can sometimes present as sporadic primary retroperitoneal tumours. MPNSTs are usually high-grade and highly aggressive tumours and are associated with a poor prognosis. Low-grade MPNSTs are very rarely described. This current case report describes a case of sporadic primary low-grade MPNST presenting as retroperitoneal spindle cell neoplasm. The diagnosis, imaging and immunohistopathological findings, as well as its successful surgical management, are presented.
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Neoplasias de la Vaina del Nervio , Neoplasias Retroperitoneales , Humanos , Diagnóstico Diferencial , Clasificación del Tumor , Neoplasias de la Vaina del Nervio/patología , Neoplasias de la Vaina del Nervio/diagnóstico , Neoplasias de la Vaina del Nervio/cirugía , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/diagnóstico , Neoplasias Retroperitoneales/cirugía , Neoplasias Retroperitoneales/diagnóstico por imagen , Sarcoma/diagnóstico , Sarcoma/patología , Sarcoma/cirugía , Sarcoma/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Background and Aim: The traditional drug delivery approach involves systemic administration of a drug that could be nonspecific in targeting, low on efficacy, and with severe side-effects. To address such challenges, the field of smart drug delivery has emerged aiming at designing and developing delivery systems that can target specific cells, tissues, and organs and have minimal off-target side-effects. Methods: A literature search was done to collate papers and reports about the currently available various strategies for smart nano-inspired drug delivery. The databases searched were PubMed, Scopus, and Google Scholar. Based on selection criteria, the most pertinent and recent items were included. Results: Smart drug delivery is a cutting-edge revolutionary intervention in modern medicines to ensure effective and safe administration of therapeutics to target sites. These hold great promise for targeted and controlled delivery of therapeutic agents to improve the efficacy with reduced side-effects as compared to the conventional drug delivery approaches. Current smart drug delivery approaches include nanoparticles, liposomes, micelles, and hydrogels, each with its own advantages and limitations. The success of these delivery systems lies in engineering and designing them, and optimizing their pharmacokinetics and pharmacodynamics properties. Conclusion: Development of drug delivery systems that can get beyond various physiological and clinical barriers, as observed in conventionally administered chemotherapeutics, has been possible through recent advancements. Using multifunctional targeting methodologies, smart drug delivery tries to localize therapy to the target location, reduces cytotoxicity, and improves the therapeutic index. Rapid advancements in research and development in smart drug delivery provide wider and more promising avenues to guarantee a better healthcare system, improve patient outcomes, and achieve higher levels of effective medical interventions like personalized medicine.
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Acceptor-donor-acceptor (A-D-A) molecular rotors have drawn substantial attention for their applications in monitoring temperature variations within cellular microenvironments, biomimetic photocatalysis, and bioimaging. In this study, we have synthesized two novel rotor molecules, NBN1 and NBN2, by incorporating benzodithiophene (BDT) as the donor core and naphthalic anhydride/naphthalimide (NA/NI) moieties as acceptors using Pd-catalyzed Stille coupling reactions. These molecules exhibited distinct charge transfer (CT) behavior in both their absorption and emission spectra and displayed prominent emission solvatochromism. Notably, NBN1 exhibited better CT properties among the two molecules. Moreover, these A-D-A molecular rotors demonstrated remarkable sensitivities of their emission spectra toward solvent polarities and temperatures. Rotors NBN1 and NBN2 showed positive temperature coefficients with internal temperature sensitivities of 0.34% °C-1 and 0.13% °C-1 in chloroform, respectively, and thus hold significant promise for detecting temperature variations in cellular microenvironment. Furthermore, we have modeled these molecules with graphitic carbon nitride (g-C3N4) to form composite systems and performed theoretical calculations to obtain valuable insights into their charge transfer behavior. Theoretical results suggested that these molecules have the potential to efficiently sensitize and modulate the band gap of g-C3N4 and show potential for diverse photocatalytic applications.
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Cardiovascular disease (CVD) is the most common cause of morbidity and mortality worldwide. Bromocriptine is a partial antagonist for D1 dopamine receptors while also serving as a selective agonist on D2 dopamine receptors as a dopamine receptor agonist. Apart from prolactin inhibiting action, bromocriptine has some beneficial effects on the blood pressure, plasma norepinephrine levels and vascular resistance. Dopamine D2 receptor activation of bromocriptine is associated with the antihypertensive effect, which lowers blood pressure via inhibiting sympathetic nerve activity and Na/K ATPase activity. Plasma levels of the pro-inflammatory cytokines such as interleukin (IL)-1B and IL-18, chemokine CCL2/ MCP-1/, and the pro-inflammatory hormone prolactin, all of which are elevated and linked to accelerated cardiometabolic illness, were decreased because of bromocriptine therapy. The most common side effects of Bromocriptine use are dizziness, nausea, headache, vomiting and hypotension. Bromocriptine is mainly contraindicated in patients with syncope with hypotension, psychosis, and type I diabetes mellitus. The authors suggest that developing therapies directed to increase D2 receptor expression and function by drugs like Bromocriptine can provide practical and novelistic approaches to prevent and manage myocardial and renal injury in the cardiovascular disease patients.
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Discrete symmetries play an important role in particle physics with violation of CP connected to the matter-antimatter imbalance in the Universe. We report the most precise test of P, T and CP invariance in decays of ortho-positronium, performed with methodology involving polarization of photons from these decays. Positronium, the simplest bound state of an electron and positron, is of recent interest with discrepancies reported between measured hyperfine energy structure and theory at the level of 10-4 signaling a need for better understanding of the positronium system at this level. We test discrete symmetries using photon polarizations determined via Compton scattering in the dedicated J-PET tomograph on an event-by-event basis and without the need to control the spin of the positronium with an external magnetic field, in contrast to previous experiments. Our result is consistent with QED expectations at the level of 0.0007 and one standard deviation.
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PURPOSE: The aim of this work is to investigate the feasibility of the Jagiellonian Positron Emission Tomography (J-PET) scanner for intra-treatment proton beam range monitoring. METHODS: The Monte Carlo simulation studies with GATE and PET image reconstruction with CASToR were performed in order to compare six J-PET scanner geometries. We simulated proton irradiation of a PMMA phantom with a Single Pencil Beam (SPB) and Spread-Out Bragg Peak (SOBP) of various ranges. The sensitivity and precision of each scanner were calculated, and considering the setup's cost-effectiveness, we indicated potentially optimal geometries for the J-PET scanner prototype dedicated to the proton beam range assessment. RESULTS: The investigations indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for clinical application. We found that the scanner sensitivity is of the order of 10-5 coincidences per primary proton, while the precision of the range assessment for both SPB and SOBP irradiation plans was found below 1 mm. Among the scanners with the same number of detector modules, the best results are found for the triple-layer dual-head geometry. The results indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for the clinical application, CONCLUSIONS:: We performed simulation studies demonstrating that the feasibility of the J-PET detector for PET-based proton beam therapy range monitoring is possible with reasonable sensitivity and precision enabling its pre-clinical tests in the clinical proton therapy environment. Considering the sensitivity, precision and cost-effectiveness, the double-layer cylindrical and triple-layer dual-head J-PET geometry configurations seem promising for future clinical application.
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Terapia de Protones , Protones , Estudios de Factibilidad , Tomografía de Emisión de Positrones , Terapia de Protones/métodos , Fantasmas de Imagen , Método de MontecarloRESUMEN
The design and synthesis of four twisted donor-acceptor (D-A) thermally activated delayed fluorescence (TADF) molecules CBZ-IQ, CBZ-2FIQ, DI-IQ and DI-2FIQ is reported in this work based on diindolocarbazole (DI) and phenyl carbazole as donor and indoloquinoxalines as acceptor. These compounds serve as photocatalysts for organic transformations. Theoretical calculations and experimental data showed reasonable singlet and triplet energy gaps of 0.17-0.26â eV for all compounds. All molecules showed increase in fluorescence quantum yields after degassing the solution and the transient photoluminescence decay showed two components: shorter prompt components (11.4â ns to 31â ns) and longer delayed components (36.4â ns to 1.5 µs) which further indicate the occurrence of TADF process. Cyclic voltammetry studies indicated well-suited excited state redox potentials of all compounds to catalyze organic transformations such as heteroarene arylation. Accordingly, photocatalytic C-H arylation of heteroarenes were performed using these compounds with excellent isolated yields of upto 80 %. Due to their suitable efficient triplet energy levels, all the emitters were also employed as energy transfer photocatalysts in E to Z isomerization of stilbene with the excellent conversion of ~90 %.
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The COVID-19 pandemic, caused by SARS-CoV-2, has profoundly affected developing countries like India. This retrospective cross-sectional analysis investigated epidemiological, clinical characteristics, treatment strategies, and outcomes for hospitalized COVID-19 patients during the Massive SARS-CoV-2 Wave in India. Among 233 patients, the median age was 47.33 years, mostly male. Hospital stays averaged 8.4 days. Common symptoms include fever (88.41%), dry cough (56.2%), myalgia (44.20%), and shortness of breath (22.8%). The most common comorbidities were diabetes mellitus (52%) and hypertension (47.2%). Elevated biomarkers include D-dimer (24.4%), CRP (32.1%), ferritin (26.60%), and others. Prescription analysis revealed that antibiotics (42.6%), Antivirals (37%), anthelmintics (20.30%), vitamins and nutritional supplements (20.71%) and glucocorticoids (12.8%) were the most commonly prescribed. Oxygen therapy was needed by 19.31% of patients in the moderate and severe categories within 24 hours of admission. The mortality rate was 8.58%. The surge led to increased hospitalizations and mortality, particularly among young adults. Diabetes and hypertension were correlated with mortality. Irregular use of drugs lacking evidence, like antibiotics and anthelmintics, vitamins and nutritional supplements, was observed in COVID-19 management. This study underscores the impact of the pandemic in India and highlights the need for evidence-based treatments.
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In positron emission tomography (PET) studies, convolutional neural networks (CNNs) may be applied directly to the reconstructed distribution of radioactive tracers injected into the patient's body, as a pattern recognition tool. Nonetheless, unprocessed PET coincidence data exist in tabular format. This paper develops the transformation of tabular data into n-dimensional matrices, as a preparation stage for classification based on CNNs. This method explicitly introduces a nonlinear transformation at the feature engineering stage and then uses principal component analysis to create the images. We apply the proposed methodology to the classification of simulated PET coincidence events originating from NEMA IEC and anthropomorphic XCAT phantom. Comparative studies of neural network architectures, including multilayer perceptron and convolutional networks, were conducted. The developed method increased the initial number of features from 6 to 209 and gave the best precision results (79.8) for all tested neural network architectures; it also showed the smallest decrease when changing the test data to another phantom.
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Cohort studies have shown that both overweight and obesity have their impact by increasing hospitalization with COVID-19. We conducted a systematic literature search in PubMed, Google Scholar, and MedRxiv databases following the PRISMA guidelines. Statistical analyses were performed using STATA software version 16 MP (Stata Corp, College Station, TX, USA) and Med Calc software version 22.009(Med Calc software Ltd, Ostend, Belgium). The primary outcome was to measure the prevalence of overweight and obesity and their impact on the risk of hospitalization among COVID-19 patients under and above 50 years of age. In total, 184 studies involving 2,365,377 patients were included. The prevalence of overweight was highest among those younger than 50 years of age over those older than 50 years of age, (26.33% vs. 30.46%), but there was no difference in obesity (36.30% vs. 36.02%). Overall, the pooled prevalence of overweight and obesity among hospitalized COVID-19 patients was 31.0% and 36.26%, respectively. Compared with normal weight, the odds of hospitalization with overweight (odds ratio [OR] 2.186, 95% confidence interval [CI] [1.19, 3.99], p < 0.01) and obesity (OR 3.069, 95% CI [1.67, 5.61], p < 0.001) in those younger than 50 years and obesity (OR 3.977, 95% CI [2.75, 5.73], p < 0.001) in the older than 50 years age group were significantly high. The increased prevalence of overweight and obesity among the under 50 years age group and obesity among the older than 50 years age group significantly increased the rate of COVID-19 infections, severity and hospitalization.
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COVID-19 , Sobrepeso , Humanos , Persona de Mediana Edad , Sobrepeso/epidemiología , COVID-19/epidemiología , Prevalencia , Obesidad/epidemiología , HospitalizaciónRESUMEN
Micronutrient deficiency is a serious health issue in resource-poor human populations worldwide, which is responsible for the death of millions of women and underage children in most developing countries. Zinc (Zn) malnutrition in middle- and lower-class families is rampant when daily calorie intake of staple cereals contains extremely low concentrations of micronutrients, especially Zn and Fe. Looking at the importance of the problem, the present investigation aimed to enhance the growth, yield, nutrient status, and biofortification of wheat crop by inoculation of native zinc-solubilizing Bacillus spp. in conjunction with soil-applied fertilizers (NPK) and zinc phosphate in saline soil. In this study, 175 bacterial isolates were recovered from the rhizosphere of wheat grown in the eastern parts of the Indo-Gangetic Plain of India. These isolates were further screened for Zn solubilization potential using sparingly insoluble zinc carbonate (ZnCO3), zinc oxide (ZnO), and zinc phosphate {Zn3(PO4)2} as a source of Zn under in vitro conditions. Of 175 bacterial isolates, 42 were found to solubilize either one or two or all the three insoluble Zn compounds, and subsequently, these isolates were identified based on 16S rRNA gene sequences. Based on zone halo diameter, solubilization efficiency, and amount of solubilized zinc, six potential bacterial strains, i.e., Bacillus altitudinis AJW-3, B. subtilis ABW-30, B. megaterium CHW-22, B. licheniformis MJW-38, Brevibacillus borstelensis CHW-2, and B. xiamenensis BLW-7, were further shortlisted for pot- and field-level evaluation in wheat crop. The results of the present investigation clearly indicated that these inoculants not only increase plant growth but also enhance the yield and yield attributes. Furthermore, bacterial inoculation also enhanced available nutrients and microbial activity in the wheat rhizosphere under pot experiments. It was observed that the application of B. megaterium CHW-22 significantly increased the Zn content in wheat straw and grains along with other nutrients (N, P, K, Fe, Cu, and Mn) followed by B. licheniformis MJW-38 as compared to other inoculants. By and large, similar observations were recorded under field conditions. Interestingly, when comparing the nutrient use efficiency (NUE) of wheat, bacterial inoculants showed their potential in enhancing the NUE in a greater way, which was further confirmed by correlation and principal component analyses. This study apparently provides evidence of Zn biofortification in wheat upon bacterial inoculation in conjunction with chemical fertilizers and zinc phosphate in degraded soil under both nethouse and field conditions.
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Mpox (previously known as Monkeypox) has recently re-emerged, primarily through human-to-human transmission in non-endemic countries including India. Virus isolation is still considered as the gold standard for diagnosis of viral infections. Here, the qPCR positive skin lesion sample from a patient was inoculated in Vero E6 cell monolayer. Characteristic cytopathic effect exhibiting typical cell rounding and detachment was observed at passage-02. The virus isolation was confirmed by qPCR. The replication kinetics of the isolate was determined that revealed maximum viral titre of log 6.3 PFU/mL at 72 h postinfection. Further, whole genome analysis through next generation sequencing revealed that the Mpox virus (MPXV) isolate is characterized by several unique SNPs and INDELs. Phylogenetically, it belonged to A.2 lineage of clade IIb, forming a close group with all other Indian MPXV along with few from USA, UK, Portugal, Thailand and Nigeria. This study reports the first successful isolation and phenotypic and genotypic characterization of MPXV from India.
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Monkeypox virus , Humanos , Pueblo Asiatico , Efecto Citopatogénico Viral , Genotipo , India , Monkeypox virus/genética , Monkeypox virus/aislamiento & purificación , Monkeypox virus/patogenicidad , Personas del Sur de Asia , Mpox/diagnóstico , Mpox/genética , Mpox/fisiopatología , Mpox/virologíaRESUMEN
This study examines the uranium, fluoride, and nitrate dispositions in groundwater as well as potential health risks in Kota district, Rajasthan, India. Total 198 groundwater samples were collected in both dry and wet periods and analyzed for physicochemical parameters along with U, F-, and NO3- using standard methods. Results indicate that the electrical conductivity, total dissolved solids, total hardness, alkalinity, Ca2+, Mg2+, HCO3-, Cl-, NO3-, and F- exceed the WHO standard limits of drinking water in both periods. Uranium concentration is at the broader of drinking water permissible limit (30 µg/L) and found about 1.05 times more. Nitrate and fluoride concentrations ranged from 9.8 to 412.0 mg/L and 0.1 to 4.0 mg/L for the dry season, while in the wet period, they varied from 10.0 to 954.0 mg/L and 0.1 to 3.5 mg/L, respectively. Correlation studies show a significantly strong positive correlation between uranium and total alkalinity and carbonate. Natural background levels (NBLs) were explored to assess the source of groundwater pollution. It shows that the second inflection points of NBLs estimated for NO3-, F-, and U are about 168 mg/L, 1.2 mg/L, and 7.3 µg/L, respectively, during the experimental period. The USEPA technique was used to evaluate the non-carcinogenic health risks associated with consuming the NO3- and F--contaminated groundwater. The health risks in Kota district show that children are more at risk than adults. The risk assessment of uranium reveals that the excess cancer risk (ECR) and hazard quotient (HQ) are found to be below the standard limits, but a high concentration of uranium (31.6 µg/L) is observed at Amarpura village of Digod block. This study will provide a baseline of uranium, fluoride, and nitrate dispositions in groundwater for simulating mass transport model and safe use of drinking water.
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Agua Potable , Agua Subterránea , Uranio , Contaminantes Químicos del Agua , Niño , Adulto , Humanos , Fluoruros/análisis , Nitratos/análisis , Agua Potable/análisis , Monitoreo del Ambiente/métodos , India , Contaminantes Químicos del Agua/análisis , Medición de RiesgoRESUMEN
OBJECTIVE: The Jagiellonian PET (J-PET) technology, based on plastic scintillators, has been proposed as a cost effective tool for detecting range deviations during proton therapy. This study investigates the feasibility of using J-PET for range monitoring by means of a detailed Monte Carlo simulation study of 95 patients who underwent proton therapy at the Cyclotron Centre Bronowice (CCB) in Krakow, Poland. Approach: Discrepancies between prescribed and delivered treatments were artificially introduced in the simulations by means of shifts in patient positioning and in the Hounsfield unit to the relative proton stopping power calibration curve. A dual-layer, cylindrical J-PET geometry was simulated in an in-room monitoring scenario and a triple-layer, dual-head geometry in an in-beam protocol. The distribution of range shifts in reconstructed PET activity was visualised in the beam's eye view. Linear prediction models were constructed from all patients in the cohort, using the mean shift in reconstructed PET activity as a predictor of the mean proton range deviation. Main results: Maps of deviations in the range of reconstructed PET distributions showed agreement with those of deviations in dose range in most patients. The linear prediction model showed a good fit, with coefficient of determination r^2 = 0.84 (in-room) and 0.75 (in-beam). Residual standard error was below 1 mm: 0.33 mm (in-room) and 0.23 mm (in-beam). Significance: The precision of the proposed prediction models shows the sensitivity of the proposed J-PET scanners to shifts in proton range for a wide range of clinical treatment plans. Furthermore, it motivates the use of such models as a tool for predicting proton range deviations and opens up new prospects for investigations into the use of intra-treatment PET images for predicting clinical metrics that aid in the assessment of the quality of delivered treatment. .
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A COVID-19 patient often presents with multiple comorbidities and is associated with adverse outcomes. A comprehensive assessment of the prevalence of comorbidities in patients with COVID-19 is essential. This study aimed to assess the prevalence of comorbidities, severity and mortality with regard to geographic region, age, gender and smoking status in patients with COVID-19. A systematic review and multistage meta-analyses were reported using PRISMA guidelines. PubMed/MEDLINE, SCOPUS, Google Scholar and EMBASE were searched from January 2020 to October 2022. Cross-sectional studies, cohort studies, case series studies, and case-control studies on comorbidities reporting among the COVID-19 populations that were published in English were included. The pooled prevalence of various medical conditions in COVID-19 patients was calculated based on regional population size weights. Stratified analyses were performed to understand the variations in the medical conditions based on age, gender, and geographic region. A total of 190 studies comprising 105 million COVID-19 patients were included. Statistical analyses were performed using STATA software, version 16 MP (StataCorp, College Station, TX). Meta-analysis of proportion was performed to obtain pooled values of the prevalence of medical comorbidities: hypertension (39%, 95% CI 36-42, n = 170 studies), obesity (27%, 95% CI 25-30%, n = 169 studies), diabetes (27%, 95% CI 25-30%, n = 175), and asthma (8%, 95% CI 7-9%, n = 112). Moreover, the prevalence of hospitalization was 35% (95% CI 29-41%, n = 61), intensive care admissions 17% (95% CI 14-21, n = 106), and mortality 18% (95% CI 16-21%, n = 145). The prevalence of hypertension was highest in Europe at 44% (95% CI 39-47%, n = 68), obesity and diabetes at 30% (95% CI, 26-34, n = 79) and 27% (95%CI, 24-30, n = 80) in North America, and asthma in Europe at 9% (95% CI 8-11, n = 41). Obesity was high among the ≥ 50 years (30%, n = 112) age group, diabetes among Men (26%, n = 124) and observational studies reported higher mortality than case-control studies (19% vs. 14%). Random effects meta-regression found a significant association between age and diabetes (p < 0.001), hypertension (p < 0.001), asthma (p < 0.05), ICU admission (p < 0.05) and mortality (p < 0.001). Overall, a higher global prevalence of hypertension (39%) and a lower prevalence of asthma (8%), and 18% of mortality were found in patients with COVID-19. Hence, geographical regions with respective chronic medical comorbidities should accelerate regular booster dose vaccination, preferably to those patients with chronic comorbidities, to prevent and lower the severity and mortality of COVID-19 disease with novel SARS-CoV-2 variants of concern (VOC).
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Asma , COVID-19 , Diabetes Mellitus , Hipertensión , Masculino , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Prevalencia , Estudios Transversales , Diabetes Mellitus/epidemiología , Hipertensión/epidemiología , Obesidad/epidemiología , Asma/epidemiología , FumarRESUMEN
INTRODUCTION: Diabetes mellitus (DM) and the 2019 coronavirus (COVID-19) appear to interact in both directions. There is mounting proof that patients with DM have a worse COVID-19 prognosis than those without it. Pharmacotherapy is also known to affect in view of the possible interplay between drugs and the pathophysiology of the above conditions in a given patient. AREAS COVERED: In this review, we discuss the pathogenesis of COVID-19 and its connections with diabetes mellitus. We also analyze the treatment modalities for COVID-19 and diabetes patients. The possible mechanisms of the different medications and their management limitations are also systematically reviewed. EXPERT OPINION: COVID-19 management as well as its knowledge base is changing constantly. The Pharmacotherapy and the choice of drugs also need to be specifically considered in view of the concomitant presence of these conditions in a patient. Anti-diabetic agents must be carefully evaluated in diabetic patients in view of the disease's severity, blood glucose level, appropriate treatment, and other components that could aggravate adverse events. A methodical technique is anticipated to enable the safe and rational use of drug therapy in COVID-19-positive diabetic patients to take.
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COVID-19 , Diabetes Mellitus , Humanos , COVID-19/complicaciones , Diabetes Mellitus/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , PronósticoRESUMEN
INTRODUCTION: Diabetes mellitus (DM) and the 2019 coronavirus (COVID-19) appear to interact in both directions. There is mounting proof that patients with DM have a worse COVID-19 prognosis than those without it. Pharmacotherapy is also known to affect in view of the possible interplay between drugs and the pathophysiology of the above conditions in a given patient. AREAS COVERED: In this review, we discuss the pathogenesis of COVID-19 and its connections with diabetes mellitus. We also analyze the treatment modalities for COVID-19 and diabetes patients. The possible mechanisms of the different medications and their management limitations are also systematically reviewed. EXPERT OPINION: COVID-19 management as well as its knowledge base is changing constantly. The Pharmacotherapy and the choice of drugs also need to be specifically considered in view of the concomitant presence of these conditions in a patient. Anti-diabetic agents must be carefully evaluated in diabetic patients in view of the disease's severity, blood glucose level, appropriate treatment, and other components that could aggravate adverse events. A methodical technique is anticipated to enable the safe and rational use of drug therapy in COVID-19-positive diabetic patients to take.