Management of Children Admitted to Hospitals across Bangladesh with Suspected or Confirmed COVID-19 and the Implications for the Future: A Nationwide Cross-Sectional Study.

There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO 'Watch' list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

Fabrication of morphologically modified strong supramolecular nanocomposite antibacterial hydrogels based on sodium deoxycholate with inverted optical activity and sustained release.

Low Molecular Weight (LMWG) gelators are small molecules that form supramolecular self-assembly involving physical forces and are highly biocompatible. However, fragility of these physical gels restricts their applicability where gels of higher mechanical strength are required. Herein, we have developed two different types of 2-D carbon nanomaterials viz. graphene oxide (GO) and carbon nanosheet (CNS) embedded sodium deoxycholate (NaDC) hydrogels. XRD, scanning electron microscopy (SEM), rheology and CD studies suggest significant modification of morphological, mechanical, viscoelastic and optical properties of the nanocomposite gels which is ascribed to the presence of the 2D nanotemplates and participation of different surface functionalities of GO and CNS in the gelation process. The overall shear resistance of both the nanocomposite hydrogels upto a shear rate of 300 shears/s-1 and above reveals tremendously improved mechanical stability with respect to the pure gels. The increased shear strength of the GO/NaDC and CNS/NaDC hydrogels is attributed to their 3-4 times broader and longer ribbon like structures in comparison to the fibrous structure of pure gels. The intact ribbon like morphology and greater entanglement impart 10 folds greater viscosity to GO-NaDC hydrogels as compared to better elasticity of CNS-NaDC hydrogels possessing broken ribbon edges. Most interestingly both GO and CNS influence the optical activity of the gels and presence of GO results in inversion of optical activity. The GO-NaDC gels are also found to demonstrate antibacterial activity against E. coli, and S. aureus. Thus, these extraordinarily modified mechanically strong gels have enhanced potential for use in tissue engineering, enantioselective and sustained drug delivery, topical antibiotics and other biomedical applications.