Effectiveness and safety of normoxic allogenic umbilical cord mesenchymal stem cells administered as adjunctive treatment in patients with severe COVID-19.

Inflammatory response in COVID-19 contributes greatly to disease severity. Mesenchymal Stem Cells (MSCs) have the potential to alleviate inflammation and reduce mortality and length of stay in COVID-19 patients. We investigated the safety and effectiveness of normoxic-allogenic umbilical cord (NA-UC)-MSCs as an adjunctive treatment in severe COVID-19 patients. A double-blind, multicentric, randomized, placebo-controlled trial involving severe COVID-19 patients was performed from January to June 2021 in three major hospitals across Java, Indonesia. Eligible participants (n = 42) were randomly assigned to two groups (1:1), namely the intervention (n = 21) and control (n = 21) groups. UC-MSCs dose was 1 × 106 /kg body weight on day D0, D3, and D6. The primary outcome was the duration of hospitalization. Meanwhile, the secondary outcomes were radiographical progression (Brixia score), respiratory and oxygenation parameters, and inflammatory markers, in addition to the safety profile of NA-UC-MSCs. NA-UC-MSCs administration did not affect the length of hospital stay of severe COVID-19 patients, nor did it improve the Brixia score or mMRC dyspnoea scale better than placebo. Nevertheless, NA-UC-MSCs led to a better recuperation in oxygenation index (120.80 ± 72.70 baseline vs. 309.63 ± 319.30 D + 22, p = 0.038) and oxygen saturation (97.24 ± 4.10% vs. 96.19 ± 3.75% in placebo, p = 0.028). Additionally, compared to the placebo group, the treatment group had a significantly smaller increase in PCT level at D + 22 (1.43 vs. 12.76, p = 0.011). No adverse effects, including serious ones, were recorded until D + 91. NA-UC-MSCs therapy is a very safe adjunct for COVID-19 patients. It improves the oxygenation profile and carries potential to suppress inflammation.

The effectiveness of ginger extract addition in calorified drinks during perioperative period to nausea severity, vomitus, post-operative anxiety, and metabolic disorder: A randomized control trial.

Background: This study was aimed to evaluate the effect of ginger extract addition to pre-operative high calorie drink to reduce nausea, vomiting, anxiety level, and lactate level as a parameter for metabolic derangement in patients undergoing surgery. Materials and methods: A prospective single-blinded randomized controlled trial design, with a study subject elective surgical procedures patient at the Department of Surgery, Dr Hasan Sadikin Hospital, Bandung. Patient were divided into two groups, group A with standard high calorie drink, and group B standard high calorie drink with ginger extract addition. Anxiety was measured by HARS score and the occurrence of nausea and vomiting were assessed after the operation. The difference of lactate levels was compared before and after operation in two groups. The data distribution was calculated by kolmogorov-smirnov for continues variables. Normal distribution was calculated by t-test, non-normal distribution was calculated by Mann-U Whitney. Nominal data calculated by chi-square test and ordinal data calculated by Mann-U Whitney. Results: 40 subjects were randomly divided into two groups. The occurrence of nausea and vomiting were lower in group B patients (p < 0.0285). HARS score anxiety level was lowered in group B patients (p < 0.0293). Lactate level was lowered in group B patients, although is not statistically significant (p 0.54). Conclusion: Addition of ginger extract in pre-operative high calorie drink reduce postoperative nausea, vomiting, and anxiety level.

Respinos: A Portable Device for Remote Vital Signs Monitoring of COVID-19 Patients.

The rapidly increasing number of COVID-19 patients has posed a massive burden on many healthcare systems worldwide. Moreover, the limited availability of diagnostic and treatment equipment makes it difficult to treat patients in the hospital. To reduce the burden and maintain the quality of care, asymptomatic patients or patients with mild symptoms are advised to self-isolate at home. However, self-isolated patients need to be continuously monitored as their health can turn into critical condition within a short time. Therefore, a portable device that can remotely monitor the condition and progression of the health of these patients is urgently needed. Here we present a portable device, called Respinos, that can monitor multiparameter vital signs including respiratory rate, heart rate, body temperature, and SpO2. It can also operate as a spirometer that measures forced vital capacity (FVC), forced expiratory volume (FEV), FEV in the first second (FEV1), and peak expiratory flow Rate (PEFR) parameters which are useful for detecting pulmonary diseases. The spirometer is designed in the form of a tube that can be ergonomically inflated by the patient, and is equipped with an accurate and disposable turbine based air flow sensor to evaluate the patient's respiratory condition. Respinos uses rechargeable batteries and wirelessly connects to a mobile application whereby the patient's condition can be monitored in real-time and consulted with doctors via chat. Extensive comparison against medical-grade reference devices showed good performance of Respinos. Overall results demonstrate the potential of Respinos for remote patient monitoring during and post pandemic.

A case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis.

Tuberculosis (TB) is a global health problem, in which the majority of cases occur in population-dense developing countries. Despite advances in various diagnostic TB modalities, extrapulmonary TB remains a challenge due to complexities related to its diagnostic approach. Hereby, we present a rare case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis (MTB). This case report highlighted the challenges faced in diagnosing blood culture-negative infective endocarditis (BCNIE). We also emphasized the importance of considering MTB as etiology of BCNIE, particularly in endemic TB areas.