ABSTRACT
Introduction: Remdesivir and Tocilizumab are two experimental drugs used in severely ill COVID-19 patients. Various clinical trials studying these drugs are giving conflicting results. Our aim is to study these two drugs and share the experience in our setting. Methods: Our Study is a retrospective analysis of Clinico-laboratory details and outcome of three groups of patients who were given either (i) Remdesivir or (ii) Tocilizumab or (iii)both Remdesivir and Tocilizumab . We compared the outcome of these patients with other patients who did not receive either of these drugs, when it was not available or not introduced as experimental drugs earlier in treatment guidelines. Results: Out of a total of 521 patients, in the above three groups who received either or both Remdesivir or Tocilizumab, 334 survived. Out of 214 patients who did not receive any of the two drugs only 74 survived. The outcome was better individually for all the three groups of patients receiving either or both of the drugs as compared to neither of the drugs.(p <0.01) Conclusion: Remdesivir and Tocilizumab were useful drugs in treatment of severely ill covid -19 patients as compared with the patients who did not receive any of the above drugs.
Subject(s)
COVID-19 Drug Treatment , Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antibodies, Monoclonal, Humanized , Humans , Retrospective Studies , SARS-CoV-2ABSTRACT
A 45 years old female on allopurinol for 3 months presented with itching, rash, facial oedema and eosinophilia with hepatic and renal dysfunction. Skin biopsy revealed interface dermatitis, suggesting the diagnosis of DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome.
Subject(s)
Allopurinol/adverse effects , Drug Hypersensitivity Syndrome/etiology , Allopurinol/therapeutic use , Biopsy , Diagnosis, Differential , Drug Hypersensitivity Syndrome/diagnosis , Female , Gout Suppressants/adverse effects , Gout Suppressants/therapeutic use , Humans , Hyperuricemia/drug therapy , Middle Aged , Skin/pathologyABSTRACT
Suprasellar tuberculomas are exceptionally rare. We present the case of a middle aged male who presented with generalised apathy and meningism of two weeks duration. Neuroimaging was suggestive of tuberculomas in suprasellar cistern, while endocrinological investigation showed panhypopituitarism manifesting as pituitary hypothyroidism, hypocortisolism, and hyperprolactinemia. Cerebrospinal fluid examination showed lymphocytic reaction with raised proteins. A diagnosis of suprasellar tuberculoma with panhypopituitarism was made. The patient was started on antituberculous treatment and hormone replacement which led to remarkable improvement in condition of patient and resolution of tuberculous granuloma in follow up imaging.
Subject(s)
Tuberculoma, Intracranial/complications , Tuberculoma, Intracranial/diagnosis , Antitubercular Agents/therapeutic use , Cerebrospinal Fluid , Diagnosis, Differential , Drug Therapy, Combination , Hormone Replacement Therapy , Humans , Hyperprolactinemia/diagnostic imaging , Hypopituitarism/diagnostic imaging , Hypopituitarism/etiology , Hypothyroidism , Magnetic Resonance Imaging , Male , Middle Aged , Tomography, X-Ray Computed , Tuberculoma, Intracranial/drug therapy , Tuberculoma, Intracranial/pathologyABSTRACT
Isoniazid (INH) is an integral component of treatment of tuberculosis. An acute overdose is potentially fatal and is characterized by the clinical triad of repetitive seizures unresponsive to the usual anticonvulsants, metabolic acidosis with a high anion gap and coma. The diagnosis of INH overdose should be considered in any patient who presents to emergency medical services (EMS) with the triad. We report a patient presenting with multiple generalised tonic clonic (GTC) convulsions with severe metabolic acidosis as a manifestation of INH toxicity.
