Systemic Review and Meta-Analysis to Evaluate Therapeutic Effectiveness of Interferon Beta-1b in Hospitalized COVID-19 Patients.

The COVID-19 pandemic has caused havoc in the health sector. Inflammatory cytokines play an important role in the disease condition. Existing evidence has provided certain insights into the repurposing of the drugs. This meta-analysis and systematic review aimed to explore the efficacy of the administration of interferon beta-1b (IFN ß-1b) and standard care versus only standard care as the therapeutic agent for managing COVID-19 patients who are severely ill. The search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, and Google Scholar, which were published during the period January 1, 2020, to February 16, 2023. All the included three studies were independently assessed for eligibility. The modified data extraction form of Cochrane were used. The quality of the three included studies was assessed using the Cochrane risk of bias tool. GradePro software was used to summarize the quality grading of the primary outcome measures. The time taken for clinical improvement was (MD: -3.28 days; 95% CI: -5.65, -0.91; P value = 0.007) when treated with IFN ß-1b. The duration of hospital stays (MD: -2.43 days; 95% CI: -4.45, -0.30; P value = 0.03), and need for intensive care unit (ICU) admission (RR: 0.71; 95% CI: 0.52, 0.97; P value = 0.03) was statistically significant. Interferon beta-1b is proven to reduce the duration of hospital stay, and the improved clinical status may become a cornerstone of COVID-19 treatment.

A Cross-Sectional Study Investigating the Association of Serum Iron Concentration and Platelet Count as a Risk Biomarker among the Pregnancy-Induced Hypertensive Women in the Highlands Western Ghats of Nilgiris.

Background: The elevated serum iron levels and reduced platelet count at 20-24th week of gestation period cause oxidative stress that leads to the pregnancy-induced hypertension (PIH). Objectives: The objective is to determine the prevalence of serum iron concentration, decrease in platelet count, and its association with PIH. Methods: A cross-sectional study was conducted in the secondary care hospital of Udhagamandalam. A total of 150 study participants were enrolled. Descriptive analysis was performed for demographic characteristics. The Pearson Chi-square test was performed for categorical variables. To measure the strength of the association between the two variables, Pearson's correlation test and logistic regression analysis were performed. Results: The mean serum iron levels in both the groups were 99.01 ± 12.86 ug/dL and 82.76 ± 18.95 ug/dL, respectively, at a P value of 0.005. The platelet count (96.34 ± 9.77 vs. 116.68 ± 23.55) was significantly lower in PIH group. A moderate and weak correlation was seen between serum iron levels and systolic blood pressure (SBP) (r = 0.435; P = 0.01) and diastolic blood pressure (DBP) (r = 0.435; P = 0.01). Moderate negative correlation was observed between SBP, DBP, and platelet count. The risk of developing PIH is 6.76 times due to increased serum iron levels and 3.67 due to decreased platelet count. Conclusion: The serum iron levels were elevated, and the platelet indices were reduced in the PIH group. This should be considered a possible risk biomarker for PIH.

Systematic review and meta-analysis of potential pleiotropic effects of sevelamer in chronic kidney disease: Beyond phosphate control.

Sevelamer, has been shown to have many pleiotropic actions on lipid panel, various inflammatory markers, and blood glucose levels in chronic kidney disease patients. We conducted a systematic review and meta-analysis to compare these pleiotropic effects of sevelamer to other phosphate binders used in chronic kidney disease patients. The relevant randomized controlled trials published from 1 January 2001 to 31 November 2019 on the following databases: Cochrane Central Register of Controlled Trials published in The Cochrane Library, PubMed, Scopus and Google Scholar were identified. All the included studies were independently assessed for eligibility and risk of bias. The modified data extraction form of Cochrane was used. This review included 44 studies for qualitative analysis and 28 reports for quantitative analysis. A meta-analysis of three studies (n = 180) showed that glycated haemoglobin had significantly decreased in sevelamer-treated patients (MD: 0.5%; p = <.001). Compared with calcium-based phosphate binders, sevelamer showed a significant reduction in low-density lipoprotein (MD: -19.43 mg/dL; p = <.001) and total cholesterol (MD: -19.98 mg/dL; p < .001). A significant increase in high-density lipoprotein (MD: 1.29 mg/dL; p = .05) was also prominent in sevelamer treated patients. However, we were not able to observe a significant change in other biochemical parameters such as TG, CRP, hs-CRP, FGF-23, IL-6 and albumin as, no statistically significant difference was observed.

A Study on the Assessment of Impact of COVID-19 Pandemic on Depression: An Observational Study among the Pregnant Women.

BACKGROUND: COVID-19 pandemic has affected the pregnant women both physically and mentally. This study is conducted to assess, the impact on COVID-19 pandemic on psychiatric symptoms among pregnancy and to compare them with non-pregnant women. METHODS: An observational study was conducted at Govt. Medical College & Hospital, Ooty (Udhagamandalam). A validated Edinburgh Depression Scale was used to screen the mental health status. Categorical variables were analysed using Chi-square test and continuous variables by independent t test. A Pearson's correlation analysis was performed to check the association of Edinburgh postnatal depression scores with the demographic characteristics. Paired t test was conducted to find the difference in EPDS scores at baseline and study conclusion visit. Regression analysis was conducted to predict the outcome variables. RESULTS: The Edinburgh Depression scores were significantly higher in the pregnant women group, (12.48 ± 3.753 vs. 8.00 ± 2.436; p value = 0.001; 95% CI 3.340-5.627), when compared to non-pregnant women (12.90 ± 3.731 vs. 9.20 ± 2.973; p value = 0.001; 95% CI 2.480-4.920). The Edinburgh Depression scores at the study conclusion visit was statistically significant, (11.05 ± 3.839 vs. 10.24 ± 3.872; p value = 0.008; 95% CI -1.40 to -0.213). Education, income, duration of marriage, body mass index, and suicidal ideation are some of the predictors identified in this study to cause depression among pregnant women. CONCLUSION: The findings of the study indicate a clinically significant increase of depressive symptoms among pregnant women. It is recommended to include routine psychological screenings and interventions during pregnancy.

Optimal Dosing of Lasmiditan in the Management of Acute Migraine Attack: A Systematic Review and Meta-analysis.

BACKGROUND: The current target of migraine treatment is focused on Triptans. Lasmiditan, a non-vasoconstrictive and highly selective 5HT1F receptor agonist is a novel therapeutic discovery for migraine for patients with cardiovascular (CV) risk factors or stable cardiovascular diseases and who fail to respond to the existing treatment. OBJECTIVE: To identify an optimal dosing of Lasmiditan 100 mg versus 200 mg for the treatment of acute migraine attacks in adult patients with cardiovascular risk factors. METHODS: Systematic searches were run in databases such as Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Google scholar, and PUBMED. Out of 83 study records identified, two studies were included for quantitative analysis. RESULTS: There was a significant headache pain freedom at 2 h [Odds Ratio (OR): 0.77; 95% Confidence interval (CI): 0.64-0.92] and sustained pain freedom at 24 h (OR): 0.75; 95% CI: 0.61-0.93] in patients taking Lasmiditan 200 mg compared to those taking Lasmiditan 100 mg. The results were statistically insignificant for parameters like most bothersome symptoms (MBS) free at 2 h, headache relief at 2 h, disability level at 2 h, and global impression of change at 2 h. A combined analysis of these parameters showed a remarkable difference between both the groups favoring Lasmiditan 200 mg [OR: 0.88; 95% CI: 0.81-0.95]. CONCLUSION: An oral dosing of Lasmiditan 200 mg is ideal for the treatment of acute migraine in adult patients with CV risk factors for attaining headache pain freedom at 2 h and sustained pain freedom at 24 compared to Lasmiditan 100 mg.

Hypersensitivity reaction associated with phenytoin.

Hypersensitivity reactions with antiepileptic drugs (AEDs) are generally associated with aromatic AEDs. We present a case of hypersensitivity reactions followed by administration of phenytoin with diazepam and ranitidine in a patient with generalized tonic-clonic seizures. Antigen-antibody reactions or decreased levels of epoxide hydrolase are well known with phenytoin. Increased level of serum phenytoin causing toxicities due to competitive inhibition with diazepam on co-administration was also reported in the literature. Prevention of the adverse effects with AEDs is a multi-stage process, which requires implementation of preventive measures through careful monitoring and prompts interventions.