Post COVID-19 clinical manifestations and its risk factors among patients in a Northern District in Kerala, India.

Background: The novel virus SARS-CoV-2 has caused a pandemic of coronavirus disease 2019 (COVID-19). There is emerging evidence of post-COVID-19 manifestations among patients who sustain acute COVID-19. Most studies report fatigue, dyspnea, and myalgia as the common symptoms; however, currently, there is limited knowledge of these post-COVID manifestations and their risk factors, especially in India. Methods: A descriptive cross-sectional study was conducted among patients who had attended the district post-COVID clinic, Wayanad district, Kerala, from October 2020 to June 2021. Data were collected by direct/telephonic patient interviews and from their existing case records, using a pretested semi-structured proforma. Results: The sample size was 667. The mean age of the study population was 45 years (standard deviation [SD]: 14.55). The majority of the population presented with dyspnea (48%), fatigue (32%), and cough (25.6%). Mental health problems were also reported in 6% of participants. The respiratory system was commonly involved (61.2%). Around one-third of the patients (36.4%) had dyspnea on exertion and 11.8% had dyspnea at rest. One-fifth of the population reported aggravation of pre-existing co-morbidity and half of the respondents had persistence of at least one symptom after 6 months. There exist statistically significant associations between identified risk factors, especially gender, increasing age, the severity of COVID-19 infection, history of tobacco/alcohol use, and co-morbidities with outcomes. Conclusion: As post-COVID syndrome is a multisystem disease, integrated rehabilitation is required with targeted intervention for survivors based on their symptoms and needs.

Quarantine and COVID-19 pandemic: Multidimensional perception of people in quarantine in North Kerala.

Background: Proper hand hygiene, face masks, social distancing, maintaining appropriate social distancing, and quarantine are the major strategies for the prevention of transmission of coronavirus disease (COVID-19) infection. The aim of the study was to determine and asses the knowledge, perceptions, health practices of quarantine and COVID-19 and to determine the psychosocial profile of people in quarantine. Methods: A descriptive cross-sectional study was done in quarantined individuals in a rural and urban setting in Malappuram district of Kerala from February 2021 to June 2021 by telephonic interview. Mental health status was assessed by Patient Health Questionnaire 9. Results: Only half (49.6%) of the population has satisfactory knowledge about COVID-19 disease. Only 53.9% has satisfactory knowledge on preventive measures and this is significantly more in rural (62.9%) compared to urban (44.4%). Only 45.3% has satisfactory adherence on practice of preventive measures. Also nearly half (44.9%) of the participants were affected by factors such as fear of infection, frustration, inadequate supplies, inadequate communication and financial insecurity. Urban population (53.2%) were more affected compared to rural (37.1%). 31.6% of the participants were having any form of depression with PHQ 9. Pearson's correlation test revealed significant correlations between different factors and outcome variables. Predictors of 'Satisfactory Practice on preventive measures' and 'Any depression' were determined. Conclusion: Only half of the population has satisfactory knowledge and practice on preventive measures. Ensure health intervention programs to improve knowledge and adherence to practices. Strengthening of system to support their needs and psychosocial support should be provided.

Cox-2 is needed but not sufficient for apoptosis induced by Cox-2 selective inhibitors in colon cancer cells.

The role of Cox-2 in NSAID-induced apoptosis is debated. We studied the role of Cox-2 inhibition in apoptosis induced by a selective Cox-2 inhibitor, SC236 (a structural analogue of celecoxib) in two colon cancer cell lines, HT29 (expressing Cox-2 protein) and HCT116 (not expressing Cox-2 protein). Apoptosis was quantified by flow cytometry. SC236 0-75 microM decreased cell numbers and induced apoptosis to identical levels in HT29 and HCT116 cells. However, SC236, concentrations >75 microM reduced Cox-2 protein expression in HT29 cells and induced greater levels of apoptosis in HT29 than in HCT116 cells. In contrast, sulindac sulfide (SSD) (which inhibits Cox-1 and Cox-2) 0-200 microM or sulindac sulfone (SSN) 0-500 microM (without significant activity against Cox-1 or Cox-2) caused identical decreases in cell number and increases in apoptosis in HT29 and HCT116 cells. Neither SSD nor SSN altered the expression of Cox-2 in HT29 cells. To determine that the higher levels of apoptosis in HT29 cells with SC236 >75 microM were related to decreased Cox-2 protein levels, we decreased Cox-2 protein expression in HT29 cells with curcumin (diferuloylmethane) and studied its effect on SC236-induced apoptosis. Curcumin augmented apoptosis induced by SC236 in HT29 cells but not in Cox-2 lacking HCT116 cells. In conclusion, selective Cox-2 inhibitors can induce apoptosis independent of Cox-2 expression. However they may selectively target cells that express Cox-2 by decreasing their Cox-2 protein expression.

Simultaneous determination of pseudoephidrine HCl (PSE) and terfanidine (TER) from formulations by reversed-phase ion pair high-performance liquid chromatography (RP-HPLC).

A new simple, precise, rapid, and selective reversed-phase ion pair high-performance liquid chromatography (RP-HPLC) method has been developed for the simultaneous determination of pseudoephidrine (PSE) and terfanidine (TER) from tablets using 60:15:25 acetontrile:methanol:water (v/v) containing 2.9 g sodium lauryl sulfate/liter, pH adjusted to 3.1 using phosphoric acid as a mobile phase and C18 Spherisorb ODS 2 (3 microns, 5 cm x 4.6 mm i.d.) as stationary phase. Detection was carried out using a UV detector at 254 nm. A constant flow of 1.0 ml/min was maintained throughout the analysis. Retention times for PSE and TER were 1.90 and 7.35 min, respectively. Linearity range and percentage recoveries for PSE and TER were 24-1200 and 12-600 micrograms/ml, and 100.01 and 100.4%, respectively.

Simultaneous determination of pseudoephedrine hydrochloride and diphenhydramine hydrochloride in cough syrup by gas chromatography (GC).

A simple, rapid and precise gas chromatographic method has been developed for the simultaneous determination of pseudoephedrine hydrochloride and diphenhydramine hydrochloride in cough syrup, using a SS column of 10% OV 1 on chromosorb W-HP (80-100 mesh) and nitrogen as a carrier gas at a flow rate of 30 ml min(-1). The oven temperature was programmed at 135 degrees C for 1 min, with a rise of 10 degrees C min(-1) up to 250 degrees C (held for 5 min). The injector and detector port temperatures were maintained at 280 degrees C. Detection was carried out using Flame ionization detector. Guaphenesin was used as an internal standard. Results of assay and recovery studies were statistically evaluated for its accuracy and precision.

Simultaneous determination of mebendazole and pyrantel pamoate from tablets by high performance liquid chromatography-reverse phase (RP-HPLC).

A new, simple, precise, rapid and stability indicating RP-HPLC method has been developed for the simultaneous determination of mebendazole and pyrantel pamoate from tablets. Chromatography was carried out on a Shodex C8 column using a mixture of 0.05 M monobasic sodium phosphate: acetonitrile: triethylamine (60:40:1.5, v/v), adjusted to pH 6.8 with phosphoric acid. Detection was carried out at 290 nm using a UV detector. Retention times for pamoic acid, pyrantel base and mebendazole were 3.61, 6.41 and 12.81 min, respectively. Linearity was obtained in the concentration range of 20-160 mug and 30-240 mug for pyrantel pamoate and mebendazole, respectively. The method after its application for the assay of pyrantel pamoate and mebendazole from tablets, was statistically evaluated for its accuracy and precision.