Severe cases of COVID-19 are characterized by hyperinflammation induced by cytokine storm, ARDS leading to multiorgan failure and death. JAK-STAT signaling has been implicated in immunopathogenesis of COVID-19 infection under different stages such as viral entry, escaping innate immunity, replication, and subsequent inflammatory processes. Prompted by this fact and prior utilization as an immunomodulatory agent for several autoimmune, allergic, and inflammatory conditions, Jakinibs have been recognized as validated small molecules targeting the rapid release of proinflammatory cytokines, primarily IL-6, and GM-CSF. Various clinical trials are under investigation to evaluate Jakinibs as potential candidates for treating COVID-19. Till date, there is only one small molecule Jakinib known as baricitinib has received FDA-approval as a standalone immunomodulatory agent in treating critical COVID-19 patients. Though various meta-analyses have confirmed and validated the safety and efficacy of Jakinibs, further studies are required to understand the elaborated pathogenesis of COVID-19, duration of Jakinib treatment, and assess the combination therapeutic strategies. In this review, we highlighted JAK-STAT signalling in the pathogenesis of COVID-19 and clinically approved Jakinibs. Moreover, this review described substantially the promising use of Jakinibs and discussed their limitations in the context of COVID-19 therapy. Hence, this review article provides a concise, yet significant insight into the therapeutic implications of Jakinibs as potential anti-COVID agents which opens up a new horizon in the treatment of COVID-19, effectively.

Introduction: Urosepsis is life threatening, unless treated immediately. Empirical treatment with appropriate antibiotics lowers the risk of a poor outcome. However, with increasing resistance among common uropathogens, there is a need for continuous review of the existing protocol to determine whether there is a correlation between empirical antibiotic therapy and in-vitro susceptibility pattern of the pathogens causing urosepsis. Methodology: A prospective study was carried out on 66 confirmed cases of urosepsis from January 2017 to December 2018 after obtaining ethical clearance. Demographic details, risk factors, length of hospital stay, bacteriological profile, empirical antibiotic given, and change in antibiotic following susceptibility report and outcome was recorded. Results: Among the 66 urosepsis cases 63 of them were started on empiric antibiotic. The correlation between the empirical antibiotic given and the in-vitro antimicrobial susceptibility was found to be significant with a p value < 0.0001. Among the 63 for whom empiric antibiotics was started further escalation of antibiotic was done in 46 patients. The remaining 20% of cases were changed over to a different antibiotic, in line with susceptibility report. The mortality rate was (15.1%) with a confidence interval of (CI = 15 ± 3.5). The association between the risk factors for urosepsis and their effect on mortality rate was analyzed. Diabetes mellitus and chronic kidney disease were identified as important independent risk factors and had direct influence on the mortality rate with significant p value of 0.0281 and 0.0015 respectively. Conclusions: A significant correlation was identified between the empirical antibiotic given and in-vitro antibiotic susceptibility pattern.

BACKGROUND We wanted to determine the prevalence of ocular manifestations assess the frequency and distribution of potential sight threatening complications in patients with psoriasis. METHODS This is a non interventional, observational hospital based study conducted at a tertiary health care centre which included 105 patients with psoriasis. A background history was taken regarding the duration of psoriasis and treatment taken. The prevalence of ocular manifestations were assessed by detailed ocular examination which involved the best corrected visual acuity using Snellen’s chart, examination of the anterior chamber using slit lamp, examination of the fundus, intraocular pressure measurement, dry eye evaluation including Schirmer’s test, tear film break up time test, and Rose Bengal stain test. RESULTS In total 105 patients with psoriasis were enrolled in this study. Among the 105 patients whose 210 eyes were examined, 77 % had psoriasis vulgaris, 14 % had scalp psoriasis, and 9 % had palmoplantar psoriasis. Among the 105 patients, 38 patients had symptomatic ocular manifestations. Out of the 38 % patients with symptomatic ocular manifestations, we found that 28 %, 25 %, 17 %, 2 % of the patients manifested with evaporative dry eye, blepharoconjunctivitis, redness and episcleritis respectively. CONCLUSIONS In our study, ocular manifestations were even seen among the asymptomatic patients. Hence a multi-disciplinary approach including effective screening and early detection of ocular manifestations followed by prompt treatment is essential to reduce the morbidity in patients with psoriasis. KEY WORDS Psoriasis, Dry Eye, Uveitis

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review

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