BackgroundInhaled budesonide benefits patients with COVID-19. ProLung™-budesonide enables the sustained, low dose administration of budesonide within a delivery vehicle similar to lung surfactant. ProLung™-budesonide may offer anti-inflammatory and protective effects to the lung in COVID-19, yet it’s effect on SARS-CoV-2 replication is unknown.ObjectiveTo determine the efficacy of ProLung™-budesonide against SARS-CoV-2 infection in vitro, evaluate its ability to decrease inflammation, and airway hyperresponsiveness in an animal model of lung inflammation.MethodsSARS-CoV-2-infected Vero 76 cells were treated with ProLung™-budesonide ([0.03– 100 μg/ml]) for 3 days, and virus yield in the supernatant was measured. Ovalbumin-sensitized C57BL/6 mice received aerosolized (a) ProLung™-budesonide weekly, (b) only budesonide, either daily or weekly, or (c) weekly empty ProLung™-carrier (without budesonide). All treatment groups were compared to sensitized untreated, or normal mice using histopathologic examination, electron microscopy (EM), airway hyperresponsiveness (AHR) to Methacholine (Mch) challenge, and eosinophil peroxidase activity (EPO) measurements in bronchioalveolar lavage (BAL).ResultsProLung™-budesonide showed significant inhibition on viral replication of SARS-CoV-2-infected cells with the selectivity index (SI) value > 24. Weekly ProLung™-budesonide and daily budesonide therapy significantly decreased lung inflammation and EPO in BAL. ProLung™-budesonide localized in type II pneumocytes, and was the only group to significantly decrease AHR, and EPO in BAL with Mch challengeConclusionsProLung™-budesonide significantly inhibited viral replication in SARS-CoV-2 infected cells. It localized into type II pneumocytes, decreased lung inflammation, AHR and EPO activity with Mch challenge. This novel drug formulation may offer a potential inhalational treatment for COVID-19.
Background: An understanding of epidemiological trend in hospital admissions, including diseases and death pattern, is critical for health care planning, appropriate resource allocation & improving existing services facilities. To evaluate the disease and death pattern of children admitted in the Department of Child Health, Bangubandhu Memorial Hospital. Chattogram.
Materials and methods: This was a retrospective study. The case records of all patients admitted in the Department of Child Health from Jan 1, 2015 to Dec 31, 2016 were analyzed.
Results: Total 3560 children were admitted during this study period. All the patients were distributed into three age groups. Infant, under five and more than five age groups constitute 35%, 33% and 32% respectively. Acute watery diarrhea (33%) bronchiolitis (21%) Bronchopneumonia (10.5%) hereditary hemolytic anemia (9%) and Enteric fever (4.3%) were the five top disease in two years of admission. Among them total 12 (0.34%) patient died. Highest case fatality rate was found in bronchopneumonia (75%). Other common causes of death include meningitis (17%) and heart failure (8.5%). Patient came from urban area was 63% and 37% came from rural area.
Conclusion: Admission related findings of this study will help to evaluate the disease pattern of a hospital and planning for more effective case-management strategies.
Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 31-35
Background: Epithelial ovarian cancer usually presents at an advanced stage and neoadjuvant chemotherapy followed by interval cytoreduction is a standard treatment procedure. Visual intraoperative impression of the extent of the disease, total disease burden and resection status at the end of the cytoreductive surgery are important prognostic factors. Systematic documentation of the operative findings forms the cornerstone of an oncology center. Methods: A prospective observational study was carried out to carry out intra-operative mapping of ovarian cancer at the time of interval cytoreduction after a course of 3-4 cycles of neo-adjuvant chemotherapy. Results: 110 patients were included in the study. Profile of the patient were documented in the study along with the operative findings. It has evolved as a clinical and surgical audit of our center. Maximum tumour burden was evident in omentum (37.2%), followed by ovaries (11.8%) and deposits in pouch of douglas (7.2%). Notably, in 64.5% cases there was complete resection followed by R1 (residual disease status up to 1 cm) in 22.7% cases and R2 (residual disease status more than 1 cm) in 12.7% cases. In 43.6% there was complete remission of the disease with no evidence of the disease on histopathological examination.
Introduction: Although breastfeeding protects the children from many adverse health conditions but controversy is still present regarding its role in the development of asthma and allergy. Many studies support a modest protective effect of breastfeeding against wheeze and asthma in infancy and early childhood. However, in later childhood (age 6 years and above) the protective effect of breastfeeding on asthma is less evident and there are some recent studies which suggest that breastfeeding actually increases the risk of asthma, wheeze or atopy to aeroallergens at older ages. Therefore a tertiary hospital based case control study has been proposed to find out the effects of exclusive breastfeeding on childhood asthma which is a highly prevalent disease in Sub-Himalayan Terai Region of North Bengal. Methods: Patients of 3-12 years of age presented with asthma symptoms to our institute, were tested for reversibility (PEFR) and /or variability wherever feasible, were given anti-asthma drug trial and were followed up to observe the improvement and thus were diagnosed as childhood asthma excluding other differential diagnoses. In the present study, a total of 94 children with asthma were studied. After matching for age and sex 94 healthy children were included in the control group. History of breastfeeding in the asthma and control group was recorded. Results: Among the asthma group 59.58% children were given exclusive breastfeeding (EBF) upto six months of age, 17.02% children were given artificial feeding (AF) and 23.40% children were given mixed feeding (MF). On the other hand in the control group 74.47%, 8.51% and 17.02% children were given exclusive breastfeeding, artificial feeding and mixed feeding respectively. So less number of asthma patients (59.58%) were exclusively breastfed in contrast to control group (74.47%), and the difference was statistically significant (χ 2 = 4.72, p = 0.0299). The odds ratio for being asthmatics who were exclusively breastfed, compared to asthmatics who were not exclusively breastfed was found to be 0.51 (OR = 0.51, 95% CI = 0.27-0.94). Conclusion: It is concluded that children living in this Sub-Himalayan Terai region of North Bengal have protective effect of breastfeeding on occurrence of asthma. In future long term multi-center large study should be carried out.
The article Heart Failure : Current Concepts, is primarily meant for physicians and MO's outlining the accepted modalities of management of heart failure. Para wise reply to the comments: (a) Serial No 1, 2 and 4 are accepted as mentioned. (b) Serial No.3 Eplerenone is a selective Aldosterone receptor antagonist, which has been accepted in a select population of heart failure patients with recent myocardial infarction and LV systolic dysfunction as studied in the EPHESUS trial. (c) Serial No. 5-these modalities are investigational and not yet approved for the treatment of heart failure.
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