Pirfenidone has been approved for the treatment of idiopathic pulmonary fibrosis due to its anti-fibrotic activity. It has been shown to have anti-inflammatory and antioxidant properties apart from being an anti-fibrotic agent. Cytokine storm, severe inflammation and oxidative stress leading to acute respiratory distress syndrome and multiorgan failure are factors causing mortality in patients of COVID-19. This article reports two cases of 35 years and 60-year-old male patients of COVID-19, those were diagnosed by real time Polymerase Chain Reaction (PCR) using nasopharyngeal samples. They were started on pirfenidone 400 mg BD, later increased to 600 mg TDS along with empirical antibiotics, dexamethasone, supplemental oxygen and non-invasive ventilator support. Both the patients improved and were discharged. Both the patients were followed by telemedicine after one week, did not require oxygen at rest and were comfortable at rest in contrast to earlier complaints. Thus, the authors conclude that pirfenidone can be a possible cure for COVID-19 patients, larger trials are required to confirm its efficacy.
Abstract:Necrotizing fasciitis (NF) is a severe disease of sudden onset that spreads rapidly. The disease is more common in the adults
Medical imaging is helpful to confirm diagnosis. Initial treatment includes a combination of intravenous antibiotics including piperacillin/tazobactam, vancomycin, and clindamycin or ampicillinsulbactam combined with metronidazole, clindamycin or carbapenems(imipenem).Aggressive surgical debridement is always necessary. Amputation of infected limb(s) may be necessary. Ancillary therapies, neither a substitute for surgical debridement nor proven efficacy have been described. Some studies recommend using intravenous immunoglobulin (IVIG).Nutritional support is imperative. High mortality rates if left untreated. High index of suspicion and knowledge is essential for early diagnosis and outcomes of NF.
Background: Covid 19 was declared a pandemic by WHO on 11 March 2020. Patients usually have pneumonia on chest x-ray at time of presentation however many patients also do not develop pneumonia and have normal chest x-ray.Methods: A total of 51 patients above the age of 15 years diagnosed with covid 19 by RT PCR of nasopharngeal/oropharyngeal samples were included in the study. History of symptoms onset was recorded, chest x-ray and haematological investigations were done of all patients.Results: A total of 51 patients >15 years of age were included in the study. 28 were male and 23 were female patients. Maximum number of patients were in age group 15-30 years. Most common presenting complain was fever (49% patients). Most common comorbidity was diabetes mellitus. There was no mortality reported in patients with normal chest x-ray.Conclusions: We conclude from the current study that patients with normal chest x-ray at the time of presentation have a very good outcome.
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