Objective We evaluated whether ivermectin combined with doxycycline reduced the clinical recovery time in adults with COVID-19 infection. Methods This was a randomized, blinded, placebo-controlled trial in patients with mild-to-moderate COVID-19 symptoms randomly assigned to treatment (n = 200) and placebo (n = 200) groups. The primary outcome was duration from treatment to clinical recovery. Secondary outcomes were disease progression and persistent COVID-19 positivity by RT-PCR. Results Among 556 screened patients, 400 were enrolled and 363 completed follow-up. The mean patient age was 40 years, and 59% were men. The median recovery time was 7 (4–10, treatment group) and 9 (5–12, placebo group) days (hazard ratio, 0.73; 95% confidence interval, 0.60–0.90). The number of patients with a ≤7-day recovery was 61% (treatment group) and 44% (placebo groups) (hazard ratio, 0.06; 95% confidence interval, 0.04–0.09). The proportion of patients who remained RT-PCR positive on day 14 and whose disease did not progress was significantly lower in the treatment group than in the placebo group. Conclusions Patients with mild-to-moderate COVID-19 infection treated with ivermectin plus doxycycline recovered earlier, were less likely to progress to more serious disease, and were more likely to be COVID-19 negative by RT-PCR on day 14. Trial Registration ClinicalTrials.gov Identifier: NCT04523831. Data Repository ID Dryad. doi:10.5061/dryad.qjq2bvqf6
Background Globally, studies have shown conflicting results regarding the association of blood groups with SARS CoV-2 infection. Objective To observe the association between ABO blood groups and the presentation and outcomes of confirmed COVID-19 cases. Design, setting, and participants This was a prospective cohort study of patients with mild-to-moderately severe COVID-19 infections who presented in the COVID-19 unit of Dhaka Medical College Hospital and were enrolled between 01 June and 25 August, 2020. Patients were followed up for at least 30 days after disease onset. We grouped participants with A-positive and A-negative blood groups into group I and participants with other blood groups into group II. Results The cohort included 438 patients; 52 patients were lost to follow-up, five died, and 381 completed the study. The prevalence of blood group A [144 (32.9%)] was significantly higher among COVID-19 patients than in the general population (p < 0.001). The presenting age [mean (SD)] of group I [42.1 (14.5)] was higher than that of group II [38.8 (12.4), p = 0.014]. Sex (p = 0.23) and co-morbidity (hypertension, p = 0.34; diabetes, p = 0.13) did not differ between the patients in groups I and II. No differences were observed regarding important presenting symptoms, including fever (p = 0.72), cough (p = 0.69), and respiratory distress (p = 0.09). There was no significant difference in the median duration of symptoms in the two group (12 days), and conversion to the next level of severity was observed in 26 (20.6%) and 36 patients (13.8%) in group I and II, respectively. However, persistent positivity of RT-PCR at 14 days of initial positivity was more frequent among the patients in group I [24 (19%)] than among those in group II [29 (11.1%)]. Conclusions The prevalence of blood group A was higher among COVID-19 patients. Although ABO blood groups were not associated with the presentation or recovery period of COVID-19, patients with blood group A had delayed seroconversion.
Background: The National Institutes of Health Stroke Scale or NIH Stroke Scale (NIHSS) is a widely used tool for assessing stroke severity. We conducted this study to determine the severity of stroke patients admitted in a tertiary care hospital.Methods: This is a cross sectional study conducted in involving 91 acute stroke patients.Result: About half (44%) of the patients were older than 60 years of age and mean age of the patients was 60.34(±16.1) years at onset and there is a slight female predominance (51.6%).Majority had hypertension (75.8%) followed by physical inactivity (67%), diabetes (37.4%), smoking (33%), obesity (23.1%), family H/O stroke (20.9%) and dyslipideamia (15.4%). Many patients were found to have hyperglycemia (14.3%) followed by hyperthermia (13.2%), hypotension (4.4%) and low oxygen saturation (3.3%) at the time of admission. Most of them had ischemic stroke (60%), followed by intracerebral hemorrhage (35%) and subarachnoid hemorrhage (5%). After leveling with NIHSS score more than half of the patients (51%) were found to be moderate grade on admission. Although, there was no association between risk factors of stroke and admission NIHSS score level, significant association was found between hypoxia and admission NIHSS score severity.Conclusion: Acute stroke patients, mostly have moderate grade of NIHSS score on admission.Hypertension, physical inactivity, diabetes, smoking, obesity, family H/O stroke and dyslipideamia are common risk factors observed among the patients which have no significant association with admission stroke severity determined by NIHSS score. There is significant association between hypoxia and admission NIHSS score severity.
Background: The aim of our study was to determine whether modified Bangla version (MMSE-B) is as effective as mini mental state examination (MMSE) tool for use in Bangladeshi people. Methods: This descriptive observational study was carried out in Department of Neurology, DMCH from January 2013 to December 2013. A total 200 healthy adults (patient attendants at the clinic) who met the inclusion criteria, were interviewed using a structured questionnaire containing information on age, sex, residence, educational backgrounds and questions set at MMSE English version (MMSE-E) and modified Bangla version for MMSE-B (Figure-1). MMSE and MMSE-B both were applied in 1:1 ration. The literate people were asked whether they are comfortable to answer in English (MMSE-E) or they would like the translated form and we applied the form of MMSE (MMSE-T) according to their wish. But in other group of people the modified Bangla version (MMSE-B) was used irrespective of level of education. Result: The mean age at presentation was 58.1±7.8 and 94% were within 50-70 years of age. Male were more common (80, 66) in both the groups and most of them belonging to rural areas. MMSE-B were mostly employed on people having only primary level of education (up to class five, n=80) or no education (n=2), whereas MMSE-E were employed up on people having a level of education higher than class five (n=96). Every question in each item of cognitive domain correlated well (correlation co-efficient range from 0.801- 0.971) except the 7th (correlation co-efficient 0.418) which had higher mean score for MMSE-B than those of MMSE-E (0.90 versus 0.54). The mean score of MMSEB was greater than the mean score of MMSE-E for most of questions except the 1st question that is related to orientation of time. The mean of total score in MMSE-E and MMSE-B were 24.04 and 24.91 respectively with a correlation co-efficient of 0.940. Conclusion: MMSE-B is adaptable for use in Bangladeshi people irrespective of level of education. Bangladesh Journal of Neuroscience 2016; Vol. 32 (2): 91-97
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