Background Lopinavir-ritonavir is a repurposed drug for coronavirus disease-2019 (COVID-19). In this study, a pooled effect of lopinavir-ritonavir on mortality, virological cure, radiological improvement and safety profile in COVID-19 patients has been evaluated. Methods The databases were searched for comparative randomized controlled studies evaluating the efficacy and/or safety of lopinavir-ritonavir in COVID-19 patients. The mortality outcome was pooled as a risk difference (RD) with 95% CI. The virological cure, radiological improvement and adverse events were pooled as risk ratio (RR) with 95% CI. All outcomes were pooled using the Mantle-Hanzle method random effect model. The heterogeneity was assessed using the I 2 test. Results Out of 82 full text assessed, seven studies were included in the analysis. The included studies had five different control interventions: supportive care (n = 4), umifenovir (arbidol) (n = 2), navaferon (recombinant anti-tumour and anti-virus protein) (n = 1), lopinavir-ritonavir + novaferon (n = 1) and lopinavir-ritonavir + interferon beta 1b + ribavirin (n = 1). Lopinavir-ritonavir group did not show significant difference in mortality [RD: 0.00 (95% CI: -0.01, 0.02), I 2 = 0], virological cure [RR: 1.06 (95% CI: 0.85, 1.31), I 2 = 0%], radiological improvement [RR: 0.81 (95% CI: 0.62, 1.05)] and adverse events [RR: 2.59 (95% CI: 0.17, 38.90), I 2 = 75%] than supportive care. Similarly, no difference was observed for any efficacy outcomes between lopinavir-ritonavir and other control interventions. We observed significantly high risk of adverse events with lopinavir-ritonavir as compared to umifenovir [RR: 2.96 (95% CI: 1.42-6.18); I 2 = 0%]. Conclusion There is no benefit of the addition of lopinavir-ritonavir to the standard care in COVID-19 patients.
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Markers of inflammation are being investigated as predictors of coronary ischaemic events. All major statins have shown almost similar and significant efficacy in reducing C-reactive protein (CRP) concentrations in acute coronary syndrome (ACS), but atorvastatin was used in a high dose (80 mg).• This study was designed to evaluate the effect of a lower dose (20 mg) of atorvastatin on hs-CRP concentrations in patients with ACS. WHAT THIS STUDY ADDS• A lower dose of atorvastatin (20 mg) was effective in decreasing hs-CRP and LDL concentrations in as short a duration as 4 weeks. The use of a lower dose of atorvastatin in patients of ACS can offer an attractive approach for early treatment of ACS patients. AIMSTo evaluate the effect of a lower dose (20 mg) of atorvastatin on hs-CRP concentrations in patients with ACS. METHODSGroup A (n = 50) patients received atorvastatin 20 mg day -1 for 4 weeks in addition to standard anti-anginal treatment. Group B (n = 50) patients received standard anti-anginal treatment without atorvastatin. RESULTShs-CRP concentrations decreased in both groups, but the decrease was greater in group A. The decrease in hs-CRP was also significantly greater in the subgroups of smoking, hypertension and past history of cardiovascular disease with atorvastatin. CONCLUSIONSThe use of a lower dose (20 mg) of atorvastatin can offer an attractive approach for early treatment of patients with ACS.
Citalopram had shown better efficacy, earlier onset of action and more number of responders and remitters as compared to sertraline in MDD in Indian patients.
Objective: The main purpose of this study was to adverse drug reaction monitoring of psychopharmacological agents. Materials and method: The study was cross sectional and was carried out in Departments of Psychiatry in Chhatrapati Shivaji Subharti Hospital and Pharmacology Department, Subharti Medical College, Meerut the duration of this study was approx 6 months (24 weeks). Institutional ethics committee approval was obtained before the start of the study. Results: A total of 110 patients enrolled in the study, and it occurs 148 adverse events. Among which the male patients were 65 (59%). and female were 45(31%). The most common age group whereas 44.5% were from a higher age group. 40 % patients were in the age group from 36 years up to 55 years. In this study most common adverse effect is found in metabolic syndrome such as these were weight gain 15.45%, change in blood glucose 18.18% and change in cholesterol 9.09%. Antipsychotics were given to 35. % patients, antidepressants to 24.5 %, sedatives and hypnotics were given to 20.9 %, anti epileptic to 10.9%, anti maniac drugs to 5.5% and other drugs 3.0% patients. More patients suffering of 25.45% from anti depressant. This study severity of adverse effects. 70(63.6%) had mild adverse effects where as 40(36.4%) had moderate adverse effects and none had severe adverse effects.38% were definitely preventable, 35% were probably preventable, and 27% were not preventable as per clinical evaluations and application of scale Conclusion: the study results strongly suggests the need for professional healthcare team to focus on assessing and reporting suspect adverse effect to increase the quality of monitoring and managing ADRs. Pharmacovigilance improvement the recognition of ADRs and helps the medical health care professional to have safe practice.
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