S econdary infections are known to complicate the clinical course of coronavirus disease . Bacterial infections are the most common secondary infections, but increasing reports of systemic fungal infections are causing concern. In the early part of the COVID-19 pandemic, <1% of secondary infections reported in COVID-19 patients were fungal (1,2). Preexisting conditions, indiscriminate use of antimicrobial and glucocorticoid drugs, and lapses in infection control practices are putative factors contributing to the emergence of systemic fungal infections in severe COVID-19 cases (3). After incidence of candidemia and invasive aspergillosis in COVID-19 patients increased (4,5), awareness of possible fungal co-infections increased among clinicians and microbiologists. One study reported invasive fungal infections in ≈6% of hospitalized COVID-19 patients (6). Occasional reports of COVID-19-associated mucormycosis (CAM) from various centers (7,8) and a series of 18 cases from a city in South India increased our concerns about CAM (9). India has a high burden of mucormycosis among patients with uncontrolled diabetes mellitus, and many severe COVID-19 patients have diabetes (8,10). India also is one of the countries worst affected by the COVID-19 pandemic. Thus, we would expect India to have many CAM cases. We conducted a nationwide multicenter study to evaluate the epidemiology and outcomes of CAM and compare the results with cases of mucormycosis unrelated to COVID-19 (non-CAM).
Methods
Study Design and SettingWe conducted a retrospective observational study involving 16 healthcare centers across India (Figure 1).
258Background: Schizophrenia and bipolar affective disorder are chronic psychiatric illness that requires long term care. This study tends to measure psychological burden and factors associated with it among caregivers of these two illnesses.Methods: This is a cross-sectional study that included participants by purposive sampling method. Self designed performa was used to collect the socio-demographic details of the caregivers. Modified caregiver strain index was used to assess the overall stress. Beck`s depression inventory and Beck`s anxiety inventory was used to assess depression and anxiety respectively.Results: Hundred caregivers, 50 each of schizophrenia and bipolar affective disorder were enrolled. Seventy-two percent of caregivers were found to have higher level of stress. Twenty-five percent had depression and 29% anxiety related problems. Stress was found to be significantly associated with being in debt, longer duration of illness, education level, marital status, subjective feeling of psychological stress and self-acknowledgement of need of professional help. Caregivers of both group experienced similar level of stress.
Conclusions:Psychological burden is seen to be high in caregivers of patients of Schizophrenia and Bipolar Affective Disorder.
Flexible tracheoscope-assisted video laryngoscopic intubation is a feasible alternative to video laryngoscope only intubation in patients with predicted difficult airways. A flexible tracheoscope used in combination with video laryngoscope may also further increase the success rate of intubation in select patients with a proven difficult airway, particularly when in-line stabilization is required.
Background & objectives:
In multitransfused thalassaemic patients, haemagglutination fails to phenotype the patient's blood group antigens due to the presence of donor-derived erythrocytes. DNA-based methods can overcome the limitations of haemagglutination and can be used to determine the correct antigen profile of these patients. This will facilitate the procurement of antigen-matched blood for transfusion to multitransfused patients. Thus, the aim of this study was to compare the serological phenotyping of common and clinically important antigens of Rh, Duffy, Kell, Kidd and MNS blood group systems with molecular genotyping amongst multitransfused thalassaemic patients.
Methods:
Blood samples from 200 patients with thalassaemia and 100 ‘O’ group regular blood donors were tested using standard serological techniques and polymerase chain reaction-based methods for common antigens/alleles (C, c, D, E, e, Fy
a
, Fy
b
, Jk
a
, Jk
b
, K, k, M, N, S, s).
Results:
Genotyping and phenotyping results were discordant in 77 per cent of thalassaemic patients for five pairs of antithetical antigens of Rh, Duffy, Kell and Kidd blood group systems. In the MNS blood group system, 59.1 per cent of patients showed discrepancy. The rate of alloimmunization among thalassaemics was 7.5 per cent.
Interpretation & conclusions:
Molecular genotyping enabled the determination of the actual antigen profile in multitransfused thalassaemia patients. This would help reduce the problem of alloimmunization in such patients and would also aid in the better management of transfusion therapy.
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