Background: The evidence on the efficacy and safety of Ayurveda interventions as add-on to the standard conventional care for COVID-19 is limited. This study was planned to explore the potential of AYUSH-64 as add-on to conventional care in improving the clinical recovery and negative RT-PCR conversion in asymptomatic and mild COVID-19 cases. Materials and Methods: An open-label randomized controlled study was conducted at Government Medical College, Nagpur, Maharashtra, India with a sample size of 60 participants. In this study, asymptomatic or mild COVID-19 patients were randomized and allocated into intervention and control group in 1:1 ratio. AYUSH-64 two capsules (500 mg each) were administered thrice daily, after food with water for 30 days along with standard care in the intervention group, while the control group received only standard care. The effect of the interventions was assessed in terms of negative RT-PCR for COVID-19, clinical cure rate and inflammatory cytokines.Outcome measures: Primary outcome was the time to attain negative RT-PCR for COVID-19 and proportion of participants turned RT-PCR negative for COVID-19 at 7th, 15th, 22nd and 30th day respectively in the intervention group compared to the control group. Secondary outcomes were the proportion of participants who attained clinical recovery at 7th, 15th, 22nd, and 30thday; improvement in laboratory parameters on the 30th day (as compared to baseline) and incidence of Adverse Drug Reactions/Adverse Events (ADRs/AEs). The data was compared within group using paired sample t-test/ Wilcoxon signed rank test and between group using independent sample t-test/Mann-Whitney test. Results: Statistically significant difference was not observed in the proportion of participants who turned RT-PCR negative during each of the follow-ups (p=0.134) and both groups demonstrated comparable efficacy. The clinical recovery rate in terms of time taken for complete cure of symptoms in the symptomatic participants was 60% and 37% on day 15 (p=0.098) and 100% and 85.2% on day 30 (p=0.112), in the intervention and control group respectively which is numerically a better clinical outcome in the intervention group. The improvement in the inflammatory markers such as IL-6, TNF-α and D-dimer was statistically significant in the intervention group (p<0.05). None of the participants developed any complications nor were any significant ADR/AE observed in both the groups.Conclusion: In patients with asymptomatic and mild COVID-19, AYUSH-64 as add-on to standard conventional care, contributed to improving the duration for attaining complete clinical cure and demonstrated potential in reducing the levels of pro-inflammatory markers in the body.

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Background: The evidence on the efficacy and safety of Ayurveda interventions as an add-on to the standard conventional care for coronavirus disease-2019 (COVID-19) is limited. Aim and objective: This study was planned to explore the potential of AYUSH-64 as an add-on to conventional care in improving the clinical recovery and negative reverse transcription–polymerase chain reaction (RT-PCR) conversion in asymptomatic and mild COVID-19 cases. Materials and methods: An open-label randomized controlled study was conducted at Government Medical College, Nagpur, Maharashtra, India, with a sample size of 60 participants. In this study, asymptomatic or mild COVID-19 patients were randomized and allocated into intervention and control groups (CG) in a 1:1 ratio. AYUSH-64 two capsules (500 mg each) were administered thrice daily, after food with water for 30 days along with standard care in the intervention group (IG), while the CG received only standard care. The primary outcome was the proportion of participants who turned RT-PCR negative for COVID-19 at 7 th , 15 th , 22 nd and 30 th days. Secondary outcomes were the proportion of participants who attained clinical recovery at 7 th , 15 th , 22 nd and 30 th days, change in laboratory parameters on the 30 th day and incidence of adverse drug reactions/adverse events. The data were compared within group using paired sample t -test/Wilcoxon signed-rank test and between group using independent sample t -test/Mann–Whitney test. Results: Statistically significant difference was not observed in the proportion of participants who turned RT-PCR negative during each of the follow-ups ( P = 0.134) and both groups demonstrated comparable efficacy. The clinical recovery in terms of complete relief in symptoms in the symptomatic participants was 60% and 37% on day 15 ( P = 0.098) and 100% and 85.2% on day 30 ( P = 0.112) in the intervention and CG, respectively. The improvement in the inflammatory markers such as interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and D-dimer was statistically significant ( P < 0.05) in the IG, whereas in the CG, it was statistically significant for D-dimer only. None of the participants developed any complications nor were any significant ADR/AE observed in the groups. Conclusions: In patients with asymptomatic and mild COVID-19, AYUSH-64, as add-on to standard conventional care, contributed to improved clinical recovery and demonstrated potential in reducing the levels of pro-inflammatory markers such as IL-6 and TNF-...

Background: Strong relationship has been demonstrated between the presence of occlusive CAD and coronary artery calcification (CAC) detected at autopsy, fluoroscopy and computed tomography (CT scan). CT scan quantifies the relative burden of CAC deposits as a marker of atherosclerosis. Study explored utility of multi-slice spiral CT scan for detection of CAC in post myocardial infarction cases.Methods: Fifty-one post myocardial infarction cases were enrolled in the study. Detailed clinical history was recorded in every case regarding age, sex, history of risk factors for CAD like systemic hypertension, diabetes mellitus, smoking and family history of CAD. Every case was evaluated for fasting and postprandial blood sugar and fasting lipid profile. Body mass index (BMI) was also calculated. Coronary artery calcium was estimated in each patient by multi -slice spiral CT scan. Conventional angiography was also undertaken in 18 patients. Co-relation of coronary calcium with different age groups, sex, risk factors, electrocardiography and angiography was drawn.Results: Out of 51 cases scanned, 40 cases (78.4%) had detectable CAC. In 30 cases (58.8%), CAC score ranged from 1 to 100 (mild score); 6 cases (11.8%) had score between 101-400 (moderate score) while in 4 cases (7.8%) CAC score was more than 400 (severe score %). For detection of angiographically detectable disease, the sensitivity of multi-slice CT was 100% and the specificity was 33.3%.Conclusions: CAC is a valid measure of atherosclerotic plaque burden and is recommended as a screening tool for demonstrating significant atherosclerosis in susceptible subjects.

Background: The association of autoimmune thyroid disease with type 1 diabetes mellitus has been well documented across populations, with it being most prevalent immunological disease in patients with type 1 diabetes. The aim of this study was to ascertain the association between type 1 diabetes and thyroid dysfunction clinically, biochemically and immunologically.Methods: Serum TSH, free T3 and free T4 values were compared between cases of type 1 diabetes mellitus and non-diabetic age and sex matched controls. Cases of type 1 diabetes mellitus were further divided in two groups, depending upon the presence or absence of antibodies against thyroid peroxidase (Anti-TPO antibodies). Mean serum TSH, free T3, free T4 levels were compared between these two groups to find or refute any association.Results: Abnormal thyroid function was reported in total 6 (14.63%) cases. Comparison of TSH, T3 and T4 levels showed statistically insignificant differences (p<0.05) in TSH levels (µIU/ml) (Cases- 3.44±2.41, controls- 3.34±0.78); T3 levels (pg/ml) (cases- 3.31±1.06, controls- 3.36±0.52) and T4 levels (ng/dl) (cases- 0.92±0.31, controls- 0.95±0.23). Total of 6 cases (14.63%) cases of type 1 diabetes mellitus were positive for anti-TPO antibodies (4- females, 2- males).Conclusions: Thyroid dysfunction is more common amongst type 1 diabetics, especially females. Estimation of anti-TPO antibodies is valuable in detecting thyroid dysfunction in type 1 diabetics.

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<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Sickle cell disease (SCD) is the commonest heritable hematologic abnormality affecting humans. Pulmonary hypertension is documented in patients of SCD by both non-invasive methods and catheterization, with incidence reported to be as high as 20%-63%. However, pulmonary hypertension has not been studied as complication of patients of sickle cell disease in India</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">A total of 94 (54 SS and 40 AS) more than 12 years old cases </span><span lang="EN-IN">diagnosed to have sickle cell disease by hemoglobin electrophoresis</span><span lang="EN-GB"> were recruited. All the participants were assessed with complete history, general and systemic examination, hematological and biochemical tests, X-ray chest, ECG, pulmonary function tests and 2D echocardiography and Doppler studies. </span><span lang="EN-IN">Cases were observed in 2 groups: SS cases and AS cases. </span><span lang="EN-GB">Sixty four</span><span lang="EN-IN"> age/sex matched healthy close relatives of the cases with ‘AA’ Hb electrophoresis pattern were the controls. </span><span lang="EN-IN"> </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">Five SS cases were detected to have pulmonary hypertension. Pulmonary hypertension was not detected in any AS case or control. Pulmonary hypertension was more common in females (3/23, 13%) than males (2/26, 7.7%). </span><span lang="EN-IN">The mean age of the SS cases with PH (32±5.15) was found to be significantly higher than that of the SS cases without PH (24.2±6.21) (p&lt;0.01)</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">The incidence of PH was low in this study, as compared to western studies. This may be since most of the cases of SCD being in remote areas having no access to health care facilities</span><span lang="EN-IN">. </span></p>

Background: Sickle cell disease is the commonest heritable hematologic abnormality affecting humans and is highly prevalent in central India. Aspartame is the only agent that can prevent sickling tested in-vitro and in-vivo so far. With the available data being relatively scarce, this study aims to study the efficacy of aspartame in sickle cell crisis and sickle cell disease.Methods: Forty cases and controls each were selected as per predefined criteria. Controls were treated with standard therapy of analgesics, IV fluids, antibiotics and oxygen, if needed. Cases were treated with oral aspartame in addition to standard therapy. Clinical grading was done before respective treatment in both cases and controls and comparisons were drawn.Results: 78.9% cases and 66% controls were pain free at the end of 72 hours; with p-value of 0.093, which is statistically insignificant. 78.7% cases (n=33) and 64.4% controls (n=33) with SS pattern had grade 0 pain at the end of 72 hours, results being statistically insignificant. 81% cases (n=7) and 75% controls (n=7) with AS pattern had grade 0 pain at the end of 72 hours, which was similar in both groups with statistically insignificant p-value of 0.753.Conclusions: Oral Aspartame as an add-on therapy to standard therapy for vaso-occlusive crisis in sickle cell disease appears to have better response than standard therapy alone.