No abstract

This hospital was among the first to report cases and deaths of COVID-19 patients in the United States. COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most neurological manifestations of COVID-19 have been reported from non-USA health systems for hospitalized patients [1-3]. All patients had laboratory confirmed SARS-CoV-2 infection. Only new onset neurological manifestations were included. Study data were extracted from electronic medical records, and all neurological manifestations were confirmed via chart review by a neurologist and neuropsychologist. The study was approved by institutional review board and ethics committee. Core presenting symptoms were fever, cough, and shortness of breath. Clinical characteristics and admission laboratory measures are summarized in Table 1. Shapiro's test revealed significant deviations from normal distribution. Therefore, non-parametric alternatives to the t test (Wilcox rank sum test and Hodges-Lehmann estimation) were used, at alpha level of 0.05, adjusted for multiple comparisons using the Benjamini-Hochberg method. Female patients younger than 65 years old were more likely to have neurological symptoms; however, the findings were not statistically significant. Asian patients were 2.02 times more likely to have neurological symptoms than

Objective: The purpose of this study was to investigate the occurrence of neurologic symptoms with a focus on altered mental status in a sample of deaths due to COVID-19. Methods: We reviewed neurologic symptoms in 71 deaths due to COVID-19 at the first US hospital with reported cases, of which 66 (93%) had medical comorbidities, 47 (66%) came from assisted living facilities or nursing homes and 35 (49%) had baseline dementia. Results: Sixty-one patients (86%) demonstrated neurologic symptoms at hospital admission. Altered mental status was seen in 47 patients (66%) and represented the most common neurologic symptom. Seven patients (10%) were comatose at hospital admission and 5 (7%) presented with altered mental status without respiratory symptoms. Three patients had seizures and two had strokes. Hypertension (61%), cardiovascular disease (59%), and dementia (49%) were the most common comorbidities associated with death due to COVID-19 in our sample. Conclusions: Neurologic symptoms, particularly altered mental status, are very common in COVID-19 patients with high risk of mortality. In a small subset of patients, altered mental status is the defining feature of disease presentation. A mental status examination should be incorporated in the medical assessment of COVID-19.

The aim was to assess QOL and its determining factors among postmenopausal women of a rural area of West-Bengal in India. Methods: This cross-sectional study was conducted among 315 postmenopausal women and the data were collected using the modified menopause quality of life questionnaire of Hilditch. (Hilditch MENQOL). Results: Out of the 315 women who have been interviewed 243 (77%) had poor quality of life. Multivariate analysis revealed that poor QOL was more among those who did not live with their own children [AOR (95% C.I.) 4.26 (2.1-8.6)], did not undertake regular exercise, [AOR (95% C.I.) 2.88 (1.38-6.03)], were literate [AOR (95% C.I.) 2.5 (1.13-4.8)], were monetarily dependent on their children [AOR (95% C.I.) 2.5 (1.32-4.88)], not living under one roof with children [AOR (95% C.I.) 4.26 (2.1-8.6)] and had attained menopause >5 years. [AOR (95% C.I.) 4.82 (2.47-9.41)]. Conclusion: Different stakeholders are required to mobilize the post-menopausal women through IEC activities to cope up with the stress of the post-menopausal phase and acquire a better quality of life beyond their reproductive age.

Over the past 20 years, hydroxyurea (HU) has emerged as an important therapeutic agent to augment Hb F and thus total hemoglobin (Hb) in Hb E [β26(B8)Glu→Lys; HBB: c.79G > A]-β-thalassemia (Hb E-β-thal), albeit used in varying doses with little consensus on its optimal dose. We report the interim analysis findings of a broader study to assess the impact of Comprehensive Thalassemia Care, of which the present report was a part. Sixty-one Hb E-β-thal patients who were transfusion independent or requiring occasional transfusions [β-thal intermedia (β-TI)] were randomized to one of two groups; A (n = 32) and B (n = 29) to receive 10 and 20 mg/kg/day HU, respectively. The primary objective of the study was to assess the differences in responses to different doses of HU. Secondary end points were to see the tolerability and safety of HU in different doses. Good response (GR) was defined as a rise of Hb by > 1.0 g/dL; intermediate response (IR) as a rise in Hb by 0.6-1.0 g/dL anytime during the study period. No response (NR): rise in Hb by < 0.5 g/dL in 12 weeks or drop in Hb level from the previous value. Over a follow-up period of 24 weeks, we had 18 (56.2%) GRs, nine (28.2%) IRs and five (15.6%) NRs, while the number of GRs, IRs and NRs in group B were five (17.2%) 12 (41.4%) and 12 (41.4%), respectively. Adverse effects were more common in group B, making this dose (20 mg/kg/day) of HU more myelo-suppressive than Hb F inducing.