Objective: Cytokine storm and coagulopathy being the major causes of morbidity in Covid 19 patients, based on an earlier pilot study yielding control of IL 6 and D-Dimer, when AFO 202 and N 163 strains of Aureobasidium Pullulans produced beta glucans, were studied separately and in combination for 30 days. In this study, we evaluated the efficiency of the two variants combinations in comparison with the control arm, which underwent a conventional regimen of treatment alone, for a shorter duration. Methods: A total of 40 RT-PCR positive Covid-19 patients divided into two groups (Gr): Gr. 1 control (n=22). Standard treatment; Gr. 2 (n =18) Standard treatment + combination of AFO 202 and N 163 beta glucans for 15 days. Biomarkers of relevance to cytokine storm and coagulopathy were evaluated at baseline on Day 7 and Day 15. Results: The C-reactive protein (CRP), which declined from 33.95 ng/ml to 5.07 ng/ml in control and from 33.95 ng/ml to 5.64 ng/ml in the treatment arm on Day 7, increased to 14.6 ng/ml in the former while it continued to be under control in the treatment arm at 5.68 ng/ml on Day 15. The same trend was observed in Ferritin, whose values were 560.58 pg/ml at baseline to 261.44 pg/ml (day 7) and 182.40 pg/ml (day 15) in the treatment group, while it was 535.24 pg/ml at baseline, 116.66 pg/ml on day 7 and 291.95 pg/ml on day 15 in the control group. IL-6 showed a higher decrease in treatment group compared to the control group. The difference between day 7 and day 15 values were statically significant. Conclusion: A statistically significant control of IL-6, CRP and Ferritin in Covid 19 patients who orally consumed AFO 202 and N 163 strains of Aureobasidium Pullulans produced Beta glucans together in 15 days make us recommend this safe food supplement be consumed by Covid 19 patients along with conventional treatments, especially to the vulnerable population, as a prophylaxis amidst the prolonged pandemic with evolution of mutated strains of SARS COV2.
Although the annular dimensions of the mitral valve increased correspondingly with body surface area, they still remained very low in the Indian population as compared with the standard values, which might cause patient-prosthesis mismatch during mitral-valve replacement surgeries.
While rationing of healthcare resources is inevitable even in the most developed economies, particularly on the wake of a pandemic, ethical basis of its implementation needs to be reviewed. With sudden and huge demand for drugs and medical supplies and equipments, the need for rationing arises and thus the concept becomes unavoidable. Thus, we aimed to review and analyse on the key ethical issues in the concept of healthcare rationing. Our search in various PubMed databases resulted articles explaining on the concept of strategizing the priorities based on universal ethical principles of justice, benevolence and ensuring equality rather than wealth, power, geographical location or other personal biases. Concrete and pragmatic regulations and guidelines for systematic rationing have to be framed and followed. In addition, physicians being sensitive and empowered on deciding bedside rationing in coordination with the recommendations of ethicists and healthcare officials, will ensure fair practice.
The vermiform appendix is a part of large intestine, situated in right iliac fossa. It is a vestigeal organ in humans. This study was done 50 adult cadavers and spontaneously aborted fetal specimens. The anatomical variations were photographed, tabulated and compared with previous studies. Bacterial infection of appendix known as appendicitis is an emergency condition in all age groups. This is treated by removal of it known as appendicectomy. Detailed knowledge about the normal and variant anatomy is important for the surgeons during the surgery. The anatomical knowledge is also useful to the radiologist for diagnosing the appendicular artery in angiograms.
Aim: The Aortic Valve (AV) annular dimension with respect to the Body Surface Area (BSA) of the Indian population is compared against the standard values. Presence of discrepancies can lead to patient prosthesis mismatch during aortic valve replacement surgeries.Methods: This study was conducted on 406 subjects. AV diameter was examined by using parasternal long axis view, where the imaging plane transects the AV in an anteroposterior direction and its x axis is aligned parallel to the long axis of aorta. Data were statistically analysed with western population. Conclusions: There is a significant difference between Indian and western population in the aortic dimension, in the body surface ranges of 0.61-0.7, 1.11-1.2, 1.21-1.3, 1.51-1.6, 1.61-1.7, 1.71-1.8 and 1.8-1.9 m 2 . In the range of 1.21-1.3 m 2 , the diameter was larger than standard, whereas in all the other ranges, AV diameter was smaller than standard values. BSA, as a good predictor of AV dimension, has also been proved.
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