Bendsengupta1395

The ongoing COVID-19 pandemic has affected most countries in the world, with significant economic and public health implications. There is rising concern that patients who recover from COVID-19 may be at risk of reinfection. Another potential concern is the uncommon clinical scenario of a patient having persistent SARS-CoV-2 RNA test over 3 months after the initial COVID-19 infection, as the patient presented. Whether presenting as a long-term infection (12 weeks) or reinfection, patients with COVID-19 will continue to have a severe inflammatory and prothrombotic state that could carry potential life-threatening thrombosis.Coronavirus disease 2019 (COVID-19) has swept through the world with millions of cases and hundreds of thousands of deaths. COVID-19-associated coagulopathy has been recognized as the major cause of morbidity and mortality. To the best of our knowledge, a majority of the cases of coagulopathy have been reported in patients with moderate-to-severe COVID-19 and limited to observations during the recovery/postcytokine storm state. Herein, we report a case series of two patients with COVID-19 who developed pulmonary embolism in the late phase of the disease. This raised the hypothesis that the risk of hypercoagulability in patients with COVID-19 can persist until the recovery phase, which would warrant a follow-up with D-dimer and fibrinogen trending, as well as postdischarge thromboprophylaxis for at least 2 weeks during the recovery phase.Rare and varied presentations of tuberculosis make it difficult for treating clinicians to arrive at the diagnosis. An adolescent female presented to the orthopedic outpatient department with slowly increasing swelling over the dorsum of the hand near the base of the third digit for 5 months. With multiple consultations, she was being treated with antibiotics as a case of abscess. On examination, the swelling was soft bulging with whitish watery discharge. Plain radiography revealed periosteal elevation with bony destruction of the proximal phalanx. Magnetic resonance imaging revealed signal intensity changes with collection suggestive of infection. Blood investigations were within the normal limits, except slightly raised erythrocyte sedimentation rate. A differential diagnosis of chronic osteomyelitis was performed. Since the swelling was growing with the overlying skin likely to give way, it was treated with incision and drainage. Cytology with Gram's and auramine staining helped in confirming the diagnosis of spina ventosa. Biopsy is the gold standard for diagnosis, and antitubercular therapy forms the mainstay of treatment.

The nonzoonotic (nonsevere acute respiratory syndrome (SARS)/Middle East respiratory syndrome) human coronaviruses (HCoVs) are usually considered as the causative agent for acute respiratory infection. We studied the characteristics and outcome of children with non-SARS HCoV acute lower respiratory infection (ALRI).

This was a cross-sectional study from a tertiary care teaching hospital in eastern India.

Of 137 samples tested positive for respiratory viruses, 13 were due to HCoV (7 boys, median age 2 years). Cough was the most common symptom, followed by breathing difficulty and fever. An underlying comorbid condition present in 38.4%. Co-infection with other viruses was seen in 69% of cases. Chest radiograph was abnormal in 69.3% of children. Antibiotics were administered in 53.8%. The median length of hospitalization was 5 d, irrespective of underlying disease. There was no mortality.

HCoV is an uncommon but increasingly recognized cause of ALRI in hospitalized children. No severe illness was found in children with underlying comorbidities. This study underscores the importance of HCoV in causation of childhood ALRI, necessitating a surveillance system in India.

HCoV is an uncommon but increasingly recognized cause of ALRI in hospitalized children. No severe illness was found in children with underlying comorbidities. This study underscores the importance of HCoV in causation of childhood ALRI, necessitating a surveillance system in India.The present work is an attempt to look at the legal and environmental implications of coronavirus disease-2019 outbreak in India. It looks at both sides of this tragedy focusing specifically on the environmental and legal aspects in the Indian context. However, the article does not refrain from discussing examples of other countries or some global aspects if necessary.

Influenza infection in pregnancy causes 4%-8% case fatality and five times more perinatal mortality. Influenza is a major contributor to mortality in developing countries; however, the morbidity has largely been underestimated. Public health interventions for prevention are also lacking.

This study aimed to determine the seasonality of influenza in pregnant Indian women and to estimate the maternal and perinatal morbidity after treatment with oseltamivir.

This was a prospective observational cohort study, conducted in a tertiary hospital.

Pregnant women with ILI (influenza-like illness) were recruited into Cohort 1 (polymerase chain reaction [PCR] positive) and Cohort 2 (PCR negative). Gestational age-matched asymptomatic controls formed Cohort 3. Women in Cohort 1 received oseltamivir for 5 days. The incidence of small-for-gestational age (SGA) and preterm birth were the primary outcomes. Maternal and neonatal morbidity formed the secondary outcomes.

Unmatched (Cohort 1 and 2) and matched analysis (Cohort 1 and 3) were done. Student's

-test and Chi-square test were used to compare between variables.

Year-round incidence of influenza was recorded. Severe illness was more in Cohort 1 compared to Cohort 2 (36.2% vs. 6.3%;

< 0.001). SGA was comparable in all the cohorts (13%). Preterm birth (7.8% vs. 3.3%;

< 0.08; relative risk-2.75) was considerably high in Cohort 1. Secondary maternal and neonatal outcomes were similar between the groups.

Influenza in pregnancy showed year-round incidence and increased maternal and neonatal morbidity despite treatment with oseltamivir. We suggest the need for newer interventions to curtail the illness in pregnancy.

Influenza in pregnancy showed year-round incidence and increased maternal and neonatal morbidity despite treatment with oseltamivir. We suggest the need for newer interventions to curtail the illness in pregnancy.

A systematic review and meta-analysis of available studies was performed to investigate the clinical characteristics that can predict COVID-19 disease severity.

Databases including PubMed, Embase, and Web of Science were searched from December 31, 2019, to May 24, 2020. Random-effects meta-analysis was used for summarizing the Pooled odds ratio (pOR) of individual clinical characteristics to describe their association with severe COVID-19 disease.

A total of 3895 articles were identified, and finally, 22 studies comprising 4380 patients were included. Severe disease was more common in males than females (pOR 1.36, 95% confidence interval [CI] 1.08-1.70). Clinical features that were associated with significantly higher odds of severe disease were abdominal pain (pOR 6.58, 95% CI 1.56-27.67), breathlessness (pOR 3.94, 95% CI 2.55-6.07), and hemoptysis (pOR 3.35, 95% CI 1.05-10.74). pOR was highest for chronic obstructive pulmonary disease (pOR 2.92, 95% CI 1.70-5.02), followed by obesity (pOR 2.84, 95% CI 1.19-6.77), malignancy (pOR 2.38, 95% CI 1.25-4.52), diabetes (pOR 2.29, 95% CI 1.56-3.39), hypertension (pOR 1.72, 95% CI 1.23-2.42), cardiovascular disease (pOR 1.61, 95% CI 1.31-1.98) and chronic kidney disease (pOR 1.46, 95% CI 1.06-2.02), for predicting severe COVID-19.

Our analysis describes the association of specific symptoms and comorbidities with severe COVID-19 disease. Knowledge of these clinical determinants will assist the clinicians in the risk-stratification of these patients for better triage and clinical management.

Our analysis describes the association of specific symptoms and comorbidities with severe COVID-19 disease. Knowledge of these clinical determinants will assist the clinicians in the risk-stratification of these patients for better triage and clinical management.

Nocardiosis is a rare infection that affects immunocompromised patients on immunosuppressive medications used for transplantation and cancer therapy. Such therapies are becoming more widely available in the Middle East region. Selleck AS-703026 Yet, reports on nocardiosis are scarce.

This was a retrospective analysis of patients who were diagnosed with nocardiosis from 2004 to 2018 at a transplantation and cancer center. Nocardiosis were defined per the European Organization for Research and Treatment of Cancer criteria.

During the study period, 35 patients with nocardiosis (male 68.5%) were identified. The most common underlying associated condition was transplantation 11 (31.4%), followed by malignancy 7 (20%), connective tissue disease and sarcoidosis 7 (20%), chronic lung disease 5 (14%), miscellaneous conditions 4 (11%), and one patient with human immunodeficiency virus.

was disseminated in 8 patients (22.9%) and isolated in 27 (77.1%); the latter included 13 patients (37.1%) with bronchial form, 11 (31.4%) with isolated visceral form, and 3 (8.6%) with cutaneous form. Pulmonary involvement occurred in 90% of the cases with cough, fever, and dyspnea being the most common symptoms. The main strain isolate was

, and the cure rate was 90%. Mortality related to nocardiosis occurred in 3 transplant patients (8.6%).

Wider use of immunosuppressive therapy warrants vigilance to nocardiosis, which can present in a myriad of clinical forms. In our series, mortality was confined to the transplantation group, probably because of the relatively heavy immunosuppression. Nonetheless, prognosis is favorable if the infection is recognized and treated early.

Wider use of immunosuppressive therapy warrants vigilance to nocardiosis, which can present in a myriad of clinical forms. In our series, mortality was confined to the transplantation group, probably because of the relatively heavy immunosuppression. Nonetheless, prognosis is favorable if the infection is recognized and treated early.

Published literature is silent about the gender gap in tuberculosis (TB) among adolescent (10-19 years) population despite extensive information on increased susceptibility of the male gender after 20 years. We analyzed the data from 1113 adolescent microbiologically confirmed TB cases using cartridge-based nucleic acid amplification test (CBNAAT) in 2019 in the State of Himachal Pradesh (HP), India.

The data generated by 39 CBNAAT sites in HP were analyzed with an objective to describe the gender gap in TB among adolescents.

Among 983 patients with pulmonary TB (PTB), the male female ratio was 11.5 (

= 0.0001), whereas in 130 patients with extra PTB (EPTB), the male female ratio was 11.8 (

= 0.0001). This male female ratio was seen to reverse after 20 years for PTB, and but it persisted till 40 years for EPTB. Two main forms of TB that were significantly high in females during adolescence were PTB and lymph node TB (

= 0.0001).

Significant gender difference with female susceptibility was seen for TB among adolescents, a fact that needs more research. Adolescent TB is a neglected area with little published data driven mainly by the fact that most countries report their TB population above and below 15 years, dividing the adolescent population into two halves. The world needs to acknowledge adolescents (10-19 years) as a separate important group for reporting TB statistics.

Significant gender difference with female susceptibility was seen for TB among adolescents, a fact that needs more research. Adolescent TB is a neglected area with little published data driven mainly by the fact that most countries report their TB population above and below 15 years, dividing the adolescent population into two halves. The world needs to acknowledge adolescents (10-19 years) as a separate important group for reporting TB statistics.