Possible Early Vertical Transmission of COVID-19 from an Infected Pregnant Female to Her Neonate: A Case Report

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-19) has emerged as a public health emergency in recent times. The reported data on the mode of transmission of coronavirus disease 2019 (COVID-19) are largely through contact, droplet, airborne and fomite transmission methods with vertical transmission being a rare entity. We hereby report a case of a probable vertical transmission of SARS-CoV-19 from an infected pregnant female to her neonate. The transmission has been confirmed by a positive RT-PCR at 16 h of life along with a positive IgG antibody test for SARS-CoV-19 in the baby and after excluding the possible environmental contamination of the sample. The baby was asymptomatic during the course of hospital stay and was discharged from the facility on Day 9 of life.

Management of cardiovascular emergencies during the COVID-19 pandemic

BACKGROUND

It has been reported that patients attending the emergency department with other pathologies may not have received optimal medical care due to the lockdown measures in the early phase of the COVID-19 pandemic.

METHODS

This was a retrospective study of patients presenting with cardiovascular emergencies to four tertiary regional emergency departments in western India during the government implementation of complete lockdown.

RESULTS

25.0% of patients during the lockdown period and 17.4% of patients during the pre-lockdown period presented outside the window period (presentation after 12 hours of symptom onset) compared with only 6% during the pre-COVID period. In the pre-COVID period, 46.9% of patients with ST elevation myocardial infarction underwent emergent catheterisation, while in the pre-lockdown and lockdown periods, these values were 26.1% and 18.8%, respectively. The proportion of patients treated with intravenous thrombolytic therapy increased from 18.4% in the pre-COVID period to 32.3% in the post-lockdown period. Inhospital mortality for acute coronary syndrome (ACS) increased from 2.69% in the pre-COVID period to 7.27% in the post-lockdown period. There was also a significant decline in emergency admissions for non-ACS conditions, such as acute decompensated heart failure and high degree or complete atrioventricular block.

CONCLUSION

The COVID-19 pandemic has led to delays in patients seeking care for cardiac problems and also affected the use of optimum therapy in our institutions.

Storage Behavior and Cryopreservation of Citrus cavaleriei, an Endangered, Cold-resistant Species of Northeast India with Exceptionally Large Seeds

BACKGROUND

Ichang Papeda (Citrus cavaleriei H.Lév. ex Cavalerie) is a wild and endangered species of NE India that requires urgent preservation of its genetic resources.

OBJECTIVE

To characterize the storage physiology of the seeds and to cryopreserve the embryo and embryonic axis (EA).

MATERIALS AND METHODS

The morphology and storage physiology of the seeds were determined, and the cryopreservation of embryos and EA attempted using various techniques (viz., air desiccation-freezing, vitrification and encapsulation-dehydration).

RESULTS

Weighing up to 4 g, seeds of Citrus cavaleriei are the largest known in the genus. Based on estimates using the seed coat ratio - seed mass (SCR-SM) model there was a very high probability of seed desiccation intolerance, which was validated physiologically; seeds lost vigour on drying below 30% moisture content (MC) and no seeds germinating after drying to <12% MC. Embryos and EAs could be air dried to 25-30% MC and cryopreserved with c. 50% survival. In contrast, EA optimally exposed to PVS2 (20 min) or encapsulated, sucrose pretreated (0.5 M, 24 h) and dehydrated (6 h) had c. 40% survival after cryopreservation.

CONCLUSION

Citrus cavaleriei produces large, recalcitrant seeds that can, nevertheless, be cryopreserved as embryos or isolated EA after air drying to c. 25-30% MC; encapsulation-dehydration and vitrification provide alternative options for the cryopreservation of EA.

COVID-19 pandemic and stent thrombosis in a post percutaneous coronary intervention patient-a case report highlighting the selection of P2Y12 inhibitor

The current pandemic of novel coronavirus disease 2019 (COVID-19) has posed a great threat to people's health worldwide, with specific implications on patients with underlying heart diseases. During this challenging period, nearly all major societies have recommended for conservative approach, even for patients with relatively stable acute cardiovascular diseases. Selection of specific antiplatelet therapy in an uncomplicated post percutaneous coronary intervention (PCI) patient can, at times, be crucial issue in such strained circumstances. We report a case of 64-year-old male, who was taken for urgent coronary angiogram (CAG) in view of non ST elevation acute coronary syndrome. Successful PCI with implantation of drug eluting stent was done for right coronary artery (RCA) and left anterior descending (LAD) artery lesions. On day 5th post-PCI, he developed acute inferior wall STEMI due to subacute stent thrombosis (ST), and despite all efforts, patient could not be saved as he didn't receive timely intervention. Increased travel time to emergency department due to lockdown because of COVID-19 and along with extra time required for donning of personal protection equipment (PPE) and other COVID-19 related safety measures prolonged the ischemic time. Potent P2Y12 inhibitor based dual antiplatelet therapy might have prevented this subacute ST, and thus mortality, as the patient was discharged on clopidogrel after PCI. While selecting specific P2Y12 inhibitor in a post PCI patient, apart from clinical condition of patient and complexity of procedure, we should also consider current COVID-19 pandemic. Current circumstances may favour ticagrelor over other P2Y12 inhibitors in view of its potent, rapid, and reversible antiplatelet action along with its optimistic effect in pneumonia.

Potential use of hydroxychloroquine, ivermectin and azithromycin drugs in fighting COVID-19: trends, scope and relevance

Alarming situation has been caused due to the emergence of COVID-19 infection around the world. There is an urgency of developing a therapeutic strategy in order to control the spread of COVID-19. Towards that initiative, potential drugs like hydroxychloroquine, ivermectin and azithromycin have been tested by diverse group of researchers worldwide for their potential against novel coronavirus. The present report presents together the comprehensive knowledge derived from the major researches about the above drugs altogether in context of the current health emergency around the world. Hydroxychloroquine and ivermectin were known to act by creating the acidic environment and inhibiting the importin (IMPα/β1) mediated viral import. Azithromycin was found to act similar to the hydroxychloroquine as an acidotropic lipophilic weak base. All the three categories of drugs seemed to potentially act against novel coronavirus infection. However, their efficacies need to be studied in detail individually and in combination in-vivo in order to combat COVID-19 infection.

Attitude towards oral hygiene among different socio-economic groups in Jaipur city, Rajasthan

Background

Socio-economic status is a total measure of a person’s work experience and of an individual or family economic and social position in relation to others, based on income, education and occupation.

Objective

The study was conducted to determine the differences in attitudes of people from different socioeconomic statuses towards their oral hygiene.

Method

A cross sectional study was conducted among subjects of various socioeconomic groups. Socioeconomic status and oral hygiene data was collected using Aggarwal scale having 22 items questionnaire addressing various aspects of knowledge and attitude of subjects towards oral health, and simplified Oral Hygiene Index (OHI- S), respectively. Statistical analysis was done using chi- square test and frequency distribution (P< 0.05 taken as significant).

Results

Among 500 subjects, 260 (52%) were found to have good oral hygiene, and most of them (43.46%) were from lower middle class group. A highly significant association was found between the oral hygiene and socioeconomic status (p=0.000).

Conclusion

It could be concluded that the socioeconomic status is not the only factor that determines a person’s attitude towards oral hygiene, but other factors such as lack of awareness, lack of availability of dentist nearby, fear and anxiety also play an important role.

Chest pain and exercise induced left bundle branch block – A clinical dilemma

Exercise-induced left bundle branch block is a rare electrocardiographic phenomenon. We present two patients with angina pectoris who developed left bundle branch block on ECG during treadmill test. The first patient had non-obstructive coronary arteries with slow flow and is a rarely reported entity. The second patient had typical chest pain with single vessel Coronary Artery Disease. Left bundle branch block occurred in stage I of Treadmill Testing and persisted for approximately 4 hours and then reverted spontaneously. These two interesting cases of this rare phenomenon are presented here with review of relevant literature.

Quality of life of cancer patients

Cancer is a one of the major public health problem both in developed and developing countries around the globe. Quality-of-life (QOL) of a cancer patient before and after the treatment is an important issue especially for the cancer survivors, their families, and the care providers. In cancer prospective, Quality-of-life can been defined as a sense of well-being, it is a multidimensional perspective that includes dimensions such as physical, psychological, social, and spiritual, changes in one QOL dimension can influence perceptions in other dimensions also. Cancer patients should demand information related to adverse effects of chemotherapy and actions to be taken to reduce them, also there should be provision of providing sufficient information prior to beginning of the treatment procedure irrespective to type of treatment, so that patient is aware of all the treatment modalities and their side effects and self-care strategies so as to reduce treatment-related concerns.

Prevalence of dental caries in overweight school going children of 12-15 years in and around Jaipur city, Rajasthan, India

INTRODUCTION

Dental caries and obesity are both multifactorial disease with a complex etiology and both are associated with dietary habits. Prevalence of dental caries and an association between body mass index (BMI) and dental caries among school children

METHODS

The present was done on 1500 school going children to assess the prevalence of dental caries in 12-15 year old overweight children. Weight and height were measured in light clothing and without shoes using an electronic weighing scale. Subjects’ heights were measured using a stadiometre. Subjects were examined on an upright chair in adequate natural daylight and dental caries was measured by using DMF index. Chi-square test was used to analyze and compare qualitative data whereas unpaired ‘t’ test was used to analyze and compare quantative data

RESULTS

Amongst 1500 children, 156 were found to be overweight, 443 were normal weight. When mean BMI between overweight and normal weight were compared a highly significant difference was observed. When DMFT of overweight and normal weight were compared no significant difference was observed

CONCLUSION

Dental caries was observed more in females as compared to males and no significant difference was observed between dental caries and weight gain