Polycystic Ovarian Syndrome management with Ayurvedic prospective

Polycystic Ovarian Syndrome is one of the most serious medical conditions associated with pregnant women, particularly young women, and It is linked to miscarriage, erratic menstrual cycle, and a disturbed body mass index. Disease incidence increases mostly day by day because of undisciplined living style, diet, depression, etc. This leads to both physical and mental disorders of the patient and, if not cared for and treated, can also lead to miscarriage or frequent abortion. PCOD is one of that condition which typically affects second or third decade of life in females. It is important to know thoroughly about this disease as modern science has no root cause cure to treat it even the treatment of modern science implicated leads to severe side effects and dependence on the drugs. PCOD is diagnosed in Ayurveda according to its presentation in so many ways like hetu, lakshana, dosha- dushya, samprapti, associated features of PCOS are closely resembling with vandhya yonivyapada, artava-vahastrotas- viddha lakshana, nastartava and ksheena- artava described by acharya Sushruta and pushpaghni jatharini and vikruta jatharini mentioned by acharya Kashyap.

A Fully Remote Diagnostic and Treatment Pathway in Patients with Obstructive Sleep Apnoea during the COVID-19 Pandemic: A Single Centre Experience

The COVID-19 pandemic led to significant delays in the diagnostic and management pathway of patients with obstructive sleep apnoea (OSA). During the first wave of COVID-19, our department adopted a fully remote diagnostic (home cardiorespiratory polygraphy) and treatment (autoset continuous positive airway pressure, CPAP) approach. As a novel mode of service delivery, our aim was to evaluate our pathway and analyse factors associated with adherence to CPAP. We analysed the first 300 patients (51 ± 13 years, 48% men) who were set up on remote CPAP between 20 May 2020 and 11 September 2020. The associations between CPAP usage at 90 days and age, gender, body mass index, disease severity, Epworth Sleepiness Scale and comorbidities were investigated with linear and logistic regression analyses. A total of 124 patients (41.3%) were fully-adherent to CPAP therapy, defined as CPAP usage ≥ 4 h on ≥ 70% of the days. Only driving status was associated with adherence to CPAP. Patients who were adherent at 28 days were more likely to stay adherent at 90 days (3.77 odd ratio /3.10–4.45/ 95% confidence interval). We have shown that a fully remote diagnostic and treatment pathway for patients with OSA can be successfully delivered, and our preliminary outcomes of adherence to CPAP are comparable with published data.

Application of a Protocol to Assess Camel Welfare: Scoring System of Collected Measures, Aggregated Assessment Indices, and Criteria to Classify a Pen

This study aimed to apply a protocol for assessing camel welfare, to develop a scoring system for the welfare measures, to produce overall assessment indices, and to classify the animal units (i.e., pens) according to their welfare level. A total of 105 measures were collected at Herd level from 76 pens at a market in Qatar. The pens held 528 camels, 132 of which were evaluated at a deeper level (i.e., Animal level). Out of the 105 measures, 71 were selected, scored, and aggregated to reach a Total Welfare Index (TWI) for each pen. The TWI ranged from 46.2 to 69.8. The Good Feeding index, including measures related to prolonged thirst and prolonged hunger, was the most critical (p < 0.001), while the Good Health index, including measures related to the absence of injuries, disease and pain, was the less problematic (p < 0.001). However, most of the pens were classified as “unsatisfactory” (61.8%) and none as “excellent”. Body Condition Score (BCS), Thirst Index, disease and physical injuries, presence of a shelter, and cleanliness of bedding were the measures which influenced the pens’ classification the most (p < 0.05). The proposed model seems useful in the identification of camel welfare issues. Further applications, as well as the involvement of many scientists and stakeholders, are needed to refine and validate the protocol and its indices.

Review of COVID-19 Re-Infection among Recovered Patients and Its Implication for Lung Health

COVID-19 infection has continued to pose a very serious health threat to mankind globally despite all efforts geared toward curbing its spread. More worrisome recently is the report from different parts of the world on the re-infection of those treated and recovered with COVID -19 patients thus making containment of the virus even more difficult. Of more worrisome is the fact that the lung, a vital human organ is a major site being attacked by the virus even on re-infection cases. If quick action is not taken early enough, it may lead to the outright death of the patient. A lung infection, (Pneumonia) caused by COVID-19 has been discovered to be having a stunning effect on hospital systems and killing COVID-19 patients silently and it occurs even as the patient is asymptomatic. This paper examines the reasons for re-infection, Lacuna in the reviewed literature with regards to PCR test results, the effect of re-infection on the lungs, and implication for patients&rsquo; lung health. The papers summarized and concluded that it&rsquo;s a fact that re-infection occurs among patients accompanied by mild or severe symptoms having far-reaching implications for the patient&rsquo;s lung health. The paper recommends that the government at all levels should collaborate with WHO, CDC, and health policymakers to legally mandating, that every recovered patient should stay an additional 2weeks in the hospital for early detection of re-infection in order to avert any invasion and damage to the lungs thus ensuring lung health. Also, proper health education should be availed to the recovered patients to avoid any exposures or habits (different from the index disease) such as smoking that can pose dangers to the already fatigued lungs.

Temporal dynamics in viral shedding and transmissibility of COVID-19

ABSTRACTWe report temporal patterns of viral shedding in 94 laboratory-confirmed COVID-19 patients and modelled COVID-19 infectiousness profile from a separate sample of 77 infector-infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% of transmission could occur before first symptoms of the index. Disease control measures should be adjusted to account for probable substantial pre-symptomatic transmission.

P710 The influence of probiotics to the efficacy of 5-ASA for the patients of ulcerative colitis

Background 5-ASA is a key drug to treat the patients with mild-to-moderate ulcerative colitis (UC). Probiotics is sometimes used to UC patients for the purpose to correct dysbiosis of intestine. In theory, the efficacy of 5-ASA, especially pH-dependent release formulation of mesalazine may be weakened by the co-treatment with probiotics because of its effect leading to acidic condition in large intestine. However, the detail analysis about UC patients treating with 5-ASA and probiotics has not been elucidated. In the present study, we demonstrated the clinical course of UC patients treated by 5-ASA with probiotics to investigate the effect of probiotics to 5-ASA treatment. Methods The subjects were 85 UC patients who were in clinical remission and taking 5-ASA at the hospital of Kyoto Prefectural University of Medicine from January to March 2014. The clinical characteristics (age, sex, clinical activity index, disease location, and type of 5-ASA) and the rate of relapse until October 2019 were compared between probiotics group and no probiotics group. Furthermore, the rates of relapse were analysed for each specific 5-ASA between probiotics user and no probiotics user. The clinical activity index (CAI) was determined using Lichtiger index. The relapse of UC is defined by the increase of CAI, additional medication for UC, and endoscopic deterioration of colonic mucosa. Results Patients were included 39 cases in probiotics group and 46 cases in no probiotics group. There was no significant difference between probiotics and no probiotics group on the average age (53.1 ± 16.8 vs. 51.3 ± 14.2 years old, p = 0.59), the rate of male gender (41.0% vs. 41.3%, p =0.97), the average CAI (2.1 ± 0.64 vs. 2.0 ± 0.73, p = 0.59), disease location (extensive/left/rectum: 20/7/12 vs. 21/10/15 cases, p = 0.31), and type of 5-ASA (salazosulfapyridine/time-dependent mesalazine/pH-dependent mesalazine: 5/18/16 vs. 6/18/22 cases, p = 0.46). Besides, there was no significant difference between probiotics group and no probiotics group (51.3% vs. 52.2%, p = 0.93) about the rate of relapse. Regarding each specific 5-ASA usage, there was no significant difference on salazosulfapyridine (40.0% vs. 33.3%, p = 1), time-dependent mesalazine (44.4% vs. 50.0%, p = 1), and pH-dependent mesalazine (62.5% vs. 59.1%, p = 0.90) between probiotics user and no probiotics user. Conclusion In the present study, the co-treatment with probiotics did not affect the relapse with UC patients regardless the type of 5-ASA, suggesting that the usage of probiotics might not disturb the efficacy of 5-ASA for UC patients.

Could clustering of comorbidities be useful for better defining the internal medicine patients’ complexity?

Internal medicine patients are mostly elderly with multiple comorbidities, usually chronic. The high prevalence of comorbidity and multimorbidity has a significant impact on both positive responses to treatment and the occurrence of adverse events. Clustering is the process of nosography grouping into meaningful associations with some index disease, so that the objects within a cluster have high similarity in comparison with one another. In the decision-making process it is imperative that, in addition to understanding the immediate clinical problems, we are able to explicit all the contextual factors that have to be taken into account for the best outcome of care. Cluster analysis could be leveraged in developing better interventions targeted to improve health outcomes in subgroups of patients.