Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Early Surgical Intervention Improves Survival in Acute Intestinal Ischemia in the Intensive Care Unit

The study is aimed at assessing whether the early surgical intervention improves survival in acute mesenteric ischemia with septic shock. A retrospective study design was applied to review the charts of patients admitted to the intensive care unit. The data were collected through a review of the full patient chart including physician and nursing notes, pathology reports, intraoperative findings, CT findings, and endoscopy. The diagnosis of AMI for each patient was determined through clinical presentation/endoscopic visualization/laboratory results/radiographic imaging, surgical exam (tissue or visual) and/or autopsy. Death and survival were evaluated between short and long-time-interval for septic shock groups using the chi-square test followed by calculating the P value. Total survival among the surgery group was 60 patients (95.24%) compared to 3 (4.76%) survival among patients who did not have surgery. The time from the onset of a shock to the time of surgical incision was calculated. The mean time to surgery was 17.7 hours. Total 65 patients (29.52%) had surgery between 4 and 12 hours from the onset of hypotension. Survivals among this group of patients were 41.7% (n=25). The survival difference was statistically significant than died patients with respect to the time of surgical intervention (P=<0.001). Early removal of ischemic bowel in patients with AII-related surgery has improved survival

Assessing Yield Response and Relationship of Soil Boron Fractions with Its Accumulation in Sorghum and Cowpea under Boron Fertilization in Different Soil Series

Boron (B) is an essential micronutrient in the growth of reproductive plant parts. Its deficiency and/or toxicity are widespread in arid and semi-arid soils with low clay contents. This study was planned to determine the response of sorghum (Sorghum bicolor L., non-leguminous crop) and cowpea (Vigna sinensis L., leguminous crop) to boron (0, 2, 4, and 16 µg g−1) on four distinct soil series from Punjab, Pakistan i.e., Udic Haplustalf (Pindorian region), Typic Torrifluvent (Shahdra region), Halic Camborthid (Khurianwala region), and Udic Haplustalf (Gujranwala region). Overall, there was a significant difference (p &lt; 0.05) in yield between the sorghum (3.8 to 5.5 g pot−1 of 5 kg dry soil) and cowpea (0.2 to 3.2 g pot−1 of 5 kg dry soil) in response to B application. The highest yield was observed in both sorghum and cowpea either in control or at 2 µg g−1 B application in all four soils. Cowpea showed the same yield trend in all four soils (i.e., an increase in yield at 2 µg g−1 B application, followed by a significant decrease at the higher B levels). In contrast, sorghum exhibited greater variability of response on different soils; Udic Haplustalf (Pindorian region) produced the greatest yield at low levels of B application. However, Halic Camborthid produced its lowest yield at that level. Boron concentration in shoots increased with the levels of B application, particularly in sorghum. In cowpea, the plant growth was extremely retarded—and most of the plants died at higher levels of B application even if a lower concentration of B was measured within the shoot. Hot water-extractable B was the most available fraction for cowpea (R2 = 0.96), whereas the easily exchangeable B was most available for sorghum (R2 = 0.90). Overall, these results have implications for micronutrient uptake for both leguminous and non-leguminous crops

Enhancing Drought Tolerance in Wheat Cultivars through Nano-ZnO Priming by Improving Leaf Pigments and Antioxidant Activity

Climate change, global warming, stagnant productivity of wheat and food security concerns owing to frequent spells of drought stress (DS) have necessitated finding biologically viable drought-mitigation strategies. A trial was conducted to test two promising wheat cultivars (Ujala-16 and Zincol-16) that were subjected to pre-sowing priming treatments with different doses of ZnO nanoparticles (NPs = 40, 80, 120 and 160 ppm) under 50% and 100% field capacity (FC) conditions. The ZnO NPs were prepared with a co-precipitation method and characterized through X-ray diffraction (XRD) and with a scanning electron microscope (SEM). For comparison purposes, untreated seeds were sown as the control treatment. The response variables included botanical traits (lengths, fresh and dry wrights of root and shoot), chlorophyll (a, b and total) contents, antioxidant and proline contents and nutrients status of wheat cultivars. The results showed that DS significantly decreased all traits of wheat cultivars, while ZnO NPs, especially the 120 ppm dose, remained superior by increasing all botanical traits at 100% FC. In addition, ZnO NPs increased the chlorophyll a (1.73 mg/g FW in Ujala-16 and 1.75 mg/g FW in Zincole-16) b (0.70 mg/g FW in Ujala-16 and 0.71 mg/g FW in Zincole-16) and total chlorophyll content (2.43 mg/g FW in Ujala-16 and 2.46 mg/g FW in Zincole-16) by improving the activity of antioxidant and proline content. Moreover, plant nutrients such as Ca, Mg, Fe, N, P, K, and Zn contents were increased by ZnO NPs, especially in the Zincol-16 cultivar. To summarize, Zincol-16 remains superior to Ujala-16, while ZnO NPs (120 ppm dose under 100% FC) increases the growth and mineral contents of both wheat varieties. Thus, this combination might be recommended to wheat growers after testing further in-depth evaluation of more doses of ZnO NPs

Analysis Covid-19 Vaccine Effectiveness Using SIR Model

Covid-19 is a new coronavirus disease that was labelled a pandemic by the World Health Organization (WHO) in March 2020. SIR Model is a versatile compartmental mathematical tool that may be used to simulate any pandemic dynamic, including the current Covid-19 out- break. In the conventional SIR model, the total population (N) is divided into three categories: susceptible(S), infected(I), and recovered(R). So, this research focused on finding the basic re- productive number, Ro of Covid-19 by using the Next Generation Matrix. Ro is greater than 1 means viruses begin to spread the population and Ro less than 1 means disease is about to vanish from the population. It is also analyze and compare the transmission of Covid-19 with and without vaccination. To apply this, the data from government websites is used to find the total number of cases and recover. With the help of mathematical software such as Maple to find the result of the graph. From the result produce from Maple, it can be observed that the slope of with vaccination is bigger than the slope of without vaccination. It clearly shows the comparison between them. The findings improved by having vaccination and then transmission rate low is good to decrease virus Covid-19 from infection