A study on incidence of adverse drug reactions of current multidrug resistant pulmonary tuberculosis treatment regimen at a tertiary care centre in kumaon region of Uttarakhand

Background: Treatment of multidrug resistant pulmonary tuberculosis (MDR-PTB) is challenging because of multiple anti-TB drugs, long treatment duration and various adverse drug reactions (ADRs). The aim of this study was to find the incidence of ADRs related to various anti-TB drugs. Methods: This was a prospective observational study done from 1st January 2019 to 30th June 2020, in the Department of Respiratory Medicine at Government Medical College, Haldwani, Uttarakhand. Results: A total of 163 MDR-PTB patients were reviewed, of which 136 (83.44%) patients experienced >1 ADRs, during intensive phase of treatment. Total 398 ADR episodes were observed, maximum ADRs (134, 33.7%) were related to Gastrointestinal system. Incidence of ADRs was more (96.97%) in 46-60 yrs. of age group, in patients living in rural area (82 of 92, 89%), in married patients (88.07%), in smokers (91.4%), in alcoholics (90.6%), in patients having co-morbidities and in patients who had anemia (88.24%). The most common ADR was joint pain in 36 (26.5%) of 136 patients. Conclusion: Strict follow-up with laboratory investigations, providing assurance and exercise plan to the patients is crucial. Healthcare providers should be trained regarding identification and management of ADRs

2-(2-arylphenyl)benzoxazole as a novel anti-inflammatory scaffold: synthesis and biological evaluation

The 2-(2-arylphenyl)benzoxazole moiety has been found to be a new and selective ligand for the enzyme cyclooxygenase-2 (COX-2). The 2-(2-arylphenyl)benzoxazoles 3a–m have been synthesized by Suzuki reaction of 2-(2-bromophenyl)benzoxazole. Further synthetic manipulation of 3f and 3i led to 3o and 3n, respectively. The compounds 3g, 3n, and 3o selectively inhibited COX-2 with selectivity index of 3n much better than that of the COX-2 selective NSAID celecoxib. The in vivo anti-inflammatory potency of 3g and 3n is comparable to that of celecoxib and the nonselective NSAID diclofenac at two different doses, and 3o showed better potency compared to these clinically used NSAIDs

2‑(2-Arylphenyl)benzoxazole As a Novel Anti-Inflammatory Scaffold: Synthesis and Biological Evaluation

The 2-(2-arylphenyl)­benzoxazole moiety has been found to be a new and selective ligand for the enzyme cyclooxygenase-2 (COX-2). The 2-(2-arylphenyl)­benzoxazoles <b>3a</b>–<b>m</b> have been synthesized by Suzuki reaction of 2-(2-bromophenyl)­benzoxazole. Further synthetic manipulation of <b>3f</b> and <b>3i</b> led to <b>3o</b> and <b>3n</b>, respectively. The compounds <b>3g</b>, <b>3n</b>, and <b>3o</b> selectively inhibited COX-2 with selectivity index of <b>3n</b> much better than that of the COX-2 selective NSAID celecoxib. The in vivo anti-inflammatory potency of <b>3g</b> and <b>3n</b> is comparable to that of celecoxib and the nonselective NSAID diclofenac at two different doses, and <b>3o</b> showed better potency compared to these clinically used NSAIDs

Acute ischaemic stroke associated with SARS-CoV-2 infection in North America.

BackgroundTo analyse the clinical characteristics of COVID-19 with acute ischaemic stroke (AIS) and identify factors predicting functional outcome.MethodsMulticentre retrospective cohort study of COVID-19 patients with AIS who presented to 30 stroke centres in the USA and Canada between 14 March and 30 August 2020. The primary endpoint was poor functional outcome, defined as a modified Rankin Scale (mRS) of 5 or 6 at discharge. Secondary endpoints include favourable outcome (mRS ≤2) and mortality at discharge, ordinal mRS (shift analysis), symptomatic intracranial haemorrhage (sICH) and occurrence of in-hospital complications.ResultsA total of 216 COVID-19 patients with AIS were included. 68.1% (147/216) were older than 60 years, while 31.9% (69/216) were younger. Median [IQR] National Institutes of Health Stroke Scale (NIHSS) at presentation was 12.5 (15.8), and 44.2% (87/197) presented with large vessel occlusion (LVO). Approximately 51.3% (98/191) of the patients had poor outcomes with an observed mortality rate of 39.1% (81/207). Age &gt;60 years (aOR: 5.11, 95% CI 2.08 to 12.56, p&lt;0.001), diabetes mellitus (aOR: 2.66, 95% CI 1.16 to 6.09, p=0.021), higher NIHSS at admission (aOR: 1.08, 95% CI 1.02 to 1.14, p=0.006), LVO (aOR: 2.45, 95% CI 1.04 to 5.78, p=0.042), and higher NLR level (aOR: 1.06, 95% CI 1.01 to 1.11, p=0.028) were significantly associated with poor functional outcome.ConclusionThere is relationship between COVID-19-associated AIS and severe disability or death. We identified several factors which predict worse outcomes, and these outcomes were more frequent compared to global averages. We found that elevated neutrophil-to-lymphocyte ratio, rather than D-Dimer, predicted both morbidity and mortality

Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

BackgroundThe mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke.ObjectiveTo describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort.MethodsWe conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020.ResultsThe total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P &lt; .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P &lt; .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P &lt; .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002).ConclusionCOVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates

Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

The mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke. To describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort. We conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020. The total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P < .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002). COVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates