COVID-19 Pandemic and the Debatable Use of Hydroxychloroquine

Healthcare professionals and scientists were not able to provide a good answer to the COVID-19 pandemic that shook the whole world. Hydroxychloroquine is an antimalarial drug with a good safety profile. It can be used in pediatric subjects as well as pregnant and breastfeeding women. Hydroxychloroquine is a widely used, essential drug in dermatology. It has got anti-inflammatory, antibacterial, antiviral and immunomodulatory properties. It was globally prescribed to prevent and treat COVID-19 caused by SARS-CoV-2 virus. The use of this drug in treating COVID-19 is debatable and for sure is not indicated in the labelling documents provided by the companies that manufacture this drug. The unnecessary use of this drug also led to short supply. We hereby review its properties, mechanism, safety profile and the issue COVID pandemic has caused to the supply of this drug

Assessment of Sleep Habits and Quality of Sleep among Elderly Residing in Rural Areas of Patiala: A Community-Based Cross-Sectional Survey

INTRODUCTION: Among the elderly, sleep problems are quite prevalent and can lead to many adverse health consequences. AIM: To assess the quality of sleep among the elderly residing in rural population and factors related to it, and provide necessary recommendations for its prevention. MATERIALS AND METHOD: In this cross-sectional study, elderly aged above 60 years residing in Patiala were taken and were interviewed separately using the modified version of the Pittsburgh Sleep Quality Index (PSQI), which was pre-tested and pre-validated prior to commencement of the study. Data recorded was divided into seven components and each component had an individual range of 0 (no difficulty) to 3 (severe difficulty) points and added to obtain a combined score of the individual with a range of 0(no difficulty)-21(severe difficulty) points. Based on the combined score,  elderly obtaining a total score of 5 or greater was classified as having  “poor sleep quality”. Statistics were applied using SPSS version 22.0, using the student’s t- test, and multivariate analysis. A p value < 0.05 was considered as significant. RESULTS: Out of 108 elderly people, most of the participants (62.9%) belonged to the age group of 60-75 years, out of which the majority (65.7%) were males. Most elderly reported having “fairly good” subjective sleep quality (53.7%, p=0.01) and was found to be significant with a global PQSI score of 7.22±4.31. Multivariate analysis revealed that significant “poor sleep quality” was observed in elderly aged above 75 years (OR:1.25, p=0.01) followed by elderly who were Immobilized (wheelchair/Bed ridden) (OR: 1.87, p=0.01). CONCLUSION: Efforts should be directed towards proper education of not only the elderly, but their children as well as colleagues and guardians to improve the sleep score of the elderly population

The Wonderful DMARD with Multiple Toxicities

Methotrexate is a type of disease-modifying anti-rheumatic drug (DMARD). It is used to reduce activity of the immune system for people who have certain conditions. Methotrexate is a chemotherapy agent and immune system suppressant. Its use may be limited by concerns regarding its adverse reactions. The occurrence of adverse drug reactions in some cases leads to the therapy discontinuation. Although adverse drug reactions (ADR) of methotrexate generally do not pose a serious threat to the health of patients and a reduction in the dose of methotrexate leads to their elimination, in some cases severe toxicities of the drug occur unpredictably. These facts explain the need for close monitoring of the patient’s condition and the identification of potential risk factors for drug toxicity on the part of different organs and functional systems. The purpose of this review is to detail about safety and tolerability of methotrexate