Pub Date : 2020-09-01DOI: 10.4103/jopcs.jopcs_5_20
Fadila, Praveen Kumar
Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. It may mimic other conditions of the central nervous system, including primary psychiatric disorders, particularly early in the disease course. Due to similarities in clinical, imaging, and laboratory findings between autoimmune and infectious encephalitis, as well as limited awareness and availability of specific antibody testing, AE remains an elusive, often underrecognized etiology. If left untreated, it may be fatal or leave significant morbidities, but with prompt recognition and sequential immunotherapy, the prognosis is encouraging despite a stormy disease course. We report a 4-year-old child with abnormal behavior and recurrent seizures who was referred as encephalitis and subsequently diagnosed as AE and managed at our hospital. He recovered well because of early identification and adequate management.
{"title":"Autoimmune encephalitis, the great masquerader: A case report and review of successful outcome in a child","authors":"Fadila, Praveen Kumar","doi":"10.4103/jopcs.jopcs_5_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_5_20","url":null,"abstract":"Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. It may mimic other conditions of the central nervous system, including primary psychiatric disorders, particularly early in the disease course. Due to similarities in clinical, imaging, and laboratory findings between autoimmune and infectious encephalitis, as well as limited awareness and availability of specific antibody testing, AE remains an elusive, often underrecognized etiology. If left untreated, it may be fatal or leave significant morbidities, but with prompt recognition and sequential immunotherapy, the prognosis is encouraging despite a stormy disease course. We report a 4-year-old child with abnormal behavior and recurrent seizures who was referred as encephalitis and subsequently diagnosed as AE and managed at our hospital. He recovered well because of early identification and adequate management.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"98 4 1","pages":"15 - 17"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87712672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.4103/jopcs.jopcs_21_20
Raman K Kumar
Among medical specialties, family medicine, internal medicine, obstetrics & gynecology, pediatrics are traditionally considered primary care disciplines. Within the scope of service provision, a wider integration from the perspective of community needs is needed in the present times. Primary care providers also include nurse practitioners. Several subspecialties, such as preventive cardiology, also intersect the disciplinary boundaries of primary care.
{"title":"Primary care specialties: Call for scholarship development during post-COVID period","authors":"Raman K Kumar","doi":"10.4103/jopcs.jopcs_21_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_21_20","url":null,"abstract":"Among medical specialties, family medicine, internal medicine, obstetrics & gynecology, pediatrics are traditionally considered primary care disciplines. Within the scope of service provision, a wider integration from the perspective of community needs is needed in the present times. Primary care providers also include nurse practitioners. Several subspecialties, such as preventive cardiology, also intersect the disciplinary boundaries of primary care.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"36 5 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80165851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.4103/jopcs.jopcs_17_20
Arvind Kumar, JS Anuvindha, Vishwajeet Singh, R. Sarda, VishalKumar Vishwakarma, A. Pal, Bharathi Arunan, S. Goel, P. Ranjan, N. Wig
Background and Objectives: Early testing and diagnosis of COVID-19 infection can help decrease the spread of the virus. Undoubtedly, health-care workers (HCWs) have been the frontline warriors in the COVID-19 pandemic and are at maximum risk of acquiring the infection. We thereby conducted this study to assess the factors that lead to delayed testing after symptom onset in health-care personnel. Methodology: This single-center, cross-sectional study was conducted at a dedicated COVID-19 Employee Health Services Outpatient Department at a tertiary care center, New Delhi, in July 2020. HCWs who were suspected COVID and presented for testing were included in the study. The duration between symptom onset and date of testing was noted. Delayed testing was defined as testing after 24 h from symptom onset. Results: A total of 653 HCWs were included in the study, and 55.9% were males. Female workers presented after a mean (standard deviation [SD]) of 3.43 days (1.91) from symptom onset as compared to male counterparts 3.16 days (1.84). Frontline HCWs who managed patients directly had delayed testing when compared to others at mean (SD) days of 3.46 (1.96) versus 3.13 (1.79), P = 0.04. Conclusion: In the ongoing COVID-19 pandemic, prevention and mitigation of the disease are still the mainstays of combating the disease, for the given fact that treatment and immunization still remain largely unanswered. All HCWs, irrespective of sex, age, and place of working, should be routinely reiterated, motivated, and reinforced for early testing in case of COVID-19-related symptoms.
{"title":"Factors leading to delayed testing from the time of symptom onset for COVID-19 by health-care personnel: A study from all india institute of medical sciences, New Delhi","authors":"Arvind Kumar, JS Anuvindha, Vishwajeet Singh, R. Sarda, VishalKumar Vishwakarma, A. Pal, Bharathi Arunan, S. Goel, P. Ranjan, N. Wig","doi":"10.4103/jopcs.jopcs_17_20","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_17_20","url":null,"abstract":"Background and Objectives: Early testing and diagnosis of COVID-19 infection can help decrease the spread of the virus. Undoubtedly, health-care workers (HCWs) have been the frontline warriors in the COVID-19 pandemic and are at maximum risk of acquiring the infection. We thereby conducted this study to assess the factors that lead to delayed testing after symptom onset in health-care personnel. Methodology: This single-center, cross-sectional study was conducted at a dedicated COVID-19 Employee Health Services Outpatient Department at a tertiary care center, New Delhi, in July 2020. HCWs who were suspected COVID and presented for testing were included in the study. The duration between symptom onset and date of testing was noted. Delayed testing was defined as testing after 24 h from symptom onset. Results: A total of 653 HCWs were included in the study, and 55.9% were males. Female workers presented after a mean (standard deviation [SD]) of 3.43 days (1.91) from symptom onset as compared to male counterparts 3.16 days (1.84). Frontline HCWs who managed patients directly had delayed testing when compared to others at mean (SD) days of 3.46 (1.96) versus 3.13 (1.79), P = 0.04. Conclusion: In the ongoing COVID-19 pandemic, prevention and mitigation of the disease are still the mainstays of combating the disease, for the given fact that treatment and immunization still remain largely unanswered. All HCWs, irrespective of sex, age, and place of working, should be routinely reiterated, motivated, and reinforced for early testing in case of COVID-19-related symptoms.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"34 1","pages":"3 - 7"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75090220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-18DOI: 10.22541/au.158981181.19035548
M. Sahu, Arvind Kumar, S. Shankar, Diksha Patidar, V. Vishwakarma, P. Sahoo, N. Wig
The global outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/2019-nCoV) has put forth a serious threat to international public health and has ruined the global economy. Till date, no drugs have been approved for coronavirus disease-2019 (COVID-19), although the use of some drugs in the trial phase has been attempted. The drugs being used for the management of COVID-19 disease include chloroquine (CQ), hydroxychloroquine (HCQ), and remdesivir. In this article, we have aimed to review existing literature and mechanism by which CQ and HCQ have an effect on COVID-19, most importantly by interfering with autophagy, lysosomal activity, receptor binding, and membrane fusion. We have systematically searched the PubMed database up to April 2020 and analyzed all the articles published on CQ, HCQ, and COVID-19. The available data provide insights into the immunomodulatory potency of HCQ, along with the molecular mechanism of action of the drug on the SARS-CoV-2.
{"title":"Insights into the mechanisms of action of chloroquine and hydroxychloroquine and its use in COVID-19 for chemoprophylaxis","authors":"M. Sahu, Arvind Kumar, S. Shankar, Diksha Patidar, V. Vishwakarma, P. Sahoo, N. Wig","doi":"10.22541/au.158981181.19035548","DOIUrl":"https://doi.org/10.22541/au.158981181.19035548","url":null,"abstract":"The global outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/2019-nCoV) has put forth a serious threat to international public health and has ruined the global economy. Till date, no drugs have been approved for coronavirus disease-2019 (COVID-19), although the use of some drugs in the trial phase has been attempted. The drugs being used for the management of COVID-19 disease include chloroquine (CQ), hydroxychloroquine (HCQ), and remdesivir. In this article, we have aimed to review existing literature and mechanism by which CQ and HCQ have an effect on COVID-19, most importantly by interfering with autophagy, lysosomal activity, receptor binding, and membrane fusion. We have systematically searched the PubMed database up to April 2020 and analyzed all the articles published on CQ, HCQ, and COVID-19. The available data provide insights into the immunomodulatory potency of HCQ, along with the molecular mechanism of action of the drug on the SARS-CoV-2.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"163 1","pages":"27 - 32"},"PeriodicalIF":0.0,"publicationDate":"2020-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80992406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-06DOI: 10.22541/au.158878859.94030358
S. Shankar, Arvind Kumar, Diksha Patidar, Sai Kanukuntla, N. Wig
Coronavirus disease 2019 (COVID-19) is characterized by fever, cough, shortness of breath, myalgia, and headache. The disease also takes a more severe form with life-threatening manifestations of acute respiratory distress syndrome, acute cardiac injury, acute kidney injury, disseminated intravascular coagulopathy, and cytokine storm. It has been elucidated that like its predecessor, the SARS CoV, the SARS CoV-2 utilizes the angiotensin-converting enzyme 2 receptor to enter cells. This knowledge brought into speculation the effects of a dysregulated renin-angiotensin system (RAS) in the pathogenesis of COVID-19. It has been proposed that the effects of a dysregulated RAS would lead to an inflammatory cascade and contribute to the cytokine storm that is central to the disease. This paper looks at the RAS pathway and hypothesizes the possibility of a positive RAS feedback loop in the pathogenesis of COVID-19.
{"title":"Renin-angiotensin system in the pathogenesis of COVID-19 and possible drug targets","authors":"S. Shankar, Arvind Kumar, Diksha Patidar, Sai Kanukuntla, N. Wig","doi":"10.22541/au.158878859.94030358","DOIUrl":"https://doi.org/10.22541/au.158878859.94030358","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is characterized by fever, cough, shortness of breath, myalgia, and headache. The disease also takes a more severe form with life-threatening manifestations of acute respiratory distress syndrome, acute cardiac injury, acute kidney injury, disseminated intravascular coagulopathy, and cytokine storm. It has been elucidated that like its predecessor, the SARS CoV, the SARS CoV-2 utilizes the angiotensin-converting enzyme 2 receptor to enter cells. This knowledge brought into speculation the effects of a dysregulated renin-angiotensin system (RAS) in the pathogenesis of COVID-19. It has been proposed that the effects of a dysregulated RAS would lead to an inflammatory cascade and contribute to the cytokine storm that is central to the disease. This paper looks at the RAS pathway and hypothesizes the possibility of a positive RAS feedback loop in the pathogenesis of COVID-19.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"4 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82450756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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