The nCOVID-19 pandemic initiated its course of contagion from the city of Wuhan and now it has spread all over the globe. SARS-CoV-2 is the causative virus and the infection as well as its symptoms are distributed across the multi-organ perimeters. Interactions between the host and virus governs the induction of ‘cytokine storm’ resulting various immunopathological consequences leading to death. Till now it has caused tens of millions of casualties and yet no credible cure has emerged to vision. This article presents a comprehensive overview on the two most promising remedial approaches that are being attempted for the management, treatment, and plausible cure of nCOVID-19. In this context, chemotherapeutic approach primarily aims to interrupt the interactions between the host and the virus causing inhibition of its entry into the host cell and/or its proliferation and suppressing the inflammatory milieu in the infected patients. On the other side, immunotherapeutic approaches aim to modulate the host immunity by fine tuning the inflammatory signaling cascades to achieve phylaxis from the virus and restoring immune-homeostasis. Considering most of the path-breaking findings, combinatorial therapy involving of chemotherapeutics as well as vaccine could usher to be a hope for all of us to eradicate the crisis

Menorrhagia during the reproductive years may be caused by an imbalance in the metabolism of local endometrial prostaglandins [1]. A micronized purified flavonoid fraction (MPFF; Daflon 500, Serdia, India) containing 90% of diosmin and 10% of flavonoids expressed as hesperidin has been shown to suppress prostaglandins E 2 , F 2a , thromboxane A 2 , and prostacycline; reduce capillary hyperfragility; and increase lymphatic drainage [2]. This study examines the efficacy of MPFF in preventing ovulatory menorrhagia and dysmenorrhoea due to dysfunctional uterine bleeding.In the absence of an institutional review board, the authors approved the study protocol. Consecutive outpatients aged between 20 and 45 years who had a history of untreated menorrhagia over the three previous cycles were identified. Following a detailed examination that included transvaginal ultrasonography, hysteroscopy, and endometrial biopsy, those with ovulatory cycles but no evidence of pregnancy, pelvic pathology, coagulation disorder, hypothyroidism, or hepatic or renal disease, and who were not taking steroids or using an intrauterine contraceptive device, were selected for the study.After obtaining informed consent, MPFF was prescribed at a dose of 1000 mg/day (2 tablets of 500 mg) 5 days prior to the expected onset of menstruation (preventive phase) and up to the end of bleeding (treatment phase) for three consecutive cycles. The women were trained to use a pictorial blood assessment chart (PBAC) [3] and were followed up for three cycles.The 36 patients studied had a mean (S.D.) age of 33.3 (7.1) years, with a clinical history of menorrhagia for 11.7 (14.4) months. The effect of treatment on the variables studied is shown as mean change from baseline in Table 1 and as the proportion of patients showing improvement on 0020-7292/$ -see front matter D

BACKGROUND: Previous studies of reference values for cerebrospinal fluid (CSF) profiles have been limited by small sample size and few exclusion criteria.OBJECTIVE: To determine age-specific normative CSF white blood cell count (WBC), glucose, and protein values in infants #90 days old.METHODS: Performed a retrospective cross-sectional study of infants #90 days old who had a diagnostic lumbar puncture between 2008 and 2016. Infants with bacterial meningitis, bacteremia, UTI, positive CSF herpes simplex virus polymerase chain reaction (PCR) result, traumatic lumbar puncture, ventriculoperitoneal shunt, prematurity, recent seizure, previous antibiotic use, and history of a complex chronic condition were excluded for calculations to determine normative values. Data on demographics and CSF values (WBC with differential, protein, glucose, enterovirus PCR) were collected. CSF values were compared by age and by enterovirus PCR results using Kruskal-Wallis and Wilcoxon rank tests. RESULTS:A total of 1029 out of 2000 patients were included and divided into 3 age groups: 0 to 28 days, 29 to 60 days, 61 to 90 days. CSF WBC values were significantly greater for 0-to 28-day old infants (median: 3, 95th percentile: 14) than for 29-to 60-day and 61-to 90-day old infants (median: 2 and 2; 95th percentile: 7 and 11, respectively) (P < .001). With each month of life, the median CSF protein significantly decreased and glucose significantly increased. In the CSF WBC differential, monocytes were found to be prevalent. CONCLUSION:We determined age-specific normative components for CSF profile values for infants 0 to 90 days.

Background The Pediatric Emergency Care Applied Research Network (PECARN) prediction rule identifies febrile infants at low risk for serious bacterial infection (SBI). However, its impact on avoidable interventions in the emergency department remains unknown. Objective To study the impact on lumbar puncture (LP) performance, empiric antibiotic use, and admissions after implementing a febrile infant clinical practice guideline for infants aged 29 to 60 days based on the PECARN prediction rule in the pediatric emergency department. Methods This single center preintervention to postintervention study included infants 29 to 60 days old who presented with a chief complaint of fever from November 2018 to November 2021 and were assessed for SBI via blood culture and either urinalysis or urine culture. A new clinical practice guideline based on the PECARN prediction rule was implemented on December 2019. Lumbar puncture attempts, antibiotic administration, and admissions were compared preimplementation and postimplementation and in subgroups of low- and high-risk patients. Results Of 1597 (PRE: 785, POST: 812) infants presenting with fever, 1032 (PRE: 500, POST: 532) met inclusion criteria. Adoption of guideline recommendations (measured as procalcitonin order rate) was 89.7% in eligible infants postimplementation. Overall, there was a significant decrease in LPs (PRE: 30.6%, POST: 22.6%, P < 0.05) and no significant change in antibiotics or admissions. Among low-risk infants, there was a significant reduction in LPs (PRE: 17.2%, POST: 4.4%, P < 0.05) and antibiotics (PRE: 14.5%, POST: 4.1%; P < 0.05). There was no change in missed SBI (PRE: 3, POST: 2, P = 0.65). No cases of missed meningitis preimplementation or postimplementation were observed. Conclusions After implementation of a guideline based on the PECARN prediction rule, we observed a reduction of LPs and antibiotics in low-risk infants. Overall, a decrease in LPs was observed, whereas antibiotic use and admissions remained unchanged.