Background: Social and health inequities predispose vulnerable populations to adverse morbidity and mortality outcomes of epidemics and pandemics. While racial disparities in cumulative incidence (CmI) and mortality from the influenza pandemics of 1918 and 2009 implicated Blacks with survival disadvantage relative to Whites in the United States, COVID-19 currently indicates comparable disparities. We aimed to: (a) assess COVID-19 CmI by race, (b) determine the Black–White case fatality (CF) and risk differentials, and (c) apply explanatory model for mortality risk differentials. Methods: COVID-19 data on confirmed cases and deaths by selective states health departments were assessed using a cross-sectional ecologic design. Chi-square was used for CF independence, while binomial regression model for the Black–White risk differentials. Results: The COVID-19 mortality CmI indicated Blacks/AA with 34% of the total mortality in the United States, albeit their 13% population size. The COVID-19 CF was higher among Blacks/AA relative to Whites; Maryland, (2.7% vs. 2.5%), Wisconsin (7.4% vs. 4.8%), Illinois (4.8% vs. 4.2%), Chicago (5.9% vs. 3.2%), Detroit (Michigan), 7.2% and St. John the Baptist Parish (Louisiana), 7.9%. Blacks/AA compared to Whites in Michigan were 15% more likely to die, CmI risk ratio (CmIRR) = 1.15, 95% CI, 1.01–1.32. Blacks/AA relative to Whites in Illinois were 13% more likely to die, CmIRR = 1.13, 95% CI, 0.93–1.39, while Blacks/AA compared to Whites in Wisconsin were 51% more likely to die, CmIRR = 1.51, 95% CI, 1.10–2.10. In Chicago, Blacks/AA were more than twice as likely to die, CmIRR = 2.24, 95% CI, 1.36–3.88. Conclusion: Substantial racial/ethnic disparities are observed in COVID-19 CF and mortality with Blacks/AA disproportionately affected across the United States.

Vaping is the process of inhaling an aerosol produced by heating a liquid or wax containing substances such as nicotine, cannabinoids (e.g., tetrahydrocannabinol, cannabidiol), flavoring, and additives (e.g., glycerol, propylene glycol). The presence of air or gas in the mediastinum is pneumomediastinum.We present a rare case of vaping-induced spontaneous pneumomediastinum. A young 20-year-old female patient with a history of vaping and no past medical history presented with acute chest pain to an emergency room. The urine drug screen was positive for cannabinoids. Imaging studies -chest x-ray and computed tomography of the chest -showed pneumomediastinum. The patient was discharged after a day of observation and counseling to quit vaping.

Introduction: To date, only corticosteroids and interleukin-6 (IL-6) inhibitors have been shown to reduce mortality of hospitalized patients with COVID-19. In this literature review, we aimed to summarize infection risk of IL inhibitors, with or without the use of corticosteroids, used to treat hospitalized patients with COVID-19. Methods: A literature search was conducted using the following evidence-based medicine reviews: Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Embase; Ovid Medline; and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions 1946 to April 28, 2021. All relevant articles were identi-SUMMARY fied using the search terms COVID-19 or SARS-coronavirus-2, infections, interleukins, inpatients, adults, and incidence. Results: We identified 36 studies of which 2 were metaanalyses, 5 were randomized controlled trials, 9 were prospective studies, and 20 were retrospective studies. When anakinra was compared with control, 2 studies reported an increased risk of infection, and 3 studies reported a similar or decreased incidence of infection. Canakinumab had a lower associated incidence of infection compared with placebo in one study. When sarilumab was compared with placebo, one study reported an increased risk of infection. Nine studies comparing tocilizumab with placebo reported decreased or no dif-

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Objective: to investigate the anti diabetic effect of the bitter melon on Alloxan induced diabetes in experimental animals (rabbits). Materials and Methods: the alcohol extract of whole fruit was tested for its efficacy in Alloxan (150mg/kg) induced diabetic rabbit. The diabetic rabbits were divided into 5groups. Group I (control) received 2% gumacasia, groupie (positive control) received standard drug Metformin (62.5mg+2%GA), group III, IV, V (T 1 T 2 T 3) were treated orally with a daily dose of 0.5(gm) 1gm, 1.5gm respectively for 35 days, for all diabetic rabbits after giving TEST,NC,PC preparations, the blood samples were collected and determined the blood glucose level 0,1,3,24hrs intervals. 0hr reading is before drug giving and remaining 3 readings after drugs giving. 24 th her reading is considered as 0hr reading for the next day. Results: administration of alcohol of an extract of bitter melon produced a dose dependent decrease in blood glucose levels in Alloxan induced rabbits. There was a significant fall in blood sugar level in High dose (1.5GM/kg) in comparison to low dose (0.5gm/kg) and median dose (1gm/kg) shown by LSD test. This is comparable to the effect of Metformin. Conclusion: the results of this study show that chronic oral administration of an extract of Momordica charantia fruit at an appropriate dosage may be good alternative anti diabetic agent.