No abstract

Cytokine storm an uncontrolled over-production of soluble markers of inflammation which is systemic inflammatory response, is a major responsible for the occurrence of ARDS. Animal studies that have implicated ACE2 in the acute lung injury caused due to SARSCoV. It has been hypothesized that ACE2 causes ALI by bringing about autophagy through the AMPK/mTOR pathway. Metformin works through AMPK activation, which leads to phosphorylation of ACE2 and there is an structural change which unables SARS CoV2 to bind with it also it is known that metformin can reduce CRP level.This study aim to find the role of metformin in COVID 19 on disease regression by both clinical assessment and laboratory values.Single blinded randomised controlled trial, parallel group, placebo controlled study for 1 month duration at tertiary health care centre. There is significant clinical improvement in 69% of the subjects at day 6 and 31% at day 7 in metformin group. Also there is effective reduction in CRP level whereas Sr.Ferritin levels are moderately reduced. There is no adverse effect during study period.

Drug compliance can be defined as reliability of a patient in using a prescribed medication as ordered by the physician. 1. The importance of this term comes into picture when a person suffering from a chronic ailment is put on long term medications. Such situations come for diseases like diabetes, hypertension, arthritis, tuberculosis etc. Diabetes Mellitus (DM), the most common endocrine disease in the world, is a major global public health issue. 3 As a group, patients with diabetes are especially prone to substantial regimen adherence problems .4 Noncompliance occurs when the patient forgets or neglects to take the prescribed dosages at recommended times or decides to discontinue the drug without consulting the physician 1. Effective and successful glucose control requires appropriate and timely use of medication over the entire period of treatment, which is often lifelong. Poor treatment adherence that contributes to suboptimal glycemic control continues to be one of the major barriers to effective diabetes management. Treatment failure is in turn associated with reduced treatment benefits and can have a negative financial burden on both individual patients and the society at large 9, 10. In fact, effective diabetes management often needs coordinated quality services 11 .