Manisha Khandait

An increase in COVID-19 immunization coverage has been linked to a decrease in the average case fatality rate. As a result, further research is needed to determine the persistence and duration of vaccine-induced protective antibodies in order to assess the effectiveness of COVID-19 vaccinations. The present study aimed to determine the COVID-19 IgG antibodies among healthcare workers (HCWs) before and after the ChAdOx1 nCoV-19 (Covishield™) vaccination. A total of 150 HCWs who had received the Covishield™ vaccine were assessed after obtaining written informed consent. Blood samples were drawn at three time points, namely, within one week prior to first dose of vaccination, prior to second dose of vaccination (28–33 days after the first dose of vaccination), and 90–95 days after the second dose of vaccination for detecting neutralizing antibodies, i.e., IgG antibodies by ELISA. The overall baseline seropositivity among the HCWs was found to be 28% (n = 42), assessed by the sample col...

<jats:p>Evidence concerning prescription audits conducted in developing countries like India is scarce, especially from the rural parts of the country. Therefore, the present prescription audit was undertaken in a rural tertiary care hospital to investigate prescriptions for their completeness, in format of prescription, legibility of writing and it was assessed against the World Health Organization (WHO) recommendation of core indicators for prescription writing in order to investigate the rational usage of drugs. A total of 200 prescriptions were randomly selected, irrespective of clinical departments, patient characteristics and diagnosis over a period of six months. All the prescriptions were prospectively analyzed and conferred to an assessment of the quality of prescribing practice, general details, medical components, WHO core drug use indicators and legibility. Amongst the 200 prescriptions precisely monitored, we found that 100% prescriptions had general details of the patients such as name, age, gender, OPD/IPD registration number, hospital name & address and consulting unit/department. While evaluating the handwriting of the doctors, 83.5% (177/200) of the prescriptions had legible handwriting, wherein the degree of legibility showed 68.5% (137/200) prescriptions with easy legibility, 20% (40/200) difficult legibility while 11.5% (23/200) were illegible. Along with the different types of drugs obtained from the selected prescriptions, we found that antibiotics were prescribed in 51.5% (103/200) of the prescriptions. A prescription audit is a good tool to systemically review the day to day work, maintenance of records and assessment of accuracy of the diagnosis given by doctors and also the outcome of the treatment received.</jats:p>

The yeast, Cryptococcus is widely present in the environment. Its main portal of entry is the respiratory tract. Clinical and experimental evidences indicate that cryptococcosis is usually a reactivation of a dormant infection. They have been recovered from soil contaminated with avian excreta, especially pigeon droppings and from decaying wood, fruits, vegetables and dust. Cryptococcusmay be found on skin of healthy subjects without causing any manifestation but it is known to cause life threatening infection in immunocompromised hosts. Primary Cutaneous Cryptococcosis (PCC) is an uncommon condition which is characterised by localised cryptococcal skin eruptions without dissemination to internal organs. Clinicians are aware of the typical presentation of cryptococcal infections occurring mostly in immunocompromised patients. Rare manifestations like PCC may go unnoticed leading to prolonged morbidity and health care cost. The present article is a case report of PCC in a 39-year-old...

Staphylococcus may be evaluated to be a serious microorganism to colonizes and contaminate both the healthy and immuno-competent people in the community along with the hospitalized patients with decreased immunity. This bacterium has been commonly present on the skin and in the nasal cavity of the human body. In the particular sites the organisms may give rise to local diseases of the nose, urethra, vagina and gastrointestinal tract, skin however most of them are minor and not associated with any mortality. S. aureus as well as coagulase-negative staphylococcus which are gram-positive bacteria that lives on the upper respiratory, mouth and skin structure creation, are the possible element for nosocomial and opportunistic disease in humans as well as in animals. Major complications involved with staphylococcus involved SSI, bullous impetigo, skin & soft tissues infection, bacteremia, pulmonary infections etc. The situation is further complicated by methicillin resistance in staphyloc...

BACKGROUND
Coronavirus disease 2019 (COVID-19) patients who suffer severe infection or comorbidities have an increased risk of developing fungal infections. There is a possibility that such infections are missed or misdiagnosed, in which case patients may suffer higher morbidity and mortality. COVID-19 infection, aggressive management strategies and comorbidities like diabetes render patients prone to opportunistic fungal infections. Mucormycosis is one of the opportunistic fungal infections that may affect treated COVID patients.

CASE SUMMARY
We present a case series of four adult males who were diagnosed with mucormycosis post-COVID-19 recovery. All the patients had diabetes and a history of systemic corticosteroids for treatment of COVID-19. The mean duration between diagnosis of COVID-19 and development of symptoms of mucor was 15.5 ± 14.5 (7–30) d. All patients underwent debridement and were started on antifungal therapy. One patient was referred to a higher center for further management, but the others responded well to treatment and showed signs of improvement at the last follow-up.

CONCLUSION
Early diagnosis and management of mucormycosis with appropriate and aggressive antifungals and surgical debridement can improve survival.

Key Words: Zygomycetes, Fungal infection, COVID-19 co-infection, Diabetes mellitus, Case series, Case report


Upadhyay S, Bharara T, Khandait M, Chawdhry A, Sharma BB. Mucormycosis – resurgence of a deadly opportunist during COVID-19 pandemic: Four case reports. World J Clin Cases 2021; 9(36): 11338-11345 [DOI: 10.12998/wjcc.v9.i36.11338]

Elevated or abnormal levels of coagulation parameters indicate thrombotic disorders that need to be managed at the earliest to prevent complications and reduce mortality in coronavirus disease (COVID-19) patients. D-dimer is a product that is a part of fibrin abasement, which can be used as a test for the diagnosis of thrombotic disorders. Higher D-dimer levels are a strong indicator of mortality in patients with active COVID-19. This study aimed to determine the relationship between D-dimer levels and the clinical prognosis of COVID-19 patients. This observational, prospective study was conducted between April 2020 and September 2020. All patients with COVID-19 infection were considered for this study, along with their D-dimer values. Patients with higher D-dimer levels and pre-existing morbidities experienced a longer hospital stay and increased complications when compared to patients without pre-existing morbidities. Abnormally elevated D-dimer levels were frequently observed upo...

Introduction: In the light of changing anti-microbial resistance pattern, the understanding of the local antibiogram is essential in the antibiotic selection procedures and preparation of hospital antibiotic policy. Aim: This retrospective study was aimed to analyze the antibacterial susceptibility pattern of major isolates from ICU and IPD. Materials and Methods: Antimicrobial susceptibility testing was done for a total of 565 Gram-negative isolates including E. coli, K. pnuemoniae, A. baumannnii and P. aeruginosa from ICU and IPD patients enrolled between July 2016 to December 2016. Results: The majority of the isolates were reported from urine samples (52%) in IPD and sputum (59%) in ICU. The susceptibility to BL/BLI was 50-75% in IPD patients and Carbapenem susceptibility was reported in more than 75% except P. aeruginosa. In ICU patients, the beta-lactam/beta-lactam inhibitor (BL/BLI) susceptibility ranged between 20-60% and the carbapenem susceptibility was around 40%-75%. The...