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Background After a diagnosis of two to five years, the survival length for pulmonary fibrosis (PF) is considered to be medium. The primary objective of PF treatment is to stabilize or minimize the pace of progression of the illness. The treatment of PF by nintedanib and pirfenidone was a breakthrough. In a group of coronavirus disease 2019 (COVID-19)-induced PF patients, we examined the efficacy of pirfenidone and nintedanib. Methodology From May 2021 to April 2022, 5,000 patients receiving antifibrotic treatment with pirfenidone or nintedanib (mean age of 78.3 ± 23.8) for PF were identified. Their clinical and functional information was retrospectively examined at zero, six, and twelve months of therapy. Results The average age of patients receiving nintedanib was greater than the average age of the pirfenidone group (p0.0001). Exertional dyspnea and dry cough, with no distinction between the two groups, were the most prevalent symptoms of the illness (p0.05). No significant changes between patients on pirfenidone and nintedanib were seen in forced vital capacity, forced expiratory volume in one second, total lung capacity, and diffusing capacity for carbon monoxide at zero or six months (p0.05). After one year, lung function measures were similar to the baseline in individuals treated with pirfenidone and nintedanib. This study highlights the appearance of both antifibrotic medicines as promising treatment options for functional stability in COVID-19-induced PF patients. Conclusions The patients affected by COVID-19 and undergoing fibrinolytic therapy may be well treated by any of the drugs with a significant improvement.

Physicians need to be aware of the difficulties that SARS-CoV-2 infection brings to other regions of the body, such as the kidneys, even though the key emphasis is on pulmonary characteristics. The most frequent kidney complication among COVID-19 hospitalized patients is considered acute kidney injury (AKI). This study aimed to describe overall different aspects of acute kidney injury (AKI) in COVID-19 patients admitted to JLNMCH during the COVID-19 pandemic and to determine the prevalence of AKI among COVID-19 hospitalized patients.All adult patients (over the age of 18 years) who screened positive for COVID-19 in a swab specimen from areas of nasopharyngeal by reverse transcriptase polymerase chain reaction and then hospitalized were included in the study. Information was gathered on the patient's demographics, general medical history, and drugs prescribed. From past medical information, associated comorbidities and home pharmaceuticals were identified. We gathered hospitalization information, such as duration of stay in ICU, details about the application of mechanical ventilation, information regarding extracorporeal membrane aeration, details of the use of vasopressor administration, and baseline results of laboratory test along with baseline clinical information during 48 hours of hospitalization.The percentage of patients with no history of AKI requiring traumatic mechanical ventilation was 79.4%, while the percentage of patients with no history of AKI not requiring traumatic mechanical ventilation was 11.5%. The difference was relevant statistically (p0.001). The percentage of patients with AKI of any stage requiring traumatic mechanical ventilation was 22.8%, while the percentage of patients with no history of AKI not requiring traumatic mechanical ventilation was 76.8%. The difference was relevant statistically (p0.022).We discovered that AKI was a rather typical finding among hospitalized COVID-19 patients. Patients hospitalized for COVID-19 had a poor prognosis if they developed AKI.

Background As the global death toll from new coronavirus illness (COVID-19) rises, the scientific community and healthcare systems are under massive pressure to manage the outbreak and develop effective medical remedies. Meanwhile, desperation has pushed practitioners, scientists, and authorities to recommend and attempt medicines with little or no proof. Despite the lack of clear and unequivocal facts supporting its efficacy and safety, hydroxychloroquine-sulfate (HCQS) has recently received substantial public and political interest in treating and prophylaxis new infectious diseases COVID-19. Aim To analyze the impact of HCQS in COVID-19-positive patients admitted at tertiary level government-owned Jawaharlal Nehru Medical College and Hospital (JLNMCH, Bhagalpur) Bihar. Methods Two hundred two RT-PCR-positive COVID-19 patients were included in this research. The study participants were randomly distributed into the intervention category and control category, each consisting of 101 study subjects. Study participants in the intervention category were administered hydroxychloroquine in 200 mg tablets. The control category was given placebo tablets that looked similar to tablets of hydroxychloroquine and were given in the same pattern. Chest X-ray PA view, 12 lead ECG, baseline hemogram including a concentration of CD4 cells, ratio between the concentration of CD8 cells and CD4 cells and concentration of CD8 cells, the concentration of C-reactive protein, RT PCR test of samples obtained from the oropharyngeal region and nasopharyngeal region nasopharyngeal for verification COVID-19 were done. These measurements were carried out in both the control and intervention categories at baseline and at the moment of obtaining a negative RT-PCR report. Results The confirmed cases of COVID-19 was 52.9% in the intervention category and 53.4% in the control category at the end of the administration of drugs. Symptoms related to COVID-19 were observed in 11.6% of subjects in the intervention category and 13.5% in the control category. Other new symptoms were observed in 16.8% of subjects in the intervention category and 14.5% of study subjects in the control category. One death was reported in the control category. Emergency hospitalization was required for one subject in the intervention category, while two subjects in the control category required emergency hospitalization. 12.4 days was the mean duration of recovery in the intervention category, while 13.6 days were the mean duration of recovery in the control category. The recovery duration and COVID-related symptoms were lesser in the intervention category than in the control category; however, the variation between the two categories was statistically non-significant (p˃0.01). Conclusion According to this research, no statistically significant difference was noticed in COVID-19 incidence between the control category and intervention category, showing that hydroxychloroquine sulfate cannot be utilized as the main curative agent in the treatment of COVID-19. However, there was a reduction in recovery days and symptoms related to COVID-19 in study subjects administered with HCQS.

Background: Stroke is one of the major global health problems. Stroke is the most common clinical manifestation of cerebrovascular disease of which more than 99% are due to arterial involvement and less than 1% due to venous involvement in the form of Cerebral Venous Thrombosis (CVT). Among arterial causes 85% are due to infarction and 15% due to haemorrhage. There is difference in serum lipid levels in subtypes of strokes to guide lipid-lowering therapy which can reduce incidence of stroke and stroke related mortality by adapting primary and secondary preventive measures. Authors have endeavoured to correlate severity of lipid derangement and stroke. Methods: In this study 64 consecutive eligible ischaemic stroke cases and 64 eligible hemorrhagic stroke cases would be included. Cases of strokes will be divided into ischaemic and hemorrhagic as per clinical features and with help of brain imaging by CT scan and MRI at the time of admission and 8 hour fasting lipid profile was collected from all cases. All this information will be filled in preformed format. Results: Serum lipid profile of two categories of stroke showed raised serum total cholesterol in 39.1% patients of ischaemic stroke in contrast to 18.8% patients with haemorrhagic stroke (p=0.019). Stroke patients showed raised in LDL cholesterol in 29.7% patients of ischaemic stroke in contrast to 9.4% patients with haemorrhagic stroke, (p=0.007). Conclusions: Based on the finding of our study we conclude that ischemic stroke patient had higher lipid derangement as compare to haemorrhagic stroke in terms of raise total cholesterol, LDL cholesterol and decrease HDL cholesterol.

Objectives: The liver metabolizes thyroid hormones and thereby influences the regulation of their systematic endocrine effects. On the other hand, thyroid hormones play an important role in hepatic lipid homeostasis. Several studies addressed the association between thyroid function tests and non alcoholic fatty liver disease. The results of those studies indicate that hypothyroidism might be related to non alcoholic fatty liver disease. The recognized link between hypothyroidism and elements of metabolic syndrome may explain this relation. The present study was performed to evaluate the thyroid function status with the severity of sonographically suggested fatty liver subjects. Materials and Methods: This cross sectional study was carried out at the Department of Medicine of Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar during the period of June 2019 to May 2020. A total number of 155 consecutive patients having sonographically detected fatty liver from the above mentioned hospitals were included in this study and they were divided into three grades depending on the sonographic criteria. Data were analyzed between these three grades in respect of age, sex, BMI, thyroid hormone levels (FT3, FT4 and TSH), fasting lipid profile and serum liver enzyme levels. Results: 82 (52.9%) patients had grade 1, 50 (32.3%) had grade 2 and 23 (14.8%) had grade 3 fatty liver. The mean age was found 39±10.9 years in Grade 1, 39.5±10.4 years in Grade 2 and 41.4±7.1 years in Grade 3. The difference was not statistically significant (p>0.05) among three groups. Male to female ratio was almost 2:3 in the whole study subjects. The mean BMI was significantly higher in grade 3 (p

BACKGROUND Resuscitation of fluids along with proper and directed use of diuretics is the key to prevent development of acute kidney injury in intensive care settings. Acute kidney injury is associated with a fall in the urine output, many a times prompting the use of diuretics. But its use either in acute or chronic kidney disease has never failed to perturb the treating physicians. Evidences stall tall for and against its use, but this ambiguity seldom affect the prevalence of its use in the clinical practice. Many recent studies stated that the use of diuretics may very well increase the output of urine, but this doesn’t reflect in the overall morbidity status. METHODS We studied the percentage of patients admitted, who fell into the trap of acute injury of kidneys, the fluid used for their resuscitation and their effect on the development of kidney injury and also the use of loop diuretic, furosemide in patients admitted to intensive care unit of Department of Medicine, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, for its effect on urine output and requirement of haemodialysis and mortality as against those without the use of diuretics. RESULTS There was an apparent increase in the urine output of the patients on diuretics furosemide, but the frequency of requirement of haemodialysis was not any better. Proper fluid resuscitation with IV crystalloids was less commonly reflected as having acute kidney injury. CONCLUSIONS Isotonic IV crystalloids should be used for the resuscitation of fluids in ICU care setup and diuretics should not be prescribed routinely, as advocated by the KDIGO, and it should be reserved for the oliguric states with fluid overload.

BACKGROUND Diabetes and disorders of kidney go hand in hand. Various forms of chronic kidney disease are linked with diabetes. Diabetes is the leading cause of kidney disease in India. Kidney ailment can be a shattering impediment, as it is linked with remarkable fall in both extent and quality of life. Hypertension is connected not only with causation, but it is also a foreseeable ending of CKD which abidingly aggravates in CKD Stages 3-5; along with that, acid-base balance, lipid profile, and glucose homeostasis gets disturbed too. HTN, proteinuria, and hyperlipidaemia may come into sight at any stage and therapy must be weighed down to specific levels. The frequency of hypertension has been on a steep rise. Increase in life expectancy and uncontrolled rise in the obesity are the two most important reasons behind this increasing prevalence. Hypertension customarily rides besides the advancing CKD, and it is often appallingly thought to be a cause rather than the effect of CKD. MATERIALS AND METHODS We studied 1040 patients presenting to us, in the department of nephrology, JLNMCH, Bhagalpur, with renal failure and calculated the prevalence of the two main causes and associated conditions, i.e., diabetes and hypertension. RESULTS As high as 3/4th of the cases of ESRD are associated with hypertension and diabetes. Male to female ratio of renal association was 7:3.86%. Patients were above the age of 25 years, just 14% were below 25 years of which less than 1% were below 12 years of age. Out of these, 29 cases were a known case of diabetes mellitus either type I or type II. Of these a staggering 493 cases were having elevated blood pressure. CONCLUSION By and large the portrayal here was just a minuscule replica of the situation worldwide. With a great turmoil anticipated at the forefront, unless a brake is applied to the unending outburst of patients with diabetes and hypertension both of which fortunately are preventable and treatable, if managed carefully.