Bacterial and fungal co-infection is a major barrier in COVID-19 patients: A specific management and therapeutic strategy is required

Microbial co-infections are another primary concern in patients with coronavirus disease 2019 (COVID-19), yet it is an untouched area among researchers. Preliminary data and systematic reviews only show the type of pathogens responsible for that, but its pathophysiology is still unknown. Studies show that these microbial co-infections are hospital-acquired/nosocomial infections, and patients admitted to intensive care units with invasive mechanical ventilation are highly susceptible to it. Patients with COVID-19 had elevated inflammatory cytokines and a weakened cell-mediated immune response, with lower CD4⁺ T and CD8⁺ T cell counts, indicating vulnerability to various co-infections. Despite this, there are only a few studies that recommend the management of co-infections.     

Azithromycin resistance and its molecular characteristics in Neisseria gonorrhoeae isolates from a tertiary care centre in North India

Treatment guidelines for management of uncomplicated gonorrhoeae have been recently modified owing to alarming upsurge in azithromycin resistance. This study investigated the prevalence and genetic determinants of gonococcal azithromycin resistance in India. Four (5.7%) of 70 gonococcal isolates were resistant to azithromycin. Of 16 isolates investigated for molecular mechanisms of resistance, 13 (81.3%) and 6 (37.5%) isolates exhibited mutations in coding and promoter regions of mtrR gene, respectively. However, ermA, ermB and ermC genes or mutations in rrl gene were absent in all isolates. Azithromycin resistance is low in India posing no immediate threat to use of dual-therapy for syndromic management.     

Does ATTRACT change our DVT management practice?

In 2017, the long awaited results of the ATTRACT trial were published in the New England Journal of Medicine leaving the scientific community with disappointment as the study did not show the expected results. Producing not the expected outcome is not uncommon in science – furthermore, it is important to disapprove common beliefs. But has the ATTRACT trial really the power to change our practice? Are the results correct in terms of evidence based on the methods used?

In 2017, the long awaited results of the ATTRACT trial were published in the New England Journal of Medicine^1,2 leaving the scientific community with disappointment as the study did not show the expected results. Producing not the expected outcome is not uncommon in science – furthermore, it is important to disapprove common beliefs. But has the ATTRACT trial really the power to change our practice? Are the results correct in terms of evidence based on the methods used? To understand the results, it is important to analyze the methods of the trial and to discuss them in a broader view.     

Synergy in IR–Hybrid CT/C-arm in the setting of critical trauma

Emergency Radiology - Access to multi-detector computed tomography (MDCT) scanning for interventional procedures can prove to be logistically challenging as resources are often in different areas...