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Article: Hydroxychloroquine: A review of its safety and efficacy in COVID-19.

Karia, Rutu H / Nagraj, Sanjana / Gupta, Ishita / Barua, Amit / Kaur, Nirmaljot / Singh, Harmandeep

Journal of family medicine and primary care

2021 Volume 10, Issue 3, Page(s) 1124–1133

Abstract: SARS-CoV-2 is a novel virus that has infected millions of people across the world. Given the compelling need to develop a therapeutic strategy, hydroxychloroquine has been advocated as an effective drug for the infection. However, multiple clinical ... ...

Abstract	SARS-CoV-2 is a novel virus that has infected millions of people across the world. Given the compelling need to develop a therapeutic strategy, hydroxychloroquine has been advocated as an effective drug for the infection. However, multiple clinical trials conducted using hydroxychloroquine have yielded contrasting results. An electronic search using the primary databases from WHO, PubMed and Google Scholar was performed that yielded 21 studies eligible for inclusion. Among a total of 1,350 patients who received hydroxychloroquine, 689 (51.04%) were females. The most commonly reported comorbidities include hypertension (15.18%), diabetes mellitus (8.44%) and pulmonary disease (8.96%). Of the hydroxychloroquine-treated patients, 70% were virologically cured compared to 12.5% of the control group (
Language	English
Publishing date	2021-04-08
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_1961_20
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Presentation and Spectrum of Male Breast Cancer in a Rural Cancer Center in a Subunit of Tata Memorial Center, India.

Khandelwal, Sachin / Goel, Priyanka / Sharma, Rakesh / Sancheti, Sankalp / Chaudhary, Debashish / Goel, Alok / Dora, Tapas / Kaur, Nirmaljot / Kapoor, Rakesh

Indian journal of surgical oncology

2021 Volume 12, Issue 2, Page(s) 330–334

Abstract: This is a retrospective study of the incidence and clinical profile of male breast cancer (MBC) presenting to a rural cancer center in Punjab, India. All MBC cases registered over a period of 4.5 years from January 2015 to July 2019 were included. The ... ...

Abstract	This is a retrospective study of the incidence and clinical profile of male breast cancer (MBC) presenting to a rural cancer center in Punjab, India. All MBC cases registered over a period of 4.5 years from January 2015 to July 2019 were included. The study included 34 MBC patients accounting for 1.9% of all breast cancer cases with median age of 62.5 years. All patients were from Punjab except one, with majority from district Sangrur. Family history was present in 7 (20.6%) patients. Mean BMI (
Language	English
Publishing date	2021-03-13
Publishing country	India
Document type	Journal Article
ZDB-ID	2568289-1
ISSN	0976-6952 ; 0975-7651
ISSN (online)	0976-6952
ISSN	0975-7651
DOI	10.1007/s13193-021-01306-8
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Article ; Online: Risks of hypertension and thromboembolism in patients receiving bevacizumab with chemotherapy for colorectal cancer: A systematic review and meta-analysis.

Chitkara, Akshit / Kaur, Nirmaljot / Desai, Aditya / Mehta, Devanshi / Anamika, Fnu / Sarkar, Srawani / Gowda, Nandini / Sethi, Prabhdeep / Thawani, Rajat / Chen, Emerson Y

Cancer medicine

2023 Volume 12, Issue 24, Page(s) 21579–21591

Abstract: Background: Guidelines show that for metastatic colorectal cancer (mCRC), a combination of three-drug regimens, fluorouracil, leucovorin, and oxaliplatin and bevacizumab (BVZ), is one of the first-line standard therapies. BVZ is generally well tolerated; ...

Abstract	Background: Guidelines show that for metastatic colorectal cancer (mCRC), a combination of three-drug regimens, fluorouracil, leucovorin, and oxaliplatin and bevacizumab (BVZ), is one of the first-line standard therapies. BVZ is generally well tolerated; however, it is associated with infrequent, life-threatening side effects such as severe hypertension (HTN) (5%-18%), Grade ≥3 arterial thromboembolism (ATE) (2.6%), Grade ≥3 hemorrhagic events (1.2%-4.6%), and gastrointestinal perforation (0.3%-2.4%). This meta-analysis aims to evaluate the additive risk of BVZ-induced severe HTN and thromboembolism when BVZ is combined with a standard chemotherapy regime in patients with mCRC. Methods: Our search was conducted from January 29, 2022, to February 22, 2022, through databases of PubMed, clinicaltrial.gov, EMBASE, Web of Science, and Cochrane Library. Data analysis from randomized controlled trials (RCTs) and clinical trials was conducted using Review Manager V.5.4, comparing BVZ-chemotherapy to chemotherapy only, focusing on cardiovascular AE such as HTN and arterial and venous thromboembolism. Results: The analysis from 26 clinical trials and RCTs showed that the odds of HTN were about four times higher, and ATE subgroup analysis of 11 studies showed over two times higher odds of ATE in patients being treated with BVZ compared to the chemotherapy-only group. Conclusion: BVZ, when added to the standard chemotherapy regimen for mCRC, was associated with higher odds of developing HTN and thromboembolism, specifically ATE, than the chemotherapy-only group. Our findings are significant as they provide vital information in analyzing the risk-benefit ratio of adding BVZ to the standard chemotherapy regime in patients with mCRC, especially in patients with vascular comorbidities.
MeSH term(s)	Humans ; Bevacizumab/adverse effects ; Colorectal Neoplasms/pathology ; Fluorouracil ; Venous Thromboembolism/etiology ; Colonic Neoplasms/drug therapy ; Hypertension/chemically induced ; Hypertension/epidemiology ; Antineoplastic Combined Chemotherapy Protocols/adverse effects
Chemical Substances	Bevacizumab (2S9ZZM9Q9V) ; Fluorouracil (U3P01618RT)
Language	English
Publishing date	2023-12-08
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.6662
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Article ; Online: "Novel Management of Depression Using Ketamine in the Intensive Care Unit".

Giri, Abhishek R / Kaur, Nirmaljot / Yarrarapu, Siva Naga S / Rottman Pietrzak, Kathleen A / Santos, Christan / Lowman, Philip E / Niaz, Shehzad / Franco, Pablo Moreno / Sanghavi, Devang K

Journal of intensive care medicine

2022 Volume 37, Issue 12, Page(s) 1654–1661

Abstract: Background: Ketamine, a dissociative anesthetic, induces improvement in depressive symptoms by antagonizing glutaminergic NMDA receptors. Ketamine has been used previously in outpatient setting for treatment-resistant depression, but we showcase its ... ...

Abstract	Background: Ketamine, a dissociative anesthetic, induces improvement in depressive symptoms by antagonizing glutaminergic NMDA receptors. Ketamine has been used previously in outpatient setting for treatment-resistant depression, but we showcase its utility in depression management at the Intensive Care Unit (ICU).
MeSH term(s)	Humans ; Ketamine/therapeutic use ; Retrospective Studies ; Depression/drug therapy ; Intensive Care Units ; Critical Care
Chemical Substances	Ketamine (690G0D6V8H)
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632828-3
ISSN	1525-1489 ; 0885-0666
ISSN (online)	1525-1489
ISSN	0885-0666
DOI	10.1177/08850666221088220
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Article ; Online: Impact of colchicine on mortality and morbidity in COVID-19: a systematic review.

Sanghavi, Devang / Bansal, Pankaj / Kaur, Ikwinder Preet / Mughal, Mohsin Sheraz / Keshavamurthy, Chandana / Cusick, Austin / Schram, Jennifer / Yarrarapu, Siva Naga S / Giri, Abhishek R / Kaur, Nirmaljot / Moreno Franco, Pablo / Abril, Andy / Aslam, Fawad

Annals of medicine

2022 Volume 54, Issue 1, Page(s) 775–789

Abstract: Introduction: Colchicine, because of its anti-inflammatory and possible anti-viral properties, has been proposed as potential therapeutic option for COVID-19. The role of colchicine to mitigate "cytokine storm" and to decrease the severity and mortality ...

Abstract	Introduction: Colchicine, because of its anti-inflammatory and possible anti-viral properties, has been proposed as potential therapeutic option for COVID-19. The role of colchicine to mitigate "cytokine storm" and to decrease the severity and mortality associated with COVID-19 has been evaluated in many studies. Objective: To evaluate the role of colchicine on morbidity and mortality in COVID-19 patients. Methods: This systematic review was conducted in accordance with the PRISMA recommendations. The literature search was conducted in 6 medical databases from inception to February 17, 2021 to identify studies evaluating colchicine as a therapeutic agent in COVID-19. All included studies were evaluated for risk of bias (ROB) using the Revised Cochrane ROB tool for randomised controlled trials (RCTs) and Newcastle-Ottawa Scale (NOS) for case-control and cohort studies. Results: Four RCTs and four observational studies were included in the final analysis. One study evaluated colchicine in outpatients, while all others evaluated inpatient use of colchicine. There was significant variability in treatment protocols for colchicine and standard of care in all studies. A statistically significant decrease in all-cause mortality was observed in three observational studies. The risk of mechanical ventilation was significantly reduced only in one observational study. Length of hospitalisation was significantly reduced in two RCTs. Risk for hospitalisation was not significantly decreased in the study evaluating colchicine in outpatients. Very few studies had low risk of bias. Conclusion: Based on the available data, colchicine shall not be recommended to treat COVID-19. Further high-quality and multi-center RCTs are required to assess the meaningful impact of this drug in COVID-19.KEY MESSAGESColchicine, an anti-inflammatory agent has demonstrated anti-viral properties in in-vitro studies by degrading the microtubules, as well as by inhibiting the production of pro-inflammatory cytokines.Colchicine has been studied as a potential therapeutic option for COVID-19, with variable results.Until further research can establish the efficacy of colchicine in COVID-19, the use of colchicine in COVID-19 shall be restricted to clinical trials.
MeSH term(s)	COVID-19/drug therapy ; Colchicine/therapeutic use ; Humans ; Morbidity ; Observational Studies as Topic ; Respiration, Artificial ; SARS-CoV-2
Chemical Substances	Colchicine (SML2Y3J35T)
Language	English
Publishing date	2022-03-08
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	1004226-x
ISSN	1365-2060 ; 1651-2219 ; 0785-3890 ; 1743-1387
ISSN (online)	1365-2060 ; 1651-2219
ISSN	0785-3890 ; 1743-1387
DOI	10.1080/07853890.2021.1993327
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Article ; Online: Impact of colchicine on mortality and morbidity in COVID-19

Devang Sanghavi / Pankaj Bansal / Ikwinder Preet Kaur / Mohsin Sheraz Mughal / Chandana Keshavamurthy / Austin Cusick / Jennifer Schram / Siva Naga S. Yarrarapu / Abhishek R. Giri / Nirmaljot Kaur / Pablo Moreno Franco / Andy Abril / Fawad Aslam

Annals of Medicine, Vol 54, Iss 1, Pp 775-

a systematic review

2022 Volume 789

Abstract: Introduction Colchicine, because of its anti-inflammatory and possible anti-viral properties, has been proposed as potential therapeutic option for COVID-19. The role of colchicine to mitigate “cytokine storm” and to decrease the severity and mortality ... ...

Abstract	Introduction Colchicine, because of its anti-inflammatory and possible anti-viral properties, has been proposed as potential therapeutic option for COVID-19. The role of colchicine to mitigate “cytokine storm” and to decrease the severity and mortality associated with COVID-19 has been evaluated in many studies.Objective To evaluate the role of colchicine on morbidity and mortality in COVID-19 patients.Methods This systematic review was conducted in accordance with the PRISMA recommendations. The literature search was conducted in 6 medical databases from inception to February 17, 2021 to identify studies evaluating colchicine as a therapeutic agent in COVID-19. All included studies were evaluated for risk of bias (ROB) using the Revised Cochrane ROB tool for randomised controlled trials (RCTs) and Newcastle-Ottawa Scale (NOS) for case-control and cohort studies.Results Four RCTs and four observational studies were included in the final analysis. One study evaluated colchicine in outpatients, while all others evaluated inpatient use of colchicine. There was significant variability in treatment protocols for colchicine and standard of care in all studies. A statistically significant decrease in all-cause mortality was observed in three observational studies. The risk of mechanical ventilation was significantly reduced only in one observational study. Length of hospitalisation was significantly reduced in two RCTs. Risk for hospitalisation was not significantly decreased in the study evaluating colchicine in outpatients. Very few studies had low risk of bias.Conclusion Based on the available data, colchicine shall not be recommended to treat COVID-19. Further high-quality and multi-center RCTs are required to assess the meaningful impact of this drug in COVID-19.KEY MESSAGESColchicine, an anti-inflammatory agent has demonstrated anti-viral properties in in-vitro studies by degrading the microtubules, as well as by inhibiting the production of pro-inflammatory cytokines.Colchicine has been studied as a potential ...
Keywords	Colchicine ; COVID-19 ; Coronavirus ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder-A Nationwide Study.

Patel, Urvish / Yousuf, Salma / Lakhani, Komal / Raval, Payu / Kaur, Nirmaljot / Okafor, Toochukwu / Shah, Chail / Singh, Harmandeep / Martin, Mehwish / Nwodika, Chika / Yogarajah, Angelina / Rakholiya, Jigisha / Patel, Maitree / Chakinala, Raja Chandra / Shah, Shamik

Medicines (Basel, Switzerland)

2020 Volume 7, Issue 11

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2020-11-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2777965-8
ISSN	2305-6320
ISSN	2305-6320
DOI	10.3390/medicines7110072
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Article ; Online: Epidemiological and Clinical Characteristics of 6635 COVID-19 Patients

Kaur, Nirmaljot / Gupta, Ishita / Singh, Harmandeep / Karia, Rutu / Ashraf, Aisha / Habib, Anam / Patel, Urvish K. / Malik, Preeti

SN Comprehensive Clinical Medicine

a Pooled Analysis

2020 Volume 2, Issue 8, Page(s) 1048–1052

Keywords	covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	2947211-8
ISSN	2523-8973
ISSN	2523-8973
DOI	10.1007/s42399-020-00393-y
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Article ; Online: Epidemiological and Clinical Characteristics of 6635 COVID-19 Patients: a Pooled Analysis.

Kaur, Nirmaljot / Gupta, Ishita / Singh, Harmandeep / Karia, Rutu / Ashraf, Aisha / Habib, Anam / Patel, Urvish K / Malik, Preeti

SN comprehensive clinical medicine

2020 Volume 2, Issue 8, Page(s) 1048–1052

Abstract: An unidentified pneumonia outbreak was first observed in Wuhan, the capital of Hubei Province, China, in December 2019. WHO officially named the disease, Coronavirus Disease 2019 (COVID-19), and declared it as pandemic on Mar 11, 2020. Globally, there ... ...

Abstract	An unidentified pneumonia outbreak was first observed in Wuhan, the capital of Hubei Province, China, in December 2019. WHO officially named the disease, Coronavirus Disease 2019 (COVID-19), and declared it as pandemic on Mar 11, 2020. Globally, there are more than 3 million confirmed cases with nearly 200,000 deaths. Hence, we aimed to perform a systematic review and pooled analysis of the current published literature on COVID-19 to provide an insight on the epidemiological and clinical characteristics of COVID-19 patients. A systematic search of published peer-reviewed articles that reported cases with demographical and clinical features of real-time reverse transcriptase polymerase chain reaction (rRT-PCR)-confirmed SARS-CoV-2 infection using MOOSE guidelines was conducted from December 1, 2019, to April 27, 2020, and 50 eligible articles were included for the final analysis. Review articles, opinion articles, and letters not presenting original data as well as studies with incomplete information were excluded. We included a total of 6635 patients from 50 articles, with 54.5 % being male. The predominant symptoms were fever (80.3%), cough (64.2%), and fatigue/myalgia (36.5%) and other symptoms including dyspnea, chest pain, and sore throat. We also found patients with GI symptoms like diarrhea (9.2%) and nausea/vomiting (5.2%). Comorbidities were found in 3,435 (51.7%) patients with the most common being hypertension (22.67%) followed by diabetes mellitus (12.78%). COVID-19 pandemic is not only leading a huge burden on health care facilities but significant disruption in the world society. Patients with coexisting comorbidities are at higher risk and need more utilization of health care resources. As this virus is spreading globally, all countries have to join hands and prepare at all levels of human resources, infrastructure, and facilities to combat the COVID-19 disease.
Keywords	covid19
Language	English
Publishing date	2020-07-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2947211-8
ISSN	2523-8973 ; 2523-8973
ISSN (online)	2523-8973
ISSN	2523-8973
DOI	10.1007/s42399-020-00393-y
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Article: COVID-19 Outcomes Amongst Patients With Pre-existing Cardiovascular Disease and Hypertension.

Chakinala, Raja Chandra / Shah, Chail D / Rakholiya, Jigisha H / Martin, Mehwish / Kaur, Nirmaljot / Singh, Harmandeep / Okafor, Toochukwu L / Nwodika, Chika / Raval, Payu / Yousuf, Salma / Lakhani, Komal / Yogarajah, Angelina / Malik, Preeti / Singh, Jagmeet / Kichloo, Asim / Patel, Urvish K

Cureus

2021 Volume 13, Issue 2, Page(s) e13420

Abstract: Introduction: Coronavirus disease 2019 (COVID-19) has multiorgan involvement and its severity varies with the presence of pre-existing risk factors like cardiovascular disease (CVD) and hypertension (HTN). Therefore, it is important to evaluate their ... ...

Abstract	Introduction: Coronavirus disease 2019 (COVID-19) has multiorgan involvement and its severity varies with the presence of pre-existing risk factors like cardiovascular disease (CVD) and hypertension (HTN). Therefore, it is important to evaluate their effect on outcomes of COVID-19 patients. The objective of this meta-analysis and meta-regression is to evaluate outcomes of COVID-19 amongst patients with CVD and HTN. Methods: English full-text observational studies having data on epidemiological characteristics of patients with COVID-19 were identified searching PubMed from December 1, 2019, to July 31, 2020, following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocol. Studies having pre-existing CVD and HTN data that described outcomes including mortality and invasive mechanical ventilation (IMV) utilization were selected. Using random-effects models, risk of composite poor outcomes (meta-analysis) and isolated mortality and IMV utilization (meta-regression) were evaluated. Pooled prevalence of CVD and HTN, correlation coefficient (r) and odds ratio (OR) were estimated. The forest plots and correlation plots were created using random-effects models. Results: Out of 29 studies (n=27,950) that met the criteria, 28 and 27 studies had data on CVD and HTN, respectively. Pooled prevalence of CVD was 18.2% and HTN was 32.7%. In meta-analysis, CVD (OR: 3.36; 95% CI: 2.29-4.94) and HTN (OR: 1.94; 95% CI: 1.57-2.40) were associated with composite poor outcome. In age-adjusted meta-regression, pre-existing CVD was having significantly higher correlation of IMV utilization (r: 0.28; OR: 1.3; 95% CI: 1.1-1.6) without having any association with mortality (r: -0.01; OR: 0.9; 95% CI: 0.9-1.1) among COVID-19 hospitalizations. HTN was neither correlated with higher IMV utilization (r: 0.01; OR: 1.0; 95% CI: 0.9-1.1) nor correlated with higher mortality (r: 0.001; OR: 1.0; 95% CI: 0.9-1.1). Conclusion: In age-adjusted analysis, though we identified pre-existing CVD as a risk factor for higher utilization of mechanical ventilation, pre-existing CVD and HTN had no independent role in increasing mortality.
Language	English
Publishing date	2021-02-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.13420
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