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Showing posts from April, 2020

The mechanism of Oseltamivir and Favipiravir as a drug of choice to fight Covid-19

Oseltamivir. Oseltamivir is available in the form of Oseltamivir Phosphate which is a prodrug. Prodrug means the initial form has no anti-viral effect and requires the enzyme esterase in the digestive tract to be replaced with Oseltamivir carboxylate which is the active form. Oseltamivir is used for the treatment of influenza type A and type B, H1N1 and H5N1 virus infections. The mechanism of action of Oseltamivir is as a neuraminidase inhibitor that can inhibit the release of influenza viruses that replicate from host cells and from cells that have been infected. In-vitro research shows neuraminidase inhibitors do not have antiviral activity in corona virus. Most of the literature does not use Oseltamivir, but in Indonesia Oseltamivir is given to Covid-19 patients and produces a fairly good response. The use of Oseltamivir for Covid-19 still needs to be studied. Oseltamivir is available in oral form. Oseltamivir dose for influenza types A and B : 2 × 75 mg, for 5 ...

Chloroquine and Hydroschloroquine for Covid-19 patients

The mechanism of action of chloroquine in the Covid-19 treatment : Inhibits the entry of the virus into host cells by increasing endosomal PH. Disrupting virus particles to bind to their receptors on the cell surface. Reducing the expression of ACE2 receptors (ACE2 receptors are the place of viruses when they enter the body). Chloroquine has been shown to inhibit in vitro replication of several Corona viruses. Chloroquine can improve the clinical picture of patients infected with SARS-Cov-2. So, China recommends patients diagnosed with Covid-19 to be treated with chloroquine phosphate. Expert consensus published in February 2020 from Guangdong province, China : recommend chloroquine phosphate tablets 500 mg, 2 × daily, for 10 days (for patients diagnosed with mild, moderate, or severe SARS-Cov-2 pneumonia) provided there are no contraindications to the drug. Suggest the use of chloroquine for Covid-19 patients who require hospital treatment with a ...

The role of vitamin C in Covid-19 therapy

Vitamin C in Covid-19 therapy is very important, vitamin C plays a role in maintaining the integrity of the body's immune system. The dosage of vitamin C must be appropriate to achieve effective bioavailability. In conditions of infection and in critical patients, there is an increase in the need for vitamin C, due to ➡ Metabolic Needs. Inflammatory process. But, on the other hand there is depletion or decreased absorption of vitamin C due to the presence of inflammatory cytokines. The role of vitamin C in Covid-19 therapy.  Vitamin C has extensive physiological functions in the body and vitamin C is an antioxidant enzymatic co-factor that is important for the potentiation of the immune system. Specifically modulating the immune system in maintaining the integrity of the immune system. Vitamin C regulates hormone production in the body. Vitamin C requires an intermediate sodium vitamin C co-transporter (SVCT) in order to cross the cell membrane. There...

Supportive and symptomatic therapy in the treatment of Covid-19, in addition to the use of anti-viral.

Coronavirus is a microorganism that causes Covid-19 cases. The corona virus is a single, encapsulated, non-segmented RNA virus. Coronaviruses are classified as the order of nidovirales from the coronaviridae family. 4 genus corona virus : Alphacoronavirus. Betacoronavirus. Gammacoronavirus. Deltacoronavirus. There are 7 types of coronavirus that can infect humans today : 2 types of Alphacoronavirus (229E and NL63). 4 types of Betacoronavirus (OC43, HKU1, MERS-Cov, SARS-Cov). Novel Coronavirus 2019 (2019-nCov). Clinical manifestations : Uncomplicated illness ➡ Patients infected with Covid-19 have non-specific symptoms (fever, cough, sore throat, malaise, headache, muscle aches) but need to be aware of elderly patients > 60 years old or elderly patients with multiple diseases or disorders of organ function. Mild pneumonia. Severe pneumonia. Acute Respiratory Distress Syndrome (ARDS). Sepsis. Septic shock. There are currently no specific treatm...

Down-Turner Syndrome, multiple monoclonal chromosome abnormalities

Down-Turner Syndrome was first described by Henry Turner in 1938. This genetic disease is a rare disease, one in two thousand five hundred female babies has this defect. Characteristics of Down-Turner Syndrome : Not an infectious disease. Happens randomly. There is no cure. Not a generation disease. Gestational age is not the cause of Down-Turner Syndrome. Low life expectancy is caused by abnormal heart complications and diabetes. Growth hormone therapy can be given. General characteristics of Down-Turner Syndrome patients : Neck wide and webbed. Short sized body. Swollen hands and feet. Wide and flat chest. Early menopause and cannot get pregnant. CASE REPORT. Baby girl. G3 mother, 39 weeks. Born with a cesarean section due to rupture of membranes without signs of childbirth. Physical examination at birth ➡ Birth weight : 2,8 kg. Birth length : 44 cm.  Lymphedema in the legs and arms. Jaundice. Phototherapy aged 2 days - 4 days. ...

Pneumonia Covid-19 case with clinical symptoms of a full body rash

CASE PRESENTATION History ➡ Male, 20 year old.  Main complaints : fever and rash. Current medical history : patient has fever and rash, diagnosed with upper respiratory viral infection. In 6 days after that the condition did not improve. The patient is then taken to Emergency Unit.  Physical examination ➡ Blood pressure : 93/54 Pulse rate : 115 times/minute Breath rate : 24 times/minute Temperature : 39,4°C O² Saturation : 91% Skin : maculopapular rash, extensive morbilliform in almost all parts of the body (except face). Other physical examination within normal limits. Supporting examination ➡ Chest radiograph : bilateral infiltrates (compatible with multifocal pneumonia).  Laboratory. Leukocytes : 8300 uL Normal value : 4200-9100 uL Lymphocytes : 800 / uL Normal value : 1300-3600 / uL CRP : 118.5 mg / L Normal value : 0-5 mg / L Rapid Strep Test : - HIV : - Treatment...

The indicative cases of Covid-19 transmission come from asymptomatic carriers

Covid-19 transmission has been reported to occur between humans, but it is not certain whether it can be transmitted by a carrier without symptoms. The following cases indicate that transmission can occur during the incubation period or asymptomatic COVID-19 carrier. Asymptomatic is a condition when someone is positive infected with the disease, but does not feel clinical symptoms. Case in Germany. Someone age 33 years (Patient 1) on January 24, 2020, complained : Sore throat. Shivering. Myalgia. The day after the fever 39,1°C. Cough. On January 26, 2020, the patient felt that he had improved. Contact History : On January 20-21, 2020, the patient met with a business partner from China (a woman who was healthy and had no signs or symptoms of infection at the time). This woman then felt herself sick when the flight returned to China. On January 26, this woman was later tested positive for Covid-19. This news was then sent to the infectious and tropical di...

Seven ways of nasopharyngeal swabs

There are two types of swabs, namely : Dacron/rayon sterile with plastic handles. Flocked swab with more flexible stem. General guidelines for collecting Covid-19 specimens : Wash hands before and after action. Use complete personal protective equipment (N95 mask and gloves). Specimen collection schedule ➡ Patients under surveillance and people in monitoring : performed on the first, second day and when the patient's condition worsens. Make sure the specimen code label matches the code in the specimen collection form. Store specimens in a parafilm-wrapped cryotube, put in plastic clips and stored at 4°C-8° C before shipping. How to nasopharyngeal swabs : Make sure there are no obstructions in the nostrils : ask the patient to sniff if any, inform the patient that this procedure will be a little uncomfortable. Head tilt, so the nose can be seen more clearly. Ask the patient to close his eyes to reduce discomfort when taking a specimen. ...

Guidelines diagnosis of Tuberculosis in adults

Diagnosis of pulmonary tuberculosis. Suspect Tuberculosis was examined for 3 sputum specimens for two days. The main diagnosis is made if Tuberculosis is found in the result of AFB. Other checks, such as : Chest X-ray. Mycobacterium tuberculosis culture. Sensitivity tests can be used to support diagnosis as indicated. The diagnosis should not be based on chest radiograph only (it does not always show a characteristic picture of lung tuberculosis and does not indicate disease activity). Chronology of diagnosis of pulmonary tuberculosis in adults. Suspect Tuberculosis of the lungs mikroskop Microscopic sputum examination ➡ BTA results + + +/+ + - - ➡ Tuberculosis Suspect Tuberculosis of the lungs mikroskop Microscopic sputum examination ➡ BTA + - - ➡ Thoracic photos and doctor's considerations ➡ Tuberculosis/Non-Tuberculosis Suspect Tuberculosis of the lungs mikroskop Microscopic sputum examination ➡ BTA + - - ➡ Microscopic sputum examination ➡ BTA re...