Indian Journal of Communicable Diseases

Atypical antipsychotics are of great benefit to patients suffering from psychiatric disorders, such as bipolar disorder and schizophrenia. Yet they have a wide array of adverse effects including metabolic disturbances. One such rare but potentially fatal complication is Diabetic ketoacidosis, associated with the use of Clozapine, an atypical antipsychotic. The objective of this article is to report a case of a 35-year-old male with underlying schizophrenia on clozapine 200mg BD who presented in the emergency with complaints of abdominal discomfort, sweating, vomiting and palpitations. The patient was managed as a case of diabetic ketoacidosis(DKA). Thorough investigations ruled out other possible causes. This study outlines the importance of being vigilant while managing a case with psychiatric disorder being treated with clozapine as the drug can lead to new-onset diabetes and diabetic ketoacidosis. Patients on clozapine must be regularly monitored especially during the early course of treatment to avoid the onset of such fatal adverse effects.
Keywords: Diabetic Ketoacidosis; Clozapine-Induced.

The World Health Organization (WHO) has categorized the coronavirus pandemic as a global public health crisis of universal concern.1 On 11 February 2020, the infection was given its name by the WHO as ‘severe acute respiratory tract coronavirus-2’ (SARS-CoV-2; likewise alluded to as 2019-nCOV), and the disease it causes as ‘COVID-19’.1 On 26 February, Pakistan affirmed its initial two cases of coronavirus. Both cases were being taken consideration as indicated by clinical standard protocols and both of them are stably affirmed by government special assistant of health. The first patient (index case) was a student at the college in Karachi (Sindh region) while the subsequent patient was from the federal territory of the country. The two patients had late travel history from Iran.2 Within seven days of the initial two cases, Pakistan affirmed three additional cases, including a case in Islamabad and Rawalpindi (Punjab Province).3 The fifth case was likewise given an account of 2 March, from, Islamabad, a 45-year woman from Gilgit, with movement history from Iran.4 On 6 March, the first patient in Karachi had completely recuperated and later released from the hospital in the wake of testing negative.5 Following day, nine new cases detailed in Karachi with Sindh having the most noteworthy number of 13 cases. These new cases have a travel history from Syria and London. Three additional cases affirmed the following day remembering the first case for Balochistan Province.6
Keywords: Pandemic; Coronavirus; Outbreak.

Purpose of review: The world is filled with news about coronavirus disease 2019, shortly COVID-19 these days. The virus has been quite devastating with the death toll reaching an insurmountable level with time. So, to have and provide an insight on the viral attack in the Indian subcontinent this article has been penned. Recent findings: India is the country with the second largest population in the world after China with a number of 1,382,715,488. The impact of the novel coronavirus 2019 has been humungous on the Indian population, with the country standing second in the world after the USA with a count of 48,50,887 (as on 14 Sep, 11.16 am). But due to the unavoidable resumption of daily chores in certain areas, the count stands high, despite the measures taken by the healthcare authorities. Hence, to provide an overview of the viral impact in the country, the article has been created. Summary: COVID-19 is turning out to be a “digital infodemic”, meaning all data sources being flooded with farreaching information, both accurate and inaccurate data across the globe. The thought of providing a clear idea on the disease status in India prompted the creation of this article, which may give some awareness on the severity of the disease.
Keywords: COVID-19; Virus; Death toll; Insurmountable; Coronavirus disease 2019.

Dietary supplementation is considered for prevention and/or treatment of COVID-19. Present review was conducted to understand the role of vitamins in COVID-19.Review articles, in English language, published within past one year, were considered in this report.Electronic databases were searched, till 30th June 2020. Of initially identified 90 publications, 13 review articles were selected for present qualitative synthesis. Out of the five vitamins considered here, vitamin D followed by vitamin C was most researched upon. Vitamin D deficiency is associated with increased susceptibility to respiratory infections including occurrence and poor outcome of COVID-19, which is likely to depend on prior vitamin D status of the individual. Most authors have recommended vitamin D supplementation especially in vitamin D deficient and high risk individuals, in daily or weekly regimen, with higher doses for vulnerable individuals. Some authors have opined that supplementation with vitamin C provides protection against respiratory infections and can even reduce duration, severity and impact of the disease, but it is not known whether a supplemental dose of vitamin C administered to patients without their deficiency would result in a benefit. Very few articles were available on other vitamins. While Vitamin A supplement may be of a small benefit and hence has been recommended,vitamin E supplementation has been noted to be harmful for both prevention and treatment. Evidence is lacking for all the vitamins under review here and hence impact of supplementation of vitamins is still unclear. Importance of maintaining optimal nutrient status to strengthen the immune system to ward off any disease cannot be over-ruled. However, nutrient supplement may also be a potential alternative for prevention and/or treatment of the disease, especially vitamin D in high risk individuals. Further intervention research is required to establish or refute the possibly effective role of vitamins in prevention/treatment of COVID-19.
Keywords: COVID-19; Vitamins; ABCDE; Nutrient supplement.

Communicable disease outbreaks having high infectivity often result into epidemics and sometimes pandemics and have potential to cause threat to public health. Conflicts may arise while implementing preventive strategies to control the spread of communicable diseases having potential threat to public health. Micro ethics deals with almost every domain of interaction between doctor and patient while providing health care to individual patient.Micro ethical issues are highly variable and difficult to standardize but still play crucial role in doctor patient relationship .However these issues are often barely addressed hence there is a urgent need to address and update micro ethics as far as control of communicable diseases is concerned.
Keywords: Communicable Diseases Control; Micro Ethics.