STUDY OF INFLAMMATORY MARKERS IN RELATION TO RADIOLOGICAL FINDINGS IN COVID 19

2021 ◽  
pp. 48-50
Author(s):  
Kalyanisri. Koneru ◽  
V M Kiran Ogirala ◽  
Kommavarapu. Kalyani Madhuri ◽  
Bokam. Bhanu Rekha
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
X Rays ◽  
X Ray ◽  
Duration Of Hospital Stay ◽  
Number Of Patients ◽  
Chest X Ray ◽  
Severity Of The Disease

BACKGROUND Currently, the Coronavirus disease 2019 (COVID-19) has become pandemic globally. Elevated inammatory markers are observed and are a common pathophysiological response to acute illness. Chest X-ray changes are also commonly seen in COVID -19 patients. The present study was undertaken to determine the relationship between inammatory markers to chest X-ray ndings in COVID-19 patients. METHODS This is a prospective observational study of COVID-19 patients admitted to tertiary care hospital from may 2020-November 2020. Comorbidities, inammatory markers, and Chest X ray were collected and analyzed. Correlations between radiological and inammatory markers were studied. AIMS & OBJECTIVES: Ÿ Correlation of inammatory markers to radiographic ndings and their outcome in COVID 19 patients Ÿ The outcome was studied in terms of: Ÿ Patients requiring oxygen/ NIVsupport Ÿ duration of hospital stay Ÿ Number of patients Recovered/death RESULTS: Ÿ Out of 500 patients studied, the mean age was 49.41 years, and (295)59% of patients were male,(205)41% were females. (455)91% patients discharged and (43)8.6% died. We found a positive correlation between inammatory markers and Chest X-ray ndings at the time of admission with a signicant statistical P-value. The inammatory markers CRP, ESR, D-Dimer & Sr.ferritin compared with the mode of ventilation(O2 & NIV, duration of hospital stay and outcome also showed signicant statistical P-value. CONCLUSIONS We conclude that in patients with raised inammatory markers there were increased abnormalities on Chest X-rays which required an increase in oxygen or NIVsupport. This can be a useful predictor of the severity of the disease and assessment of outcome.

scholarly journals Brixia Chest X-ray Scoring System in Critically Ill Patients with COVID-19 Pneumonia for Determining Outcomes

2021 ◽  
Author(s):  
Nishant Agrawal ◽  
Samruddhi Dhanaji Chougale ◽  
Prashant Jedge ◽  
Shivakumar Iyer ◽  
John Dsouza
Keyword(s):  
Scoring System ◽  
Early Stage ◽  
Tertiary Care ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
X Ray ◽  
Lung Abnormalities ◽  
Chest X Ray ◽  
The Mean

Introduction: In early stage of disease of Coronavirus Disease 2019 (COVID-19) infection chest Computed Tomography (CT) imaging is considered as the most effective method for detecting lung abnormalities. A Brixia Chest X-ray (CXR) scoring system which uses an 18-point severity scale to grade lung abnormalities due to COVID-19 was developed to improve the risk stratification for infected patients. Aim: To ascertain the validity of Brixia scoring system and to measure the outcome in COVID-19 patients. Materials and Methods: A retrospective study was conducted from 1st April 2020 to 31st July 2020, at a tertiary care hospital in India. Baseline CXR of COVID-19 patients were scored based on Brixia scoring system. The lungs were divided into six equal zones. Subsequently, scores (from 0-3) were assigned to each zone, based on lung abnormalities. A group comparison was implemented using Chi-Square test for categorical variables. Whereas an independent t-test was applied for continuous variables that followed normal distribution. Results: The study included 130 patients. The mean age was 57.09±13.73 years, 70.8% patients included were males. Out of 130 patients, 79 patients died. Among patients who died the mean CXR score was calculated to be 12.13±2.50. The mean CXR score was calculated to be 11.18±2.30 in patients who recovered and got discharged. During the process of comparison of CXR scores with the outcomes, the t-value came out to be 2.20 and the resulting p-value was 0.03 (statistically significant). Conclusion: Brixia score more than 12 was associated with increased mortality due to COVID-19, with p-value of 0.03.

scholarly journals Role of Chest X-Ray in Coronavirus Disease and Correlation of Radiological Features with Clinical Outcomes in Indian Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Satyanand Sathi ◽  
Richa Tiwari ◽  
Savita Verma ◽  
Anil Kumar Garg ◽  
Virendra Singh Saini ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hospital Stay ◽  
Rank Correlation ◽  
X Rays ◽  
X Ray ◽  
Radiological Features ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient ◽  
Discharged Patients ◽  
Chest X Ray

Recent literature has reported that radiological features of coronavirus disease (COVID-19) patients are influenced by computed tomography. This study aimed to assess the characteristic chest X-ray features of COVID-19 and correlate them with clinical outcomes of patients. This retrospective study included 120 COVID-19 patients. Baseline chest X-rays and serial chest X-rays were reviewed. A severity index in the form of maximum radiological assessment of lung edema (RALE) score was calculated for each lung, and scores of both the lungs were summed to obtain a final score. The mean ± standard deviation (SD) and frequency (%) were determined, and an unpaired t test, Spearman’s rank correlation coefficient, and logistic regression analyses were performed for statistical analyses. Among 120 COVID-19 patients, 74 (61.67%) and 46 (38.33%) were males and females, respectively; 64 patients (53.33%) had ground-glass opacities (GGO), 55 (45.83%) had consolidation, and 38 (31.67%) had reticular-nodular opacities, with lower zone distribution (50%) and peripheral distribution (41.67%). Baseline chest X-ray showed a sensitivity of 63.3% in diagnosing typical findings of SARS-CoV-2 pneumonia. The maximum RALE score was 2.13 ± 1.9 in hospitalized patients and 0.57 ± 0.77 in discharged patients ( p value <0.0001). Spearman’s rank correlation coefficient between maximum RALE score and clinical outcome parameters was as follows: age, 0.721 ( p value <0.00001); >10 days of hospital stay, 0.5478 ( p value <0.05); ≤10 days of hospital stay, 0.5384 ( p value <0.0001); discharged patients, 0.5433 ( p value <0.0001); and death, 0.6182 ( p value = 0.0568). The logistic regression analysis revealed that maximum RALE scores (0.0932 [0.024–0.367]), (10.730 [2.727–42.206]), (1.258 [0.990–1.598]), and (0.794 [0.625–1.009]) predicted discharge, death, >10 days of hospital stay, and ≤10 days of hospital stay, respectively. The study findings suggested that the RALE score can quantify the extent of COVID-19 and can predict the prognosis of patients.

COVID-19: An Experience from a Tertiary Care Hospital of Nowshera

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Epidemic Area ◽  
History Of ◽  
Severity Of The Disease ◽  
Age Range

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.

scholarly journals Burden, types of diseases and outcome in LBW babies admitted at a Tertiary Care Hospital.

2020 ◽  
Vol 27 (03) ◽  
pp. 547-551
Author(s):  
Shahid Iqbal ◽  
Fazal Ur Rehman ◽  
Muhammad Haneef
Keyword(s):  
Birth Weight ◽  
Analytical Study ◽  
Distress Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Duration Of Hospital Stay ◽  
Hospital Study ◽  
Study Setting

Objectives: LBW has long been labeled as one of the major risk factor for mortality as well as morbidity in neonates. South Asia is said to have highest number of LBWs which estimated to be 1 in 4 newborns that weigh < 2500 grams. This study was planned with an aim to note the burden, types of diseases and outcome in LBW newborns admitted at a tertiary care hospital. Study Design: Descriptive analytical study. Setting: Included all neonates admitted to NICU of Sheikh khalifa Bin Zaid Al Nahyan Teaching Hospital, Rawlakot. Period: 1st July 2018 to 31st December 2018. Material & Methods: The prevalence of LBW amongst all admissions was calculated along with demographic features of all LBW babies like disease, reasons for the admission, duration of hospital stay along with outcome was noted on a predesigned proforma. Results: Out of total of 1410 admission in NICU during the study period, 512 (36.3%) were noted to be LBW. Amongst LBW babies, mean weight was 1.91 kg while 269 (52.5%) were male and 243 (47.5%) female. There were 364 (67.6%) babies born at full term. There were 82 (16.0%) with birth weight of less than 1.5 kg, 166 (32.4%) between 1.5 to 2 kg while 264 (51.6%) were above 2 kg. Amongst all LBW babies, mortality was reported in 185 (36.1%) while 112 (60.5%) died on the 1st day of admission. Respiratory distress syndrome (31.4%), sepsis (20.3%) and neonatal jaundice 58 (11.3%) were the commonest diseases seen. Highest mortality (56.1%) was seen in babies who had birth weight below 1.5 kg (p value = 0.001). Conclusion: LBW is a major cause of hospitalization and mortality. RDS and sepsis were the most frequent diseases noted in LBW babies. Immediate care following birth is vital for babies already at risk of LBW.

scholarly journals Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Treatment Pattern ◽  
Operative Procedures ◽  
Care Hospital ◽  
Third Generation ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

scholarly journals Correlation of the severity of HRCT findings with the other hematologic parameters & viral load in patients with confirmed COVID – 19 Infection

2021 ◽  
Vol 12 (9) ◽  
pp. 4-10
Author(s):  
Anjali Goyal ◽  
Misha Antani ◽  
Suhani Agarwal ◽  
Chandni Gadara ◽  
Milap Shah ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Viral Clearance ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Duration Of Hospital Stay ◽  
Severity Scores ◽  
Wbc Count ◽  
D Dimer

Background: The latter half of 2019 saw the spread of a highly contagious and fatal respiratory tract disease originating in the Hubei province of Wuhan in China which was labelled as COVID 19. Although a multi organ disease, it is seen to spread through the respiratory tract with lung being the primary target. Aims and Objective: The study was conducted to correlate the severity of lung involvement as assessed by the HRCT severity, with the Viral Severity index, laboratory parameters, duration of hospital stay, viral clearance and resolution of lung symptoms. Materials and Methods: An observational retrospective study was carried out from the laboratory records of consecutive 208 patients admitted to the tertiary care hospital between March 2020 to May 2020. Results: Out of a total of 208 patients, 200(96%) recovered and 8(4%) expired. The expired patients showed a higher average age (50.79+/- 17.42; 62.25+/-12.37) years in the recovered & expired patients respectively (p=0.06). A longer duration of hospital stay was seen in the expired patients (15.05+/-9.55&18.62+/-10.22) days in the recovered & expired patients respectively. A low average (Hemoglobin) Hb values (12.17+/-2.01&10.9+/-2.31) g/dl in the recovered and expired patients respectively along with a higher total WBC count was seen in the expired patients (8.62+/-3.81& 16.86+/-12.79) k/U in the recovered and expired patients with a highly significant p value of < 0.001). Higher CT severity scores were seen in the expired patients (10.74+/-5.57&17.12+/-6.55) in the recovered and expired patients respectively (p=0.0018). None of the expired patients had a normal D Dimer level. HRCT values and the Rising D Dimer levels tend to show a positive correlation with the disease outcome and progression. The Higher Viral severity and HRCT score was associated with a longer duration of hospital stay reflecting a higher duration of viral clearance. Conclusion: The Chest CT scores along with the laboratory parameters like the total WBC count and the D Dimer levels can together act as important parameters to monitor the Covid 19 disease course.

THE IMPORTANCE OF CHEST-X-RAY (TIMIKA SCORE) TO PREDICT THE CLINICO-BACTERIOLOGICAL PROFILE OF PULMONARY TUBERCULOSIS PATIENTS

2021 ◽  
pp. 55-58
Author(s):  
Surinder Pal Singh ◽  
Harjinder Singh ◽  
Komal Deep Kaur ◽  
Kailash Meena ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sputum Smear ◽  
Karnofsky Performance Score ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Cavitary Lesion ◽  
X Ray ◽  
Chest X Ray

Introduction: Chest x-ray (CXR) is the primary modality for diagnosis and severity assessment and monitoring the ATT response in pulmonary tuberculosis (PTB). The aim of our study was to determine the correlation between the radiographic involvement of disease on CXR based on Timika CXR score with the clinically and bacteriological specications at diagnosis and initiation of ATT in sputum smear-positive PTB patients. Material And Method: A cross-sectional study was conducted in the Department of Pulmonary Medicine, a tertiary care hospital, Punjab, from January to June 2020. Seventy new sputum smear-positive cases of PTB were included. At the time of diagnosis, the patient's baseline test, clinical signs and symptoms were evaluated using TB scores I, II, Karnofsky performance score (KPS), and body mass index (BMI). Two chest physicians, according to the Timika CXR score, evaluated the CXR of each patient Independently. Result: Cavitary lesion on CXR resulted in a signicantly higher Timika score associated with higher Mycobacterial load in sputum grading compared to non-cavitary disease. 55.17% of patients with CXR score ≥71 had statistically signicant higher baseline sputum grading compared to 9.76% of patients with CXR ≤ 71. Higher Timika CXR score ≥ 71 was signicantly associated with a longer mean duration of symptoms, lower BMI, higher TB score, lower KPS at baseline, higher ESR, low hemoglobin, low serum albumin. Discussion: The study shows that Timika CXR score signicantly correlates with radiographic involvement and extent of disease severity on CXR with the clinically and bacteriological prole of PTB patients, which a pulmonologist can use in a medical practice. A Higher CXR Timika score is associated with the patient's poor clinical condition and the severity of the disease. Cavitary lesion on CXR associated with higher sputum smear grading. It is observed that the Timika CXR score can be used to identify the PTB patients at risk of treatment failure for their more aggressive management.

scholarly journals COMPARISON OF EFFICACY OF TRANEXAMIC ACID 10 MG/KG AND 15 MG/KG IN REDUCING BLEEDING AND TRANSFUSIONS IN TOTAL KNEE ARTHROPLASTY

2019 ◽  
pp. 535-538
Author(s):  
HIMA R NAMBIAR ◽  
SHAILA S KAMATH
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
P Value ◽  
Duration Of Hospital Stay ◽  
Institutional Ethics ◽  
Number Of Patients ◽  
Total Knee ◽  
Group B

Objective: The objective of this study was to compare the efficacy of tranexamic acid 10 mg/kg and 15 mg/kg in reducing bleeding and transfusions in total knee arthroplasty. Methods: After approval from the Institutional Ethics Committee, KMC, Mangaluru, 88 patients fulfilling the inclusion criteria of this study undergoing total knee replacements were informed of the study details and consent was obtained for the same. They were randomized into two groups using computer-generated block randomization, i.e., Group A and Group B, and were administered tranexamic acid 10 mg/kg and 15 mg/kg intravenously, respectively. Intraoperatively, hemodynamic parameters were noted. Postoperatively, hemoglobin levels were assessed on days 1 and 3. Transfusions, thromboembolic complications, and duration of hospital stay were noted. Results: Of the 88 participants of the trial, 44 in Groups A and B each, there were no significant differences in the parameters observed in this study such as intraoperative hemodynamic changes, post-operative fall in hemoglobin on day 3, number of patients requiring transfusions, number of thromboembolic events, and duration of hospital stay. A significant p-value was observed in the fall in hemoglobin in the post-operative day 3 (p=0.043). Conclusion: About 15 mg/kg tranexamic acid proved to have a lesser fall in hemoglobin on day 3 postoperatively when compared to the 10 mg/kg group. However, the fall of hemoglobin on day 3 was statistically significant and warranted a blood transfusion in two patients in the 10 mg/kg group but did not prolong their hospital stay.

scholarly journals Epidemiological profile of patients presenting to dermatology department of a tertiary care hospital during nationwide lockdown due to COVID-19: a retrospective study from north India

2021 ◽  
Vol 9 (2) ◽  
pp. 443
Author(s):  
Faizan Younus Shah ◽  
Irfan Tasaduq ◽  
Yaqzata Bashir ◽  
Ifrah Shafat Kitab ◽  
Aaqib Aslam Shah ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Hair Loss ◽  
Seborrheic Dermatitis ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Dermatology Department ◽  
Female Pattern Hair Loss ◽  
Number Of Patients ◽  
Male Pattern

Background: The COVID-19 pandemic has seen an unprecedented lockdown with restrictions on human movement and interaction, imposed throughout the world to contain the spread of the disease. This gave us the unique opportunity to study the pattern of patients presenting to the dermatology out-patient department during this period.Methods: The study was a retrospective observational study involving the assessment of patient records from 25th March 2020 to 7th June 2020. This period corresponds to the duration of strictly imposed nationwide lockdown which was relaxed with phased resumption from 8th June 2020, termed as unlock 1.Results: A decrease in the absolute as well as proportional number of patients was seen in majority of the cases with a statistically significant proportional decline being seen in cases of allergic contact dermatitis (p-value =0.007), acne (p value <0.001), male pattern hair loss (p value <0.001) and female pattern hair loss (p value <0.001), verrucae (p value=0.01), seborrheic dermatitis (p value <0.001), ephelids (p value <0.001), melasma (p value<0.001), post-inflammatory hyperpigmentation (p value=0.006). However, there were certain disorders whose proportionate representation increased significantly during the lockdown period contrary to prevalent belief. These disorders included urticaria (p value <0.001), herpes zoster (p value <0.001), scabies (p value =0.01), generalized pruritus (p value <0.001) and prurigo (p value <0.001).Conclusions: Disorders like acne, male pattern hair loss, female pattern hair loss, verrucae, seborrheic dermatitis, ephelids, melasma and post-inflammatory hyperpigmentation which do not cause significant morbidity showed a significant decrease in proportional representation. The proportionate representation of disorders like urticaria, herpes zoster, scabies, generalized pruritus and prurigo increased significantly during the lockdown period.

scholarly journals Role of early CT scan in diagnosis of occult scaphoid fractures- a prospective study

2017 ◽  
Vol 5 (9) ◽  
pp. 4072
Author(s):  
Omeshwar Singh ◽  
Anuradha Sen ◽  
Sumeet Singh Charak ◽  
Shakeel Ahmad
Keyword(s):  
Ct Scan ◽  
Tertiary Care ◽  
False Negative ◽  
False Negative Rate ◽  
Scaphoid Bone ◽  
X Rays ◽  
X Ray ◽  
Scaphoid Fractures ◽  
Number Of Patients

Background: Wrists injuries are one of the common presentations to emergency departments and orthopaedic clinics. The scaphoid bone is the most commonly injured of the carpal bones accounting for 50-80% of carpal injuries and predominantly occurs in young healthy individuals. Scaphoid fractures are the most problematic to diagnose in a clinical setting because it can take up to 6 weeks for scaphoid fractures to become conclusive on plain X-ray films. Aim of the study was to retrospective study was carried out to study the role of early CT scan in diagnosis of occult scaphoid fractures.Methods: A total of 123 patients presented with an acute wrist injury with subsequent signs of scaphoid injury in the absence of a diagnostic fracture on plain X-ray within the time period from June 2014 to May 2016 in a tertiary care centre.Results: This study shows that 31% of normal X-rays were pathological on CT scan and out of these; scaphoid fractures (74% of pathologies) represent a large number of patients with fractures that were missed by initial plain films.Conclusions: This study shows an extremely high false-negative rate for plain X-rays and advocate CT at the first attendance to fracture clinic if there is suspicion of scaphoid injury. An earlier diagnosis leads to appropriate management and reduces restrictions to the patient in terms of prolonged immobilization and repeated clinical reviews.

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