scholarly journals Role of electrolytes in determining severity in COVID-19

2021 ◽  
Vol 9 (1) ◽  
pp. 18-23
Author(s):  
Anita R ◽  
Omkar KC ◽  
Rohit K ◽  
Rakesh KB
Keyword(s):  
Serum Magnesium ◽  
Severe Disease ◽  
Severe Infection ◽  
High Sensitivity ◽  
Viral Disease ◽  
P Value ◽  
International Studies ◽  
Mean Values ◽  
The Mean

Introduction: Coronavirus disease 2019 (COVID-19) is a viral disease which originated in the city of Wuhan (China) and progressively spread to all the continents and brought the world to a standstill. Various severity markers have been seen to play a role in the COVID-19. International studies have demonstrated role of serum electrolyte in COVID-19 as a potential severity marker. Hence, this study was undertaken in Indian patients. Material and methods: 100 COVID-19 reverse transcription polymerase chain reaction (RT-PCR) positive patient of non-severe and severe disease of either gender getting admitted to hospital and above 18 years were enrolled in the month of August to September 2020. The mean values of electrolytes and high-sensitivity C-reactive protein (HsCRP) in non- severe and severe disease were compared and correlated. Results: 100 patients including 70 of non-severe and 30 of severe disease were evaluated. The mean sodiumwas 134.03±6.77mEq/L and 135.5± 6.77mEq/l in the non-severe and the severe groups respectively (p value=0.91); potassium was 4.24±0.61mEq/l and 4.52±0.80 mEq/l respectively (p value=0.75); corrected serum calcium was 8.38±0.74 mg/dl and 8.48±0.74mg/dl respectively (p value = 0.95); phosphorus levels was 3.66±1.99mg/dl and 3.45±1.63 respectively (p value = 0.52); and serum magnesium level was 2.15±0.3 mEq/l and 2.03±0.56 mEq/l (p value = 0.18). The mean level of HsCRP was 30.95±49.41 mg/L in non- severe while 94.78±79.62 mg/L in severe infection (p value=0.03). In the severe group, the electrolyte values were found to be poorly correlated with the hsCRP levels. Conclusion: Electrolytes does not serve as severity markers in COVID-19 in an Indian population.

scholarly journals Serum Procalcitonin in the Prediction of Severity and Outcome of Acute Pancreatitis

2021 ◽  
Vol 9 (1) ◽  
pp. 16-21
Author(s):  
Khan Md Nazmus Saqeb
Keyword(s):  
Acute Pancreatitis ◽  
Statistical Analysis ◽  
Severe Disease ◽  
High Sensitivity ◽  
Biochemical Tests ◽  
Single Marker ◽  
Predicting Outcome ◽  
The Mean ◽  
The Difference

Background: Different modalities are available for predicting severity and outcome of acute pancreatitis. A single marker with high sensitivity and specificity is yet to be identified. Aim: This study intends to find out the utility of serum procalcitonin in predicting the severity and outcome of acute pancreatitis. Methods: 117 patients admitted with acute pancreatitis were included.Clinical parameters and biochemical tests were recorded on admission, on day-3 & day-5 of admission. CT scan was performed in all patients. Serum procalcitonin was done on admission. Multifactorial scores were calculated using these data.Every patient was followed for identification of organ failure or other complications. Statistical analysis was done with SPSS. Result: Among 117 patients, 67(57.3%) were male. Biliary, hypertriglyceridemia, alcohol, malignancy and post-ERCP complications were found as aetiology in 25(21.4%), 23(19.7%), 8(6.8%), 3(2.6%),2(1.7%) cases respectively. In 53(45.3%) cases no definite etiology could be found. 83(70.9%) patients had mild,15(12.8%) had moderately severe and 19(16.2%) had severe acute pancreatitis. 23(19.65%) patients developed complication, whereas 94 (80.34%) developed none. The mean serum procalcitonin(pg/ml) of patients with mild, moderately severe and severe disease was 146±165.21, 1297±439.44, 4361±1493.55 respectively. The difference among the groups were statistically significant. Mean serum procalcitonin(pg/ml) in patientswho developed complications was 3744±1827.05 and in those without complication it was 301±559.97.ROC curve evaluating the role of serum procalcitonin in predicting outcome of acute pancreatitis showed AUC of 0.985. A cutoff point of 1131.28pg/ml showed highest sensitivity (95.7%) & specificity (94.7%). Conclusion: Serum procalcitonin can be a new promising marker to predict severity and outcome of acute pancreatitis. Bangladesh Crit Care J March 2021; 9(1): 16-21

Seasonal trends in the stable isotopic composition of snow and meltwater runoff in a subarctic catchment at Okstindan, Norway

2004 ◽  
Vol 35 (2) ◽  
pp. 119-137 ◽  
Author(s):  
S.D. Gurney ◽  
D.S.L. Lawrence
Keyword(s):  
Isotopic Composition ◽  
Mean Value ◽  
Mean Values ◽  
Stable Isotopic Composition ◽  
Meltwater Runoff ◽  
Stable Isotopic ◽  
The Mean ◽  
The Difference ◽  
Δ18o And Δd

Seasonal variations in the stable isotopic composition of snow and meltwater were investigated in a sub-arctic, mountainous, but non-glacial, catchment at Okstindan in northern Norway based on analyses of δ18O and δD. Samples were collected during four field periods (August 1998; April 1999; June 1999 and August 1999) at three sites lying on an altitudinal transect (740–970 m a.s.l.). Snowpack data display an increase in the mean values of δ18O (increasing from a mean value of −13.51 to −11.49‰ between April and August), as well as a decrease in variability through the melt period. Comparison with a regional meteoric water line indicates that the slope of the δ18O–δD line for the snowpacks decreases over the same period, dropping from 7.49 to approximately 6.2.This change points to the role of evaporation in snowpack ablation and is confirmed by the vertical profile of deuterium excess. Snowpack seepage data, although limited, also suggest reduced values of δD, as might be associated with local evaporation during meltwater generation. In general, meltwaters were depleted in δ18O relative to the source snowpack at the peak of the melt (June), but later in the year (August) the difference between the two was not statistically significant. The diurnal pattern of isotopic composition indicates that the most depleted meltwaters coincide with the peak in temperature and, hence, meltwater production.

TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Priyanka Jain ◽  
Rakesh Jain
Keyword(s):  
Hypertonic Saline ◽  
Normal Saline ◽  
Mean Difference ◽  
Clinical Severity ◽  
Research Centre ◽  
P Value ◽  
College Hospital ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.

Evaluation of Transient Elastography in Prediction Of De novo Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia abdelaty Abdelkader ◽  
Moustafa Hamed Abdelaleem ◽  
Mohammed El-Gharib Abo El- maaty ◽  
Heba Ismail Aly ◽  
Sayed Ahmed Sayed
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transient Elastography ◽  
P Value ◽  
Hepatic Decompensation ◽  
Non Invasive ◽  
Prediction Of Mortality ◽  
The Mean ◽  
One Year

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value < 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value <0.001) .Regarding prediction of mortality, LS at cut off value > 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA

scholarly journals The prognostic role of inflammatory markers in COVID 19 patients – A retrospective analysis.

2021 ◽  
Author(s):  
Shivkumar Gopalakrishnan ◽  
sangeetha kandasamy ◽  
S.Malini ◽  
S.Peer Mohamed ◽  
k.velmurugan
Keyword(s):  
Inflammatory Markers ◽  
Severe Disease ◽  
Radiation Hazard ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
D Dimer

Abstract Background. Approximately 5% of COVID-19 patients suffer near fatal disease. Clinical and radiologic features may predict severe disease albeit with limited specificity and radiation hazard. Laboratory biomarkers are eyed as simple, specific and point of care triage tools to optimize management decisions.This study aimed to study the role of inflammatory markers in prognosticating COVID-19 patients.Methodology. A hospital based retrospective study was conducted on COVID-19 adult inpatients classified into three groups as mild disease-recovered [Group I], severe disease-recovered [Group II] and dead [Group III]. Categorical outcomes were compared using Chi square test. Univariate binary logistic regression analysis was performed to test the association between the explanatory and outcome variables. Unadjusted OR along with 95% CI was calculated. The utility of lab parameters (Ferritin, LDH, D dimer, N/L ratio and PLT/L ratio) in predicting severity of COVID-19 was assessed by Receiver Operative Curve (ROC) analysis. P value < 0.05 was considered statistically significant.Results. The mean age was 49.32 +/- 17.1 years. Among study population, 378 were Group I, 66 Group II, and 56 Group III. Median levels of Ferritin among the 3 groups were 62ng/mL, 388.50 ng/mL and 1199.50 ng/mL. Median value of LDH were 95U/L, 720 and 982.50(p <0.001). D-dimer values of 3 groups were 23.20ng/mL, 104.30 ng/mL and 197.10 ng/mL (p <0.001). CRP done qualitatively was positive in 2 (0.53%), 30 (45.45%) and 53 (94.64%) of patients. The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH and D-dimer [unadjusted OR 1.007, 1.004 &1.020]Conclusion. One time measurement of serum ferritin, LDH, D-dimer and CRP is promising to predict outcomes for COVID 19 inpatients. Single qualitative CRP was equally good but more cost effective than quantitative CRP. The most specific combination was NLR, Lymphocyte percentage and D-dimer levels done between 7th – 10th day of symptoms.

scholarly journals Role of Chemical Biomarkers in Prediction of Intra-Amniotic Infection in Cases with Preterm Premature Rupture of Membrane, Observational Study

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Interleukin 6 ◽  
Mean Value ◽  
Maternal Serum ◽  
P Value ◽  
Subclinical Infection ◽  
Premature Rupture ◽  
Cutoff Value ◽  
The Mean ◽  
Sensitivity Specificity

Introduction: Early recognition of subclinical intra-amniotic infection before development of clinical Chorioamnionitis dramatically improve neonatal outcome before affection of fetal neurological function. Objective: this study was conducted to evaluate the role of procalcitonin and interleukin-6 in early prediction of intrauterine infection in pregnant women with premature rupture of membranes. Methods: This observational prospective cohort study was conducted on 100 pregnant women with preterm premature rupture of membrane (PPROM), Patients were divided into 2 groups: Group I: with normal CRP and WBCs level. Group2: with subclinical infection which was detected by elevated WBCs count >15,000 c/mm3 and / or positive CRP. This group was divided into two groups (Group (II) and Group (III) according to development of Chorioamnionitis. follow up of these patients was done to detect the cutoff value of procalcitonin and interleukin-6 as a predictive indicator of clinical intra-amniotic infection in patients with premature rupture of membrane. Results: This study showed that the mean value of maternal serum PCT concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.0001 which is highly significant between the studied cases and with cutoff value was >0.67ng/ml, sensitivity, specificity, PPV, NPV was 88.7%, 42.9%, 79.7% and 60% respectively and the mean value of maternal serum IL-6 concentration was also higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.001which is highly significant between the studied cases and with cutoff value was >11.1pg/ ml, sensitivity, specificity, PPV, NPV was 67.9%, 61.9%, 81.8% and 43.3% respectively. Conclusion: maternal serum procalcitonin is a good predictor of clinical intra-amniotic infection with good sensitivity, specificity, PPV, NPV which is nearly good as CRP which is better than serum interleukin-6 regarding sensitivity

Cardiomyopathy in Cirrhotic Patients and Its Relationship with the Severity of Cirrhosis

2021 ◽  
Vol 15 (10) ◽  
pp. 2779-2782
Author(s):  
Saira Khalid ◽  
Nasir Shah ◽  
Yasir Abbas Zaidi ◽  
Muhammad Saleem Hasan ◽  
Saqib Jahangir ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Severe Disease ◽  
P Value ◽  
Cirrhotic Cardiomyopathy ◽  
Male Predominance ◽  
Class A ◽  
Class B ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Class C

Study Objectives: To determine the frequency of cirrhotic cardiomyopathy in patients with liver cirrhosis and to compare it across varying grades of cirrhosis on Child Turcotte Pugh classification. Study Design and Settings: It was a descriptive cross-sectional study carried at Department of Medicine, Lahore General Hospital Lahore over 1 year from Jan 2018 to Dec 2018. Patients and Methods: The present research involved 100 male and female patients aged between 16-70 years having liver cirrhosis diagnosed at least 6 months ago. These patients underwent echocardiographic screening of cardiomyopathy which was diagnosed by the presence of diastolic dysfunction (i.e. increased E/A ratio>1). An informed written consent was obtained from every patient. Results of the Study: There was a male predominance (M:F, 1.6:1) among cirrhotic patients with a mean age of 51.9±9.8 years. The mean BMI was 26.5±3.7 Kg/m2 while the mean duration of cirrhosis was 22.0±10.9 months. Majority (49.0%) of the patients belonged to CTP Class C followed by Class-B (39.0%) and Class-A (12.0%). Cirrhotic cardiomyopathy was observed in 41.0% patients with cirrhosis. There was statistically insignificant difference in the observed frequency of cirrhotic cardiomyopathy among various subgroups of cirrhotic patients depending upon patient’s age (p-value=0.928), gender (p-value=0.997), BMI (p-value=0.983) and duration of disease (p-value=0.782). However, it increased considerably with worsening of disease on CTP Classification; Class-A vs. Class-B vs. Class-C (8.3% vs. 35.9% vs. 53.1%; p-value=0.013). Conclusion: Cirrhotic cardiomyopathy was observed in a substantial proportion of cirrhotic patients and was more frequent in patients with more severe disease which warrants routine echocardiographic screening of cirrhotic patients so that timely recognition and anticipated treatment of this complication may improve the case outcome in future medical practice. Keywords: Cirrhosis, Cardiomyopathy, Child Turcotte Pugh Class

scholarly journals A profile and treatment outcome of seasonal hyper-acute panuveitis

1970 ◽  
Vol 2 (1) ◽  
pp. 35-38 ◽  
Author(s):  
E Shrestha
Keyword(s):  
Visual Acuity ◽  
Medical Treatment ◽  
Visual Outcome ◽  
P Value ◽  
Fisher Exact Test ◽  
Mean Values ◽  
Exact Test ◽  
Pediatric Age Group ◽  
Significant Difference ◽  
The Mean

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38

Achieving comparable perfusion results across vendors. The next step in standardizing stroke care: a technical report

2019 ◽  
Vol 11 (12) ◽  
pp. 1257-1260 ◽  
Author(s):  
Girish Bathla ◽  
Kaustubh Limaye ◽  
Bruno Policeni ◽  
Ernst Klotz ◽  
Markus Juergens ◽  
...  
Keyword(s):  
Ct Perfusion ◽  
Stroke Care ◽  
Vessel Occlusion ◽  
Mean Values ◽  
Technical Report ◽  
Significant Difference ◽  
Wilcoxon Paired Test ◽  
The Mean ◽  
Core Infarct

BackgroundThe role of mechanical thrombectomy in acute ischemic stroke (AIS) has been further expanded by recent trials which relied on the results of CT perfusion (CTP) imaging. However, CTP parameters for ischemia and infarct can vary significantly across different vendors.MethodsWe compared the outcomes of the Siemens CTP software against the clinically validated RAPID software in 45 consecutive patients with suspected AIS. Both perfusion softwares initially processed images using vendor defined parameters for hypoperfusion and non-viable tissue. The software thresholds on the Siemens software were decrementally altered to see if concordant results between softwares could be attained.ResultsAt baseline settings, the mean values for core infarct and hypoperfusion were different (mean of 30/69 mL, respectively, for RAPID and 49/77 mL for Siemens). However, reducing the threshold values for the later software showed a concordance of values at a relative cerebral blood flow <20%, with resulting core infarct and hypoperfusion volumes at 31/69 mL, respectively, for the Siemens software. A Wilcoxon paired test showed no significant difference between the calculated core infarct and hypoperfusion values, both for the entire population as well as for the subgroup of patients with large vessel occlusion.ConclusionEquivalent CTP results between vendor softwares may be attainable by altering the thresholds for hypoperfused and non-viable tissue, despite differences in acquisition techniques, post-processing, and scanners.

Thyroid Hormone Levels in Panic Disorder*

1987 ◽  
Vol 32 (6) ◽  
pp. 467-469 ◽  
Author(s):  
Vikram K. Yeragani ◽  
John M. Rainey ◽  
Robert Pohl ◽  
Aurelio Ortiz ◽  
Paula Weinberg ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Thyroid Dysfunction ◽  
Clinical History ◽  
Panic Attacks ◽  
P Value ◽  
Mean Values ◽  
Trh Stimulation ◽  
History Of ◽  
The Mean ◽  
Normal Controls

A history of thyroid dysfunction has been reported in patients with phobic disorders. There is also evidence of a blunted TSH response to TRH stimulation in patients with panic disorder. In this study, values of T3, T4 and T7 were compared between 26 patients with panic attacks and 20 normal controls. Patients were diagnosed according to DSM-III criteria and those with a clinical history of thyroid dysfunction were excluded. Patients were not on any medication when the blood samples were drawn. The mean values of T3, T4 and T7 did not significantly differ between the two groups, suggesting no evidence of hypo or hyperthyroidism; however, the variance of distribution of T3, T4 and T7 values was significantly different between the two groups (Fmax values for T3: 2.55, p value < 0.05; T4: 3.15, p value < 0.01; T7: 2.55, p value < 0.05).

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