scholarly journals Introduction of a Radiologic Severity Index for the 2019 Novel Corona Virus (COVID-19)

2020 ◽  
Author(s):  
Mehrzad Lotfi ◽  
Sepideh Sefidbakht ◽  
Mohsen Moghadami ◽  
Pouya Iranpour ◽  
Yasaman Emami ◽  
...  
Keyword(s):  
Severity Score ◽  
Scoring System ◽  
Severe Disease ◽  
Severity Of Illness ◽  
Severity Index ◽  
P Value ◽  
Cross Sectional ◽  
Lung Abnormalities ◽  
Severe Group ◽  
Reverse Relationship

Abstract Background: Given the limited number of beds in intensive care units, establishing a system that can predict the outcome in COVID19 positive patients based on imaging plays an important role in using resources efficiently. Therefor this study was conducted to design an optimal scoring system related to the severity of COVID19 cases for distinguishing severe from non-severe patients. Materials and Methods: In this cross-sectional retrospective study, 82 patients with a definite diagnosis of COVID-19 infection, who had at least one chest CT scan in hospital course were enrolled.To assess the severity of pulmonary parenchymal involvement, we semi-quantitatively evaluated the extent and nature of abnormalities. The area of lung involvement was scored in three levels based on a 0-4 grading scale. Also, we established a 4-point scoring system for defining the nature of lung abnormalities. The two scores were multiplied by each other. A final radiologic severity score was determined after adding together the scores of all levels.Result: Of all cases, fifty-three (64.6%) were male with an average age of age 53.75. Among the patients in our study, 7 (8.5%) had severe disease and the mortality rate was 7.2%. The mean (±standard deviation) of the radiologic severity score was 34.3(±18.4) in the severe group and 11.3(±11.4) in the non-sever group. (P-value <0.05). Also, we found a significant reverse relationship between our severity score and O2 saturation (P-value <0.05).Conclusion: The radiologic severity score demonstrated a significant correlation with the patients' mortality and severity of illness in COVID-19 patients.

scholarly journals The Characteristics of Mortality Predictor Scoring for Sepsis Patients in Haji Adam Malik Hospital

2021 ◽  
Vol 8 (10) ◽  
pp. 339-344
Author(s):  
Abdul Halim Harahap ◽  
Franciscus Ginting ◽  
Lenni Evalena Sihotang
Keyword(s):  
Sofa Score ◽  
Scoring System ◽  
Scoring Systems ◽  
Developed Countries ◽  
Apache Ii ◽  
Apache Ii Score ◽  
P Value ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Score Apache

Introduction: Sepsis is a leading cause of death in the Intensive Care Unit (ICU) in developed countries and its incidence is increasing. Many scoring systems are used to assess the severity of disease in patients admitted to the ICU. SOFA score to assess the degree of organ dysfunction in septic patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is most often used for patients admitted to the ICU. CCI scoring system to assess the effect of comorbid disease in critically ill patients on mortality. The study aimed to describe the characteristics of the use of scoring to predict patients’ mortality admitted to Haji Adam Malik Hospital. Methods: This is an observational study with a cross-sectional design. A total of 299 study subjects met the inclusion criteria and exclusion criteria, three types of scoring, namely SOFA score, APACHE II score, and CCI score were used to assess the prognosis of septic patients. Data analysis was performed using SPSS. P-value <0.05 was considered statistically significant. Results: A total of 252 people (84.3%) of sepsis patients died. The mean age of the septic patients who died was 54.25 years. The SOFA score ranged from 0-24, the median SOFA score in deceased sepsis patients was 5.0. The APACHE II score ranged from 0-71, the median APACHE II score in deceased sepsis patients was 23.0. The CCI score ranged from 0-37, the median CCI score in deceased sepsis patients was 5.0. Conclusion: Higher scores are associated with an increased probability of death in septic patients. Keywords: Sepsis; mortality predictor; SOFA score; APACHE II score, CCI score.

Sputum Neutrophil Elastase in pediatric cystic fibrosis and non-cystic fibrosis bronchiectasis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eman M Fouda ◽  
Heba A Ali ◽  
Mona A. A Salem ◽  
Heba H Radwan
Keyword(s):  
Cystic Fibrosis ◽  
Neutrophil Elastase ◽  
Severity Index ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Sweat Chloride ◽  
Chronic Lung Diseases ◽  
Severe Group ◽  
Group B

Abstract Objective To assess the value of sputum neutrophil elastase as a biomarker of severity in cases of non-cystic fibrosis bronchectasis & cystic fibrosis. Methods This cross-sectional study was conducted on 50 bronchiectasis patients aged from 1 to 13 years presented to pediatric chest clinic and department of Ain shams university hospital., there were classified into 2 groups; Group A cystic fibrosis patients(30) and group B non-cystic fibrosis bronchiectasis patients(20). Inclusion criteria :children aged from 1 to 16 years, patients were diagnosed with bronchiectasis clinically and with HRCT chest and cystic Fibrosis patients were diagnosed by positive sweat chloride test and genetic study. Exclusion Criteria includes no other known chronic lung diseases. All patients were evaluated by full medical history and full clinical examination, the following lab investigations were done :sweat chloride test, CFTR mutation study, sputum sampling and culture. Quantitative sputum neutrophil elastase assay was done, and the severity of disease was assessed using clinical scores as SK score ,FACED score and bronchiectasis severity index and by using radiological scores as Bhalla and modified Reiff score. Results Steatorrhea was more prevalent among cystic fibrosis patients (80%) than non-CF bronchiectasis patients (0%).(P = 0.00). Clubbing was more prevalent among non -cystic fibrosis bronchectasis (10) (50 %), than cystic fibrosis (2 patients) (6.7 %).(P = 0.00). In cystic fibrosis, neutrophil elastase was significantly higher among severe group (126 ng/mL) than among the moderate (30 ng/mL) and mild (16 ng/mL) groups.(P = 0.00). While in non-CF bronchiectasis patients, neutrophil elastase was significantly higher among severe group (67 ng/mL) than among the moderate (24 ng/mL) and mild (11 ng/mL) groups.(P = 0.00) Conclusion There was a significant correlation between sputum neutrophil elastase and disease severity in bronchiectasis (both cystic fibrosis and non-CF).

scholarly journals The Effect of the COVID-19 Pandemic on the Pediatric Emergency Department Flow

2021 ◽  
pp. 1-25
Author(s):  
Andrea Rivera-Sepulveda ◽  
Timothy Maul ◽  
Katherine Dong ◽  
Kylee Crate ◽  
Talia Helman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Admission Rate ◽  
Severity Index ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
P Value ◽  
Pediatric Emergency Department ◽  
Cross Sectional ◽  
Chief Complaints

ABSTRACT Objective: To determine how the early stages of the COVID-19 pandemic affected the utilization of the Pediatric Emergency Department (PED). Methods: Cross-sectional study of PED visits during January through April, 2016-2020. Data included: total PED visits, emergency severity index (ESI), disposition, chief complaint, age (months), time from first Provider to Disposition (PTD), and PED length of stay (PED-LOS). P-value <0.01 was statistically significant. Results: In total, 67,499 visits were reported. There was a significant decrease in PED visits of 24-71% from March to April 2020. Chief complaints for fever and cough were highest in March 2020; while April 2020 had a shorter mean PED-LOS (from 158 to 123 minutes), an increase of admissions (from 8% to 14%), a decrease in ESI 4 (10%), and an increase in ESI 3 (8%) (p<0.001). There was no difference in mean monthly PTD time. Conclusions: Patient flow in the PED was negatively affected by a decrease in PED visits and increase in admission rate that may be related to higher acuity. By understanding the interaction between hospital processes on PEDs and patient factors during a pandemic, we are able to anticipate and better allocate future resources.

scholarly journals Role of Physiotherapy in Hospitalised Patients of COVID-19 disease

2021 ◽  
Vol 9 (3) ◽  
pp. 154-159
Author(s):  
Dr. Sanjay Kumar Bharty ◽  
◽  
Dr. Jitendra Kishore Bhargava ◽  
Dr. Brahma Prakash ◽  
Dr. Vikas Patel ◽  
...  
Keyword(s):  
Severity Index ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Breathing Exercises ◽  
Hospitalised Patients ◽  
Before And After ◽  
Respiratory Physiotherapy

Introduction: Respiratory physiotherapy is one of the therapeutic methods in various respiratoryviral infections. Breathing exercises with other interventions, could enhance the total lung capacityand symptom alleviation in patients with virus-related acute respiratory distress syndrome (ARDS).Aim: To study the clinical evaluation of the role of physiotherapy in hospitalised patients of covid-19diseases. Method: This was an Observational (prospective, cross-sectional) study. 187 patientswere recruited and diagnosed as COVID-19 as per RTPCR at NSCB Medical College, Jabalpur (MP).Patients were randomised into the physiotherapy group and controlled group. Patients in thephysiotherapy group were undergone positional changes, prone ventilation, Breathing exercise,Resistive training, Passive joint motion, Muscle stretching, Bedside standing training, enduranceexercise by a specialized physiotherapist. Mean cough severity index, MMRC grade, respiration rateand peripheral blood saturation were recorded before and after intervention and compared with thecontrolled group. Result: There was significant improvement found in MMRC grade and respirationrate after physical therapy in the physiotherapy group (p-value < 0.05). Exertional dyspnoea andcough severity index significant deceased in physiotherapy group. The positive change was found inperipheral blood saturation. There was decreased in hospitalization stay in the physiotherapy groupas compared to the controlled group. Conclusion: Our study revealed the positive effect ofphysiotherapy on covid-19 disease in terms of symptoms and hospitalization duration among thephysiotherapy group. Physiotherapy exerts a beneficial role in the management of the covid-19disease.

scholarly journals Harmless Acute Pancreatitis Score

2022 ◽  
Vol 19 (1) ◽  
pp. 47-50
Author(s):  
Shiv Vansh Bharti ◽  
Anup Sharma
Keyword(s):  
Acute Pancreatitis ◽  
Scoring System ◽  
Poor Prognosis ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Common Disease ◽  
Intensive Care Unit Care ◽  
Close Monitoring ◽  
Cross Sectional ◽  
Severe Pancreatitis

Introduction: Acute Pancreatitis is a common disease in our region. It can range from mild to severe disease with high mortality rate. It is critical to identify patients who are at high risk for a severe disease course, since they require close monitoring and immediate aggressive treatment. Aims: To compare the effectiveness of Harmless Acute Pancreatitis Score with Ranson’s scoring system in predicting the severity of Acute Pancreatitis. Methods: A prospective cross sectional study was done among 45 patients who were admitted in surgery department over a period of one year with diagnosis of acute pancreatitis. If haematocrit was less than39% in female and less than43% in male, serum creatinine less than two miligram /deciliter and no sign of peritonitis, it was assigned as Harmless Acute Pancreatitis Score Zero. If at least one parameter was abnormal it was assigned as Harmless Acute Pancreatitis Score +. Severe pancreatitis (poor prognosis) was considered in those who required Intensive Care Unit care, who had in hospital mortality and who had hospitalization of more than five days. Patients with on admission Ranson’s score of more than three were suspected to have severe Pancreatitis. Results: There were total 45 patients, 18 females and 27 males. Twenty four patients were assigned as Harmless Acute Pancreatitis Score zero and 21 patients were assigned as Harmless Acute Pancreatitis Score +. Harmless Acute Pancreatitis Score was able to predict correctly in 18 out of 26 patients who fulfilled the criteria of poor prognosis (p<0.001). Conclusion: Harmless Acute Pancreatitis Score proved to be a better screening tool compared to on admission Ranson’s scoring system to predict the severity of Acute Pancreatitis, which may help predict the prognosis of the patient.

scholarly journals Physician-reported Clinical Unmet Needs, Burden and Treatment Patterns of Paediatric Psoriasis Patients: a US and EU Real-world Evidence Study

2021 ◽  
Author(s):  
Marieke M.B. Seyger ◽  
Matthias Augustin ◽  
Michael Sticherling ◽  
Teresa Bachhuber ◽  
Juanzhi Fang ◽  
...  
Keyword(s):  
Severe Disease ◽  
Topical Therapy ◽  
Significant Proportion ◽  
Unmet Need ◽  
Severity Index ◽  
Paediatric Population ◽  
Cross Sectional Survey ◽  
Psoriasis Area Severity Index ◽  
Cross Sectional ◽  
Pasi Score

This study is a retrospective analysis using data collected from the Adelphi Paediatric Psoriasis Disease-Specific Programme cross-sectional survey. Despite being treated for their psoriasis, a substantial proportion of paediatric patients presented with moderate (18.3%) or severe (1.3%) disease at sampling; 42.9% and 92.0% had a body surface area (BSA) of >10%, and 38.8% and 100.0% had a Psoriasis Area Severity Index (PASI) score >10, respectively. Overall, 69.9% of patients had only ever been treated with a topical therapy for their psoriasis. For patients with moderate or severe disease at sampling, 16.3% and 14.4% were currently receiving conventional systemics or biologic therapy, respectively. There is a clinical unmet need in this paediatric population; a considerable percentage of patients still experienced moderate or severe disease and persistent psoriasis symptoms, with numerous body areas affected. A significant proportion of patients were undertreated, which may explain the high burden of disease observed.

scholarly journals The Correlation between Anxiety and Insomnia Levels to Families of Health Workers during COVID-19

2021 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Noripansyah Noripansyah ◽  
Lily Nabila Amar
Keyword(s):  
Health Workers ◽  
Psychological Impact ◽  
Family Members ◽  
Rank Correlation ◽  
Severity Index ◽  
Ordinal Scale ◽  
P Value ◽  
Cross Sectional ◽  
The Family ◽  
Psychological Pressure

There are 5,197 positive confirmed cases of COVID-19 in Banjarbaru. It is known that the COVID-19 pandemic causes essential problems related to basic needs such as economic, social, shelter and nutrition, as well as the physical effects of the disease. Not only health workers but also families of health workers experience psychological pressure. In a preliminary study, it was found that the family feel worried and anxious about their families members who work in a hospital to take care of patients. This research aims to investigate the correlation between anxiety levels and insomnia in family members of health workers at Idaman Hospital, Banjarbaru, during the COVID-19 pandemic. This research uses a Cross-Sectional approach using social media with the google form platform taking 125 correspondence as a sample. The research instrument used the DASS-21 and Insomnia Severity Index. The data were analyzed using the SPSS program, with the Spearman rank correlation test working by testing the associative hypothesis of two ordinal scale variables (ranking). A total of 70.4% of family members of health workers at Idaman Hospital Banjarbaru have a very severe level of anxiety. In addition, 46.4% of the families of health workers at Idaman Hospital Banjarbaru experienced severe insomnia. The correlation for state anxiety-insomnia is 0.846 with a p-value = 0.000 (p < 0.05). This indicates that the two variables have a significant relationship with moderate correlation strength. The direction of the positive correlation indicates that these two variables move in the same direction, meaning that the higher the anxiety, the higher insomnia is experienced. Due to the COVID-19 pandemic, the population was limited. It is necessary to conduct further and comprehensive research on the psychological impact on family members of health workers. It is very limited to find research that examines the psychological condition of the family of health workers because, as we know, that not only affects the health workers themselves, but the family also experiences psychological impacts.

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 CORRELATION BETWEEN SERUM C-REACTIVE PROTEIN LEVEL WITH SEVERITY OF THE DISEASE IN COVID-19 PATIENTS

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Sangeeta Gahlot ◽  
Surendra Yadav ◽  
Makkhan Lal Saini
Keyword(s):  
Severe Disease ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
P Value ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Group I ◽  
Moderate Disease ◽  
Severity Of The Disease

Background: To find the levels of serum CRP in confirmed Covid-19 patients and to compare their levels in patients with mild to moderate disease and patients with severe disease who required ICU care for management. Methods: A Cross sectional study was carried out on 100 confirmed cases of Covid-19, in whom Serum levels of Random sugar (RBS), Creatinine, Urea, C- reactive protein (CRP) were measured. Results: The levels of serum Urea, Creatinine were significantly increased in group II when compared to group 1, and the levels of CRP were significantly increased with p value <0.0001 in group IIwhen compared to group I. Conclusion: Findings of our study suggest that determination of biochemical parameters like CRP at the time of hospitalization helps in predicting the severity of disease and need for ICU for better treatment management and prevention of adverse outcome. Keywords: Severe acute respiratory syndrome, Covid-19, C- reactive protein, Intensive care unit.

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