scholarly journals Cardiovascular manifestations and echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 (MIS-C): A retrospective study

2021 ◽  
Vol 8 (11) ◽  
pp. 391-393
Author(s):  
Jashvanth H J ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar

Background: The multisystem inflammatory syndrome in children (MIS-C) has been described recently during COVID-19 pandemic. It is a delayed post-infectious response with a lag time of 4–6 weeks following the exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), involving multiple systems which is being increasingly reported worldwide. Aim: The study aims to investigate and report the cardiovascular manifestation and echocardiographic findings in pediatric patients diagnosed with MIS-C. Materials and Methods: The present study is a retrospective analysis of clinical data gathered from 40 admitted children diagnosed with MIS-C. The study was conducted for 1 year (from 1st June 2020 to 30th May 2021) at Cheluvamba Hospital, a tertiary care center attached to Mysore Medical College And Research Institute, Mysore, Karnataka. Results: Out of 40 children, 21 (52.5%) had manifestation of cardiovascular system in the form of shock, requiring ionotropic support and care at the Intensive Care Unit. Among them, 90% patients show elevated cardiac biomarker (Troponin T), 33.3% had two-dimensional echocardiographic (2D echo) findings in which 9.5% show coronary artery dilatation and 23.8% show left ventricular hypertrophy. Conclusion: MIS-C is a hyperinflammatory syndrome related to SARS-CoV-2 infection. Cardiac involvement is evidenced by perturbation of cardiac chamber size, function, coronary artery abnormalities, and elevated cardiac biomarker. Though, most of the patients responded to the initial treatment and recovered, there is scarcity of data regarding long-term cardiovascular complication.

Author(s):  
Carolina Torres Bianqui ◽  
Abigail Cueto ◽  
Romina Soto ◽  
Pablo Urbano ◽  
Agustina Amenabar ◽  
...  

Objectives: The aim of this study was to assess differences in echocardiographic findings between a normal adult and a post Covid-19 population. Background: Coronavirus disease (Covid-19) is known to produce a systemic inflammatory syndrome, with pulmonary and cardiac involvement. However, the cardiovascular impact in patients with mild clinical forms of the disease is uncertain. There is small evidence supporting the finding of global ventricular longitudinal strain (GLS) alterations in these patients. Methods: One hundred and five consecutive patients admitted to an ambulatory care center, underwent a conventional transthoracic echocardiographic (TTE) study with acquisition of GLS. Patients were included if they underwent a positive diagnostic reverse transcriptase polymerase chain reaction (PCR) test, having no relevant preexisting conditions, with exception of obesity. Demographic and clinical data were prospectively obtained. For this purpose, we considered a normal cut off point of -17,09%, based on previous studies. Echocardiographic findings were compared with those of 67 healthy individuals. Results: Out of 172 patients, 105 correspond to Covid-19 group, and 67 to healthy individuals. There were no significant differences in GLS regarding age, left ventricular mass index (LVMI) and E/e’ ratio. The multivariate analysis showed that the percentage of patients with pathological GLS values was significantly higher within the Covid-19 and male groups (OR 6.02 IC 1.88-22.57; p 0.004 and OR 3.17 IC 1.03-10.50; p 0.05, respectively). Conclusion: These data support that Covid-19 infection could affect ventricular GLS and encourage the use of conventional TTE with GLS measurements in patients with non-significant forms of the disease.


2021 ◽  
Vol 8 ◽  
Author(s):  
Manuel Rattka ◽  
Lina Stuhler ◽  
Claudia Winsauer ◽  
Jens Dreyhaupt ◽  
Kevin Thiessen ◽  
...  

Objective: Since the outbreak of the COVID-19 pandemic, healthcare professionals reported declining numbers of patients admitted with ST-segment myocardial infarction (STEMI) associated with increased in-hospital morbidity and mortality. However, the effect of lockdown on outcomes of STEMI patients admitted during the COVID-19 crisis has not been prospectively evaluated.Methods: A prospective, observational study on STEMI patients admitted to our tertiary care center during the COVID-19 pandemic was conducted. Outcomes of patients admitted during lockdown were compared to those patients admitted before and after pandemic-related lockdown.Results: A total of 147 patients were enrolled in our study, including 57 patients in the pre-lockdown group (November 1, 2019 to March 20, 2020), 16 patients in the lockdown group (March 21 to April 19, 2020), and 74 patients in the post-lockdown group (April 20 to September 30, 2020). Patients admitted during lockdown had significantly longer time to first medical contact, longer door-to-needle-time, higher serum troponin T levels, worse left ventricular end-diastolic pressure, and higher need for circulatory support. After a median follow-up of 142 days, survival was significantly worse in STEMI patients of the lockdown group (log-rank: p = 0.0035).Conclusions: This is the first prospective study on outcomes of STEMI patients admitted during public lockdown amid the COVID-19 pandemic. Our results suggest that lockdown might deteriorate outcomes of STEMI patients. Public health strategies to constrain spread of COVID-19, such as lockdown, have to be accompanied by distinct public instructions to ensure timely medical care in acute diseases such as STEMI.


Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.


Author(s):  
Abu Hasan Sarkar ◽  
Bishnu Ram Das

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE. 


Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.


Author(s):  
Ashvin Chaudhari ◽  
Dalchand C. Kumawat

Background: Periodic experimental and epidemiological studies are essential to understand the pattern of poisoning in society. These studies are useful for planning of providing better and fast health care facilities to decrease poisoning connected mortality. This study was intended to assess the pattern & consequence of acute poisoning cases.Methods: This study was conducted with 100 patients admitted at a Geetanjali Medical college and hospital from June 2015 to December 2017 were studied. We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these patients.Results: Most of the patients were from the age group of 21 - 30 years (49 %) followed by 31-40 years (33%). Males (59%) prevailed females (41%). Out of all subjects, 53% belonged to middle socioeconomic class, whereas only 19% were from high socioeconomic class. Out of all patients, 62% were from illiterate class and 38% were literate. Suicide (77%) was the most communal nature of poisoning. Phenyl (19%) was the most commonly used poison. Mortality was found to be 4% and was mainly related to organophosphate compounds.Conclusions: Poisoning is further common in young males so they should be emotionally maintained in stressful conditions. Mortality was found significantly to organophosphate poisoning. Easy availability of this compound should be checked. Early care in tertiary care center may assistance to reduce mortality in India.


2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.


2021 ◽  
pp. 18-19
Author(s):  
Vijaya Bhaskara Reddy. M. G ◽  
Salman Ahmed. F ◽  
Santosh Kumar Rajput ◽  
Ganashyam. K. R

Background: Spleen mediates important immunologic, storage and hematologic functions. A person can undergo a splenectomy for various causes which includes both surgical and non surgical. The recent trend being towards spleen preservation, it is necessary to critically analyse the indications for splenectomy and assess if the desired post operative outcomes are achieved by splenectomy. Materials and Methods: This prospective observational study was carried out on patients of Department of General Surgery, Mysore Medical College and Research Institute, Mysore, from august 2017 to November 2019. 45 adult subjects (both male and females) aged ≥ 18 years, who underwent elective or emergency splenectomy for various indications were studied. Results: The most common indication for splenectomy was trauma in 27 patients(60%) followed by splenic abscess(15.6%). Most of the patients underwent emergency splenectomy i.e., 25 cases(55%) . In our study the majority received blood transfusion, 15.5% developed wound infection and 2 cases(4.4%) needed reexploration due to rebleeding.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ashwat Dhillon ◽  
Kanhaiya Poddar ◽  
Murat Tuzcu ◽  
Eric Roselli ◽  
Lars Svensson ◽  
...  

Background: Data regarding association of elevated cardiac enzymes and adverse outcomes in patients who undergo aortic valve replacement (AVR) has been inconclusive. Role of coronary revascularization prior to AVR remains uncertain. We sought to understand prognostic implication of post procedure troponin T (TnT) elevation in patients undergoing AVR. Hypothesis: We hypothesized that patients with significantly elevated TnT after AVR will have worse outcomes representing important coronary circulation which is not revascularized. Methods: We retrospectively studied 4648 consecutive patients who underwent AVR at a single tertiary care center between January 2007 and December 2013. These were divided into surgical AVR (SAVR) and transcatheter AVR (TAVR). Median post procedure peak TnT was identified in the SAVR and TAVR groups. Patients were divided into quartiles based on median TnT level. Results: Of 4648 patients who underwent AVR, 4200 (66% male) were SAVR and 448 (59% male) were TAVR. Median post procedure peak TnT values in the TAVR and SAVR group were 0.19 [0.08-0.39] & 0.36 [0.22-0.64] respectively (p<0.001). 6 month mortality was 1.5% (65/4200) in SAVR cases and 2.7% (12/448) in TAVR cases (p=0.08). In patients with TnT less than 50 th percentile, 6 month mortality was 0.7% & 1.8% after SAVR & TAVR respectively (p=0.1). In patients with TnT higher than 50 th percentile, 6 month mortality was 2.4% & 3.6% after SAVR & TAVR respectively (p=0.26). In the SAVR group, mortality was 0.7% in patients with TnT levels less than 50 th percentile & 2.4% in patients with TnT higher than 50 th percentile (p<0.001). See Figure. Conclusion: Peak troponin T was significantly higher after SAVR as compared to TAVR. Higher post procedure peak TnT is associated with increased 6 month mortality. These results are highly significant in the SAVR group. The mechanism and significance of these findings requires further studies.


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