TO EVALUATE THE RESPIRATORY FUNCTIONS OF COVID-19 PNEUMONIA SURVIVORS THREE MONTHS AFTER RECOVERY AT TERTIARY CARE CENTRE.

2021 ◽  
pp. 125-128
Author(s):  
A. Ramasamy ◽  
K. Anbananthan ◽  
S. A. Natesh ◽  
Anu Sree. S. C
Keyword(s):  
Psychological Assessment ◽  
Functional Disability ◽  
Tertiary Care ◽  
Careful Monitoring ◽  
Tertiary Care Centre ◽  
Walk Distance ◽  
Medical College ◽  
Minute Walk Distance ◽  
Minute Walk

BACKGROUND: In this study we provide a suggested structure for the respiratory follow up of patients with clinicoradiological conrmation of COVID 19 pneumonia three months after recovery. OBJECTIVES: 1.To evaluate the respiratory function and functional disability of COVID – 19 Survivors 3 months after recovery.. MATERIALS AND METHODS: This was a retrospective study done on 70patients, who were attending the OPD/ IP of Thanjavur medical college three months after recovery from COVID PNEUMONIA.These patients were enrolled consecutively from August 2020 to January 2021 .Datas during admission had been collected from patient records.Spirometry, 6-minute walk distance, pulse oximetry ,CT chest scan, psychological assessment were performed 3 months after discharge.Statistical Analysis was done by SPSS trial version 20. RESULTS:,Amongthe 70 studypopulations ,Age rangedfrom24 to74 yearswithmeanage 56.9 yearsofageandSD-11.45,mostof them were male (80%).Nearly 75% of the patients had sp02 80-90% during admission and after recovery nearly 95% of the patient had more than 90% spo2.On admission more than half of the patients had moderate CT severity score ,after recovery more than 70%ofthepatientshad mildCTseverity score .Afterrecovery more than70%ofthepatientsdoesnotrequire oxygen. Onspirometry nearly70%ofthepatientswiththeagegroupof 41-60yearsofagehadmildrestrictionsafterrecovery. CONCLUSION: Three months after SARS CoV-2 infection shows signicant improvement in functional and radiological abnormalities on careful monitoring. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.

scholarly journals Mexiletine in myotonic dystrophy type-1

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011002
Author(s):  
Chad Heatwole ◽  
Elizabeth Luebbe ◽  
Spencer Rosero ◽  
Katy Eichinger ◽  
William Martens ◽  
...  
Keyword(s):  
Myotonic Dystrophy ◽  
Cardiac Conduction ◽  
Myotonic Dystrophy Type 1 ◽  
Myotonic Dystrophy Type ◽  
Walk Distance ◽  
Hand Grip ◽  
Minute Walk Distance ◽  
Minute Walk

ObjectiveTo assess mexiletine's long-term safety and effect on 6 minute walk distance in a well-defined cohort of myotonic dystrophy type-1 (DM1) patients.MethodsWe performed a randomized, double-blind, placebo-controlled trial of mexiletine (150 mg 3 times daily) to evaluate its efficacy and safety in a homogenous cohort of adult ambulatory DM1 patients. The primary outcome was change in 6-minute walk distance at 6 months. Secondary outcomes included changes in hand grip myotonia, strength, swallowing, forced vital capacity, lean muscle mass, Myotonic Dystrophy Health Index scores, and 24-hour Holter and EKG results at 3 and 6 months.ResultsForty-two participants were randomized and 40 completed the 6-month follow-up (n = 20 in both groups). No significant effects of mexiletine were observed on 6-minute walk distance, but hand grip myotonia was improved with mexiletine treatment. There were no differences between the mexiletine and placebo groups with respect to the frequency or type of adverse events. Changes in PR, QRS, and QTc intervals were similar in mexiletine and placebo-treated participants.ConclusionsThere was no benefit of mexiletine on six-minute walk distance at 6 months. Although mexiletine had a sustained positive effect on objectively measured hand grip myotonia, this was not seen in measures reflecting participants' perceptions of their myotonia. No effects of mexiletine on cardiac conduction parameters were seen over the 6-month follow-up period.Classification of evidenceThis study provides Class I evidence that for ambulatory patients with DM1 mexiletine does not significantly change six-minute walk distance at 6 months.

scholarly journals A clinical study of pulmonary function tests in patients with COPD exacerbation

2017 ◽  
Vol 4 (6) ◽  
pp. 1645
Author(s):  
Shivaraj A. L. ◽  
Arun B. J. ◽  
George A. D'Souza ◽  
Niranjan Nagaraj
Keyword(s):  
Pulmonary Function Tests ◽  
Walking Distance ◽  
Initial Assessment ◽  
Walk Distance ◽  
College Hospital ◽  
Copd Exacerbations ◽  
Exacerbation Of Copd ◽  
Minute Walk Distance ◽  
Minute Walk

Background: COPD is now recognized as an important cause of morbidity and mortality world over. This study aims to assess the serial change in spirometric values and 6-minute walking distance in COPD patients following exacerbation.Methods: A prospective study of 40 patients who were admitted to St. Johns Medical College Hospital with Acute Exacerbation of COPD. After proper history, initial assessment and evaluation, appropriate treatment started according to standard hospital protocols. Spirometry and 6-minute walk distance (6MWD) was done at discharge and at an interval of two and six months during follow up. All the collected data was tabulated and statistically analysed by using software’s SAS 9.2, SPSS 15.0.Results: Among the 40 patients studied, there was a 9.18% drop in FVC (from 2.83 litres to 2.57 litres), 13.26% change in the FEV1/FVC ratio with a mean drop of 150 ml in FEV1 (1.5 litres to 1.35 litres) and 25 meters decline of 6MWD from 391.45 to 366.63 over 6 months follow up period, although none of them were statistically significant.Conclusions: A drop in FEV1 and (6MWD) minute walk distance was found in our study population over 6 months follow period after COPD exacerbations which is in line with the various study reports available in the literature reinforcing the fact that patients with increased airway inflammation show faster decline in FEV1.

scholarly journals Penetrating neck injuries with laryngeal framework involvement: in a tertiary care centre

2019 ◽  
Vol 5 (5) ◽  
pp. 1379
Author(s):  
Chozhan Periasamy ◽  
Malarvizhi Ravisankar ◽  
Mathumithaa Subburayalu
Keyword(s):  
Vocal Fold ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Young Male ◽  
Neck Injuries ◽  
Tertiary Care Centre ◽  
Male Population ◽  
Medical College ◽  
Laryngeal Injury

<p class="abstract"><strong>Background:</strong> Penetrating neck injuries are very common as a mode of homicidal and suicidal injuries. Not many of them are deep enough to affect the laryngeal framework.</p><p><strong>Methods:</strong> Prospective study in the Department of ENT Stanley Medical College, Chennai. The study period was from January 2018 to December 2018. Follow up of 3 months was done.</p><p class="abstract"><strong>Results:</strong> Penetrating neck injuries treated on emergency care with tracheostomy and wound exploration and repair. It was found to be more common in young male population.</p><p><strong>Conclusions:</strong> Laryngeal framework involvement necessitates tracheostomy during wound exploration. On table laryngeal injury repair improves prognosis and early post-operative vocal fold assessment helps frame a treatment plan designed specifically for the patient.</p>

scholarly journals A comparative study between coblation adenoidectomy and conventional adenoidectomy

2018 ◽  
Vol 4 (3) ◽  
pp. 721
Author(s):  
V. Saravana Selvan ◽  
Muthamil Silambu ◽  
D. Vinodh Kumaran
Keyword(s):  
Comparative Study ◽  
Pain Score ◽  
Tertiary Care ◽  
Conventional Technique ◽  
School Absenteeism ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Intraoperative Bleeding ◽  
Medical College

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the advantages and results between coblation adenoidectomy and conventional adenoidectomy by curettage.</p><p class="abstract"><strong>Methods:</strong> The study was<strong> </strong>conducted in Stanley medical college, Chennai (a tertiary care centre) from June 2013 to June 2016. Fifty patients were studied who underwent adenoidectomy. Twenty five patients underwent conventional adenoidectomy by curettage and rest by nasal endoscopy assisted coblation adenoidectomy. Following outcomes were evaluated: pain score on first day, days reporting pain, analgesic days, school absenteeism, endoscopic adenoid grading and intraoperative bleeding.  </p><p class="abstract"><strong>Results:</strong> Patients who underwent coblation adenoidectomy showed better results during follow up with lesser complications.</p><p class="abstract"><strong>Conclusions:</strong> Coblation adenoidectomy is a better technique when compared to conventional technique of curettage.</p>

scholarly journals PSYCHOLOGICAL FACTORS ASSOCIATED WITH AMBULATION PERFORMANCE AFTER HIP FRACTURE AMONG HOME-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S419-S419
Author(s):  
Richard H Fortinsky
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Gait Speed ◽  
Psychological Factors ◽  
Walk Distance ◽  
Balance Confidence ◽  
Minute Walk Distance ◽  
Minute Walk ◽  
Walking Endurance

Abstract Many older adults fail to resume optimal community living after hip fracture due to sustained limitations in ambulation capacity, yet reasons remain poorly understood. Roles of psychological factors in affecting ambulation performance post-hip fracture remain particularly understudied; depression has been associated with poorer self-reported functional status, and little is known about self-perceived balance confidence, resilience, and optimism. This presentation reports associations between each psychological factor, measured at CAP baseline, and gait speed and walking endurance, measured at baseline and 16 weeks later. In the CAP cohort (N=210), baseline mean/sd 4-meter gait speed (gs), 50-foot walk gs, and 6-minute walk distance were: 0.60/0.19 meters per second (mps); 0.67/0.20 mps; and 186.9/55.4 meters, respectively. In multivariate models, balance confidence was positively associated with all baseline ambulation measures (p&lt;0.001 in all models), and resilience was positively associated with all 16-week follow-up ambulation measures (p&gt;0.05 in all models). Implications of results will be discussed.

scholarly journals OUR INSTIUTIONAL EXPERIENCE IN VISCERAL ARTERY ANEURYSMS

2021 ◽  
Vol 9 (03) ◽  
pp. 605-606
Author(s):  
Srinivasan a ◽  
Prathap Kumar ◽  
Velladuraichi a ◽  
Ilaya Kumar ◽  
Sritharan b
Keyword(s):  
Tertiary Care ◽  
Current Status ◽  
Visceral Artery ◽  
Interventional Treatment ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Visceral Artery Aneurysms ◽  
Coeliac Trunk ◽  
Madras Medical College

Objectives: To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over the 5. years in our institution, a tertiary care centre, Madras Medical College. Methods 14 patients with 19 VAA were analysed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. Results: VAA were localised at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was mostly degenerative, connective tissue disease. The rate of rupture was higher in pseudo-aneurysms than true aneurysms (66% vs 5%). 18 VAA were treated by intervention {coil embolisation} (n=3) or surgery (n=9) or hybrid [n=1] and one patient was managed conservatively. Three cases with ruptured VAA were treated on an emergency basis. The largest aneurysm was about 16cm and smallest one was about 1mm . After interventional treatment, the 30-day mortality was 21.4 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included USG and/or CT after a mean period of 7 months. The current status of the patient was obtained by a structured telephone survey. Conclusions: There is increase incidence of Celiac and SMA aneurysms. Aneurysm size seems to be a reliable predictor for rupture. Young patient need vasculitic workup for further management.

scholarly journals Early experience with selexipag for the treatment of adults with pulmonary arterial hypertension associated with congenital heart disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Van Dissel ◽  
M Post ◽  
G.T Sieswerda ◽  
H.W Vliegen ◽  
A.P.J Van Dijk ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Side Effects ◽  
Congenital Heart ◽  
Funding Source ◽  
Walk Distance ◽  
Titration Phase ◽  
Pulmonary Arterial ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Background Recently, selexipag, a new orally available and selective prostacyclin receptor agonist, has become available for treatment of pulmonary arterial hypertension (PAH), but experience in patients with PAH associated with congenital heart disease (CHD) is limited to patients with closed defects. Purpose We present our early multi-centre experience using selexipag in the heterogeneous PAH-CHD population. Methods We prospectively evaluated adults with PAH-CHD from five PAH-CHD expert centres who were treated with selexipag. Patients were titrated to highest tolerable individualized dose (200 to 1,600 μg twice daily), after which patients entered the maintenance phase. Data on functional class (FC), 6-minute walk distance (6MWD), imaging and biochemical (N terminal pro-brain natriuretic peptide [NT-proBNP]) parameters were collected. Results Thirty-four patients (age 43±14 years, 56% female, 60% Eisenmenger syndrome, 22% Down syndrome, 60% dual PAH therapy) were started on selexipag. All patients experienced at least 2 side effects during the initial uptitration phase. Most side effects were manageable and diminished after reaching the maintenance dose, but eight patients discontinued treatment due to side effects during the titration phase. The most frequent side effects were consistent with the known side effects of prostacyclins, including headache, nausea, diarrhoea and jaw pain. Majority (68%) of patients reached lower maintenance doses of 200–600 μg. At 12 months, FC improved in three patients and remained unchanged in the others. 6-minute walk distance remained stable throughout follow-up (475 to 470 m; p=n.s.) in patients who remained on-treatment compared to patients who stopped selexipag (485 to 370 m). NT-proBNP levels remained stable in patients on-treatment (520 to 600 ng/L) but worsened in patients who stopped (700 to 1000 ng/L). One patient died during follow-up from end-stage heart failure. Conclusion There is a promising role for selexipag in the treatment of adults with PAH-CHD. However, based on our experience, the use is challenging due to complexity in dosing and side effect profiles, which limit patients' tolerability and acceptance during the titration phase. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Actelion Pharmaceuticals

Study of Hemoptysis in a Tertiary Care Center of Province 1: Causes and Recurrences

2020 ◽  
Vol 5 (2) ◽  
pp. 1050-1054
Author(s):  
Ram Hari Ghimire ◽  
Ashima Ghimire ◽  
Rupesh Kumar Shreewastav ◽  
Sushil Yadav ◽  
Bidesh Bidesh Bista
Keyword(s):  
Diagnostic Yield ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Chest Clinic ◽  
Telephone Calls

Introduction: Hemoptysis is a common but distressing and alarming symptom in a patient. Data related to detail clinical profile and follow up study of hemoptysis are lacking. Objective: This study was carried out to see the clinical profile of patients with hemoptysis and to study the recurrences in tertiary care centre of province 1 within the study period. Methodology: This was a prospective observational study conducted at the department of Pulmonary, Critical Care and Sleep Medicine of Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. The study was carried out between 30th January 2017 to 1st February 2020. For follow up of recurrences of hemoptysis, the patients were asked for regular chest clinic follow up and regular telephone calls made to the patients, in case, patients could not attend the chest clinic for any reason. Results: A total of 150 patients were enrolled over the last 3 years. Among them 75% were male. The maximum number of patients (27%) were between 31-40 years of age group. Old sequelae of pulmonary tuberculosis (PTB) (32%) and bronchiectasis (28%) were the commonest cause of hemoptysis. Lung cancer (10%) and active PTB (10%) were other causes of hemoptysis. CT scan of the chest provided the highest (84%) diagnostic yield. Most of the cases were having mild hemoptysis (50%). 17% of the patients in our study had recurrences of hemoptysis. Conclusion: Old PTB sequelae with bronchiectasis (fibrobronchiectasis) were the commonest cause of hemoptysis. Conservative management worked most effectively in controlling hemoptysis, if used properly.

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