Association between CHA2DS2-VASc score and in-hospital death in ICU patients with COVID-19

2021 ◽  
Vol 4 (4) ◽  
pp. 595-600
Author(s):  
Mukesh Jha ◽  
Utkarsh Mukesh Balani ◽  
Vimlesh Pandey ◽  
Prachi Balani ◽  
Vipin Patel ◽  
...  

Background: CHA2DS2-VASc score is a scientifically proven risk assessment score for patients with atrial fibrillation. It may be a good predictor of in-hospital death in COVID-19 patients. The present study aimed to evaluate the association between CHA2DS2-VASc score and in-hospital mortality in the prognosis of intensive care unit (ICU) patients with COVID-19. Methods: Eighty-four COVID-19 patients who were hospitalized in the ICU were retrospectively analyzed in a tertiary health care center, and the CHA2DS2-VASc score was determined. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 20.0). A p-value <0.05 was considered statistically significant. Results: The median age of patients was 60.0 years, and most were males (75.0%). Findings of the study showed that the CHA2DS2-VASc score was considerably higher among the hospitalized patients than discharged patients (3.08 ± 1.72 vs. 1.38 ± 1.16; p<0.001), and patients who required mechanical ventilation compared to those who did not require mechanical ventilation (3.03 ± 1.68 vs. 1.15 ± 0.97; P <0.001), respectively. Patients with CHA2DS2-VASc score of ≥3 had substantially higher age [67(45-87) vs. 58(19-75); P ˂0.001], computed tomography involvement score [67.5(20-90) vs. 35(15-90); P ˂0.001] and need for mechanical ventilation [29(90.6%) vs. 22(42.3%); P ˂0.001]. A significant difference was found in oxygen saturation on admission (P =0.001) between the two groups. In-hospital death was significantly higher among patients with a CHA2DS2-VASc score of ≥3 (P <0.001). The CHA2DS2-VASc score was positively correlated with white blood cells count (r=0.257, P =0.018) and negatively correlated with the number of days spent in the hospital (r=-0.184, P=0.130) due to higher in-hospital death in ICU patients with COVID-19. Conclusion: CHA2DS2-VASc score may be an effective tool to estimate in-hospital death in COVID-19 patients who were hospitalized in the ICU.

2019 ◽  
Author(s):  
maytham salim Al-Nasrawii ◽  
Ali Neamah Al-Aaragi ◽  
Ali Abd Al-Latif G Mohammed

Abstract Background: World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) “Exclusive breastfeeding (EBF)” is explained as “the infant receives only breast milk, no other liquids or solids. Its recommended for the first 6 months of life, and then complementary feeding should be started. EBF helps to reduce child morbidity and mortality from several diseases such as diarrhea, respiratory and /or ear infections and other infectious diseases, shielding lactation women from breast and ovarian cancer. In addition to offers societal economic and environmental benefits, The objective of this study was to assess the knowledge and awareness of exclusive breast feeding among mothers with a child < 2 years of age. Methods : A descriptive cross-sectional study was carried out in Health Directorate of Holy Karbala city. The study consist of (487) mothers how attendant to six Primary Health Care center (PHC). The collected data was done by direct interview with mothers and using a questionnaire form that designed based on the study objectives according to WHO criteria. Data were analyzed by SPSS, descriptive statistics included numbers (N) and percentage (%), and the inferential statistical test was done by using Chi-Square test , P-value was equal or less than 0.05 considered as statistically significant to find for any association between the results variables. Result : A total of 487 participants were included in the study, the rate of response was 92.7%. The highest percentage (66.3%) of study sample were full in the age group (21-30) years, and more than three quarters were lived in urban area. Nearly half of the study sample 47% had primary education and 60% those housewives, and the main source of information being family and friends (84.4%). As an overall assessment, 61.8% of the study sample had good knowledge and awareness about exclusive Breastfeeding, with highly significant differences to education level ,occupation residence of the mother. Conclusion: Over half of the subjects had good knowledge and awareness of exclusive Breastfeeding. And, on the other hand, there was a very significant difference between education level, occupation and mother's residence with a level of knowledge.


Author(s):  
A. Abilov ◽  
A. Azhmyakov ◽  
I. Novgorodova ◽  
N. Bogolyubova

Purpose: to study hematological parameters of blood in bulls-producers of dairy breeds on the day of semen collection in the Udmurt Republic after a long winter period of operation, depending on the breeds, age and place of selection.Materials and methods. The work was performed at the Federal Research Center for Animal Husbandry named after Academy Member L. K. Ernst on the basis of AO "Udmurtplem" of the Udmurt Republic in the period from 2020 to 2021 on dairy bulls (n=20) aged 15-69 months, including a purebred Holstein breed of domestic selection (n=6), a Holstein black-and-white breed of European selection (the Netherlands, n=6), a black-and-white breed with blood transfusion on Holsteins on at the level of 94-98% (n=8). The content of white blood cells, red blood cells, hemoglobin and hematocrit, depending on age and breed, was studied on the ABC VET hematological analyzer on the day of taking the seed.Results. It was found that on average, in 20 bulls aged 15-69 months, the level of white blood cells was at the level of reference values of 8.8±0.25 x 109/l, red blood cells 10.3 x 1012/l, which is 50% more than the reference values. The concentration of hemoglobin is 128.0±2.92 g/l, hematocrit is on average 54.3%, with a norm of 24-46%. Breeding bulls at a reliable level, differing in age, showed that some animals had high indicators for red blood cells of 10.3±0.26 x 102, for hematocrit of 54.3% against 24-46% of reference values. Also, according to hematological indicators, there was a tendency to increase the concentration of hemoglobin and hematocrit in European-bred bulls.Conclusion. The study of the variability in hematological parameters depending on the selection showed that there is no significant difference in leukocytes and all indicators are at the level of reference values, and in erythrocytes more than 50% than the highest indicators. The highest hemoglobin values were at the level of 141-156 g/l instead of 128 g/l according to the highest reference values. Hematocrit also showed high max values in all groups in comparison with the reference values of 59-66% versus 46% in the norm. It is necessary when analyzing hematological blood parameters in addition to the average statistical indicators (M+m) also, monitor the variability (min-max) in order to obtain more objective information.


2012 ◽  
Vol 32 (suppl 1) ◽  
pp. 91-98 ◽  
Author(s):  
Patricia C. Teixeira ◽  
Danielle C. Dias ◽  
Guilherme C. Rocha ◽  
Antônio M. Antonucci ◽  
Fernanda M. França ◽  
...  

The aim of this study was to evaluate alterations to the physiological profile (cortisol, glycaemia, and blood parameters) of Lithobates catesbeianus caused by the stressors density and hypoxia. The organisms were in the prometamorphosis stage and exposed to different tadpole densities: 1 tadpole/L (T1), 5 tadpoles/L (T2), and 10 tadpoles/L (T3) for 12 days. The blood was collected through the rupture of the caudal blood vessel and collected under normoxia (immediate collection) and hypoxia (after 15 minutes of air exposure) conditions. Cortisol levels rose on the fourth and eighth days of treatment and returned to basal levels by the end of the experiment. The stressor mechanisms tested did not affect glycaemia. White blood cells (total number of lymphocytes, neutrophils, and eosinophils) showed a significant difference at the twelfth day of the experiment when compared with the start of the experiment. We concluded that, under controlled conditions, a density of up to 10 tadpoles/L and air exposure for 15 minutes did not cause harmful physiological alterations during the experimental period. The answer to these stressors maybe was in another hormonal level (corticosterone).


Biomeditsina ◽  
2021 ◽  
Vol 17 (3E) ◽  
pp. 17-22
Author(s):  
O. V. Alimkina ◽  
A. E. Petrenko

The work is devoted to the study of changes in the cellular composition of bronchoalveolar lavage over time in the modeling of acute respiratory distress syndrome (ARDS) in mice. ARDS was modeled by administering α-galactosylceramide and a mixture of lipopolysaccharide with a complete Freud’s adjuvant. After euthanasia, bronchoalveolar lavage was taken for analysis. On this basis, changes in the total number of white blood cells, the percentage of neutrophils and macrophages were assessed. It was found that the percentage of neutrophils in the ARDS group shows a statistically significant difference from that in the intact group, starting from 3 hours after modeling ARDS. Further, a statistically significant decrease in macrophages was observed. 


2020 ◽  
Vol 3 (5) ◽  
pp. 01-04
Author(s):  
Abdullah Ghouth

The Background and Purpose: to assess the prevalence of hypertension and micro-vascular complications among type 2 diabetic patients registered in primary health care center in Mukalla city at eastern Yemen. Methods: A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in Yemen. Results: Prevalence of hypertension in the T2DM patients were 46.7% (56/120). Retinopathy is the most micro-vascular complications among the adults having T2DM (73/120, 60.8%) while nephropathy is the least prevalence (13/120, 10.8%), prevalence of neuropathy was 49.2% (59/120). a high prevalence of retinopathy in males (66%) than females (55.7%) and a high prevalence of neuropathy in male adults (52.2%) than females (46%).No statistical significant difference were exit related to gender for any studied complications. Similar findings were observed regarding age related variations. Conclusion: A high prevalence of hypertension, retinopathy and neuropathy were reported among T2DM patients in Mukalla. Adopting effective and safe treatment strategies are highly recommended to prevent premature death and complications due to DM.


Author(s):  
Udeme O. Georgewill ◽  
Festus Azibanigha Joseph ◽  
Elias Adikwu

Nitrofurantoin (NT) used for the treatment of urinary tract infections may have antiplasmodial activity. Dihydroartemisinin-piperaquine (DP) is an artemisinin based combination therapy used for the treatment of malaria. This study evaluated the antiplasmodial effect of dihydroartemisinin-piperaquine-nitrofurantoin (DP-NT) on mice infected with Plasmodium berghei. Adult Swiss albino mice (30-35 g) of both sexes were used. The mice were randomly grouped, inoculated with Plasmodium berghei, and treated orally with DP (1.7/13.7 mg/kg), NT (57.1 mg/kg) and DP-NT (1.71/13.7/ 57.1 mg/kg), respectively using curative, prophylactic and suppressive tests. The negative control was orally treated with normal saline (0.3 mL), while the positive control was orally treated with chloroquine CQ (10mg/kg). After treatment, blood samples were collected and evaluated for percentage parasitemia, inhibitions and hematological parameters. Liver samples were evaluated for histological changes. The mice were observed for mean survival time (MST). Treatment with DP-NT decreased parasitemia levels when compared to individual doses of DP and NT with significant difference observed at p<0.05. DP-NT prolonged MST when compared to individual doses of DP and NT with significant difference observed at p<0.05. The decrease in packed cell volume, red blood cells, hemoglobin and increase in white blood cells in parasitized mice were significantly restored by DP-NT  when compared to individual doses of DP and NT with difference observed at p<0.05. DP-NT eradicated liver Plasmodium parasite.  NT remarkably increased the antiplasmodial activity of DP. DP-NT may be used for the treatment of malaria.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A414-A414
Author(s):  
Ibrahim Naoum ◽  
Abedalghani Abedalhalim ◽  
Amir Aker ◽  
Luai Khalaili ◽  
Sameer Kassem

Abstract Background: Diabetes and chronic obstructive pulmonary disease (COPD) are widely prevalent and comorbidity with these diseases is quite common. However, there is limited data on the interrelation between glycemic control and COPD exacerbations in diabetic patients. Objective: To study the association between pre-admission glycemic control and COPD clinical outcomes including mortality, risk of hospital readmission and the need for mechanical ventilation. Methods: A retrospective population-based cohort study. We screened for patients with both diabetes and COPD exacerbation aged 35 years and above. Pre-admission glycemic control was defined by the last HBA1C level prior to hospitalization. Patients with HBA1C&gt;8% were defined as uncontrolled. We evaluated the difference between controlled and uncontrolled groups in the rates of mortality, readmission and the need for mechanical ventilation. We examined demographic and clinical parameters that might reflect COPD severity including: COPD medication use, blood hemoglobin, platelets, LDH and CRP levels. Results: 513 hospitalizations with diabetes and COPD were screened. 222 hospitalization were excluded either due to unestablished diagnosis of COPD or due to lack of HBA1C test in the preceding year. Of the remaining 291, 208 admissions were with controlled diabetes whereas 83 were uncontrolled. Although not statistically significant, the rate of re-hospitalization was higher in the uncontrolled group (OR 1.99, CI 0.99–4.0, p-value 0.051). There was no statistically significant difference in mortality (OR 1.6, CI 0.73–3.5, p-value 0.243). The use of oxygen and the need for noninvasive mechanical ventilation were significantly higher in the uncontrolled group (67.5% vs. 52.4%, p-value 0.019, 33.7% versus 18.8%, p-value 0.006, respectively). There was no significant difference in possible confounders tested between the groups. Conclusion: Uncontrolled diabetes may adversely affect patients with COPD exacerbation. Larger studies are needed to conclusively determine the impact of glycemic control on COPD morbidity and mortality.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253227
Author(s):  
I-Hung Lin ◽  
Chien-Cheng Chien ◽  
Yi-Hao Chen ◽  
Shu-i Pao ◽  
Jiann-Torng Chen ◽  
...  

We evaluated the clinical utility of ultra-widefield imaging as an adjunctive tool for training resident ophthalmologists in the detection of retinal breaks. This was a prospective study conducted at a secondary health care center (Tri-Service General Hospital) in Taiwan. Participants were 44 patients (53 eyes) who were referred to our hospital after being diagnosed with retinal breaks. Patients first underwent an indirect ophthalmoscopy examination of the total fundus without scleral depression by our junior (first and second year) or senior (third and fourth year) resident ophthalmologist and then underwent an ultra-widefield imaging examination with a central image and four gaze-steered (up, down, nasal, and temporal) images to determine the number of retinal breaks in the total fundus and the four quadrants. Of the total 53 eyes, 31 were examined by junior residents and 22 were examined by senior residents. In the group of junior residents, ultra-widefield imaging was significantly better at detecting retinal breaks of the total fundus (49 vs. 33 retinal breaks, p < 0.001) and the temporal quadrant (17 vs. 10 retinal breaks, p = 0.018) than indirect ophthalmoscopy. In the group of senior residents, there was no significant difference in the ability to detect retinal breaks in the total fundus or each of the four quadrants with ultra-widefield imaging or indirect ophthalmoscopy. Our results indicate that, compared to indirect ophthalmoscopy, ultra-widefield imaging with a central image and four gaze-steered images has a better performance and is a useful adjunct tool for the detection of retinal breaks in junior resident training. Additionally, it could be a useful method for teaching indirect ophthalmoscopy examination to junior residents.


2020 ◽  
Vol 19 (1) ◽  
pp. 186-195
Author(s):  
Shubha Ratna Shakya ◽  
Shyam Narayan Labh

 The complete blood cell count (CBC) is an important and powerful diagnostic tool to monitor the health status of fish in response to changes related to nutrition, water quality, and disease in response to therapy.Thus, the present study was about to know the effect of lapsi fruit pulp (Choerospondias axillaris) on some blood parameters in the fingerlings of rohu Labeo rohita cultured in Corona of Agriculture Hatchery farm, Chitwan, Nepal. Altogether eighteen hapas made of heavy-duty nylon net (1.5m3) were kept and placed inside the pond, distributed linearly, and then 270 fingerlings (@15 fishes/ hapa) were kept distributed randomly. Six practical diets like T1 (0.0 g kg-1), T2 (0.1 g kg-1), T3 (0.2 g kg-1), T4 (0.4 g kg-1), T5 (0.8 g kg-1) and T6 (1.6 g kg-1) were prepared. Feed containing 40% protein was supplemented with the ethanol extract of lapsi fruits. At the end of 90 days of the feeding trial, a significant difference (P< 0.05) in blood parameters were observed between the treated and control diet-fed groups. Hemoglobin (Hb), white blood cells (WBCs), red blood cells (RBCs), packed cell volume (PCV), and other erythrocyte indices were recorded higher in the treated groups. RBC, WBC, Hct, and Hb were found significantly higher in the T4 (0.4 %) diet-fed group. The study showed a minimum of 0.4 % (0.4g kg-1) lapsi fruit extract needed in fish feeds to increase blood parameters to enhance growth and immunity.


2013 ◽  
Vol 16 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Rahmadevita S.A.M ◽  
Yeni Rustina ◽  
Elfi Syahreni

AbstrakNeonatus yang menggunakan ventilasi mekanik akibat gangguan pernapasan mengalami masalah oksigenisasi dan frekuensi denyut jantung. Berbagai upaya perlu dilakukan agar neonates tenang sehingga kebutuhan oksigen dapat diminimalkan, salah satu upaya tersebut adalah terapi musik. Penelitian ini bertujuan untuk menguji pengaruh terapi musik terhadap saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan neonatus yang menggunakan ventilasi mekanik. Penelitian kuasi eksperimen dengan rancangan pretest-posttest without control meibatkan 13 neonatus yang dipilih secara konsekutif. Intervensi yang diberikan adalah terapi musik dengan Brahm’s Lullaby selama 30 menit dengan headphone. Pengumpulan data menggunakan observasi dan dianalisis dengan Paired t test. Hasil penelitian menunjukkan adanya perbedaan bermakna antara rerata saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan sebelum dan setelah pemberian terapi musik. Pada saturasi oksigen terjadi peningkatan, sedangkan pada frekuensi denyut jantung dan pernapasan mengalami penurunan. Terapi musik dapat digunakan sebagai pendamping terapi medis untuk memperbaiki oksigenisasi pada neonatus yang menggunakan ventilasi mekanik.Kata kunci: denyut jantung neonatus, pernapasan, saturasi oksigen, terapi musik, ventilasi mekanikAbstractImproving Oxygen Saturation, Heart Rate, and Respiratory Rate of Neonates Using Mechanical Ventilation with Music Therapy. Neonates using mechanical ventilation cause of respiratory disorder experience oxygenation and heart rate problems. Interventions should be made in order to calm neonates so that the need of oxygen can be minimized, one of these interventions is music therapy. This study aimed to identify the effect of music therapy on oxygen saturation, heart rate and respiratory rate of neonates using mechanical ventilation. This quasi experiment study with a pretest-posttest design without control involved 13 neonates selected by consecutive sampling. Data collected through observation and analyzed by paired t test. There was a significant difference on the average of oxygen saturation, heart rate and respiratory rate of infants using mechanical ventilation before and after music therapy (p value <0,05). Music therapy can be used as a complementary medical therapies to improve oxygenation in neonates using mechanical ventilation.Key words: heart rate, mechanical ventilation, music therapy, neonate, oxygen saturation, respiratory rate


Sign in / Sign up

Export Citation Format

Share Document