Alveolar air leak and paraseptal emphysema in severe COVID-19 disease

Background Corona virus 2019 (COVID-19) pandemic spread in the world as a great medical crisis. Its pathophysiology, manifestations, complications, and management are not completely defined, yet. In this study frequency of alveolar air leak in critically ill COVID-19 subjects is explored. Methods A total of 820 critically ill COVID-19 subjects who admitted with respiratory insufficiency to ICUs of Sina University Hospital from March 2020 to June 2021 were included. All their chest x ray (CXR) and Computed tomography (CT) of chest were reviewed. All alveolar air leak episodes (pneumothorax, pneumomediastinum, pneumopericardium, subcutaneous emphysema) suspected films reviewed by attending intensivist and radiologist. Results Of the 820 ill COVID-19 subjects in ICUs, 492(60%) were male, and 328 (40%) were female. The Mean age of 820 subjects was 60.84 + 16.82. 584 (71.22%) of subjects were non-intubated, and 236 (28.78%) were intubated. Alveolar air leak occurred in 98 (11.95%) of subjects. Alveolar air leak episodes include pneumothorax in 26 (3.17%), subcutaneous emphysema in 72 (8.78%), pneumomediastinum in 9 (1.10%), and pneumopericardium in 1 (0.12%) of subjects. The mean age in non-intubated subjects was 59.65 + 16.84, and for intubated subjects was 63 + 16.42. There was a significant difference in age between the groups who get intubated, versus not intubated P 0.001. Of the 584 non-intubated subjects, 31 (5.31%) had subcutaneous emphysema, of the 236 intubated subjects, 41 (17.37%) had subcutaneous emphysema. Difference between groups was statistically significant, P <0.001. When we compared intubated and non-intubated patients in case of total numbers of alveolar air leak episodes, the difference was statistically significant P <0.001. Conclusion According to this study, intubation was implemented more in older patients. Also, invasive ventilation was significantly associated with subcutaneous emphysema and total number of alveolar air leak episodes. In every patient with exaggeration of hypoxia, dyspnea or chest pain, pneumothorax should be kept in mind as a differential diagnosis. Keywords: COVID-19; Respiratory failure; Alveolar air leak; Paraseptal emphysema

Download Full-text

Costovertebral angle as a novel tool for predicting the thoracic complication risk following percutaneous nephrolithotomy requiring supracostal access

Canadian Urological Association Journal ◽

10.5489/cuaj.7114 ◽

2021 ◽

Vol 15 (11) ◽

Author(s):

Ahmet Guzel ◽

Taylan Oksay ◽

Sefa Alperen Ozturk ◽

Arap Sedat Soyupek ◽

Alper Ozorak ◽

...

Keyword(s):

Percutaneous Nephrolithotomy ◽

Information Age ◽

University Hospital ◽

Access Site ◽

Stone Size ◽

Complication Risk ◽

Significant Difference ◽

Chest X Ray ◽

The Mean ◽

Pleural Injury

Introduction: The objective of this study was to determine whether the costovertebral angle (CVA) and other factors can predict the risk of thoracic complications following percutaneous nephrolithotomy (PCNL). Methods: The data of patients who underwent prone PCNL with supracostal access at Suleyman Demirel University Hospital between January 2015 and December 2019 were retrospectively reviewed. Patients’ demographics information (age, sex, body mass index [BMI], stone size, and stone location), operative data (supracostal access site, renal puncture site, and laterality), and postoperative thoracic complications (pleural injury) were evaluated. The CVA was measured on preoperative posteroanterior chest X-ray images. The mean CVA of patients with and without thoracic complications was evaluated. Results: A total of 89 patients (mean age 46.12±15.66 years; 59 men and 30 women) with supracostal access were included in the study. Thoracic complications occurred in 17 (19.1%) patients. Nine (52.9%) hemothorax cases, five (29.4%) pneumothorax cases, and three (17.7%) urinothorax cases were detected. There was a statistically significant difference in the complication rate compared to the percutaneous access site (10th–11th supracostal vs. 11th–12th supracostal) (p=0.004). The mean CVA was significantly lower in patients with complications (45.47±3.59) than in those without complications (53.26±5.98) (p=0.000). No association was found (p>0.05) with age, sex, BMI, laterality, stone surface area, and access site among patients with and without thoracic complications. Conclusions: Preoperative CVA can be an effective tool in predicting the risk of postoperative thoracic complications.

Download Full-text

Comparative Analysis of Different Local Anesthetic Solutions Available in Market: An In Vitro and Clinical Study

European Journal of Dentistry ◽

10.1055/s-0041-1727553 ◽

2021 ◽

Author(s):

Eisha Imran ◽

Faisal Moeen ◽

Beenish Abbas ◽

Bakhtawar Yaqoob ◽

Mehreen Wajahat ◽

...

Keyword(s):

Comparative Analysis ◽

Local Anesthetic ◽

Compositional Analysis ◽

Bacterial Activity ◽

Similar Composition ◽

Ph Values ◽

Significant Difference ◽

The Mean ◽

The Difference

Abstract Objectives The study aimed to evaluate and compare various commercially available local anesthetic solutions. Materials and Methods A total of 150 commercially available local anesthetic cartridges of similar composition (2% lidocaine with epinephrine 1:100,000) were randomly collected and divided into 3 groups. The designations of groups were selected from their product names such that each group consisted of 60 cartridges. Group S (Septodont, France) Group M (Medicaine, Korea) and Group H (HD-Caine, Pakistan). The samples were divided into five sub-groups, each consisting of 10 cartridges from each group to investigate each parameter. Results The acquired data was statistically analyzed and compared (using SPSS version 12). Compositional analysis revealed a non-significant (P>0.05) difference when the three Groups were compared with standard lidocaine and epinephrine solutions. The mean pH values of samples from group S, M and H respectively fell within the range of pH values of commercially available solutions. Non-significant difference in EPT values of Group S and H was found when efficacy was compared (p = 0.3), however a significant difference (p < 0.01) was observed in contrast to Group M. Anti-bacterial activity was observed in all the group and a non-significant difference in cell viability values of Group S and M was found (p = 0.6), while the difference was significant in comparison to Group H. Conclusion Within the limitations of these investigations, it appears that the properties of different manufacturers fall within the recommended ranges as mentioned in literature and do not appear to be statistically different in the variables we have tested.

Download Full-text

Analysis of the breeding records of a herd of pigs

The Journal of Agricultural Science ◽

10.1017/s0021859600045731 ◽

1954 ◽

Vol 45 (1) ◽

pp. 19-27 ◽

Cited By ~ 10

Author(s):

R. Braude ◽

P. M. Clarke ◽

K. G. Mitchell

Keyword(s):

Statistical Analysis ◽

Large White ◽

Seasonal Differences ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Length Of Gestation

1. A survey and. statistical analysis of the records of litters born in the N.I.R.D. herd of Large White pigs over a period of 16 years are presented.2. The mean length of gestation was 114 days for both gilts and sows.3. The mean numbers of pigs born alive and born dead per litter from gilts, 10·0 and 0·2 respectively, were both significantly smaller than the corresponding figures for sows, 11·8 and O·8. No seasonal differences were found.4. The mean total losses of pigs from birth to weaning at 8 weeks were 29·5% of pigs born alive. The losses in litters from gilts, 23·0%, were significantly smaller than in litters from sows, 31·0%. The losses during the winter months both for gilts, 32·5%, and for sows, 35·9%, were significantly higher than during the summer months, 19·4% and 26·7% for gilts and sows respectively.5. Over 50% of the total losses were due to crushing by the dam, 74·1% of the losses from this cause occurring during the first 48 hr. after birth.6. The mean number of pigs weaned per litter was 8·0. The difference between the number weaned per litter from gilts, 7·7, and per litter from number of pigs was weaned per litter from sows during the summer months, 8·7, than during the winter months, 7·4.7. There was no significant difference between the number of male and of female pigs weaned.8. The mean weight at weaning was 29·9 lb., male pigs, 30·3 lb., being significantly heavier than females, 29·51b. Pigs in litters from gilts, 27·81b., were significantly lighter at weaning than those from sows, 30·0 lb., and for both gilts and sows, pigs reared during the summer months, 29·7 and 31·8 lb. respectively, were significantly heavier than those reared during the winter months, 25·9 and 28·2 lb. respectively.

Download Full-text

Influence of Apical Patency and Cleaning of the Apical Foramen on Periapical Extrusion in Retreatment

Brazilian Dental Journal ◽

10.1590/0103-6440201302016 ◽

2013 ◽

Vol 24 (5) ◽

pp. 482-486 ◽

Cited By ~ 5

Author(s):

Marili Doro Andrade Deonizio ◽

Gilson Blitzkow Sydney ◽

Antonio Batista ◽

Roberto Pontarolo ◽

Paulo Ricardo Bittencourt Guimarães ◽

...

Keyword(s):

Material Removal ◽

Filling Material ◽

Mean Values ◽

Filtration System ◽

Root Canal Retreatment ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

The Difference ◽

Removal Technique

This study evaluated the influence of apical patency, root filling removal technique and cleaning of the apical foramen, concerning the amount of debris extruded during root canal retreatment. Forty mandibular incisors were randomly assigned to 4 groups - GIM (n=10), GIIM (n=10), GIPT (n=10) and GIIPT (n=10), which were named according to leaving (I) or not (II) apical patency during canal preparation and filling removal technique (manual - M or ProTaper system - PT). After filling material removal, each specimen of each group had the apical foramen cleaned by sizes 15, 20 and 25 instruments, generating 12 subgroups: GIM15, GIM20, GIM25, GIIM15, GIIM20, GIIM25, GIPT15, GIPT20, GIPT25, GIIPT15, GIIPT20 and GIIPT25. Extruded filling debris was collected by a Milipore filtration system, an HV-durapore, 0.45 µm pore filter with a 25 mm diameter. The filters were weighed before and after the collection on an analytical scale (10–5 g), and the difference was calculated. The mean weight of extruded filling debris was analyzed statistically by Kruskal-Wallis and Friedman ANOVA tests (α=0.05). The mean values found in the groups (in mg) were: GIM (0.95±0.94), GIIM (0.47±0.62), GIPT (0.30±0.31) and GIIPT (0.32±0.44). There was no statistically significant difference among any of the groups or subgroups (p>0.05). ProTaper provided the smallest amount of extruded filling material, regardless of presence or absence of apical patency, followed by manual technique, without and with apical patency. Additional amounts of debris were collected during cleaning of the apical foramen, regardless of the instrument, presence/absence of patency or root filling removal technique.

Download Full-text

Effect of smoking on cardiovascular autonomic functions

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2021.101 ◽

2021 ◽

Vol 9 (2) ◽

pp. 3780-3784

Author(s):

P.Vani ◽

◽

Sharan B Singh M ◽

Keyword(s):

Heart Rate ◽

Autonomic Function ◽

T Test ◽

Resting Heart Rate ◽

Autonomic Functions ◽

Mean Values ◽

Function Tests ◽

Significant Difference ◽

The Mean ◽

The Difference

Introduction: Cigarette smoking is a prime risk factor for cardiovascular morbidity and mortality. Chronic smoking results in autonomic dysfunction leading to increased cardiovascular risk in smokers. The present study was planned to study the effect of smoking on the Cardiovascular Autonomic Functions among smokers. Materials and Methods: Fifty male subjects who were in the age group of 25 to 45 years. They were grouped into 25 smokers and 25 non-smokers. The participant subjects were selected among the staff members, residents and the patients from the routine OPD in SVIMS. Prior to study, they were informed about the procedure and the purpose of the study tests and written consents were obtained from them. The Cardiovascular Autonomic Function Tests were assessed by using a POLYGRAPH which was available in the department. Results and Conclusion: After applying the ‘t’-test for the difference between the two sample means, it was observed that there was a highly significant difference between the mean values of the BMI(i.e.p<0.01) and the para-sympathetic function tests among the smokers and the non – smokers(i.e.p<0.00). The Resting Heart Rate had significantly increased and the Deep breathing difference, the postural tachycardial index (Response to standing) and the Valsalva Ratio had significantly decreased in the smokers as compared to those in the non – smokers. After applying the ‘t’-test for the difference between the two sample means, it was observed that there was no significant difference between the mean values of the Postural hypotension test (i.e. p>0.05) and that there was a highly significant difference between the mean values of the Sustained handgrip test in the smokers and the non – smokers (i.e. p<0.00). KEY WORDS: Cardiovascular autonomic function tests, Smoking, Resting heart rate.

Download Full-text

Status of microsatellite instability in different histomorphological patterns of colorectal carcinoma among a group of Bangladeshi people

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20214514 ◽

2021 ◽

Vol 8 (12) ◽

pp. 1799

Author(s):

Momammed Mustafizur Rahman ◽

Shabnam Imam ◽

Sayedatun Nessa ◽

A. K. M. Maruf Raza ◽

Farida Arjuman ◽

...

Keyword(s):

Colorectal Carcinoma ◽

Observational Study ◽

Microsatellite Instability ◽

University Hospital ◽

Biological Behavior ◽

Cancer Tissue ◽

Cross Sectional ◽

The Mean ◽

The Difference ◽

Medical University

Background: This cross- sectional observational study was carried out with an aim to look for microsatellite instability (MSI) status in colorectal carcinoma and their association with different histomorphological patterns and biological behavior of colorectal carcinoma.Methods: This cross-sectional observational study was done in the Department of Pathology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh during September 2014 to October 2015. A total of 39 surgically resected sample of colorectal carcinoma were included. Consent from each patient was taken. The samples were histopathologically evaluated according to the standard protocol. The statistical analyses were done using Statistical packages for social sciences (SPSS 15) for Windows.Results: A total of 39 cases of colorectal carcinoma were included in this study. Majority of the patients (55.5%) was in 6th decade in MSI and 29.1% were MSI absent group. The mean age was found 47.67±10.97 years in present group and 47.84±14.26 years in absent group. The difference was not statistically significant (p>0.05). TNM stage with MSI was observed. The mean CEA level was 100.74±103.66 and 60.43±91.72. The mean Hb was 9.72±1.99 % and 9.92±2.17, the range was 7.2-12.2 and 4.6-13.4 among the groups. The mean difference was not statistically significant (p>0.05). Ulcerated was 3 (33.3%) and 19 (64.5%). Stage 3 tumor was 4 (44.4%) and 16 (51.6%). Grade 2 tumor was 5 (55.6%) and 17 (58.0%).Conclusions: For the first time in Bangladesh, this study was undertaken to evaluate the microsatellite instability (MSI) status in colorectal cancer tissue and their association with different histomorphological patterns of colorectal carcinoma.

Download Full-text

Quantitative electroencephalography as a tool for objective neurophysiological seizure diagnosis: A retrospective study

Indian Journal of Medical Sciences ◽

10.25259/ijms_160_2020 ◽

2020 ◽

Vol 0 ◽

pp. 1-6

Author(s):

Rajesh Kumar ◽

Tribhuwan Kumar ◽

Kamlesh Jha ◽

Yogesh Kumar

Keyword(s):

Energy Level ◽

Matched Control ◽

Age Groups ◽

Quantitative Electroencephalography ◽

Beta Band ◽

Significant Difference ◽

Males And Females ◽

The Mean ◽

The Difference ◽

Electrical Activities

Objectives: Seizure is the fourth most common neurological disorder in the world; it affects all age groups with equal possibility of occurrence in both males and females. Many antiepileptic drugs are available today, but its diagnosis is challenging. The present study attempted to see if seizure activities could be predicted by analyzing the pre-seizure electrical activities. The prediction may help in taking preventive measures appropriately beforehand in the individuals with seizure proneness. Material and Methods: We selected 11 generalized seizure patients and 19 control patients out of total 115 patients referred for electro-diagnostics for various reasons. EEG of the subjects recorded, segmented as per protocol, and analyzed using MATLAB and EEGLAB tools. Results: The mean energy level in alpha and beta band of the study subject was significantly lower (P = 0.04 and 0.004, respectively) as compared to the age matched control subjects. Theta and delta bands did not show any significant difference between the groups. The difference between the pre- and post-electrical seizure energy and entropy was statistically insignificant. Conclusion: The study shows that the energy level remains low in the seizure patients in the alpha and beta bands. This further goes down when electrophysiological seizure activities starts. The randomness or entropy does not alter significantly among the seizure subjects in comparison to non-seizure subjects.

Download Full-text

Prevalence ofPlasmodium falciparumParasitaemia and Its Correlation with Haematological Parameters among HIV-Positive Individuals in Nigeria

Journal of Tropical Medicine ◽

10.1155/2014/161284 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Olusola Ojurongbe ◽

Oluwatoyin Adeola Oyeniran ◽

Oyebode Armstrong Terry Alli ◽

Sunday Samuel Taiwo ◽

Taiwo Adetola Ojurongbe ◽

...

Keyword(s):

Haemoglobin Concentration ◽

Malaria Parasitaemia ◽

Cd4 Cell Count ◽

Significant Difference ◽

Parasite Detection ◽

Important Health ◽

The Mean ◽

Polymerase Chain ◽

The Difference ◽

Cd4 Cell

Malaria and HIV are the two most important health challenges of our time. Haematologic abnormalities are features inPlasmodium falciparuminfection, and anaemia is a well-known outcome. The prevalence and haematological impact ofP. falciparumparasitaemia were determined among HIV-infected individuals in Nigeria. Parasite detection was carried out using microscopy and Polymerase Chain Reaction (PCR). Haemoglobin concentration was determined using an automated machine while CD4+ T-cells count was analyzed using flow cytometer. Thirty-seven (18.5%) out of the 200 HIV individuals enrolled had malaria parasites detected in their blood. All the positive cases were detected by PCR while only 20 (10%) were detected by thick blood microscopy. The mean haemoglobin concentration and packed cell volume (PCV) of HIV individuals with malaria parasitaemia were lower compared to those without malaria parasitaemia but the difference was not statistically significant. Also no significant difference was observed in malaria positivity in respect to sex and mean CD4+ cell count. The study highlights the effects ofP. falciparumparasitaemia on the haematologic and immune components of HIV individuals.

Download Full-text

Effects of Orthokeratology Lens On Axial Length Elongation in Myopia With Anisometropia Children

10.21203/rs.3.rs-741927/v1 ◽

2021 ◽

Author(s):

Ziyang Chen ◽

Kai-Ming Chen ◽

Ying Shi ◽

Zhao-Da Ye ◽

Sheng Chen ◽

...

Keyword(s):

Retrospective Study ◽

Axial Length ◽

Statistical Significance ◽

Spherical Equivalent ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Better Than ◽

Group 1

Abstract AimTo investigate the effect of orthokeratology (OK) lens on axial length (AL) elongation in myopia with anisometropia children.MethodsThirty-seven unilateral myopia (group 1) and fifty-nine bilateral myopia with anisometropia children were involved in this 1-year retrospective study. And bilateral myopia with anisometropia children were divided into group 2A (diopter of the lower SER eye under − 2.00D) and group 2B(diopter of the lower SER eye is equal or greater than − 2.00D). The change in AL were observed.The datas were analysed using SPSS 21.0.Results(1) In group 1, the mean baseline AL of the H eyes and L eye were 24.70 ± 0.89 mm and 23.55 ± 0.69 mm, respectively. In group 2A, the mean baseline AL of the H eyes and L eyes were 24.61 ± 0.84 mm and 24.00 ± 0.70 mm respectively. In group 2B, the mean baseline AL of the H eyes and L eyes were 25.28 ± 0.72 mm and 24.70 ± 0.74 mm. After 1 year, the change in AL of the L eyes was faster than the H eyes in group 1 and group 2A (all P<0.001).While the AL of the H eyes and L eyes had the same increased rate in group 2B. (2) The effect of controlling AL elongation of H eyes is consistent in three groups (P = 0.559).The effect of controlling AL elongation of L eyes in group 2B was better than that in group 1 and group 2A (P < 0.001). And the difference between group 1 and group 2A has no statistical significance. (3) The AL difference in H eyes and L eyes decreased from baseline 1.16 ± 0.55mm to 0.88 ± 0.68mm after 1 year in group 1.And in group 2A, the AL difference in H eyes and L eyes decreased from baseline 0.61 ± 0.34mm to 0.48 ± 0.28mm. There was statistically significant difference (all P<0.001). In group 2B, the baseline AL difference in H eyes and L eyes has no significant difference from that after 1 year (P = 0.069).ConclusionsMonocular OK lens is effective on suppression AL growth of the myopic eyes and reduce anisometropia value in unilateral myopic children. Binocular OK lenses only reduce anisometropia with the diopter of the low eye under − 2.00D. Binocular OK lenses cannot reduce anisometropia with the diopter of the low eye equal or greater than − 2.00D. Whether OK lens can reduce refractive anisometropia value is related to the spherical equivalent refractive of low refractive eye in bilateral myopia with anisometropia children after 1-year follow-up.

Download Full-text

The effect of ear acupressure medicine at the “Shen Men” point on the nausea and vomiting during pregnancy

10.53350/pjmhs211551774 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1774-1779

Author(s):

Sanaz Nehbandani ◽

Hajar Salehi ◽

Khadije Rezaie Keikhaie ◽

Hossein Rashki Ghalenow ◽

Fatemeh Mirzaie ◽

...

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Intervention Group ◽

Nausea And Vomiting ◽

Control Group ◽

Health Clinics ◽

Significant Difference ◽

Quasi Experimental ◽

The Mean ◽

The Difference

Introduction & Objective: Nausea and vomiting during pregnancy is one of the most common gastrointestinal disorders that more than 85% of pregnant women experience. However, controlling and treating this complication is still one of the most important issues in antenatal care. Therefore, the aim of this study was to investigate the effect of ear acupressure at Shen Men point on relieving nausea, vomiting and retching during pregnancy. Materials and Methods: In this quasi-experimental study, 100 pregnant women with a gestational age of less than 16 weeks attending the health clinics of Zabol city during 2019-2020 were studied in two control and intervention groups (n = 50 in each group). The samples in the intervention group were trained to apply pressure on their ears’ Shen Men point with the thumb for three minutes three times a day (morning, noon, and night), for a duration of one month. At the end of second and fourth weeks, the data were collected using the Rhodes index form and then, were analyzed by SPSS software version 22. Results: According to the results, there was no significant difference between the two groups in terms of age, gestational age, occupation and education. The difference in the mean scores of nausea, vomiting and retching was not statistically significant between the control and intervention groups before the study. But four weeks after the study, a significant difference was observed in the mean scores of vomiting, nausea and retching between the two groups, so that the mean scores of vomiting, nausea and retching were significantly lower in the intervention group than in the control group. Conclusion: The ear acupressure medicine at the Shen men point can be used as a non-invasive, safe and inexpensive method to relieve nausea, vomiting and retching during pregnancy. Keywords: Acupressure medicine, Shen Men, Vomiting, Pregnancy, Nausea, Retching, Rhodosis

Download Full-text