Post Discharge Outcome of COVID 19 Cases Reported from Pakistan

2021 ◽  
Vol 15 (10) ◽  
pp. 2611-2613
Author(s):  
Sadia Ishaque ◽  
Beenish Syed ◽  
Saima Akhter ◽  
Talha Safeer ◽  
Yousra Mansoor ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Complete Blood Count ◽  
Hospital Data ◽  
Post Discharge ◽  
X Ray ◽  
Normal Limits ◽  
Significant Difference ◽  
Chest X Ray ◽  
Time Of Admission ◽  
Hospital Study

Aim: To characterize the clinical outcome of COVID-19 patients following discharge from the hospital. Study design: Prospective cohort study. Place and Duration of Study: Department of Infectious Diseases, Liaquat National Hospital, Karachi from 1st May to 31st August 2020. Methodology: Ninety six patients were included, age over 23 years and had a confirmed COVID-19 on PCR. At the time of admission and on discharge, in-hospital data were recorded. The demographic information, symptoms, complete blood count, inflammatory markers, and chest X-ray noted. Results: Diabetes (50%) and Ischemic heart disease (50%) were the most frequent comorbidities. The majority of patients (75%) improved their X-ray findings after being discharged from the hospital. At the time of discharge, 75% of the patients expressed fatigue; none of the patients developed a fever. There was a substantial significant difference in tiredness reported at discharge and in the fourth week. Significant variations in shortness of breath and oxygen consumption were also found between tiredness indicated at discharge and the fourth week. The majority of lab values were within normal limits. Conclusion: Most patients gradually improved after receiving appropriate treatment and supportive care in the hospital and later at home. The most prevalent and prolonged symptom reported by most patients was fatigue. By the fourth week, most symptoms had ameliorated significantly. Keywords: SARS-CoV2, Clinical outcome, Fatigue, COVID-19 follow-up

scholarly journals The Efficacy of Chest X-Ray for the Diagnosis and Follow-up in Young Adult COVID-19 Patients with Mild Dyspnea No Comorbid Diseases

2021 ◽  
Author(s):  
ferhat cuce ◽  
deniz dogan ◽  
ugur bozlar ◽  
mustafa tasar ◽  
ervin gjoni ◽  
...  
Keyword(s):  
Young Adult ◽  
X Ray ◽  
Early Admission ◽  
Significant Difference ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Comorbid Diseases ◽  
Time Of Admission ◽  
Hospital Stay Duration

Purpose: We investigated whether Chest X-Ray (CXR) could replace CT modality in the diagnosis and during the treatment of young adult COVID-19 patients with mild dyspnea with no comorbid diseases. Materials and Method: This retrospective study involved an examination of the records of a total of 956 patients hospitalized between March 1 and May 15, 2020. The study included a total of 64 patients, aged 21–60 years with mild dyspnea with no comorbid diseases and with COVID-19 infection confirmed by a polymerase chain reaction, who underwent a CXR at admission and CT imaging within 24 hours. The first CXR and CT images at the time of admission were evaluated in terms of lesions and localization. The clinical-radiological course of the diseases with CXR were also statistically evaluated. Results: CT was normal in 18/64 (28.2%) patients, all of whom also had normal CXR. The rest of the patients 46/64 (71.8%) with an abnormal CT, the CXR was normal in 18/46 (39.1%) and abnormal in 28/46 (60.9%). The time between the onset of complaints and admission to the hospital in patients with abnormal and normal CXR was 3.5 ± 2.3 days and 2.1 ± 1.1, which was statistically significant (p = 0.004). The hospital stay duration of the patient with abnormal and normal CXR was 9.6 ± 3.5 and 9.5 ± 3.4 (p=0.928), respectively, and was not statistically significant. Conclusion: CXR could be used in the diagnosis and follow-up of young adult COVID 19 patients with mild dyspnea no comorbid disease. In the case of early admission to the hospital, there is not a significant difference between using CXR or CT in the management of these patients. Therefore, the use of CXR in these patients groups will reduce the burden of CT units in pandemic conditions with limited resources.

scholarly journals Differentiation Between Anteroposterior and Posteroanterior Chest X-Ray View Position With Convolutional Neural Networks

2020 ◽  
Author(s):  
René Hosch ◽  
Lennard Kroll ◽  
Felix Nensa ◽  
Sven Koitka
Keyword(s):  
Neural Networks ◽  
Convolutional Neural Networks ◽  
Performance Comparison ◽  
University Hospital ◽  
Hospital Data ◽  
X Ray ◽  
Ensemble Models ◽  
Class Distribution ◽  
Meta Information ◽  
Chest X Ray

Purpose Detection and validation of the chest X-ray view position with use of convolutional neural networks to improve meta-information for data cleaning within a hospital data infrastructure. Material and Methods Within this paper we developed a convolutional neural network which automatically detects the anteroposterior and posteroanterior view position of a chest radiograph. We trained two different network architectures (VGG variant and ResNet-34) with data published by the RSNA (26 684 radiographs, class distribution 46 % AP, 54 % PA) and validated these on a self-compiled dataset with data from the University Hospital Essen (4507, radiographs, class distribution 55 % PA, 45 % AP) labeled by a human reader. For visualization and better understanding of the network predictions, a Grad-CAM was generated for each network decision. The network results were evaluated based on the accuracy, the area under the curve (AUC), and the F1-score against the human reader labels. Also a final performance comparison between model predictions and DICOM labels was performed. Results The ensemble models reached accuracy and F1-scores greater than 95 %. The AUC reaches more than 0.99 for the ensemble models. The Grad-CAMs provide insight as to which anatomical structures contributed to a decision by the networks which are comparable with the ones a radiologist would use. Furthermore, the trained models were able to generalize over mislabeled examples, which was found by comparing the human reader labels to the predicted labels as well as the DICOM labels. Conclusion The results show that certain incorrectly entered meta-information of radiological images can be effectively corrected by deep learning in order to increase data quality in clinical application as well as in research. Key Points:  Citation Format

scholarly journals What is the Utility of Routine Complete Blood Count, Liver Function Tests, and Chest X-ray in the Evaluation of Patients with Clinically Node-Negative Breast Cancer?

2019 ◽  
Vol 85 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Ameliay Merrill ◽  
Mary M. Garland ◽  
Marissa Howard-Mcnatt ◽  
Mena Isnassuos ◽  
Kathleen C. Perry ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Count ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Screening Tests ◽  
Occult Metastasis ◽  
Preoperative Screening ◽  
Node Negative ◽  
X Ray ◽  
Chest X Ray

National Comprehensive Cancer Network guidelines suggest a selective workup of early-stage breast cancer with complete blood count (CBC) and liver function tests (LFTs) and no longer recommend chest X-ray (CXR) to screen for occult metastasis. We evaluated the utility of routine preoperative screening tests in patients with clinically node-negative (cN0) breast cancer. We identified 1611 patients with cN0 breast cancer treated at our institution between October 1998 and December 2015; 94.4 per cent of the patients underwent at least one preoperative screening test: 90.8 per cent CBC, 89.4 per cent LFTs, and 63.6 per cent CXR. Thirty-six per cent of CBCs, 13.1 per cent of LFTs, and 6.7 per cent of CXRs were abnormal. Abnormalities led to 17 CTscans, and one found an occult metastasis. Eleven patients (0.7%) were diagnosed with metastatic disease post-operatively, but only half had abnormal preoperative screening tests. Positive predictive values of preoperative CBC, LFTs, and CXR for occult metastasis are 1.3 per cent, 1.1 per cent, and 1.5 per cent, respectively. Preoperative screening in cN0 breast cancer is of low yield. Even when abnormalities are found, metastasis is present in less than 1 per cent of patients, and a normal study does not rule out metastasis. Routine preoperative determination is not warranted, and staging studies should be limited to patients with signs or symptoms.

scholarly journals Sotrovimab: is it effective in early treatment of mild and moderate COVID-19 infections? A retrospective study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ahmed Elesdoudy
Keyword(s):  
Kidney Function ◽  
United Arab Emirates ◽  
Early Treatment ◽  
Vital Signs ◽  
Laboratory Studies ◽  
Kidney Function Tests ◽  
X Ray ◽  
Function Tests ◽  
Significant Difference ◽  
Chest X Ray

Abstract Background The monoclonal antibody sotrovimab is manufactured to antagonize many types of coronaviruses including the SARS-CoV-2. It is used mainly to treat mild and moderate COVID-19 infection and to prevent the progression of the disease from critical disease to severe. Objectives To assess the effectiveness of sotrovimab in the early treatment of mild and moderate COVID-19 infections and prevention of disease progression to severe and critical disease. Methods This study was performed on 220 outpatients who have already received sotrovimab in Obaidullah Hospital, United Arab Emirates. All patients underwent the following before receiving sotrovimab: routine laboratory studies (CBC, liver function tests, and kidney function tests) and other laboratory tests (C reactive protein (CRP), D dimer, and chest x-ray). All patients received sotrovimab in a dose of 500 mg once intravenous infusion over 30 min. All laboratory studies and CXR are repeated after 1 week of receiving the dose of sotrovimab. Results The outcome was 43 patients deteriorated (19.5%) and 177 patients improved (80.5%). The progress of patients’ symptoms after receiving sotrovimab where the shortness of breath (SOB) deteriorated in 43 patients (19.5%) and improved in 177 patients (80.5%). The cough symptom deteriorated in 43 patients (19.5%), improved in 177 patients (80.5%). The progress of patients' radiology (chest x-ray) where it is deteriorated in 43 patients (19.5%) and improved in 177 patients (80.5%). The rate of hospitalization after receiving sotrovimab where 41 patients were hospitalized (18.6%) and 179 patients were not hospitalized (81.4%). There was a statistically significant difference before and after using sotrovimab in vital signs, inflammatory markers, kidney function tests, electrolytes, endocrine functions, and hepatic profile. Conclusion Among adults with mild and moderate COVID-19, the use of sotrovimab significantly improved resolution of symptoms, outcome, radiology, or laboratory marker and decreased hospitalization. The findings support using sotrovimab in the early treatment of mild and moderate COVID-19. Wide-scale studies may be required for clarifying the effects of sotrovimab in the treatment of mild and moderate COVID-19 infections.

scholarly journals The Management of Patients with Pneumonia in Family Medicine in Slovenia

2020 ◽  
Vol 89 (3-4) ◽  
pp. 139-148
Author(s):  
Aljaž Brlek ◽  
Ernestina Bedek
Keyword(s):  
Complete Blood Count ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Primary Level ◽  
X Ray ◽  
Comprehensive Management ◽  
Management Protocol ◽  
Chest X Ray ◽  
Common Infections

Background: Pneumonia is among the most common infections treated in family practice. In Slovenia, a comprehensive management of pneumonia at the primary level has not yet been researched, which results in the lack of data regarding guideline adherence. Our aim was to describe the management of patients with pneumonia in family practices and to analyse characteristics of family physicians (FPs) and their practices which influence guideline adherence.Methods: The study was conducted as a cross-sectional research with clinical vignette and questions about characteristics of FPs and their practices, in the form of an online questionnaire; 892 specialists and FPs without specialty, and 320 residents were contacted. Using the guidelines, a proper management protocol for patients with pneumonia was designed and used for the evaluation of respondents’ answers. The collected data were analyzed using logistic regression.Results: The response rate was 475/1212 (39.2 %). When managing patients with pneumonia, 66.7 % of FPs performed a complete blood count with differential, 92.6 % CRP, 54.5 % chest X-ray, 62.6 % prescribed amoxicillin and 29.7 % amoxicillin with clavulanic acid. The correct preliminary diagnosis was provided by 93.7 % of FPs, correct diagnostics by 13.5 %, no referral by 90.3 %, proper treatment by 53.1 % and checkup by 48.8 % of FPs. 3.2 % of FPs exhibited an altogether adequate patient management. Negative association between female FPs and adequate diagnostics, and between FPs older than 45 years and adequate treatment and checkup was noticed.Conclusion: The research indicated many differences in managing pneumonia. Only a small share of FPs completely adhered to the set guidelines.

STUDY THE CHANGE OF HIGH-SENSITIVE TROPONIN T CONCENTRATION IN CHILDREN HEART FAILURE AT PEDIATRIC DEPARTMENT OF BINH DINH GENERAL HOSPITAL

2014 ◽  
pp. 48-54
Author(s):  
Van Khanh Luong ◽  
Hung Viet Phan
Keyword(s):  
Heart Failure ◽  
General Hospital ◽  
Troponin T ◽  
High Sensitivity ◽  
Ventricular Dilatation ◽  
Pediatric Department ◽  
X Ray ◽  
Significant Difference ◽  
Chest X Ray ◽  
High Sensitivity Troponin T

Objective: Search the relationship between concentration of high-sensitivity Troponin T with the degree of heart failure, and some changes on chest X-ray and echocardiography. Patients and Methods: based on 44 pediatric patients who were diagnosed heart failure at Pediatric Department of Binh Dinh General Hospital, from 4/2012 -3/2013. Results: Hs-Troponin T concentrations increased in 79.5% of patients had heart failure with a median of 30.2 pg/ml and quartile is 14.6 to 64.5. There is significant difference statistically hs-Troponin T levels according to age of patients with p<0.01. There is a very closely positive relationship between the hs-Troponin T concentration with the degree of heart failure (rs = 0.80, p<0.01). There is a moderate positive correlation between the hs-Troponin T concentration with ventricular dilatation (rs = 0.34, p<0.05). There is no correlation between the hs-Troponin T concentration with changes on chest X-ray. Conclusion: There is statistically significant relationship between the hs-Troponin T concentration with the degree of heart failure and ventricular dilatation on echocardiography. Key words: Troponin T, heart failure, echocardiography

Abstract 163: Type of Prehospital Airway Management Does Not Affect Chest X-Ray Abnormality in Resuscitated Out-of-Hospital Cardiac Arrest Patients

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Hiromichi Naito ◽  
Atsunori Nakao ◽  
Alexandra Weissman ◽  
Jonathan Elmer ◽  
Christian Martin-Gill ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Airway Management ◽  
Supraglottic Airway ◽  
Positive Pressure ◽  
Thoracic Imaging ◽  
X Ray ◽  
Significant Difference ◽  
Chest X Ray ◽  
Prehospital Airway Management ◽  
Hospital Cardiac Arrest

Introduction: Chest x-ray (CXR) abnormalities after cardiopulmonary resuscitation are common. Mechanisms by which these abnormalities develop are not fully elucidated, but aspiration of secretions and regurgitated gastric contents during prehospital airway management may be an important modifiable cause. Hypothesis: We hypothesized that endotracheal intubation (ETI) is associated with decreased incidence of CXR abnormalities after out-of-hospital cardiac arrest (OHCA), as compared to bag-valve-mask (BVM) or supraglottic airway (SGA) use. Methods: We conducted a retrospective review including resuscitated OHCA patients treated at a single academic medical center from 2010-2015. We included patients that had an initial CXR obtained within 66 hours of arrival. We excluded patients with tracheostomy, patients without positive pressure ventilation on emergency department (ED) arrival, or missing initial airway management data. We classified patients by airway management at the time of ED arrival into three groups: BVM, SGA, and ETI. Board certified thoracic imaging radiologists determined if there was any CXR abnormality, and if the observed abnormality was likely due to aspiration. The incidence of any abnormality and aspiration were compared between groups. A multivariable logistic regression model was used to adjust for baseline clinical characteristics. Results: Of the 766 subjects included in the study, 22 (3%) had BVM, 68 (9%) had SGA, and 676 (88%) had ETI. Most 58% were male, 34% had initial rhythm VF/VT, and 61% had a witnessed arrest. Any abnormality on CXR was identified in 543 (71%) cases, and likely aspiration was observed in 205 (27%) cases. Incidence of CXR abnormality was not significantly different between groups: BVM group 18/22 (82%), reference; SGA group 52/68 (76%), OR 0.75, 95% CI 0.13-4.31; ETI group 473/676 (70%), OR 0.81, 95% CI 0.16-4.01. Incidence of aspiration on CXR was also not different between groups: BVM group 6/22 (27%), reference; SGA group 19/68 (28%), OR 1.04, 95% CI 0.18-6.22; ETI group 180/676 (27%), OR 1.26, 95% CI 0.25-6.32. Conclusion: Prehospital airway management strategy for resuscitated OHCA patients was not associated with a significant difference in the incidence of any abnormality or aspiration on CXR.

scholarly journals Study of Clinical and Biochemical Parameters of Type 2 Diabetic Subjects with Pulmonary Tuberculosis

2014 ◽  
Vol 4 (1) ◽  
pp. 5-8
Author(s):  
F Afsana ◽  
SNAA Jamil ◽  
ZA Latif
Keyword(s):  
Pulmonary Tuberculosis ◽  
Biochemical Parameters ◽  
Complete Blood Count ◽  
Radiological Finding ◽  
X Rays ◽  
Radiographic Findings ◽  
Bacteriological Culture ◽  
X Ray ◽  
Chest X Ray

Aims: Type 2 DM is a global epidemic and recognized as a threat to pulmonary tuberculosis (PTB) control worldwide especially in developing countries. When tuberculosis is diagnosed in diabetic subjects both can be affected in term of clinical presentation and course of disease. The aim of the study was to evaluate the demographic, clinical and biochemical parameters of newly detected PTB patients with type 2 diabetes. Methods: Seventy two diabetic subjects with newly detected PTB attending outpatient department, BIRDEM were studied. Patients with fever, cough, hemoptysis and/or weight loss were interviewed by a structured questionnaire. After thorough clinical examination, blood sugar, complete blood count (CBC), ESR, sputum for bacteriological culture and acid fast bacilli (AFB) (3 samples), X-ray chest were done. The diagnosis of PTB was based on a positive sputum AFB test, a suggestive CBC report or typical radiographic findings with high clinical probability. Diagnosed PTB cases were included in the study. All patients were followed up at least at1st, 3rd and 6th month of antitubercular therapy. Result: Mean age of study subjects was 46(19-75) years. The study subjects do not have past history of tuberculosis. Most of the study subjects (98.6%) were on insulin for treatment of diabetes. Mean body mass index (BMI) was 19.9kg/m². Mean ESR (mm in 1st hour) was 94.5 with 60% subjects having ESR >100. Sputum for bacteriological culture revealed no growth in 77.3% patients. Chest X-ray revealed cavity in 47.2%, opacity in 40.3%, both opacity and cavity in 5.6 %, pleural effusion in 5.6% and 5.5% had no detectable lesion. All patients were sputum AFB positive and among them 73.6% (n=53) had AFB positive in all 3 samples. Most of the patients (n=62, 86.6%) become sputum AFB negative after one month of treatment initiation. Rest 10 subjects (13.4%) become sputum negative in 2 months follow up and all of these patients had cavitary lesions in chest X-rays. A good number of the patients (98%) with positive x-ray finding showed radiological improvement after 2 months of antitubercular treatment. All the patients completed their therapy without any interruption for 6 months. Conclusion: Pulmonary cavity and opacity is the commonest radiological finding among study subjects. Sputum positivity for AFB is a good diagnostic tool for PTB in diabetic subjects. Subjects with cavitary lesion in chest X-ray become sputum negative than others. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18545 Birdem Med J 2014; 4(1): 5-8

H1N1 Status Cannot Be Reliably Predicted by Chest X-ray and Complete Blood Count Findings

2015 ◽  
Vol 23 (1) ◽  
pp. 36-38
Author(s):  
Leron Domachevsky ◽  
Zvi Shimoni ◽  
Roni Molnar ◽  
Sharbell Hashoulh ◽  
Paul Froom
Keyword(s):  
Blood Count ◽  
Complete Blood Count ◽  
X Ray ◽  
Chest X Ray

scholarly journals Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

2015 ◽  
Vol 41 (4) ◽  
pp. 331-342 ◽  
Author(s):  
Alexandre Melo Kawassaki ◽  
Daniel Antunes Silva Pereira ◽  
Fernando Uliana Kay ◽  
Ieda Maria Magalhães Laurindo ◽  
Carlos Roberto Ribeiro Carvalho ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Smoking Status ◽  
Pulmonary Involvement ◽  
Diagnostic Methods ◽  
Test Results ◽  
Cross Sectional ◽  
X Ray ◽  
Significant Difference ◽  
History Of ◽  
Chest X Ray

AbstractObjective: To determine whether simple diagnostic methods can yield relevant disease information in patients with rheumatoid arthritis (RA).Methods: Patients with RA were randomly selected for inclusion in a cross-sectional study involving clinical evaluation of pulmonary function, including pulse oximetry (determination of SpO2, at rest), chest X-ray, and spirometry.Results: A total of 246 RA patients underwent complete assessments. Half of the patients in our sample reported a history of smoking. Spirometry was abnormal in 30% of the patients; the chest X-ray was abnormal in 45%; and the SpO2 was abnormal in 13%. Normal chest X-ray, spirometry, and SpO2 were observed simultaneously in only 41% of the RA patients. A history of smoking was associated with abnormal spirometry findings, including evidence of obstructive or restrictive lung disease, and with abnormal chest X-ray findings, as well as with an interstitial pattern on the chest X-ray. Comparing the patients in whom all test results were normal (n = 101) with those in whom abnormal test results were obtained (n = 145), we found a statistically significant difference between the two groups, in terms of age and smoking status. Notably, there were signs of airway disease in nearly half of the patients with minimal or no history of tobacco smoke exposure.Conclusions: Pulmonary involvement in RA can be identified through the use of a combination of diagnostic methods that are simple, safe, and inexpensive. Our results lead us to suggest that RA patients with signs of lung involvement should be screened for lung abnormalities, even if presenting with no respiratory symptoms.

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