Chest CT Findings and Their Temporal Evolution in COVID-19 Pneumonia.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic originated in China in November 2019 and is caused by the SARS-CoV-2 virus. The virus binds to nasal and pharyngeal epithelial cells and migrates to the lower respiratory tract. The confirmatory test for COVID-19 infection is the reverse transcription-polymerase chain reaction (RT-PCR). Chest CT plays an important role in the diagnosis, triage, and treatment of affected individuals. We describe the findings on chest CT and their temporal evolution in COVID-19 pneumonia. METHODS: We conducted a retrospective, cross-sectional study on COVID-19-positive patients who underwent chest CT. CT images of the patients were reviewed for ground-glass opacities, consolidation, crazy-paving appearance, vascular dilatation, traction bronchiectasis, architectural distortion, and subpleural and parenchymal bands. Distribution of opacities on axial sections, ancillary findings, and co-existent lung diseases were recorded. To assess the temporal evolution of CT findings, the time in days between the onset of the first symptom and the date of the CT scan of each patient was recorded. Statistical analysis was performed. RESULTS: Ground-glass opacities, consolidation, and a combination of both were the most important features in COVID-19 pneumonia. Patients in the early stage showed simple ground-glass opacities; in the progressive stage showed consolidation and ground-glass opacities with crazy-paving appearance, subpleural and parenchymal bands, and architectural distortion; in the peak stage showed progression of these findings; and in the late stage showed interval resolution of these findings. Axial distribution of these opacities was asymmetric, with peripheral subpleural predominance involving posterior, lateral, and both these locations, associated with apicobasal gradient. CONCLUSION: Chest CT permits rapid diagnosis of COVID-19 pneumonia, enabling appropriate treatment to be instituted at the earliest. Thus, it is life-saving in resource-constrained environments.

Diagnostic accuracy of high resolution ultrasound to differentiate neoplastic and non neoplastic causes of cervical lymphadenopathy.

INTRODUCTION: Lymph nodes are normal structures distributed throughout the human body and are enlarged in various disease entities. Identifying the relevant lymph nodes is important in treating these patients. High resolution sonography (HRSG) and fine needle aspiration cytology (FNAC) play crucial role in planning the treatment. OBJECTIVE: To assess the diagnostic accuracy of HRSG differentiate neoplastic and non neoplastic causes of enlarged cervical lymph nodes. MATERIALS AND METHODS: HRSG evaluation of enlarged cervical lymph nodes were performed to differentiate neoplastic from non neoplastic lymph nodes followed by FNAC correlation and the accuracy of HRSG was studied. RESULTS: One hundred and fourteen lymph nodes of 106 patients were analysed to accomplish the study objective. In our study, HRSG had 96% sensitivity and 90.6% specificity for differentiating between neoplatic and non-neoplastic cervical lymphadenopathy. Similarly positive and negative predictive values were 88.9% and 96.7% respectively. Overall accuracy of HRSG was 93%. CONCLUSION: Owing to high sensitivity and negative predictive value, HRSG with Doppler is an excellent first line investigating tool for enlarged lymph nodes and avoids invasive procedures like FNAC in cases of reactive/ inflammatory (non-neoplastic) lymph nodes. However, neoplastic diagnosis of HRSG needs further confirmation by FNAC.

Phase angle measurement in pulmonary tuberculosis patients and control subjects using bio-impedance analysis.

BACKGROUND: Bio-impedance is the measure of impedance of the body. Impedance consists of resistance and reactance. Phase angle (PA) is the tan value of the ratio of reactance versus resistance. PA depends on cell membrane integrity and on body cell mass. Earlier studies have shown a correlation between PA values and body cell mass. Body cell mass varies in chronic diseases like HIV infection, tuberculosis, cancers and chronic renal failure. AIMS: The aim of this study was to compare the PA values of tuberculosis patients (TB) with that of control subjects and to compare the anthropometric values between the groups. MATERIAL AND METHODS: Bioimpedance analysis and PA measurements were done using Bodystat Quadscan 4000 machine on 30 tuberculosis patients and controls between the age group of 18 to 50 years. RESULTS: The PA values were 5.09 +/- 1.11 degrees and 7.2 +/- 1.27 degrees in TB patients and control subjects respectively. PA values were positively correlated with Body mass index (BMI) in TB patients and control (r = 0.42 and 0.011, both p < 0.001). Mean difference and its 95% confidence interval between groups for PA were -2.11 (-2.72, -1.49), for weight -13.9 (-18.1, -9.7), for BMI -5.65 (-7.1, -4.2), for corrected arm muscle area (CAMA) -9.91 (-13.2, -6.6) and for impedance 152.6 (106.6, 198.6). PA, weight, BMI and CAMA were significantly higher in control subjects and impedance was lower in control groups using independent sample t test. CONCLUSIONS: PA and nutritional status were significantly low in TB patients as compared with control subjects.

Phase Angle Measurement in Healthy Human Subjects through Bio-Impedance Analysis.

OBJECTIVES: Bioelectrical impedance is the measure of impedance of the body. Impedance consists of electric resistance and reactance. Phase angle (PA) is the tan value of the ratio of reactance versus electric resistance. PA depends on cell membrane integrity and on body cell mass. There exists a correlation between PA values and body cell mass. The objective of this study was to compare the PA values of normal individuals and their anthropometric measurements. MATERIALS AND METHODS: Anthropometric measurements, Bioelectrical impedance analysis and PA measurements were done using Bodystat Quadscan 4000 machine on 42 healthy subjects between the age group of 18 to 50 yrs at a private hospital, Bangalore, Karnataka, India for eight months. Kolmogrov-Smirnov and Pearson's correlation tests were used for data analysis. RESULTS: The PA values were 7.321.17º in healthy subjects. PA values were significantly positively correlated with body mass index (BMI) (r= 0.011, P<0.001). The phase angle values for males and females were 7.43±0.98º and 7.05±1.1.58º, respectively. CONCLUSION: PA values positively correlated with BMI indicating the nutritional status of the study group. PA values were similar to the values to found in other studies.