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Background & objectives: As severe COVID-19 and mortality are not common in children, there is a scarcity of data regarding the cause of mortality in children infected with SARS-CoV-2. This study was aimed to describe the all-cause mortality and COVID-19 death (disease-specific mortality) in children with SARS-CoV-2 infection admitted to a paediatric COVID facility in a tertiary care centre. Methods: Data with respect to clinical, epidemiological profile and causes of death in non-survivors (0-12 yr old) of SARS-CoV-2 infection admitted to a dedicated tertiary care COVID hospital in north India between April 2020 and June 2021 were retrieved and analyzed retrospectively. Results: A total of 475 SARS-CoV-2–positive children were admitted during the study period, of whom 47 died [18 neonates, 14 post-neonatal infants and 15 children (1-12 yr of age)]. The all-cause mortality and COVID-19 death (disease-specific mortality) were 9.9 per cent (47 of 475) and 1.9 per cent (9 of 475), respectively. Underlying comorbidities were present in 35 (74.5%) children, the most common being prematurity and perinatal complications (n=11, 24%) followed by congenital heart disease (n=6, 13%). The common causes of death included septic shock in 10 (21%), COVID pneumonia/severe acute respiratory distress syndrome in nine (19%), neonatal illnesses in eight (17%), primary central nervous system disease in seven (15%) and congenital heart disease with complication in six (13%) children. Interpretation & conclusions: Our results showed a high prevalence of underlying comorbidities and a low COVID-19 death (disease-specific mortality). Our findings highlight that mortality due to COVID-19 can be overestimated if COVID-19 death and all-cause mortality in children infected with SARS-CoV-2 are not separated. Standardized recording of cause of death in children with SARS-CoV-2 infection is important.
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Abstract Introduction COVID-19 has been one of the worst pandemics faced by the human civilization, and otorhinolaryngological manifestations are commonly seen in this disease. Objective The present study was done to profile the ear, nose, and throat (ENT) manifestations in patients diagnosed with COVID-19. An attempt has also been made to assess whether there was any difference between the symptoms of different strains of COVID-19. A brief review of the current knowledge of the transmission of the disease and its treatment has also been done. Methods A cross-sectional, record-based study was conducted in a COVID hospital of India between May and July 2020. Descriptive statistics were used and appropriate parametric/nonparametric tests were applied to assess the association between various variables. Results Out of 250 patients, 80 cases were asymptomatic and 170 were symptomatic. Most of the symptomatic patients had sore throat and nasal congestion. Conclusion Knowledge of the ENT manifestations of COVID-19 is essential for its early identification and to devise appropriate prevention protocols for the benefit of health care workers (HCWs) and of the general population.
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Introduction: In the intact wrist, three dimensional motionsof the carpal bones has been reported as a screw displacementaxis representation of the motion as the angular motion ofthe bones or as translations between the bones, however thelatter has frequently been quantified as a displacement in thedirection of the screw axis. Current research aimed to establishcorrelation between global wrist laxity and movement of thescaphoid and the lunate in various places during radio ulnardeviation of the wrist.Material and methods: The proposed study was a prospectivestudy conducted in the Department of Orthopedics, RMCH,Bareilly, UP, comprising 100 healthy volunteers with equal sexration who never had any symptoms pertaining to their wristjoint. An informed written consent was obtained. Standardposterolateral and true lateral radiograph of wrist were madeto exclude any radiological abnormality. PA and lateralradiograph were obtained in full radial and ulnar deviation.A custom-made positioning device was used to ensure properplacement of the hand and wrist during the examination.Results: We observed that the age varied from 21 years to 40years. Radial deviation varied from 10 to 25 degree with meanof 18.06 degree. Ulnar deviation varied from 25 to 60 degreewith mean of 36.51 degree. Laxity score varied from 31 to 100with mean of 64.20.Conclusion: Within the limitations of the present study,it can be concluded that the ulnar deviation of the wrist isseen to cause radial translation ad dorsal rotation of theproximal carpal row. Similarly, the radial deviation was seento cause ulnar translation and volar rotation of the proximalcarpal row.
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Introduction:In a clinical laboratory, consistency of test results cannot be solely achieved by controlling the accuracy in the analytical phase of glucose estimation alone. Considering the high chances of pre-analytical errors, due consideration has to be given for storage criteria as well.Aims: Aim is to find out the quantitative alterations and the useful time interval between collection and analysis and the effect of temperature on the laboratory results of plasma glucose.Study Design:Cross sectional study.Place and Duration of Study:Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru between 2015 and 2016.Methodology:In this study, 17 apparently healthyvolunteers aged 20-30 years wereenrolled with their consent.Plasma glucose levels were estimated by glucose oxidase-peroxidase kit method in semi-autoanalyzer at different temperatures and at different time intervals after collection and at room temperature but separating plasma at different time intervals and correlating it with the initial value.Results:The mean of plasma glucose when estimated immediately after separation of plasma was 78.16 ± 13.28 mg/dL. Only when glucose was estimated within 2hrs when stored at 2-8° Celsius after plasma separation (71.57 ±12.64), non-significant difference was noted(p value –0.696) otherwise as the temperature and time interval for estimation increases, the value of glucose decreases significantly. The effect of delayed separation of plasma showed that as the time of separation increases the value of glucose decreases significantly in the sample.Conclusion:Most mistakes occur before the samples are analysed, either during sampling or preparation for analysis. Thus, proper storage temperature and time must be considered for plasma glucose estimation, if measurement cannot be done immediately
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Introduction: As the wrist moves to ulnar deviation, theproximal carpal row undergoes radial translation, dorsalrotation and supination. Similarly, the radial deviationinvolves ulnar translation of the proximal carpal row, its volarrotation and pronation. These combined movements of theproximal carpal row are called rotational shift of the carpus.Study aimed to quantify the rotational shift of the proximalcarpal row during ulnar or radial deviation of the wrist.Material and methods: The proposed study was a prospectivestudy conducted in the Department of Orthopedics, RMCH,Bareilly, UP comprising 100 healthy volunteers with equal sexration who never had any symptoms pertaining to their wristjoint. PA and lateral radiograph were obtained in full radialand ulnar deviation. A custom-made positioning device wasused to ensure proper placement of the hand and wrist duringthe examination.Results: In the present study, we observed that theradioscaphoid angle in radiation deviation varied from 50to 85 degree with mean of 68.96 degree. Radioulnate anglein radial deviation varied from -2 to 45 degree with mean of17.79 degree. Radioscaphoid angle in ulnar deviation variedfrom 10 to 70 degree with mean of 39.97 degree. Radioulnateangle in ulnar deviation varied from -3 to -38 degree withmean of -17.15 degree.Conclusion: Within the limitations of the present study, itcan be concluded that the ulnar deviation of the wrist is seento cause radial translation ad dorsal rotation of the proximalcarpal row. Similarly, the radial deviation was seen to causeulnar translation and volar rotation of the proximal carpal row.
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This study was aimed at investigating the nutrient and bioactive components of Annona muricataand Fagara zanthxoyloidefrom south-southern Nigeria. The roots and leaves of these plants were collected from communities within this region and an analysis of the phytochemical, mineral and vitamin components of these plant parts were carried out using standard methods. The results of the investigation revealed the a high presence of alkaloids (27.34 ± 0.15 and 12.98 ± 0.98), flavonoids (19.66 ± 0.04 and 3.71 ± 0.46) and phenols (15.10 ± 0.11 and 0.07 ± 0.42) in the leaves and roots of Annona muricatawhile alkaloids (35.55 ± 0.95 and 50.90 ± 0.83), tannins (28.70 ± 0.19 and 55.37 ± 0.47) and terpenoids (18.23 ± 0.08 and 41.21 ± 0.16) were observed in leaves and roots of Fagara zanthoxyloide. Mineral analysis revealed the presence of iron (20.23 ± 0.01 and 5.21 ± 0.02), calcium (3.67 ± 0.06 and 1.59 ± 0.01), copper (2.17 ± 0.011 and 0.16 ± 0.01) and magnesium (3.04 ± 0.01 and 2.18 ± 0.005) in leaves and roots of Annona muricataand iron, copper (2.53 ± 0.011and 7.38 ± 0.017) and zinc (5.16 ± 0.02 and 5.32 ± 0.011) in leaves and roots of Fagara zanthoxyloide.The leaves and roots of both plants also showed the presence of folate (26.82±0.48 and 23.47±0.03 for A. muricata and 15.82±0.18 and 20.63±0.91 for F. zanthoxyloide) and ascorbate (31.97±0.03and 26.89±0.19 for A. muricataand13.86±0.13 and 30.21±0.01for F. zanthoxyloide) in appreciable quantities while vitamins D, E and K were also observed in minute concentrations in both plant samples. These results may thus suggest that these plants from this region as a result of their rich nutrients and bioactive compositions may play a large role in alleviating the salient nutritional, physiological and medical challenges observed among people within this region.
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Introduction:Hyperglycemia induced oxidative stress in Type 2 Diabetes Mellitus modifyvarious biomolecules to cause Diabetic Nephropathy (DN). IMA (Ischemia-Modified Albumin) is one such oxidative stress marker already examined in various clinical events but have not yet been evaluated in different stages of DN. Aim:To estimate and assess the relationship of IMA with glycemic status and lipid parameters in all stages of DN. Study Design: Cross-sectional study.Place and Duration of Study: Study was conducted at Department of Biochemistry,Kasturba Medical College Hospitals, Mangaluru conducted between 2014 and 2015 Materials andMethods:There were 60 type 2 diabeticcases and 30 healthy controls. Diabetic cases were further categorized into three equal groups on the basis of UACR (urine albumin-creatinine ratio), DN stage I having UACR less than 30 mg/g, DN stage II having UACR 30 to 300 mg/g, and DN stage III havingUACR ≥ 300 mg/g of creatinine. Using enzyme-linked immunosorbent assay serum IMA level was estimated whereas automated analyzers was used for serum creatinine, HbA1c, urine albumin and urine creatinine analysis.Results:Lowest level of IMA (109 ng/mL) measured in DN stage I, which was significantly different from those in DN stage II (154 ng/mL) and DN stage III (178 ng/mL). The significant positive correlation between IMA and fasting blood glucose, glycated hemoglobin were present in stage II and stage III DN. In this study significant positive correlation of serum IMA to serum total cholesterol, low density lipoprotein cholesterol and negative correlation with high density lipoprotein were revealed in all stage of DN. Conclusion:Current study postulates that early evaluation of serum IMA in diabetic patients with deranged lipid profile will provide an index of nephropathy development. This will help in prognosis and controlling complication in diabetes mellitus.
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Prediabetes is associated with the features of metabolic syndrome and inflammation contributing directly to the pathogenesis of cardiovascular disease (CVD). This study was conducted to explore the utility of interleukin-6 (IL-6) in determining the risk of CVD in prediabetes. It involves estimation of IL-6 & insulin along with its correlation with insulin, fasting plasma glucose (FPG), Insulin resistance (IR) and physical measurements. Eighty subjects were grouped into 40 prediabetes and 40 normoglycemic on the basis of FPG values. The mean insulin, IL-6, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and anthropometric measurements were found to be significantly higher (P <0.05) in prediabetes group. IL-6 had a significant correlation with fasting insulin (r = −0.413) and HOMA-IR (r = −0.413), but no correlation with FPG (r = −0.227) in the prediabetes group. IL-6 also showed a positive correlation with body mass index BMI(r = −0.339), waist circumference WC (r = −484) and waist-to-hip ratio WHR (r = −0.430). This study concludes that prediabetes is associated with inflammation, increasing the risk of CVD in these individuals.