Awareness and Knowledge of Carpal Tunnel Syndrome among Adult Saudi Population

Introductions: The median nerve's occasional or persistent compression or entrapment in the carpal tunnel from the wrist to the hand causes carpal tunnel syndrome (CTS). The main symptoms are pain, tingling, swelling, and loss of grip strength and function in the thumb, index finger, middle finger, and thumb of thumb. This study examined Saudi adults' awareness and understanding of Carpal Tunnel Syndrome and its link with demographics and chronic conditions. Material(s) and Method(s): This cross-sectional study examined adults' knowledge, attitudes, and practices regarding carpal tunnel syndrome from 2021 to 2022 in different Saudi Arabian regions. This study used a researcher-created questionnaire. In the awareness category, general public questions included CTS clinical aspects, etiology, and effects on daily life. Practice questions covered CTS preventive and chronic diseases. Volunteers were selected following informed consent. Result(s): 420 participants aged 34.8 +/- 13.49 years. 280 (66.6%) were male, 140 (33.3%) females. 38 (9.04%) were non-Saudi workers, while 384 were Saudis. 235 (55.9%) individuals knew about wrist CTS and 161 (38.3%) about pain. 157 (37.3%) individuals experienced thumb tingling or numbness, while 117 and 142 agreed that CTS may produce thumb weakness (27.8%) and hand grip (35.2%). The older age group reported more thumb numbness or tingling than the other groups, although there was no statistical difference (p= 0.09). CTS was not associated with chronic disease;however, diabetes was the main comorbidity in all age groups (44;45.3%), especially in the middle age group (21;60%). 5.4% had CTS. CTS was rare during pregnancy (0.7%), however all age groups agreed that it could influence their employment and social life (p= 0.014 and < 0.00001). The average knowledge score was 43.3 +/- 40.5, whereas the awareness score was 50.1 +/- 44.2. These findings indicate that Saudis were aware of CTS clinical symptoms. Conclusion(s): The study examined Saudi adults' awareness and understanding of CTS and estimated the association between CTS and demographics and chronic conditions. The study found that adult CTS awareness and knowledge were sufficient and associated with age and quality of life. CTS awareness campaigns may lower risk and raise knowledge of prevention and treatment. People who work with discomfort or use computers for long periods of time without breaks are more prone to develop CTS. Larger research is needed to understand how physical exercise causes CTS.Copyright © 2023, Ibn Sina Trust. All rights reserved.

Lung ultrasound in the COVID-19 era: a lesson to be learned for the future.

Lung Ultrasound (LUS) is a reliable, radiation free and bedside imaging technique to assess several pulmonary diseases. Although the diagnosis of COVID-19 is made with the nasopharyngeal swab, detection of pulmonary involvement is key for a safe patient management. LUS is a valid alternative to explore, in paucisymptomatic self-presenting patients, the presence and extension of pneumonia compared to High Resolution Computed Tomography (HRCT) that represent the gold standard. This is a single-centre prospective study with 131 patients enrolled. Twelve lung areas were explored reporting a semiquantitative assessment to obtain the LUS score. Each patient performed reverse-transcription polymerase chain reaction test (rRT-PCR), hemogasanalysis and HRCT. We observed an inverse correlation between LUSs and pO2, P/F, SpO2, AaDO2 (p value < 0.01), a direct correlation with LUSs and AaDO2 (p value < 0.01). Compared with HRCT, LUS showed sensitivity and specificity of 81.8% and 55.4%, respectively, and VPN 75%, VPP 65%. Therefore, LUS can represent an effective alternative tool to detect pulmonary involvement in COVID-19 compared to HRCT.

Impact of admission viral load on respiratory outcomes in hospitalized SARS-CoV-2 infected patients with cancer and without cancer: A 2-, 4- and 6-months follow-up prospective study.

BACKGROUND: This prospective follow-up study aimed to determine the temporal changes in respiratory outcomes over 6 months period in patients with and without cancer hospitalized for severe COVID-19 and to determine the associated risk factors based on admission viral load. METHODS: All adult patients hospitalized with a confirmed diagnosis of severe SARS-CoV-2 infection were investigated using rRT-PCR on nasopharyngeal swab specimens. Patients were divided into three arbitrary groups according to their cycle threshold (CT) values obtained at admission as high (CT<25.0), medium (CT between 25.0 and 30.0), and low (CT>30.0) viral load. Patients had pulmonary function tests, chest high-resolution computed tomography (HRCT), and a 6-minute walking time distance measured at each follow-up visit. RESULTS: This follow-up study had a total of 112 participants, of which 75 were cancer-free and 37 had active cancer. Overall, 29.5% had a low viral load, compared to 48.2% who had a high viral load, and 22.3% had a medium viral load. For patients who did not have cancer, the mean age was 57.3 (SD 15.4) and for those who had cancer, it was 62.3 (SD 18.4). Most patients had overall better temporal changes in pulmonary function and tolerance, as well as exercise capacity, even though severe and chronic respiratory abnormalities persisted in a fraction of the patients. In patients without cancer who had a high viral load, we have seen a substantial reduction in diffusion capacity of the lungs for carbon monoxide (DLCO) predicted value with a median of 65 (IQR 63-70) while in patients with cancer, it was 60 (IQR 56-67) at 2 months. At 4 and 6 months, the predicted DLCO values for patients without cancer were 65 (IQR 61-70), whereas the predicted DLCO values for patients with active cancer were 62 (IQR 60-67) and 67 (59-73). Importantly, radiological abnormalities persisted in 22 (29%) non-cancer patients and 16 (43%) cancer patients. Multivariate regression analysis showed an increased odds ratio of impaired HRCT associated with a high viral load of 3.04 (95% CI:1.68-6.14; p < 0.001) for patients without cancer and 5.07 (95% CI: 4.04-10.8; p < 0.0001) for patients with cancer. The CT pneumonia score at hospitalization was 2.25 (95% CI:1.76-3.08; p = 0.041) and 2.85 (95% CI:1.89-5.14; p = 0.031) for non-cancer and cancer patients respectively. CONCLUSIONS: The evidence of persistent pulmonary abnormalities and radiographic changes was found in both patient groups who had high viral load at hospital admission and suggesting that SARS-CoV-2 viral load might serve as a useful indicator to predict the development of respiratory complications in patients with COVID-19.

CLINICO-RADIOLOGICAL EVALUATION AND CORRELATION OF HRCT CHEST IMAGING FINDINGS WITH DISEASE STATUS IN COVID-19 PATIENTS

Background: High-resolution computed tomography (HRCT) chest is rapid and has a strong sensitivity for diagnosing viral pneumonia including COVID 19 disease in its early stages in comparison to RT-PCR, thus being crucial in triaging patients for treatment and isolation, to prevent further transmission of the disease. In this study we are going to analyse the temporal changes in imaging findings of COVID-19 on HRCT chest. Methods: prospective study was conducted in the Department of Radiology of an exclusive 500 bedded COVID Hospital in Bhubaneswar, Odisha, India. Evaluation of hundred patients was done based on inclusion and exclusion criteria, after obtaining informed consent over a period of 2 years from September 2020 to September 2022. All pertinent epidemiological data was gathered from hospital records. All COVID 19 RT-PCR positive patients who underwent HRCT Chest on admission and repeat scan within 30 days, following the progression of the disease were included. Those who were clinically suspected COVID cases but were RT PCR negative on RT-PCR testing, were excluded. Results: HRCT chest demonstrated diffuse ground glass opacities to be the predominant finding (55%) with the associated findings of sub pleural atelectatic bands (31%) and septal thickening (23%). There was a positive correlation of blood parameters like CRP in COVID patients. A higher incidence was found in patients with Type-2 diabetes mellitus, followed by those with hypertension. In majority of the cases (80%) bilateral lungs and in about 81% cases, two or more lung lobes were involved. Mild and moderately ill patients were found to have a CTSS (CT severity score) in the score range of 15-25. Typical category was the most common type followed by atypical and indeterminate categories. Conclusions: 'Typical pattern' along with diffuse ground glass opacities of multiple lobes in the HRCT chest was the most common pattern of lung involvement. High Computer Tomography Severity Score (CTSS) corresponds to a higher disease severity, which helps in taking a timely decision for early treatment. HRCT Thorax has early and fast diagnostic capability as compared to RT-PCR in the detection of COVID-19. The elderly and those with comorbidities are at a higher risk of developing severe disease. Blood parameters like CRP can be used for disease monitoring and follow-up purposes. [ FROM AUTHOR] Copyright of Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research) is the property of Journal of Cardiovascular Disease Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Artificial intelligence guided HRCT assessment predicts the severity of COVID-19 pneumonia based on clinical parameters.

BACKGROUND: The purpose of the study was to compare the results of AI (artificial intelligence) analysis of the extent of pulmonary lesions on HRCT (high resolution computed tomography) images in COVID-19 pneumonia, with clinical data including laboratory markers of inflammation, to verify whether AI HRCT assessment can predict the clinical severity of COVID-19 pneumonia. METHODS: The analyzed group consisted of 388 patients with COVID-19 pneumonia, with automatically analyzed HRCT parameters of volume: AIV (absolute inflammation), AGV (absolute ground glass), ACV (absolute consolidation), PIV (percentage inflammation), PGV (percentage ground glass), PCV (percentage consolidation). Clinical data included: age, sex, admission parameters: respiratory rate, oxygen saturation, CRP (C-reactive protein), IL6 (interleukin 6), IG - immature granulocytes, WBC (white blood count), neutrophil count, lymphocyte count, serum ferritin, LDH (lactate dehydrogenase), NIH (National Institute of Health) severity score; parameters of clinical course: in-hospital death, transfer to the ICU (intensive care unit), length of hospital stay. RESULTS: The highest correlation coefficients were found for PGV, PIV, with LDH (respectively 0.65, 0.64); PIV, PGV, with oxygen saturation (respectively - 0.53, -0.52); AIV, AGV, with CRP (respectively 0.48, 0.46); AGV, AIV, with ferritin (respectively 0.46, 0.45). Patients with critical pneumonia had significantly lower oxygen saturation, and higher levels of immune-inflammatory biomarkers on admission. The radiological parameters of lung involvement proved to be strong predictors of transfer to the ICU (in particular, PGV ≥ cut-off point 29% with Odds Ratio (OR): 7.53) and in-hospital death (in particular: AIV ≥ cut-off point 831 cm3 with OR: 4.31). CONCLUSIONS: Automatic analysis of HRCT images by AI may be a valuable method for predicting the severity of COVID-19 pneumonia. The radiological parameters of lung involvement correlate with laboratory markers of inflammation, and are strong predictors of transfer to the ICU and in-hospital death from COVID-19. TRIAL REGISTRATION: National Center for Research and Development CRACoV-HHS project, contract number SZPITALE-JEDNOIMIENNE/18/2020.

Impact of Covid-19 on Endoscopic Demography: A Cross Sectional Study

Background: Pandemics are never easy to deal with, especially this new covid pandemic which has exposed the vulnerability and multiple lacunae in our existing health care. In this midst of chaos and uncertainty delivering endoscopic services had become a nightmare, as endoscopy is a procedure done in the aero digestive tract and also an aerosol generating procedure. This led to a lot of enigma and skepticism in selection of patients and precautions to be taken while performing procedures. Objective(s): To Know the Feasibility and Utility of endoscopy as diagnostic and therapeutic services in Covid pandemic in the midst of chaos and uncertainties. Material(s) and Method(s): It is a retrospective study conducted from May 2020 to December 2020 in a Tertiary care Gastro hospital. Patients were screened clinically by Questionnaire highlighting the travel history, contact history, and residing history (hot spots for covid). X-Ray, HRCT and RT-PCR was done to exclude high risk cases. Clinical screening for symptoms, Vitals, Spo2 was done on all the patients. The procedures were performed using standard endoscopy equipment with appropriate COVID 19 protocols. Result(s): One thousand two hundred and eighty (1280) patients aged between 20 years to > 70 years were referred and undertake upper and lower GI endoscopy in a Tertiary Care gastro hospital. Majority of the cases who underwent endoscopy were in the age group 31-40 years 317 (24.8%). They comprised of 59.9% males and 40.1% females. Common endoscopic diagnoses were Gastric erosions 31.4% followed by Normal Upper gastrointestinal endoscopy (UGIE) / Lax Gastroesophageal (GE) Junction 17.4%. The most common symptom was dyspepsia seen in 725 (56.6%) of the patients, followed by dysphagia in 92 (7.2%), abdominal discomfort 64 (5%). Conclusion(s): This study highlights, with proper history and clinical screening and appropriate precautions it was possible to provide endoscopy service to the needy without a strict protocol and expensive pre-endoscopy work up like HRCT and RT-PCR for all patients, without compromising patient or staff safety. Patients with alarm symptoms like Dysphagia and GI Bleed benefited the most, many patients with functional GI Disorders also were reassured with negative endoscopy and counseling. As during these times, people were in panic mode with all negative things happening around;many of these functional patients with overlap anxiety disorders were scared to death. A positive diagnosis is very important while managing most of these GI disorders.Copyright © 2022 Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

Short-term follow-up HRCT Chest of COVID-19 survivors and association with persistent dyspnea

BackgroundThere is an increasing concern that a proportion of the survivors of COVID 19 might develop fibrotic and/or other non-reversible lung changes. The aim of this retrospective study was to review the imaging findings of HRCT of lungs in a cohort of COVID 19 survivors, coming for short-term clinical follow-up and to assess the relation of the observed HRCT changes with the presence of dyspnea.ResultsIn total, 40 patients with residual CT findings were included in this study with a mean age of 44.3 years and male: female ratio of 3:2. The presence of residual ground-glass opacities (85%) and reticular opacities (80%) was the most common findings. 25% of the cases had cystic changes in their lung. The presence of dyspnea was significantly associated with male sex and a history of smoking. On HRCT, the presence of cystic changes, involvement of > 10 lung segments, and an HRCT severity score > 7 were significantly associated with dyspnea.ConclusionSurvivors of COVID 19 demonstrate persistent changes in the lung on HRCT. We recommend that a follow-up HRCT should be performed in these patients to identify those with post-COVID sequelae.

Lung Ultrasound (LUS) in COVID-19 Pneumonia: Usefulness in Two Atypical Cases.

Clinical experience and scientific articles have shown that patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be paucisymptomatic or asymptomatic at the time of diagnosis. In this paper, we will discuss two paucisymptomatic patients with blood tests suggestive for SARS-CoV-2 infection but with repeated negative nasopharyngeal swabs and without typical features of COVID-19 pneumonia on chest high-resolution computed tomography. In these cases, lung ultrasound helped to raise clinical suspicion of COVID-19 pneumonia and facilitate diagnosis. LEARNING POINTS: During the current COVID-19 pandemic, lung ultrasound (LUS) is being used extensively to evaluate and monitor lung damage in infected patients.Several patients have been described with negative PCR swabs who tested positive for SARS-CoV-2 in bronchoalveolar lavage fluid.Typical signs of interstitial pneumonia on LUS strongly indicate COVID-19 pneumonia, thus suggesting further investigation and invasive tests to confirm the diagnosis.

Ultra-low-dose chest CT protocol during the second wave of COVID-19 pandemic: a double-observer prospective study on 250 patients to evaluate its detection accuracy

BackgroundWhile the second wave of COVID-19 pandemic almost reached its climax, unfortunately, new viral strains are rapidly spreading, and numbers of infected young adults are rising. Consequently, chest high-resolution computed tomography (HRCT) demands are increasing, regarding patients' screening, initial evaluation and follow up. This study aims to evaluate the detection accuracy of ultra-low-dose chest CT in comparison with the routine low-dose chest CT to reduce the irradiation exposure hazards.ResultsThis study was prospectively conducted on 250 patients during the period from 15th December 2020 to 10th February 2021. All of the included patients were clinically suspected of COVID-19 infection. All patients were subjected to routine low-dose (45 mAs) and ultra-low-dose (22 mAs) chest CT examinations. Finally, all patients had confirmatory PCR swab tests and other dedicated laboratory tests. They included 149 males and 101 females (59.6%:40.4%). Their age ranged from 16 to 84 years (mean age 50 ± 34 SD). Patients were divided according to body weight;104 patients were less than 80 kg, and 146 patients were more than 80 kg. HRCT findings were examined by two expert consultant radiologists independently, and data analysis was performed by other two expert specialist and consultant radiologists. The inter-observer agreement (IOA) was excellent (96–100%). The ultra-low-dose chest CT reached 93.53–96.84% sensitivity and 90.38–93.84% accuracy. The signal-to-noise ratio (SNR) is 12.8:16.1;CTDIvol (mGy) = 1.1 ± 0.3, DLP (mGy cm) = 42.2 ± 7.9, mean effective dose (mSv/mGy cm) = 0.59 and absolute cancer risk = 0.02 × 10-4.ConclusionUltra-low-dose HRCT can be reliably used during the second wave of COVID-19 pandemic to reduce the irradiation exposure hazards.

The value of lung ultrasound in COVID-19 pneumonia, verified by high resolution computed tomography assessed by artificial intelligence.

BACKGROUND: Lung ultrasound (LUS) is an increasingly popular imaging method in clinical practice. It became particularly important during the COVID-19 pandemic due to its mobility and ease of use compared to high-resolution computed tomography (HRCT). The objective of this study was to assess the value of LUS in quantifying the degree of lung involvement and in discrimination of lesion types in the course of COVID-19 pneumonia as compared to HRCT analyzed by the artificial intelligence (AI). METHODS: This was a prospective observational study including adult patients hospitalized due to COVID-19 in whom initial HRCT and LUS were performed with an interval < 72 h. HRCT assessment was performed automatically by AI. We evaluated the correlations between the inflammation volume assessed both in LUS and HRCT, between LUS results and the HRCT structure of inflammation, and between LUS and the laboratory markers of inflammation. Additionally we compared the LUS results in subgroups depending on the respiratory failure throughout the hospitalization. RESULTS: Study group comprised 65 patients, median 63 years old. For both lungs, the median LUS score was 19 (IQR-interquartile range 11-24) and the median CT score was 22 (IQR 16-26). Strong correlations were found between LUS and CT scores (for both lungs r = 0.75), and between LUS score and percentage inflammation volume (PIV) (r = 0.69). The correlations remained significant, if weakened, for individual lung lobes. The correlations between LUS score and the value of the percentage consolidation volume (PCV) divided by percentage ground glass volume (PGV), were weak or not significant. We found significant correlation between LUS score and C-reactive protein (r = 0.55), and between LUS score and interleukin 6 (r = 0.39). LUS score was significantly higher in subgroups with more severe respiratory failure. CONCLUSIONS: LUS can be regarded as an accurate method to evaluate the extent of COVID-19 pneumonia and as a promising tool to estimate its clinical severity. Evaluation of LUS in the assessment of the structure of inflammation, requires further studies in the course of the disease. TRIAL REGISTRATION: The study has been preregistered 13 Aug 2020 on clinicaltrials.gov with the number NCT04513210.

Patients with Diabetes Experienced More Serious and Protracted Sickness from the COVID-19 Infection: A Prospective Study.

Background and Objectives: In December 2019, a flu-like illness began in the Chinese city of Wuhan. This sickness mainly affected the lungs, ranging from a minor respiratory tract infection to a severe lung involvement that mimicked the symptoms of Severe Acute Respiratory Syndrome (SARS). The World Health Organization (WHO) labelled this sickness as a pandemic in March 2020, after it quickly spread throughout the world population. It became clear, as the illness progressed, that people with concomitant illnesses, particularly diabetes mellitus (DM) and other immunocompromised states, were outmatched by this illness. This study was aimed to evaluate the correlation between Computed Tomographic Severity Score (CTSS) and underlying diabetes mellitus in coronavirus disease (COVID)-19 patients. Materials and Methods: This was a hospital-based prospective study in which a total of 152 patients with reverse transcriptase polymerase chain reaction (RT-PCR) positive COVID status who underwent high-resolution computed tomography (HRCT) of the chest were evaluated and categorized into mild, moderate and severe cases based on the extent of lung parenchymal involvement. A total score from 0-25 was given, based on the magnitude of lung involvement. Statistical analysis was used to derive a correlation between DM and CTSS, if any. Results: From our study, it was proven that patients with underlying diabetic status had more severe involvement of the lung as compared to non-diabetics, and it was found to be statistically significant (p = 0.024). Conclusions: On analysis of what we found based on the study, it can be concluded that patients with underlying diabetic status had a more prolonged and severe illness in comparison to non-diabetics, with higher CTSS in diabetics than in non-diabetics.

Residual Lung Abnormalities Following COVID-19 Hospitalization: Interim Analysis of the UKILD Post-COVID Study.

RATIONALE: Shared symptoms and genetic architecture between COVID-19 and lung fibrosis suggests SARS-CoV-2 infection may lead to progressive lung damage. OBJECTIVES: The UKILD Post-COVID study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 based on risk strata. METHODS: The Post-HOSPitalisation COVID Study (PHOSP-COVID) was used for capture of routine and research follow-up within 240 days from discharge. Thoracic CTs linked by PHOSP-COVID identifiers were scored for percentage of residual lung abnormalities (ground glass opacities and reticulations). Risk factors in linked CT were estimated with Bayesian binomial regression and risk strata were generated. Numbers within strata were used to estimate post-hospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol driven research follow-up. MEASUREMENTS AND MAIN RESULTS: The interim cohort comprised 3700 people. Of 209 subjects with linked CTs (median 119 days, interquartile range 83-155), 166 people (79.4%) had >10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (RR 1·21 95%CrI 1·05; 1·40), percent predicted DLco<80% (RR 1·25 95%CrI 1·00; 1·56) and severe admission requiring ventilation support (RR 1·27 95%CrI 1·07; 1·55). In the remaining 3491 people, moderate to very-high risk of residual lung abnormalities was classified in 7·8%, post-hospitalization prevalence was estimated at 8.5% (95%CrI 7.6%; 9.5%) rising to 11.7% (95%CrI 10.3%; 13.1%) in sensitivity analysis. CONCLUSIONS: Residual lung abnormalities were estimated in up to 11% of people discharged following COVID-19 related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).

Co-infection of SARS-CoV-2 with other respiratory pathogens in patients with liver disease.

Respiratory illness caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was first documented in Wuhan, China, in December 2019, followed by its rapid spread across the globe. Accumulating evidence has demonstrated viral/bacterial co-infection in the respiratory tract could modulate disease severity and its outcome in COVID-19 infection. In this retrospective study, 300 chronic liver disease patients with radiologically confirmed lower respiratory tract infection were enrolled from September 2020 to December 2021. In all of them, along with SARS-CoV-2, other respiratory viral/bacterial pathogens were studied. In total, 23.7 % (n=71) patients were positive for SARS-CoV-2. Among the positive patients, 23.9 % (n=17) had co-infection with other respiratory pathogens, bacterial co-infections being dominant. The SARS-CoV-2 negative cohort had 39.7  % positivity (n=91) for other respiratory pathogens, the most common being those of the rhinovirus/enterovirus family. Ground glass opacity (GGO) with consolidation was found to be the most common radiological finding among SARS-CoV-2 positive co-infected patients, as compared to only GGO among SARS-CoV-2 mono-infected patients. Accurate diagnosis of co-infections, especially during pandemics including COVID-19, can ameliorate the treatment and management of suspected cases.

Comparative Study of COVID-19 Pneumonia in First and Second Waves

Background: The main aim of the study was to evaluate the different parameters of the COVID-19 pneumonia in India during the first and second waves.Method: Five hundred RT-PCR positive and HRCT documented COVID-19 pneumonia patients each from first wave (June 2020-December 2020) and second wave (March 2021-May 2021) were selected. The results were evaluated in terms of age groups affected, gender wise distribution, and CT severity score on HRCT. The final conclusion was done by comparing these variables from first wave with the ones during the second wave and inferences drawn upon thereof. Results: During the first wave, majority of the population involved belonged to more than 45years category whereas during the second wave majority belonged to the 18-45years category. Further, the severity of the disease was more during the second wave than the first wave with more males being affected than females in both the waves.Conclusion: Second COVID-19 wave in India was more severe than the first wave in terms of the number of patients affected as well as the severity of the pneumonia in the involved patients, likely due to continuously mutating variants of the virus & lifting up of the restrictions. © 2023 JK Science.

Pattern of Lung Involvement in Predicting Severity and Sequelae in Patients With COVID-19.

Background During the COVID pandemic, high-resolution CT scan has played a pivotal role in detecting lung involvement and severity based on the segments of the lung involved. The pattern of involvement was not considered, and our aim is to observe the pattern of lung involvement in predicting severity and guiding management protocol in patients with COVID-19. Methodology It was a prospective observational study conducted with 151 patients admitted with COVID-19 with a positive reverse transcriptase polymerase chain reaction test (RT-PCR) in a single tertiary care hospital in south India. Patients with pre-existing lung pathologies were excluded from the study. Eligible patients were then divided into mild, moderate, and severe categories based on Indian Council of Medical Research (ICMR) guidelines, and high-resolution computed tomography (HRCT) chest was done, findings of which were then categorized based on lung involvement; into ground glass opacities (GGO), interstitial involvement and mixture of both. These were then analyzed to determine their importance with respect to the duration of stay and severity of the disease. Results The data collected was analyzed by IBM SPSS software version 23.0 (IBM Corp., Armonk, NY, USA). The study population included 114 males (75.5%) and 37 females (24.5%). HRCT chest was done which showed 62.3% of patients had GGO, 14.6% had interstitial lung involvement, 18.5% had a mixture of both and 4.6% had normal lung findings. These findings, when compared to clinical categories of severity, showed a significant co-relation between pattern of involvement of the lung and the severity of the disease. It also showed significant co-relation with the duration of stay. Conclusion HRCT chest has proven to be useful in the determination of patient's severity and can guide with management. We suggest earlier initiation of steroids and anticoagulants in patients with interstitial involvement even for the patients not on oxygen therapy yet. It can be used as a triage modality for screening due to the advantage of presenting with immediate results as opposed to RT-PCR which might take hours and can delay treatment which can prevent worsening.

High Resolution Computed Tomography Manifestations in Covid-19 Suspected and Diagnosed Patients

Aim: To study the High Resolution Computed Tomography manifestations in the evaluation of COVID-19 suspected and diagnosed patients and study its correlation in respect to CT severity scoring with symptomology, comorbidities, lab parameters and oxygen requirement in the study group. Method(s): This was a descriptive study conducted between August 2020 to October 2022 at Dr D.Y. Patil Medical College, Hospital and Research Centre, Pune after taking necessary approval by the institutional scientific and ethics committee. 500 patients meeting the inclusion criteria for the study were included in the study after taking a written informed consent from all the patients. Result(s): A total of 500 study participants were included;of them 27% (n=133) were categorized as mild on the basis of CT severity score, 51% (n=257) were categorized as moderate and 78 participants (15.6%) were categorized as severe. Thirty two (6.4%) patients who were suspected for having COVID-19 infection and being diagnosed as COVID-19 positive on RTPCR tests showed normal HRCT scans. Our study group included 311 male and 189 female patients. Ground glass opacities were the. Most common typical CT chest manifestation in our study group seen in all of severe patients followed by 97.3% in moderate groups, 94.7% in mild group. Consolidation was seen in 55.1% of severe patients followed by 31.9% in moderate disease groups, 15.8% in mild group. Bilateral involvement of lung parenchyma on HRCT was more common and was seen to affect 84.8% (n=429) of total population there was a lower lobe preponderance in early and mild disease with the right lower lobe being the most common lobe being affected followed by the left lower lobe. In our study group, atypical findings of COVID 19 disease on HRCT were seen in 24 % (n=120) of total population. In our study groups, among the atypical findings pleural effusion is the most common atypical finding which was seen in 10.2% (n=51) of total study population followed by mediastinal lymphadenopathy which was seen in 9.2% (n=46) of total study population. The mean number of days since symptoms was highest for patients in severe disease category (7.3 days) followed by moderate group (5.3 days) and mild group (3.0 days). In our study oxygenation support was required for 64.1% of patients in severe group followed by 39.3% in moderate group and 6.8% in mild group. Conclusion(s): COVID 19 disease has had a significant negative impact on the healthcare system all across the world and CT imaging plays an important role in assessing disease severity and progression. Our study supports the use of HRCT in patients with COVID-19 infection, which could be used as a rapid and an effective gatekeeper to rule-out patients with a low likelihood of disease. Copyright © 2023 Ubiquity Press. All rights reserved.

Case study on the effect of T-AYU-HM Premium with modern medicine in severe Covid-19 Patient

Indian traditional system of medicine has a definite role in the treatment of Covid-19. This case report presents the outcome of Ayurvedic interventions along with modern medicines in a severe covid-19 infected patient with breathlessness. A patient with a history of cough, breathing difficulty and generalized weakness tested positive for the rapid antigen test and prescribed the standard treatment of care with 14 days of strict home quarantine. During follow-up, there was no clinical improvement and oxygen saturation was fluctuating and required oxygen support. Therefore, the patient sought ayurvedic intervention at the covid-19 healthcare center with supportive oxygen therapy. The patient was managed with ayurvedic intervention along with modern medicines. On the date of admission to the covid-19 care center, the patient's SpO2 72% on room air, HRCT 80-90%, and ESR, CRP, and LDH were 40(mm/hour), 11.47(mg/L), and 306(Units/L) respectively. By adhering to the integrated therapy patient's oxygen saturation and clinical profile were improved with time. On the 11th day of treatment patient, SpO2 was sustained at 95% and HRCT report was 70-80%, and clinical profile improved remarkably. The patient's HRCT after one month was50-60% compared to the previous report suggestive of remarkable improvement. The effect on inflammatory markers and oxygen saturation suggests that integration of modern medicines along with ayurvedic medicine in the patient was significant and deserves further studies. Integrating ayurvedic treatment along with modern medicine might be considered as an effective approach in the management of severe covid-19 patients. Copyright © RJPT All right reserved.

HRCT chest analysis for detection of pulmonary arterial hypertension in COVID-19 patients using convolutional neural networks

COVID-19, caused by SARS - COV 2 virus, has afflicted approximately 62.3 million people worldwide, with 1.46 million deaths around the globe by the end of November 2020. In most cases, the cause of death has been due to acute pneumonia. However, there have been cases where patients developed pulmonary arterial hypertension leading to sudden death. The virus can affect the heart in previously healthy individuals also. The severe inflammatory response in the body can affect arteries exaggerating cardiac damage. Studies recommend monitoring the cardiac conditions of POST COVID-19 patients. This paper employs a convolutional neural network (CNN) model to learn features from the standard axial slice of high-resolution chest CT. The CNN captures variation in the pulmonary artery region to determine whether a patient is at high risk of developing pulmonary arterial hypertension or not. With 86.1 % classification accuracy, the model shows a promising future for studies related to POST COVID risk analysis of heart complications. © 2022 IEEE.

Patient with Suspected COVID-19 Infection Tests Negative in Nasopharyngeal Swabs but is Confirmed by Laboratory Tests and Chest CT Scan: A Case Report

Chest CT imaging can be helpful in early diagnosis of COVID-19 instead of relying on real time polymerase chain reaction (RT-PCR) that can give false negative result. Nasopharyngeal samples from a 22 years old man were detected as negative for COVID-19 for consecutive three RT-PCR tests. Complete blood count (CBC), D-dimer, serum ferritin, eosinophil sedimentation rate (ESR) test, tuberculosis test, real time PCR and high-resolution computed tomography (HRCT) were done to rule out the cause of flu like symptoms. HRCT reveals a haze area in the right perihilar region adjacent to medial part of horizontal fissure on the 3rd day of manifestation of symptoms. Radiological studies showed early consolidation of COVID-19 whereas RT-PCR showed negative results. Chest CT imaging is a highly sensitive technique that has also been used in detection of corona virus. This case study emphasizes the importance of HRCT for early and confirm diagnosis of COVID-19 whereas RT-PCR results can vary. This process may show negative results and is time consuming. Copyright 2023 by the authors. Licensee Zoological Society of Pakistan.