Ultrasonography: An Unchartered Modality in the Current Pandemic - A Study among Patients Admitted in the COVID-19 Intensive Care Unit.

BACKGROUND: The objectives were to perform an analysis of lung ultrasonography (LUS) findings in severely ill patients with novel coronavirus disease-2019 (COVID-19) and to compare the accuracy with high-resolution computed tomography (HRCT) of the thorax. METHODS: Sixty-two intensive care unit (ICU) patients with COVID-19 were evaluated during their hospital stay. LUS was performed with convex and linear transducers using a designated ultrasonography machine placed in the COVID-19 ICU. The thorax was scanned in 12 areas. Initial LUS was performed on admission and follow-up LUS was done in 7 (mean) days. At the time of the initial LUS, HRCT was performed in 28/62 patients and a chest radiography in 19/62 patients. RESULTS: On admission, LUS detected pleural line thickening (>6 lung areas) in 49/62, confluent B-lines in 38/62, and separate B-lines in 34/62, consolidation in 12/62, C prime profile in 19/62, and pleural and cardiac effusions in 4/62 and 1/62, respectively. The single beam "torchlight" artifact was seen in 16/62, which may possibly be a variation of the B-line which has not been described earlier. Follow-up LUS detected significantly lower rates (P < 0.05) of abnormalities. CONCLUSION: Ultrasound demonstrated B-lines, variable consolidations, and pleural line irregularities. This study also sheds light on the appearance of the C prime pattern and "torchlight" B-lines which were not described in COVID-19 earlier. LUS findings were significantly reduced by the time of the follow-up scan, insinuating at a rather slow but consistent reduction in some COVID-19 lung lesions. However, the lung ultrasound poorly correlated with HRCT as a diagnostic modality in COVID-19 patients.

A Comparative Evaluation of the Anxiolytic Effect of Oral Midazolam and a Homeopathic Remedy in Children During Dental Treatment.

Background Midazolam is recommended by many health standards. However, there is no compelling evidence that midazolam has anti-anxiety effects in children. Homeopathy can be one of the mainstays for effective child management while reducing negative side effects. The aim of the study was to evaluate the anxiolytic efficacy of midazolam (oral) and homeopathic remedies in children during dental treatments. Methodology The current ex-vivo study was conducted in the department of Pedodontics and Preventive Dentistry department of a private dental institution. A total of 48 children aged four to 14 years were selected based on the inclusion and exclusion criteria. The participants were evenly and randomly divided into groups A and B using the lottery method. Group A: 20 minutes previous to the treatment, a right blend of an equal volume of 0.5mg/kg injectable solution of midazolam hydrochloride. Group B: Received Aconite napellus (homeopathic remedy). Results During anxiety, the hypothalamic pituitary adrenal axis gets activated which causes a release of body fluids including salivary cortisol levels. Salivary amylase also responds quickly during stress and anxiety by increasing its levels. Midazolam is used in Dentistry to reduce anxiety as it is able to reduce salivary cortisol and amylase levels. Aconite napellus being homeopathic remedy is useful in Dentistry to reduce salivary cortisol and amylase levels which is observed in the present study. There was a decrease in salivary cortisol and amylase concentrations following midazolam (8.51 ± 6.7) (41.48 ± 23.8) and Aconite napellus (homeopathic remedy) (7.53 ± 5.2) (37.08± 22.8) administration, as well as a decrease in heart rate, systolic and diastolic blood pressure. Furthermore, all of the differences were statistically significant (p<0.05). Conclusion In children with behavioral difficulties, homeopathic remedy was marginally more successful than oral midazolam in lowering anxiety during dental treatment.

Morphological Event Based Signal Quality Assessment of Electrocardiogram.

ECG signals acquired from mobile devices by unskilled users are corrupted with several noises. Poor signal quality may result in an increased number of false alarms, degrading diagnostic performance, and increasing the burden on the doctors in decoding the information for further clinical intervention. So, it is necessary to assess the quality of the signals before doing any further processing. This paper presents a method for accessing the reliability of ECG signals obtained from wearable sensors. A morphological event-based quality assessment method is proposed where a signal will be classified as GOOD/BAD. Results show that our method can achieve an accuracy = 92 % with sensitivity = 0.98 and specificity = 0.59.

Emphysematous epididymo-orchitis: An unusual case report.

INTRODUCTION: Emphysematous epididymo-orchitis in the young to middle age groups without any comorbidity like diabetes or metabolic disorders is an uncommon entity. CASE REPORT: We present a case of a nondiabetic young patient, diagnosed with emphysematous epididymo-orchitis as a sequela to urinary tract infection. DISCUSSION: Clinically differentiating diagnoses of the acute scrotum may be difficult and ultrasound can be used reliably as the initial modality showing the presence of air for early diagnosis. CONCLUSION: Nondiabetic young patients without any metabolic disorder should also be suspected for emphysematous epididymo-orchitis in the setting of the acute scrotum. An ultrasound examination can predict its presence with confidence.

Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth.

The aim of this study was to compare the efficacy of articaine versus lidocaine, both containing epinephrine, using a single buccal infiltration for extraction of primary molars.A total of 100 children requiring primary molar extraction received buccal infiltration using either 4% articaine or 2% lidocaine, both with epinephrine, with 50 children in each group. The Wong-Baker Facial Pain Scale (FPS) was used to evaluate pain perception subjectively. The heart rate and the blood pressure values were assessed objectively as an indirect measure of physiological pain perception. The Wilcoxon-Mann-Whitney test was used for comparing mean pain scores, heart rate, and blood pressure in both the groups. Single buccal infiltration with articaine was sufficient for achieving palatal or lingual anesthesia in all the children receiving it while all children in the lidocaine group required supplemental anesthesia. The mean FPS value was found to be higher in lidocaine group and was statistically significant. The mean heart rate recorded during the intervention was less than the mean baseline values in the articaine group, which was found to be statistically significant. For pediatric patients age 7 to 12 years, single buccal infiltration with 4% articaine with 1:100,000 epinephrine is more effective compared to 2% lidocaine with 1:80,000 epinephrine for primarly molar extraction.

Estimation of malondialdehyde levels in serum and saliva of children affected with sickle cell anemia.

BACKGROUND: Sickle cell anemia (SCA) is an inherited disorder of hemoglobin synthesis characterized by deformed erythrocytes. Hemoglobin S present in sickle-shaped erythrocytes exhibits an enhanced rate of auto-oxidation compared with normal hemoglobin A. It produces more of reactive oxygen species (ROS) which promotes oxidatively stressed environment. ROS degrade the membranes of sickle cell erythrocytes composed of polyunsaturated lipids and form malondialdehyde (MDA) as a by-product. AIM: The aim of the study is to evaluate and compare the MDA levels of serum and saliva in SCA patients. DESIGN: A total of 150 children aged 4-12 years were divided into two groups: Group A (n = 75) consisting of children suffering from SCA and Group B (n = 75) consisting of healthy children. Blood and saliva samples were collected aseptically from both the groups, and they were subjected to thiobarbituric acid assay. Absorbance was evaluated spectrophotometrically at 531 nm, and the values of concentration of MDA were derived. RESULTS: The mean MDA levels in serum and saliva were 8.9825 ± 1.04 and 0.5152 ± 0.28, respectively, in Group A and they were found to be higher than mean MDA levels of serum (5.87 ± 0.92) and saliva (0.2929 ± 0.06) of Group B and the difference of their mean was found to be statistically significant. CONCLUSION: A significant correlation of the MDA was found in saliva and serum of the patients with SCA. This finding suggests that saliva can be effectively used as a noninvasive alternative for assessing the oxidative stress in patients with SCA.