Relation between macrophage inflammatory protein-1 and intercellular adhesion molecule-1 and computed tomography findings in critically-ill saudi covid-19 patients.

BACKGROUND: Several, clinical and biochemical factors were suggested as risk factors for more severe forms of Covid-19. Macrophage inflammatory protein-1 alpha (MIP-1α, CCL3) is a chemokine mainly involved in cell adhesion and migration. Intracellular adhesion molecule 1 (ICAM-1) is an inducible cell adhesion molecule involved in multiple immune processes. The present study aimed to assess the relationship between baseline serum MIP-1α and ICAM-1 level in critically-ill Covid-19 patients and the severity of computed tomography (CT) findings. METHODS: The study included 100 consecutive critically-ill patients with Covid-19 infection. Diagnosis of infection was established on the basis of RT-PCR tests. Serum MIP-1α and ICAM-1 levels were assessed using commercially available ELISA kits. All patients were subjected to a high-resolution computed tomography assessment. RESULTS: According to the computed tomography severity score, patients were classified into those with moderate/severe (n=49) and mild (n = 51) pulmonary involvement. Severe involvement was associated with significantly higher MIP-1α and ICAM-1 level. Correlation analysis identified significant positive correlations between MIP-1α and age, D-dimer, IL6, in contrast, there was an inverse correlation with INF-alpha. Additionally, ICAM-1 showed significant positive correlations with age, D-Dimer,- TNF-α, IL6,while an inverse correlation with INF-alpha was observed. CONCLUSIONS: MIP-1α and ICAM-1 level are related to CT radiological severity in Covid-19 patients. Moreover, these markers are well-correlated with other inflammatory markers suggesting that they can be used as reliable prognostic markers in Covid-19 patients.

Evaluation of transversus abdominis plane (TAP) block in lipoabdominoplasty surgical procedure: a comparative study.

BACKGROUND: The transversus abdominis plane (TAP) block is a well-known regional nerve block, used for the pain control in various surgeries. There are only few studies in the literature, which have evaluated analgesic efficacy of TAP block in Abdominoplasty; A surgery in which post-operative pain is of major concern for both patient and operating surgeon. OBJECTIVES: We conducted randomized control trial, to assess the efficacy of ultrasound-guided bilateral TAP block in Abdominoplasty patients for controlling post-operative pain. METHODS: Sixty patients planned for lipoabdominoplasty were randomly assigned to two groups A and B, with thirty Patients in each group. The ultrasound guided TAP block was administered in group A patients whereas no block was administered to group B. The patients in two groups were compared for demographic characteristics, pain intensity on mobilization, opioid consumption, time to first rescue analgesic dosage and nausea- vomiting incidences. RESULTS: The demographic characteristics were similar in both groups. The Group A Patients required significantly smaller mean dose of opioids and had significantly longer mean time of first request for analgesic medication. The Median VAS score on mobilization in Group A was significantly lower than Group B. Only few patients in group A experienced nausea-vomiting compared to group B. CONCLUSIONS: The ultrasound guided TAP block provides effective analgesia after Lipoabdominoplasty, which allows more convenient early post-operative mobilization and decreases opioid requirement as well as its related side-effects. Hence we suggest that ultrasound guided TAP block should be considered in most lipoabdominoplasty cases for better patient experience.