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Introduction: There is a scarcity of information on the incidence and outcomes of acute kidney injury (AKI) in COVID-19 patients in India. Therefore, we analyzed the correlation of AKI risk factors, ventilatory support, and renal replacement therapy and compared the outcomes of first and second COVID-19 waves in this tertiary care center. Methods: We retrospectively analyzed the patients' medical records with a positive RT-PCR for COVID-19 between July 2020 and May 2021. We looked at the clinical outcomes of the first and second COVID-19 waves and documented the frequency, risk factors for AKI, and the relationship between AKI and in-hospital mortality. Univariate and multivariate binomial logistic regression yielded odds ratios for the risk variables of AKI. Risk differences and age-adjusted odds ratios, as well as 99.5% confidence intervals, were used to compare COVID-19 outcomes between the first and second waves. Results: Of the 1260 hospitalized patients with COVID-19, 86 (6.8%) presented with AKI and 8 (0.7%) patients required dialysis. The most common comorbidity was diabetes mellitus (55.2%), hypertension (42.1%), hypothyroidism (11.3%), and coronary artery disease (8.1%). A total of 229 (18.17%) patients were admitted to ICU, 574 (45.5%) received ventilation, and 26 (2.0%) required mechanical ventilation.The incidence of in-hospital death in the patients with AKI as per the stage from 1 to 3 was 9 (15.8%), 7 (35%), and 5 (55.6%), respectively.Compared to the first wave, the second wave cohort had a lower risk of AKI (adj OR: 0.426; CI: 0.232-0.782) and mortality (adj OR: 0.252; CI: 0.090-0.707). Conclusions: In our study, AKI prevalence was 6.8%, the need for ventilation was 45.5%, ECMO 0.2%, and the mortality rate 2.9%. Second wave of COVID-19 exhibits improved clinical outcomes compared to the first wave.
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Primary malignant pericardial mesothelioma (PMPM) is a rare tumor of the pericardium. The cause of this tumor is unknown and it has a very poor prognosis. Exposure to asbestos is correlated with the onset of pleural and peritoneal mesothelioma; however, the role of asbestos in pericardial mesothelioma is unclear. Here we highlight the radiological features of this rare tumor and its correlative pathological confirmation with the help of new immunohistochemical (IHC) markers.
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Toxoplasmosis is a serious and life-threatening disease in humans with a high prevalence in immunocompromised persons. The disease has a wide spectrum, depending on the immune status of the person. A CNS manifestation of toxoplasmosis in an immunocompetent person is very rare and often undetected. Our case of CNS toxoplasmosis in an immunocompetent person emphasizes the radiological diagnosis, which was further confirmed by advanced microbiology technique.
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Duodenal lymphangitis carcinomatosa has been sporadically described, and little attention has been paid so far. To our knowledge, no data on radiological findings for this rare entity has been published. We report a case of duodenal lymphangitis carcinomatosa secondary to gallbladder mass in a 44-year-old Indian man to focus on the radiological diagnosis, which was further confirmed by endoscopic-guided biopsy and immunohistochemical analysis.
