Can blood glucose levels predict biochemical and haematological abnormalities in COVID -19 patients - Experience from a tertiary care hospital in Balochistan.

OBJECTIVE: To find out the association between poor glycaemic levels and biochemical and haematological abnormalities in patients of corona virus disease-2019. METHODS: The prospective, observational, cohort study was conducted at the Combined Military Hospital, Quetta, Pakistan, from September 2020 to February 2021, and comprised all patients who tested positive for coronavirus disease-2019 on polymerase chain reaction test and were subsequently admitted. The patients were divided into two groups on the basis of random blood glucose level at the time of admission; ≥11.1mmol/l (206mg/dl) in group A and 4-11.1mmol (74-206mg/dl) in group B. Association between categorical variables was evaluated and hazard ratio was measured. Data was analysed using SPSS 21. RESULTS: Of the 349 patients, there were 56(16%) in group A; 40(71.4%) males and 16(28.6%) females with age range 39-61 years. There were 293(84%) subjects in group B; 239(81.5%) males and 54(18.5%) females with age range 27-53 years. Overall, 75(21.4%) patients were known type 2 diabetics. A significant association was found between poor glycaemic control and raised levels of C-reactive protein, lactate dehydrogenase, ferritin, erythrocyte sedimentation rate, troponin, creatine kinase, creatine kinase-MB, alanine aminotransferase, creatinine and D-dimers (p<0.05). Inter-group differences were significant for acute kidney injury, acute liver injury, Intensive care unit admission for coagulation abnormalities and for overall mortality (p<0.05). CONCLUSIONS: Poor glycaemic control was found to be a risk factor for developing multisystem complications in patients of coronavirus disease-2019.

Central Nervous System Tuberculosis With Shower Like Pattern of Intracranial Tuberculomas in an Immunocompetent Patient.

Central nervous system tuberculosis (CNS TB), though comparatively uncommon as compared to other forms of extrapulmonary tuberculosis (TB), results in high morbidity and mortality. The symptoms are non-specific and of a progressive nature resulting in delayed diagnosis. We present a case of CNS TB that presented two months after the onset of symptoms. The patient's condition reached the point of being bedbound. On investigation, the widespread involvement of the brain with shower-like pattern of ring enhancing tuberculomas and associated tuberculous meningitis was found. This was a surprising finding considering the patient was immunocompetent. Contrast-enhanced magnetic resonance imaging showed lesions in midbrain, pons, medulla, thalamus, bilateral cerebellar hemispheres and bilateral cerebral hemispheres. Upon treatment initiation the patient responded well with resolution of all lesions.

Occlusal Plane Evaluation In Dentate Patients For Complete Denture Prosthodontic Practice.

BACKGROUND: Preclinical determination of occlusal plane is an important clinical step in construction of complete denture. Objective of present study was to find out the parallelism of occlusal plane to ala-tragus line in dentate subjects to provide a guideline for establishment of occlusal plane for edentulous patients. METHODS: In local dental College from April to October 2017 using purposive sampling technique this comparative study was conducted. After preliminarily examination, desired photographs of 120 subjects using fulfilling the inclusion criteria were taken biting on proper positioned Fox's Plan. Photographs were analysed through the computer software named Digimizer Image Analysis (Version 4.2.5.0) for three posterior reference points on the tragus of the ear at its superior (ATs), middle (ATm) and inferior (ATi) margin and one anterior reference point, i.e., Inferior margin of the Ala of the nose. Three lines were drawn with the help of the software that were extending from the posterior reference points to anterior reference point and fourth line Parallel to the upper level of the fox plane (FxP). Finally, the angles between the above-mentioned lines computed were analysed to check the parallelism. One sample t-test was utilized using SPSS. RESULTS: Mean angles value on right side of subjects between FxP to three reference points ATs, ATm, ATi were 3.261, 2.720 and 2.245 and on the left they were 2.347, 2.558 and 2.029 respectively showing no parallelism (angle value zero). CONCLUSIONS: Major findings revealed no parallelism among these planes.

Genotyping of rotaviruses detected in children admitted to hospital from Faisalabad Region, Pakistan.

Rotavirus infection is very common in developing countries and occurs at least once in children under the age of 5 years. The rate of detection of rotavirus infection in various age groups (0-5 years) in patients with gastroenteritis admitted to hospital from the Faisalabad region, Pakistan is reported. Out of 300 fecal samples, 189 (57.3%) were positive for rotavirus by immunoassay. Patients aged 7-12 months (35.4%) were infected most commonly followed by the age group 0-6 months (28%). Different genotypes of rotavirus were identified by hemi-nested RT-PCR. The most common genotype was G1P[8] (25.3%), followed by G1P[6] (21.1%). Other genotypes were G1P[9], G2P[6], G9P[10]), G3P[8] (1.5%), and G9P[11] (1%). There were two (1%) cases of mixed G genotype, one patient with two genotypes G1, G10 and another patient with 3 genotypes G1, G10, and G12. There were 6 (3.1%) cases of mixed P genotypes, 3 P[4], P[11] and 3 P[8], P[11]. These results provide an outline of rotavirus infection in this area for the first time.