Lung Ultrasonography Is an Acceptable Imaging Modality to Diagnose COVID-19 and Effectively Correlates with HRCT Chest-A Prospective Study.

It has been validated beyond doubt that High-Resolution Computed Tomography (HRCT) chest and to some extent chest radiographs have a role in corona virus disease-19 (COVID-19). Much less is known about the role of lung ultrasonography (LUS) in COVID-19. In this paper, our main purpose was to gauge the relationship between LUS and chest HRCT in reverse transcriptase polymerase chain reaction (RT-PCR) documented cases of COVID-19, as well as in those with high suspicion of COVID-19 with negative RT-PCR. It was a prospective study carried out at our tertiary care hospital, namely, SKIMS Soura. The total number of patients in this study were 152 (200 patients were selected out of which only 152 had undergone both LUS and chest HRCT). The patients were subjected to both LUS and chest HRCT. The radiologist who performed LUS was blinded to clinical findings and HRCT was evaluated by a radiologist with about a decade of experience. The LUS findings compatible with the disease were subpleural consolidations, B-lines and irregular pleural lines. Findings that were compatible with COVID-19 on chest HRCT were bibasilar, subpleural predominant ground glass opacities, crazy paving and consolidations. COVID-19-positive patients were taken up for chest HRCT for disease severity stratification and were also subjected to LUS. On HRCT chest, the imaging abnormalities compatible with COVID-19 were evident in 110 individuals (72.37%), and on Lung Ultrasound they were observed in 120 individuals (78.95%). Imaging of COVID-19 patients assessed by both LUS and HRCT chest,, showed a positive correlation (p < 0.0001). The study revealed a sensitivity of 88%, a specificity of 76.62%, a positive predictive value of 78.57% and a negative predictive value of 86.76%. None of the individuals with a diagnosis of COVID-19 on HRCT were missed on LUS. An excellent correlation was derived between the LUS score and CT total severity score (p < 0.0001 with a kappa of 0.431). Similar precision compared with chest HRCT in the detection of chest flaws in COVID-19 patients was obtained on LUS.

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.

Unilateral absence of external oblique musculo-aponeurotic complex during routine inguinal hernia repair.

INTRODUCTION: The isolated absence of the external oblique musculo-aponeurotic complex in adults is an extremely rare anomaly. This complex is an important contributor to the strength of the inguinal canal. The present case report describes the unilateral absence of the external oblique muscle in a patient. CASE PRESENTATION: A 40-year-old male patient presented with a history of intermittent lower abdominal pain for 5 years which had increased over the past 6 months. Abdominal examination revealed unilateral reducible, incomplete, left sided direct inguinal hernia. CLINICAL DISCUSSION: Elective unilateral Lichtenstein's mesh hernioplasty was planned for the patient. Intraoperatively, there was no evidence of the external oblique aponeurosis and the spermatic cord was noted deep to the thickened membranous fascial layer. The inguinal ligament was thin and atrophic and was attached to the pubic tubercle medially and anterior superior iliac spine laterally. There was no evidence of any superior aponeurotic connection to the inguinal ligament. A postoperative ultrasound examination of the abdomen confirmed the unilateral absence of the external oblique musculo-aponeurotic complex. CONCLUSION: The possibility of such an anomaly should be considered in patients without other risk factors for hernia.

Cerebrotendinous xanthomatosis - A case report.

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder resulting from a defective enzyme in bile acid synthesis pathway leading to neurological, ocular, vascular, and musculoskeletal symptoms from deposition of cholestanol and cholesterol in these tissues. We present clinical and imaging features of a 32-year-old female who presented with mental retardation, gait instability and swelling along posterior aspect of both ankles. Imaging studies were performed which revealed spectrum of CTX findings in brain and tendons. Subsequently the diagnosis was confirmed by biopsy and laboratory tests.