Correlation of Vitamin D deficiency with chest X-rays severity scores and different inflammatory markers in severe and critical COVID-19 patients

Objective: To determine the relationship between Vitamin D deficiency with Chest X-Rays severity score and Different Inflammatory Markers in Severe and Critical COVID-19 Patients. Design: A cross-sectional study Setting: The study was conducted in COVID-19 isolation units at Mardan Medical Complex Teaching Hospital (MMCTH) and Bacha Khan Medical College, Pakistan Participants: 206 patients who tested positive for COVID-19 by PCR were included in the final analysis.Data Collection/Intervention: We collected demographic, comorbidity, laboratory, and clinical outcome data from the electronic records of admitted, deceased, or discharged patients.Main outcome measure: Frequency of symptoms, comorbidities, mortality and morbidity, chest x-ray severity scores, different inflammatory markers in Vitamin D deficient Covid-19 patients Results: 128(62.14%) were severe and 78(37.5%) were critical COVID-19 patients. The whole cohort had 82(39.80%) males and 124(60.20%) females, with a median age of 55 IQR (50-73). Study participants' median Vitamin D level was 14.01ng/ml, with a minimum of 7.5ng/ml and a maximum of 70.8ng/ml. 67/206 patients died, with a fatality ratio of 32.5%. 54/67(80.59%) suffered from one or more comorbid conditions. Conclusion: Low Vitamin D levels were linked to a higher risk of death, higher x-ray severity scores, and different inflammatory markers. Vitamin D levels greater than 30ng/ml for older patients and greater than 40ng/ml in older patients with comorbidities were associated with reduced severity and mortality in patients with COVID-19

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Concussion knowledge and attitudes among amateur South African rugby players

Background: The South African Rugby Union's BokSmart programme currently educates coaches and referees on concussion. Rugby players are often more familiar with their teammates than the coach or referee. Therefore they are well-positioned to play a pivotal role in rugby safety if they have adequate knowledge to identify subtle signs and abnormal behaviour displayed by a concussed teammate. However, no programme focuses on concussion education among South African rugby players and there is a dearth of literature on concussion education programmes among rugby players which could lead to safer return to play (RTP) habits.Objectives: To evaluate South African rugby players' concussion knowledge and attitudes/behaviours regarding RTP following a concussion.Methods: A descriptive, cross-sectional study was used. Participants (n=294) were divided into junior amateur high school (JAHS) (n=216) and senior amateur club (SAC) (n=78) players. The modified RoCKAS-ST questionnaire was used to evaluate their concussion knowledge index (CKI) and concussion attitudes/behaviours index (CAI) regarding RTP.Results: On average, 62% (JAHS) and 60% (SAC) of the CKI questions were answered correctly. JAHS participants correctly identified 66% of concussion symptoms, similarly to the SAC participants (63%), rendering similar (p=0.37) overall CKI scores when comparing the two groups. The CAI questions yielded similar (p=0.98) results between the groups, reporting safe responses in 66% (JAHS) and 67% (SAC) of the items.Discussion and conclusion: Junior and senior South African amateur rugby players lacked approximately one-third of essential concussion knowledge, which may lead to a display of unsafe attitudes/ behaviours to concussion and RTP. Further research is warranted to inform educational programmes on concussion among rugby players