ABSTRACT
Background:Whilst the COVID-19 predominantly affects the respiratory tract, it is also observed to cause a wide range of cardiac complications. Accordingly, the ECHO findings range from specific regional wall motion abnormalities to different degrees of global cardiac dysfunction. Thus, there is a need to better understand the interactions between COVID-19 and the cardiac functions.Methods: In this retrospective observational study, 86 subjects admitted with severe COVID-19 pneumonia were considered. Those with pre-existing heart-diseases were excluded. The ECHO parameters were assessed as right heart or left heart abnormalities; they were correlated with Inflammatory markers.Results: Right heart abnormality was the most common finding (51.1%). 23% had combined right and left heart abnormalities, 4.6% had left heart abnormality, rest 21% had a normal 2D-ECHO findings. 55.8% had evidence of pulmonary hypertension. RV dilatation and dysfunction is associated with a pro-thrombotic, inflammatory state reflected by elevation of CRP and D-dimer levels; however, these ECHO findings did not correlate with increase in marker levels (p=0.227, >0.05). Conclusions:RV dysfunction is more common than LV dysfunction among COVID-19 patients. 2D-ECHO findings may serve as a useful guide in optimization and modification of treatment strategies in critically ill COVID-19 patients, but are not independent predictors of mortality (p=0.09, >0.05).
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Introduction: Rat killer paste (yellow phosphorous) is one of the most common forms of poisoning in South India. It causeshepatotoxicity. No specific antidote has been found. Recently, N-acetylcysteine is used as supportive therapy in many casesof acute liver failure.Aim: This study aims to evaluate the effectiveness of early N-acetylcysteine in preventing the rat killer paste poisoning.Methods: Patients who ingested rat killer paste poison and age >12 years were included in the study. Patients having jaundice,liver disease, and age <12 years were excluded from the study.Results: Among 30 patients studied, five patients died, seven patients developed hepatitis, one patient developed acute kidneyinjury with hepatitis, and one patient developed hyponatremia.Conclusion: Early initiation of N-acetylcysteine had a significant impact in reducing mortality.
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Background: Catheter associated urinary tract infections (CAUTIs) are the most common causes of UTIs in postoperative cases. Many risk factors are associated with its incidence. The present study was conducted with the aim to determine the related risk factors and to identify the causative agents contributing to the urinary tract infection.Methods: This prospective study was conducted on 210 patients meeting the requirements of inclusion criteria during September 2012 to February 2014. Detailed history of the patients was recorded. Urine culture was done at different time intervals to identify the causative agent suggestive to CAUTI. Univariate analyses of the association of each variable with CAUTI and multivariable logistic regression were done to predict CAUTI outcome.Results: The mean age of study participants was 51.61 years. Among them 141 were males and 69 were female patients. On univariate analysis purpose for urine catheterization, place of catheterization, breach in the closed system of drainage, duration of catheterization, hemoglobin value less than 10, raised renal parameters with serum creatinine more than 1.5 were all significantly associated with development of CAUTI (p value 0.000). Sex of the patient (p value 0.279) and catheter size (p value 0.279) was not found to have a significant correlation with increased risk of CAUTI. On multivariate analysis, age, catheter size, diabetes, duration of catheterization, a breach in the closed system of catheter drainage and sex were found to be the significant risk factors associated with CAUTI (p<0.05).Conclusion: An understanding of the risk factors in development of CAUTI, significantly helps in reducing the additional burden on the health care system. Measures such as shortening the duration of catheterization, strict control of diabetes and sterile precautions in insertion and maintenance of indwelling catheters can help in prevention CAUTI.
ABSTRACT
Odontogenic keratocyst (OKC) first described by Philipsen in 1956 constitutes approximately 11% of all cysts of the jaws. Adenomatoid odontogenic tumour (AOT) is an uncommon, benign epithelial lesion of odontogenic origin. The aim of this study was to analyse the expression of Bcl-2 in OKC and its comparison with other selected benign odontogenic tumours (OTs). Ten formalin fixed paraffin embedded blocks of OKCs, five each of AOT and unicystic ameloblastoma Bcl-2 protein is characterized by its ability to inhibit apoptosis. OKC were characterized by higher expression of Bcl-2 in basal cell epithelium. AOT and unicystic ameloblastoma differed from OKC in a wide spectrum of apoptosis and/or cell cycle-related protein expressions, higher proliferation in the basal cell layer, and vice versa, lower proliferation in the suprabasal cell layer. The solitary OKC seems to be less biologically aggressive and should be classified as a cyst rather than a tumour, means that at least few of OKCs manifests as ordinary cysts. Some of the present study findings could support the theory that OKCs are with high proliferative, probably that these lesions are developmental cysts with some neoplastic properties because of the high intrinsic growth potential. WHO recommends the term KCOT as it better reflects the neoplastic nature of the lesion; however, this reclassification has not yet been universally accepted.