A correlation of disease severity and outcome with malnutrition status in adults with COVID-19

Background: Coronavirus disease 2019 (COVID-19) pathology increases catabolism and depletes the protein stores, causing malnutrition. However, nutrition assessment in COVID-19 is often overlooked in the current pandemic. The Controlling Nutritional Status (CONUT) score is a validated score to assess nutritional status in hospitalized patients. The objective of the study was to estimate malnutrition among hospitalized adult patients with COVID-19 using the -The Controlling Nutritional Status (CONUT) score and study itseffect on the disease severity and outcomes. Methods:The study was a retrospective study on 146 patients with COVID-19. The history, demographic details were noted and the following parameters were noted at baseline and time of outcome-COVID-19 disease severity, radiological severity, CONUT score, inflammatory markers-serum LDH, CRP, Ferritin, D-Dimer. The outcome parameters-mortality, duration of hospital stay and severity of disease at outcome were measured. Results: Out of the 146 patients, 84 (57.53%) were male and 62 (42.47%) were female. 97.26% patients had malnutrition at baseline with 42 (28.77%) mild, 70 (47.95%) moderate and 30 (20.55%) severe malnutrition based on CONUT score. The CONUT scores were greater at outcome compared to baseline (p<0.001). Higher grades of malnutrition were associated with greater baseline and outcome disease severity (p<0.001), radiological severity (p<0.001), higher levels of inflammatory markers (p<0.001) and a higher mortality (p<0.001). However, there was no significant difference in duration of hospital stay (p=0.67).Conclusions: Malnutrition results in worse outcomes and greater mortality in COVID-19. Individual tailored nutritional support in the hospitalized COVID-19 patients, can thus potentially improve outcomes.

Outcome Analysis of Distal Tibial Fractures Managed by Open Reduction Internal Fixation using Plate Osteosynthesis

Introduction: Fracture of the distal tibia is one of the common fractures encountered by an orthopedic surgeon. Many studieshave been associated even as little as 1 mm incongruence of articular surface landed with worst outcome. Distal tibial fracturesare complicated by poor bone stock, soft tissue complication, poor vascularity leading to nonunion, gross comminution, andmalalignment.Aim: The aim of the study was to evaluate functional outcome analysis of distal tibial fractures managed by open reductioninternal fixation using plate osteosynthesis.Materials and Methods: This was a prospective study conducted at KAPV Medical College, Tiruchirappalli. A total of 20 patientswere treated with distal tibial plating. Fibular plating was done in eight of these patients. Patients were analyzed using Karlströmand Olerud scoring system, with follow-up of 3–18 months.Results: Ten patients had excellent functional results, six patients had good results, three patients had acceptable results,and 1 patient had a poor result. Quality and vascularity of bone seem to influence the outcome to a large extent.Conclusion: Based on our study, we conclude that distal tibial fractures managed with plate minimally invasive plateosteosynthesis technique allow early mobilization of the patients and provide a good functional outcome.

​Outcome Analysis of Distal Tibial Fractures Managed by Open Reduction Internal Fixation Using Plate Osteosynthesis

Introduction: Fracture of the distal tibia is one of the common fractures encountered by an orthopedic surgeon. Many studieshave been associated even as little as 1 mm incongruence of articular surface landed with worst outcome. Distal tibial fracturesare complicated by poor bone stock, soft tissue complication, and poor vascularity, leading to non-union, gross comminution,and malalignment.Aim: The aim of the study was to evaluate the functional outcome analysis of distal tibial fractures managed by open reductioninternal fixation using plate osteosynthesis.Materials and Methods: This a prospective study conducted at KAPV Medical College, Tiruchirappalli. 20 patients treatedwith distal tibial plating. Fibular plating was done in eight of these patients. Patients were analyzed using Karlström and Olerudscoring system, with follow-up of 3–18 months.Results: Ten patients had excellent functional results, six patients had good results, three patients had acceptable results, andone patient had a poor result. Quality and vascularity of bone seem to influence the outcome to a large extent.Conclusion: Based on our study, we conclude that distal tibial fractures managed with plate minimally invasive percutaneousplate osteosynthesis technique allow early mobilization of the patients and provide a good functional outcome.

Studies on antimicrobial activity of actinomycetes against MDR wound bacterial isolates.

A total of five different actinomycete isolates were recovered from mine soil samples collected from Salem, Tamilnadu. These were then assessed for their antibacterial activity against five multidrug resistance bacterial wound isolates. All five isolates of actinomycete exhibited antagonistic activity. The zone of inhibition ranged between 11-25 mm. Among the 5 isolates of actinomycetes A5 isolate has highest antibacterial activity against S.aureus and E.coli. Out of five bacterial isolates Pseudomonas aeruginosa was highly suppressed by actinomycetes followed by E.coli. The maximum antibacterial activity was observed on 14th day incubation. The result of primary screening reveals that most of the active actinomycetes isolates were active against gram positive bacteria (S.aureus) than gram negative bacteria. The antibiotic profile of these isolates underlined their potential as a source of novel antibiotics.