Study the co-relation between SpO2 and radiological and biochemical markers with the severity and outcome in geriatric Covid-19 patients

Background: Pandemics are natural calamities, which humans have been encountering since time im-memorial. The world has witnessed and endured several pandemics like from Justinian Plague to Spanish Flu. The 21st century has already witnessed three major pandemics like Severe Acute Respiratory Syndrome in 2002, Middle East Respiratory syndrome in 2012 and at present COVID?19. The first case of COVID?19 was reported in Wuhan, Hubein Province in Dec 2019. The first case of COVID?19 was reported in Kerala on 30th January 2020. COVID?19 virus is a single stranded RNA Virus and resembles SARS -2 virus and hence the name SARS -COV 2. There has been a report of around 34 million cases with 1 million deaths. Majority of the deaths occur in the elderly population as they have immunosenescence and multiple comorbidities. Hence a study aiming at analysis of correlation between SpO2, radiological and biochemical markers is essential in management of COVID 19 in elderly. Aims & Objectives: To study the correlation between SpO2 and radiological features in X ray and CT Chest and biochemical markers with the severity and outcome in geriatric patients. Study Period: April 2020 to September 2020, Duration: 6 months. Study Centre: Chengalpattu Medical College, Tamilnadu. Inclusion Criteria: RT PCR positive Covid 19 patients more than 60 years of age. Exclusion Criteria: Covid 19 patients less than 60 years, RT PCR Negative patients. Materials and Methods: Retrospective analysis of records of 300 Covid 19 patients, aged more than 60 years hospitalized in Chengalpattu Medical College during April to September 2020 was done and biochemical parameters mentioned below were corelated with features in CXR and CT Chest RTPCR positive spo2 and analysis with severity of disease and outcome was done. Results and Discussion: On retrospective analysis of records of elderly Covid 19 patients, it was observed that the elderly could be graded as mild, moderate and severe based on clinical criteria. Radiological parameters co-relating in the same group classified as mild, moderate and severe could be derived and could be used for assessment of patients. Similarly, it was observed that the biochemical parameters of D? Dimer, C reactive protein, Neutrophil Lymphocyte Ratio correlated most significantly in that order with the clinical severity of disease and hence could be used as useful tools for assessment of severity of patients and the ranges corelating withseverity could be derived. Conclusion: Analyzing SpO2, radiological features, biochemical parameters individually and in combination with clinical severity and outcome in elderly patients helps in deriving biochemical and radiological parameters to predict severity which in turn helps in a holistic approach and right management at the right time preventing or reducing mortality due to Covid 19 in the elderly.

ECG and X-ray findings in pericardial effusion in adult hypothyroid patients

Introduction: Pericardial effusions can be caused by multiple disease states, including any process that results in pericarditis or myocarditis. The inflammatory reaction in these disease states can result in fluid accumulation in the pericardial space. Systemic manifestations of hypothyroidism can significantly vary according to the thyroid function, the presence of associated diseases and the duration of autoimmunity. Long-term overt hypothyroidism significantly affects growth as well as heart, liver, skin, and kidney functions, causing signs and symptoms that promptly lead to its diagnosis. The aim of the study: To analyze the important diagnostic tool ECG and X-ray finding among diagnosed pericardial effusion adult hypothyroid patients. Materials and methods: The study was conducted in 2017. Patients attending the Outpatient Clinic of the Department of Endocrinology who satisfied the inclusion criteria were registered for the study after obtaining their consent. A detailed questionnaire was used to elicit symptoms of hypothyroidism. ECG and x-ray findings were predicted accordingly. Results: Low voltage complexes were found in 17 patients (24.29%), sinus bradycardia was found in 6 patients (0.09%), the poor progression of R waves in 3 patients (0.04%). The remaining 44 patients had a normal ECG. Chest films showed Mild cardiomegaly in 20 patients (28.57%). 11 of these 20 patients had pericardial effusion on echocardiography. One patient with echo proven pericardial effusion had normal chest X-ray. So chest X-rays can be used to look for clues for pericardial effusion. Abirami Gunasekaran,Jayalakshmi Ramasamy, Kamatchi Karunanidhi. ECG and X-ray findings in pericardial effusion in adult hypothyroid patients. IAIM, 2018; 5(5): 87-91. Page 88 Conclusion: Clinical features of pericardial effusion show statistically significant association with its presence on echocardiogram. ECG and CXR can be used to predict the presence of a Pericardial Effusion.

A study on prevalence of pericardial effusion in newly diagnosed adult hypothyroid patients

Introduction: Hypothyroidism is a common endocrine disorder resulting from a deficiency of thyroid hormone. It usually is a primary process in which the thyroid gland produces insufficient amounts of thyroid hormone. It can also be secondary that is lack of thyroid hormone secretion due to the failure of either adequate thyroid - stimulating hormone (TSH) secretion from the pituitary gland or thyrotropin-releasing hormone (TRH) from the hypothalamus (secondary or tertiary hypothyroidism). Pericardial effusion is frequently found in patients with hypothyroidism, but it is rarely associated with cardiac tamponade. Hypothyroidism complicated by cardiac tamponade is rarely referenced in the medical literature. The aim of the study: To find a correlation between severity of disease and presence of pericardial effusion. Materials and methods: The study was conducted in 2017. Patients attending the Outpatient Clinic of the Department of Endocrinology who satisfied the inclusion criteria were registered for the study after obtaining their consent. A detailed questionnaire was used to elicit symptoms of hypothyroidism. The patients were examined for signs of hypothyroidism. Special attention was given to the examination of the cardiovascular system to look for clinical features of pericardial effusion. Results: The prevalence of pericardial effusion in this study was 17%. 2 out of the 70 hypothyroid patients showed evidence of pericardial effusion. Mild pericardial effusion was found in 11 patients (15.71%) and moderate pericardial effusion in 1 patient (0.01%). Abirami Gunasekaran, Kamatchi Karunanidhi, Jayalakshmi Ramasamy. A study on prevalence of pericardial effusion in newly diagnosed adult hypothyroid patients. IAIM, 2018; 5(5): 83-86. Page 84 Conclusion: Clinical features of pericardial effusion show statistically significant association with its presence on echocardiogram. Macroglossia was more commonly found in patients with Pericardial Effusion. ECG and CXR can be used to predict the presence of Pericardial Effusion