ABSTRACT
Background & objectives: Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods: The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results: Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated.Interpretation & conclusions: The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.
ABSTRACT
Dactylitis due to tuberculosis (TB) is an extremely uncommon manifestation of TB. We report a unique case of isolated index finger dactylitis with right hilar adenopathy due to TB in a 15-year-old immunocompetent student. High index of clinical suspicion, radiological findings and histological confirmation helped in the diagnosis. Anti-tuberculous therapy remains the cornerstone for the management of these cases.
ABSTRACT
A case of a 63-year-old patient with motor neurone disease (amyotrophic lateral sclerosis) with central sleep apnoea syndrome is being reported. His sleep architecture was fragmented with a high apnea-hypopnea index of 65 per hour and maximum oxygen-desaturation of 78 percent. Total correction of sleep pattern with nasal non-invasive ventilation (BiPAP-ST) was demonstrated.
Subject(s)
Amyotrophic Lateral Sclerosis/complications , Humans , Male , Middle Aged , Polysomnography , Positive-Pressure Respiration , Sleep Apnea, Central/etiologyABSTRACT
A patient of dengue hemorrhagic fever who progressed into acute respiratory distress syndrome (ARDS) is reported. The patient recovered after mechanical ventilation and supportive treatment.
Subject(s)
Adult , Anti-Infective Agents/therapeutic use , Severe Dengue/complications , Diagnosis, Differential , Humans , Lung/microbiology , Male , Positive-Pressure Respiration , Respiratory Distress Syndrome/microbiology , Respiratory Function Tests , Treatment OutcomeABSTRACT
A patient of tuberculous pyopneumothroax with broncho-pleural fistula in whom a mature roundworm Ascaris lumbricoides migrated from the intestine to lodge itself in the pleural cavity is being reported.