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Background: Sympathetic crashing causes sudden cardiac failure in minutes or hours. Early diagnosis and treatment may avoid acute heart failure fatalities. Sympathetic crashing reduces afterload, shifting fluid into the pulmonary circulation and causing pulmonary edema. The usual strategy of progressively increasing vasodilator dosage has increased preload. Treating SCAPE with large doses of nitroglycerin and non-invasive breathing is helpful. High doses of nitroglycerin boost afterload and eliminate ICU admissions. In this study, a standard protocol for the treatment of patients with sympathetic crashing acute pulmonary edema is assessed for its effectiveness. Methods: An observational study was conducted prospectively at Bhima Bhoi Medical College and Hospital in Balangir, Odisha, India over the course of a year. The patients presenting with SCAPE symptoms were treated according to standard protocol. The outcomes were subjected to statistical analysis to derive a correlation between treatment and response. Results: The mean initial bolus given to all the patients was 836 礸. The total cumulative dose of nitroglycerin used in each patient was 36 mg. The symptoms of most of the patients resolved within the first 6 hours of treatment. Conclusions: The standard protocol developed at the institute, which included a high dose of nitroglycerine along with non-invasive ventilation, was efficient in treating acute heart failure due to sympathetic crashing and acute pulmonary edema. Nitroglycerin, along with non-invasive ventilation, should be used in the management of sympathetic crashing pulmonary edema and acute heart failure.
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Background: It is well-recognized that uncontrolled glycemia reflects the severity and mortality rates of respiratory virus epidemics. The aim of the study was to report the features and course of therapy of diabetic individuals admitted to a tertiary care facility with COVID-19 infection. Additionally, we tried to assess how hyperglycemia affected the clinical results. Methods: This study used observational methods to conduct a retrospective chart review of 125 cases from October 2021 to March 2022 at a single center. Results: Males made up 94.6% of the 125 examined cases. Within the age range of 21 to 78 years, the study group's average age was 49.6�.4 years. Of the patients, 66.4% had prior knowledge of diabetes. When compared to pre-existing diabetes individuals with the newly diagnosed diabetes individuals, the latter had a higher death rate (p=0.03) and needed mechanical breathing (p=0.02). Conclusions: Hyperglycemia that is uncontrolled harms COVID-19-infected patients. There is an increased risk of hyperglycemia problems that have been discovered or unknown.to screen for cases of undiscovered diabetes in hospital patients, which may be especially relevant during the COVID-19 pandemic, optimal glycemia optimization is essential.
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Background: Childhood TB constitutes 10-20% of all TB cases in high burden countries like India and accounting for 8-20% of TB related deaths. Diagnosis of TB in children is difficult. One test, CBNAAT which was recently endorsed by WHO has the potential to lead a revolution in diagnosis of active TB disease.Methods: A cross sectional study in SCB MCH and SVPPGIP, Cuttack in all the suspected TB patients admitted during the period from January 2016 to October 2017.Results: A total of 100 suspicious patients admitted to the Department of Pediatrics in SCB MCH and SVPPGIP during the study period. Of these 45 were diagnosed TB and rest others were diagnosed otherwise than TB. Diagnosis of TB was established on basis of Microscopy, CBNAAT, culture, biochemistry, cytology, clinical findings, neuroimaging, FNAC/biopsy, USG abdomen. Out of 45 TB patients 30 were CBNAAT positive taking the body fluid samples other than blood, urine and stool with a sensitivity of 66.7% and specificity of 100%. Out of 45 TB patients 14 were having ZN Smear positive taking the same fluid sample with a sensitivity of 31.1% and specificity of 100%. Whereas out of these 45 TB patients 32 were MGIT culture positive taking the same sample with a sensitivity of 71.1% and specificity of 100%. When diagnostic performances of CBNAAT and MGIT culture were compared, it was found to be statistically insignificant with a P value 0.54.Conclusions: The CBNAAT is able to confirm a diagnosis of TB with 66.7% sensitivity and 100% specificity within 2 hours. We can use CBNAAT as a diagnostic method as it provides rapid result and simultaneous better sensitive result, it can be helpful in starting ATT in sick patients and also in outdoor patients.