Correlation of Vitamin D deficiency with chest X-rays severity scores and different inflammatory markers in severe and critical COVID-19 patients

Objective: To determine the relationship between Vitamin D deficiency with Chest X-Rays severity score and Different Inflammatory Markers in Severe and Critical COVID-19 Patients. Design: A cross-sectional study Setting: The study was conducted in COVID-19 isolation units at Mardan Medical Complex Teaching Hospital (MMCTH) and Bacha Khan Medical College, Pakistan Participants: 206 patients who tested positive for COVID-19 by PCR were included in the final analysis.Data Collection/Intervention: We collected demographic, comorbidity, laboratory, and clinical outcome data from the electronic records of admitted, deceased, or discharged patients.Main outcome measure: Frequency of symptoms, comorbidities, mortality and morbidity, chest x-ray severity scores, different inflammatory markers in Vitamin D deficient Covid-19 patients Results: 128(62.14%) were severe and 78(37.5%) were critical COVID-19 patients. The whole cohort had 82(39.80%) males and 124(60.20%) females, with a median age of 55 IQR (50-73). Study participants' median Vitamin D level was 14.01ng/ml, with a minimum of 7.5ng/ml and a maximum of 70.8ng/ml. 67/206 patients died, with a fatality ratio of 32.5%. 54/67(80.59%) suffered from one or more comorbid conditions. Conclusion: Low Vitamin D levels were linked to a higher risk of death, higher x-ray severity scores, and different inflammatory markers. Vitamin D levels greater than 30ng/ml for older patients and greater than 40ng/ml in older patients with comorbidities were associated with reduced severity and mortality in patients with COVID-19

Peribulbar block in pediatric posterior segment ocular surgery

Vitreous and retinal [VR] surgery with or without scleral buckling is associated with significant postoperative pain in adults, and recent studies have addressed the effect of retro or peribulbar block on these parameters VR surgery in children has received little attention regarding the incidence of pain and the role of regional anesthesia in modifying these parameters. In this study, we compared peribulbar block with conventional opioid analgesia in children undergoing VR surgery. In a prospective, randomized, single-blind study, 85 children [age 8 to 14 years] were allocated to receive peribulbar block [n = 42] or intravenous fentanyl 2micro g/kg [n = 43] after induction of general anesthesia. Parameters compared were: Intraoperative incidence of oculocardiac reflex and requirement for additional analgesic; postoperative pain intensity; time to first analgesic, total number of postoperative analgesic supplements; and parental assessment of the child's postoperative comfort at 24 hours. The incidence of intraoperative oculocardiac reflex was significantly less in the peribulbar group [p = .0001]. Significantly more children receiving peribulbar block were pain free on awakening [p = .0004] and throughout the postoperative period. The number of children requiring opioid was significantly lower with peribulbar block [p = .008]. Peribulbar block appears to be a safe and clinically superior alternative to intravenous fentanyl for pediatric VR surgery