ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) has quickly spread to become a pandemic. Most studies demonstrate that increased liver enzymes in COVID-19 have little clinical relevance. In severe COVID-19, lower albumin levels are seen. Aim: To see how hypoalbuminemia levels affect the COVID-19 patients. Study design: Retrospective cohort study. Place and duration of study: Services Institute of Medical Sciences Lahore and Bahria International Hospital, Lahore from 10th January 2021 to 17th September 2021. Methodology: Sixty-seven confirmed cases of COVID-19 on RT-PCR were recruited. They were further divided into two groups. Group N (normal albumin levels) had thirty-six participants whereas group HA (hypoalbuminemia) contained thirty-one participants. Both males and females of all age groups, having complete medical records were included. Biochemical variables were noted from the medical record within 48 to 72 hours after admission. Twenty eight days follow up was done to note the mortality. Patients having incomplete medical records who expired within 2 days after admission were excluded. Results: A significantly higher number of deaths, lymphopenia, hypertensive, diabetics, and asthmatic participants were found in Group HA as compared to Group N. Hypoalbuminemia is mostly seen in older age and biochemical variables such as total leukocyte count and, neutrophils were elevated, whereas lower levels of lymphocytes were found in group HA. Lower lymphocytes and higher creatinine levels are the most prevalent predictors of mortality. The Pearson’s correlation of albumin with lymphocytes showed a positive correlation and inverse correlation with TLC, Neutrophil counts, CRP levels Conclusion: The group HA is associated with higher mortality and increased levels of prognostic factors of mortality.
ABSTRACT
Background: Spontaneous pneumothorax is a rare complication seen in patients of COVID-19 pneumonia. The risk factors associated with this complication and its incidence remain unknown largely. We herein, review and present the incidence, clinical characteristics and outcomes of spontaneous pneumothorax in 1767 patients admitted in three COVID treatment tertiary care centers in Lahore. Study Design: Retrospective study Place and Duration of Study: Services Institute of Medical Sciences Lahore and Bahria International Hospital Lahore from 15th April 2020 to 15th May 2021. Methodology: One thousandseven hundred and sixty-seven patients who were diagnosed with a spontaneous pneumothorax were enrolled. Clinical characteristics of these cases were also reviewed and recorded. Results: One thousand and five hundred patients had positive RT PCR from nasopharyngeal swab. Eleven (.62%) cases of COVID-19 patients who developed spontaneous pneumothorax were identified. The initial HRCT imaging showed typical and diffuse bilateral ground-glass opacities and consolidations, mainly in their peripheral, posterior and basal lung regions. Three patients had pneumothorax late in the course of disease after they were discharged home. We had only one mortality among those (11) cases and that was also not related to the pneumothorax directly but to development of sepsis and multi-organ failure. Conclusion: Spontaneous pneumothorax is a rare complication seen in COVID-19 pneumonia.
ABSTRACT
Objective: To compare the performance of medical undergraduate students in online and traditional exams and to gauge student satisfaction regarding online exams. Study Design: Cross Sectional study Place and Duration of Study: This study was conducted at the Liaquat National Hospital and Medical College during the period of June-July 2020. Materials and Methods: The target population was second year MBBS students who had given a paper based traditional exam in their first year of medical college and an online exam in second year. Scores of both the exams were compared. Students 'opinions about the online exam were collected through an online survey. Data was analyzed using SPSS version-17. Results: There were 88 students who had attempted both year 1 and 2 examinations. There were statistically significant differences amongst median scores of both exams [p=0.016]. Out of 78 responses received majority of the students were satisfied with the instructions and felt that the amount of proctoring was sufficient for a fair exam. Students were equally divided in term of technical or connectivity issues and background noise. Regarding the entire online examination most students reported similar concerns i.e. not fully prepared for the exam due to Covid-19 patients at home and lack of resources. As compared to traditional exam students found online exam difficult to attempt due to technical issues such as power outages, internet issues and software glitches. Conclusion: With better performance in an online exam, students still prefer the traditional exam format better than online exams due to several reasons. This highlights the importance of investing in e-learning and e-assessment infrastructure.