ABSTRACT
Introduction: Following second wave of COVID 19 infection in India there has been unprecedented spike in mucormycosis cases. Liposomal amphotericin(LAmB) is the drug of choice in most of these cases. Though nephrotoxicity of conventional amphotericin has been well described in literature, there is sparse data on nephrotoxicity following of LAmB use.Herein we describe spectrum of kidney disease and electrolyte abnormalities that arised following LAmB use in patients afflicted with mucormycosis. Method(s): It is a single centre retrospective observational study. Hospitalised patients with mucormycosis who were started on LamB and if they develop Acute Kidney Injury (AKI)criteria as per KDIGO2012 guidelines during hospital stay were included in the study after excluding patients with pre existing Chronic Kidney Diseases( CKD),concomitant use of other Nephrotoxic medications,use of nonLAmB formulations for mucormycosis treatment,AKI at the time of admission and critical illness requiring ICU stay.Their demographic characteristics,co morbidities,salient clinical examination findings and laboratory parameters were entered in excel sheet.Descriptive statistics were used to analyse data. Result(s): Mean Age of study population was 51.03 years. Male to female ratio was 25:6.Among comorbidities, Diabetes was seen in 74.19% cases, Hypertension was seen in 35.4% and Ischemic Heart disease was seen 9.6% cases. When risk factors for mucormycosis were analysed 100% of study population had recent COVID19 infection, 93.5% of study population had prior steroid use and 9.6% of the patients had received Tocilizumab. Out of 102 patients who received LAmB 31(30.3%) developed AKI. Among these cases, Stage1 AKI was seen in 8 (25.8 %) cases,Stage 2 AKI was seen in 17 (54.8%) cases and Stage3 AKI was seen in 6 (19.3%) cases. None of these patients had oliguria or requirement of dialysis during hospital stay. 54.8% of patients had persistent AKI at the time of discharge.Hypokalemia was seen in 77.4% cases and 41.9% had severe hypokalemia requiring IV potassium treatment.Hyponatremia was seen in 51.6% cases, most of these cases were mild and only one patient had severe hyponatremia requiring hypertonic saline infusion.Hypomagnesemia was seen in 29 % cases. Conclusion(s): LAmB was associated with significant nephrotoxicity resulting in development of AKI in 30% of cases.Most of these cases had stage 2 AKI and none of them required dialysis support.Almost half of the study population had persistent AKI at the time of discharge.Among the electrolyte disorders,Hypokalemia was particularly severe. No conflict of interestCopyright © 2023
ABSTRACT
A COVID 19 outbreak caused by the new SARSCoV2 virus was declared by the World Health Organization (WHO) in March 2020. Since then, other studies have used Chest Xray or CT scans to identify this infection. Often, one aspect of the study is that these XRAY or CT scans of Covid patients have to be enhanced. The purpose of picture fusion is to merge complimentary, multi-sensor and/or multi-view images. Our major purpose of our work is to assist doctors speed up treatments in order to give their patients the most effective remedies as soon as possible. This study employs two multi-view data sets, which are merged using hybrid methodology and divided into two phases, as input images for our system. In first stage we use two fusion rules of Dual tree Complex Wavelet Transform (DT-CWT) and Discrete Cosine Transform (DCT) separately on both the images. In second stage we use fusion rule based on Singular Value Decomposition (SVD) on those fused images acquired from first stage. The performance of fused image is carried out by standard deviation (SD), root mean square (RMSE), peak signal to noise ratio (PSNR), percentage fit error (PEF), mean absolute error (MAE), mutual information (MI), quality index (QI) and measure of structural similarity (SSIM). © 2021 Author(s).
Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , COVID-19/prevention & control , Health Facilities , Employment , Delivery of Health CareABSTRACT
Context: The ongoing COVID-19 pandemic poses important challenges to mental health. Pregnant women are a vulnerable group to experience adverse psychological impact of the pandemic, with consequences on maternal and foetal outcomes;currently there are scant data for the same in India. To the best of our knowledge, this report is the first from India on psychological status of pregnant women during COVID-19 pandemic. Aim: The aim is to study the impact of ongoing COVID-19 pandemic on psychological status of pregnant women. Setting and Design: Cross-sectional observational study in a tertiary care hospital setting in Mumbai. Materials and Methods: Out of total 98 pregnant women reporting to antenatal clinic of the hospital during the study period from June to July 2020, 66 gave informed consent to participate in the study. Perceived Stress Scale (PSS-10), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) were administered using an online form. Statistical Analysis: Group comparisons were analyzed using appropriate nonparametric tests. Results: About 66.7% of women were primigravida, 39% in second trimester and 75.8% in age group 21-30 years. 28.8% missed scheduled antenatal visit, higher when compared to hospital data prior to pandemic. 39.4% worried about their unborn baby getting infected from Corona virus and 25.8% worried about themselves getting infected. About 72.2% reported moderate levels of perceived stress as measured by PSS-10, 51.6% reported mild-to-moderate level of depressive symptoms by PHQ-9 and 39.4% reported mild-to-moderate anxiety symptoms by GAD-7. PHQ-9 and GAD-7 scores of women aged 21-30 years were higher than those aged 31-40 years (P = 0.017 and 0.005 respectively). Conclusion: High rates of perceived stress, depressive, and anxiety symptoms in pregnant women found in this study suggest a need to incorporate psychological screening and interventions in routine antenatal care during ongoing pandemic.