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1.
Chest ; 162(4):A1612, 2022.
Article in English | EMBASE | ID: covidwho-2060849

ABSTRACT

SESSION TITLE: Unusual Cancer Cases SESSION TYPE: Case Reports PRESENTED ON: 10/19/2022 09:15 am - 10:15 am INTRODUCTION: Cutaneous lesions may present as a clue to an internal malignancy and provide an easily accessible site for tissue confirmation. We present a case of an eyelid metastatic lesion presenting as an initial sign of primary pulmonary malignancy. CASE PRESENTATION: A 67-year-old woman with past medical history of SARS-COVID-2 pneumonia six months ago and reformed smoker (26 pack year) who quit 27 years ago, presented to the primary care physician's office with a chief complaint of a small right upper eyelid margin (base of eyelashes) lesion (Figure 1A), and ongoing nonproductive cough and fatigue since diagnosis of SARS-COVID-2 pneumonia. The eyelid lesion appeared two weeks prior and had quickly grown in size. The lesion was associated with mild itching, but without any associated pain, discharge, or bleeding. She also complained of left elbow and foot pain but denied fever, chills, rigors, hemoptysis, pleurisy, and weight loss. Physical examination was negative for lymphadenopathy. Chest x-ray revealed a hazy left upper lobe opacity. Urine antigen for blastomycoses and histoplasma were negative. Rheumatoid factor, erythrocyte sedimentation rate, C reactive protein, QuantiFERON TB gold and anti-nuclear and cyclic citrullinated peptide antibodies were negative. Computed tomography of chest revealed a left upper lobe 3.7 x 5.4 x 5.6 cm mass, numerous bilateral ground glass opacities, and scattered (less than 5 mm) nodules (Figure 1B). Simultaneously, the patient was evaluated by an ophthalmologist for excision of the eyelid lesion. Histopathological evaluation revealed malignancy compatible with metastatic lung adenocarcinoma (Figure 1C) DISCUSSION: While an uncommon presentation, this case highlights the importance of a through history and examination in a patient presenting with pulmonary symptoms with risk factors for a lung malignancy. While she did have imaging that demonstrated lung masses, the diagnosis of lung cancer came not from invasive sampling of these masses, but rather from excision and histopathological evaluation of an eyelid soft tissue mass. Lung cancer is prone to metastasis, however cutaneous manifestations of lung cancer are relatively rare and are more common in the advanced stages of disease, making cutaneous metastasis a poor prognostic factor. In terms of cutaneous metastases, ocular metastases are one of the rarest locations making this a unique presentation. In a patient presenting with pulmonary masses, any concurrent development of new and/or growing skin lesions should be evaluated to rule out metastasis and potentially yield diagnosis. CONCLUSIONS: In patients presenting with concern for a malignant lung process, a skin exam should be completed, and suspicious skin lesions should be biopsied. Although rare, lung malignancies do metastasize to ocular cutaneous tissues and are a marker of more advanced stage of the malignancy. Reference #1: Hidaka T, Ishii Y, Kitamura S. Clinical features of skin metastasis from lung cancer. Intern Med. 1996;35:459-462. Reference #2: Marcoval J, Penin RM, Llatjos R, Martinez-Ballarin, I. Cutaneous metastasis from lung cancer: retrospective analysis of 30 patients. Australas J Dermatol. 2012;53(4):288-290. Reference #3: Abdeen Y, Amireh S, Patel A, Al-Halawani M, Shaaban H, Miller R. Cutaneous metastasis as a first presentation for lung adenocarcinoma. N Am J Med Sci. 2016;8(5): 222-225. DISCLOSURES: No relevant relationships by Gregory Griepentrog No relevant relationships by Chinmay Jani No relevant relationships by Bailey Ray No relevant relationships by Harpreet Singh No relevant relationships by Amit Taneja No relevant relationships by Kara Young

2.
European Journal of Molecular and Clinical Medicine ; 9(6):847-855, 2022.
Article in English | EMBASE | ID: covidwho-2058596

ABSTRACT

Aim and objectives: The present study assessed the correlation between rising levels of CRP and D-dimer with morbidity and mortality in adult Covid-19 patients. Materials and method: This retrospective observational study was conducted at Max Super speciality Hospital I.P. Extension, Delhi a tertiary care centre in North India. CRP and D-Dimer values were collected at the time of admission and within 15 days after admission. The statistical analysis was done by independent t-test. Results: The study population consisted of 194 (64.7%) males and 106 (35.3%) females. The mean age of the study population was 56.78±15.42 (28-94) years. The mean age of the non-survivors (58.83±15.64 years) was significantly more than survivors (54.43±14.85 years). The mean CRP and D-DIMER at the time of admission and within 15 days after admission was significantly more among non-survivors compared to survivors. Conclusion: A high CRP and elevated D-Dimer levels among COVID-19 patients predict higher odds of mortality;however, large scale and longer-term studies are needed to validate our findings. The predictive model based upon CRP and D-DIMER levels can help the clinicians to improve individual treatment, make timely clinical decisions, and make optimal use of limited clinical resources.

3.
Indian Journal of Critical Care Medicine ; 26:S128, 2022.
Article in English | EMBASE | ID: covidwho-2006415

ABSTRACT

Aim and background: Cytokine storm caused by the release of proinflammatory mediators, e.g., IL-6, TNF-, IL2, IL10, G-CSF, etc., is the hallmark of COVID-19 disease. This cytokine storm is characterized by immuno-thrombomodulation. C-Reactive Protein (CRP) and d-dimer are markers of proinflammatory state, which can also be used as a prognostic marker for the underlying disease processes. Objective: To determine the clinical utility of raised C-reactive protein (CRP) and d-Dimer levels as prognostic markers in patients with the diagnosis of COVID-19. Materials and methods: This retrospective observational study will be conducted at Max Super speciality Hospital I.P. Extension, Delhi after ethical committee clearance. Adult (age > 18 years) patients with confirmed diagnosis of COVID-19 admitted to COVID-ICU between 1st April 2021 till 30th June 2021 will be included and checked for CRP and d-Dimer values retrospectively. Correlation between raised CRP and d-dimer on presentation and rising trend of markers with 28-day mortality, Average length of ICU stay, need for invasive mechanical ventilation, and need for Renal Replacement Therapy will be seen. Results: Results will be shared after the completion of the study.

4.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005711

ABSTRACT

Background: Infections occur with up to twofold increased risk in patients with monoclonal gammopathy of undetermined significance (MGUS) and tenfold increased risk in multiple myeloma (MM). To reduce risk, revaccination following autologous hematopoietic cell transplantation (AHCT) is recommended to restore humoral immunity. We have previously shown that vaccine titers after AHCT have prognostic significance. In the COVID era, reliable clinical data about antibody titers is relevant yet scarce. We investigated the significance of different vaccine titers in newly diagnosed patients in different stages of the disease. Methods: The study population comprised of 77 patients with MGUS, smoldering multiple myeloma (SMM) and MM who were seen at a tertiary cancer center from 2018- 2022. All patients had antibody titers (B. pertussis, Diptheria, H. Influenzae B, Hepatitis, Influenza, Meningitis, Mumps, Rubeola, Rubella, Poliovirus, S. pneumoniae, Varicella Zoster and Tetanus) tested at the time of diagnosis, prior to start of treatment if indicated. Titers were interpreted in accordance with the manufacturers' recommendations. Patient characteristics were compared using the Kruskal- Wallis and Fisher's exact tests. Associations with % titer positivity were evaluated using the Kruskal- Wallis test. Results: There was significant difference in antibody titer positivity between the different patient groups (51.4% in MGUS, 40.5% in SMM and 34.2% in MM) (p < 0.001). There was no difference in antibody titer positivity depending on age, sex or race. Among individual pathogens, there was a significant difference between the three groups in regards to titers for Diphtheria, Mumps, Poliovirus 3, Strep pneumoniae 19, Strep pneumoniae 56 and Varicella Zoster. Conclusions: Antibody titers for vaccine preventable diseases are significantly different between patients with MGUS, SMM and MM at the time of diagnosis, with MGUS having the highest and MM having the lowest positivity. Patient related factors such as age, sex or race were not associated with antibody titer positivity. Current guidelines for revaccination are not extended to patients with MGUS and SMM and can be considered in prospective trials.

6.
Economic and Political Weekly ; 56(40):12-15, 2021.
Article in English | Scopus | ID: covidwho-1469294

ABSTRACT

COVID-19 has not only caused deaths but has also exacerbated hunger and starvation due to nationwide lockdowns in the country that have led to a massive breakdown in the supply chain networks. These tough times are no less than a "wake-up call" for India to devise a permanent supply chain solution that ensures an uninterrupted supply of food and nutrition as well as timely healthcare and employment for its population. © 2021 Economic and Political Weekly. All rights reserved.

7.
Library Philosophy and Practice ; 2021:1-16, 2021.
Article in English | Scopus | ID: covidwho-1212295

ABSTRACT

Due to the outbreak of COVID-19, the educational institutions in India suddenly switched to online mode of teaching. This new learning mode gives the flexibility to connect at any time from any place. This sudden shift has impacted the learning behaviour of students to a large extent, which is studied and analysed in this paper for a computer programming course. An online questionnaire is prepared and circulated among the students for which 158 responses were received. Based on the responses, it is found out from the analysis that 75.32% of students favour learning this course in offline mode while 48.1% favour the virtual mode. The maximum support for the classroom teaching is evident from the data which shows that 98.73% students find the teacher’s competency good in offline mode, 98.1% find teacher’s content delivery effective in offline mode and 79.75% are of the view that possibility of frequent interaction is more in offline mode, whereas 87.97%, 85.44% and 42.41% of students are congenial with the online mode in terms of same parameters. Also, 69.62% of students are comfortable with offline mode, while 55.06% with online mode. For evaluation mode and pattern of question paper, 78.5% favour online mode of evaluation with a mix of multiple-choice questions and coding questions. It is irrespective of their preference to offline mode for teaching-learning. In the end, some recommendations are proposed based on the analysis to improve the teaching-learning methodology during the time of crisis. © 2021

8.
Medico-Legal Update ; 21(1):1240-1246, 2021.
Article in English | EMBASE | ID: covidwho-1068408

ABSTRACT

The outbreak of (COVID-19) has created a global health crisis that has had a deep impact on the way we perceive our world and our everyday lives. This survey was helpful to know the impact of neck pain and leisure activity during lockdown of Female IT workers while remaining at work, and to analyse psychosocial effect on neck pain. Methodology: Female office workers with neck pain (n = 60) completed a survey about impact of their neck pain and leisure activities. Consequences of neck pain were evaluated with questions on self-reported impact on work and leisure activity. Responses to survey questions were analysed using descriptive analyses. Result: The point prevalence of NP was significantly related to age, gender, health status, job satisfaction, and length of employment. Conclusions: The findings provide evidence that the impact on work and leisure was substantial.

9.
Indian Journal of Forensic Medicine and Toxicology ; 14(4):6982-6985, 2020.
Article in English | Scopus | ID: covidwho-1068384

ABSTRACT

Background: Coronavirus is RNA virus, positive stranded, and is enveloped was first isolated in 1965, can cause symptoms like common cold, severe respiratory symptoms,gastrointestinal,liver and CNS symptoms. WHO announced the original name of coronavirus as COVID19. This virus has been named as Severe Acute Respiratory Syndrome Cov-2 currently and WHO has now declared this virus as emergency of public health concern. More than seventy thousand people in the China and 25 other countries have been infected. Materials and Method: Various lab investigations like CBC, Real Time-PCR, d-dimer levels, cell culture, electron microscopy, Low platelet count, ESR, CRP levels, Chest CT, Xray, Liver and Kidney Function tests, SOFA (sequential organ failure assessment) score have been useful in diagnosing the causative agent. Conclusion: Since no antiviral treatment has been effective till now so transmission can be slowed down by preventive measures like self-quarantine,isolation, maintaining distance from one another and use of personal equipment. © 2020, Institute of Medico-Legal Publications. All rights reserved.

10.
Indian Journal of Public Health Research and Development ; 11(12):41-46, 2020.
Article in English | EMBASE | ID: covidwho-995326

ABSTRACT

Background: The explosion of coronavirus disease Covid-19 has created as a worldwide health crisis that has had a deep impact on the way we perceive our world and our everyday lives. Not only the Speed, but the security measures put in situ to contain the spread of the virus also require social distancing by refraining from doing what’s inherently human, Quarantine keeps such people far away from others so that they don’t unknowingly infect anyone in their vicinity. It’s employed by Governments to stop the spread of communicable diseases. Such a survey would help me to understand the impact of psychological state and Stress during Quarantine to guard against (COVID-19). Objective: To find out the impact of Quarantine on Mental Health and Stress to protect against the coronavirus (COVID-19). Methods: 65 PEOPLE were asked by questionnaire to fill 20 different questions related to Social, distancing is a public health strategy to limit the spread of COVID-19. Result: The result of this study supports that 65 people, who they are Quarantine. At least or more than 15 days, are suffering from moderate to high-level Stress. Conclusion: The social isolation, quarantine, and lockdown can increase stress responses and generate more status of uncertainty.

11.
International Journal of Research in Pharmaceutical Sciences ; 11(Special Issue 1):1163-1166, 2020.
Article in English | EMBASE | ID: covidwho-995045

ABSTRACT

Coronavirus is an RNA virus, positive stranded, and enveloped was first iso-lated in 1965, can cause symptoms like common cold, severe respiratory symptoms, gastrointestinal, liver and CNS symptoms. WHO announced the original name of coronavirus as COVID 19 in December 2019. This virus has been named as Severe Acute Respiratory Syndrome cov 2 currently and WHO has now declared this virus as emergency of public health concern. More than seventy thousand people in China and 25 other countries have been infected. The confirmed cases of Covid 19 Infection, up to 14th April, 2020 in India were 11,487 and out of which 393 have been deceased and most number of cases were found to be confirmed in Maharashtra (2,684). Animals like camels, cattles, cats, bats probably serve as hosts for coronavirus. Various laboratory investigations like CBC, Real Time-PCR, D-dimer levels, cell culture, electron microscopy, Low platelet count, ESR, CRP levels, Chest CT, X ray, Liver and Kidney Function tests, SOFA (sequential organ failure assessment) score have been useful in diagnosing the causative agent. Since no antiviral treatment has been effective till now, so the transmission can be slowed down by preventive measures like self quarantine, isolation, maintaning distance from one another and use of personal equipments.

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