A Comparative Study of the Patterns of Mortality in COVID-19 Patients in Juxtaposition with Non-COVID-19 Mortality in the First and Second Waves of the Pandemic.

BACKGROUND AND OBJECTIVES: The Coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to the public healthcare system worldwide like none before, producing far-reaching global economic, humanitarian, and social crises. It is estimated to have affected more than 1.8 million people worldwide. India has faced two phases of the pandemic, being the country with 2nd most number of deaths with varying mortality patterns across the two waves. In this study, we compare the patterns of mortality between the two phases of pandemics in association with COVID-19 and non-COVID-19 deaths. MATERIALS AND METHODS: A retrospective observational study at a tertiary care center in Central India was carried out. Demographic patterns of mortality have been studied in each of the groups, and a comparative analysis was done between COVID-19 and non-COVID-19 mortality patterns in each phase of the study, that is, from 20th March 2020 to 19th September 2020 and from 20th September 2020 to May 2021, as well as between the two phases. RESULTS: The case fatality rate of COVID-19 positive patients in the second phase of the study was 22.04%, whereas the those of non-COVID-19 patients in the second phase were found to be 15.95%. A maximum number of COVID-19 positive deaths during the first wave of the pandemic occurred in September 2020 and during the second wave in April 2021. In the first phase of the study, 69.6% of patients who died were males, and 30.3% were females, whereas in the second phase among COVID-19 positive subjects, 65% deaths were among males, and 35% deaths were among females. COVID-19 positive mortality in the second phase showed, 26.53% to be hypertensive, while 13.8% were diabetic. CONCLUSION: It was found that most of the deaths in both phases of COVID-19 amongst COVID-19 positive patients and non-COVID patients were amongst the elderly population (>60 years) with male predominance. Most deaths in both populations occurred during the first 3 days of admission whereas it was relatively less in the second phase. Noncommunicable diseases like systemic hypertension, and DM had a significant influence on all-cause mortality and morbidity in both COVID-19 positive and non-COVID-19 patients in the first and second waves of COVID-19. Noncommunicable diseases thus played a major role in mortality among both the populations under study.

Study and Correlation of Clinical, Laboratory and Radiological Findings in the Diagnosis of Thyroid Disorders.

Diseases of thyroid gland are among the most abundant endocrine disorders. Both hypothyroidism and hyperthyroidism have been linked with increased risk of cardiovascular disease and adverse effects of thyrotoxicosis in terms of osteoporosis risk is well established. Early diagnosis and treatment is the cornerstone of management of thyroid disorders. Anti-TPO antibody are useful markers for the detection of autoimmune thyroid disease while ultrasonography is the modality of choice for characterization of thyroid disease.Our study aims to review the relationship between clinical,laboratory and USG findings in the diagnosis of thyroid disorders. MATERIAL: An observational prospective study was conducted in a tertiary health care centre for a period of 18 months.Adult patients with symptoms of thyroid disease and deranged FT3/FT4/TSH were included. Anti-TPO antibody was done using ELISA.Chi-square was used to compare data with p-value <0.05 was considered to be significant. OBSERVATION: Total 150 patients were analysed out of which 23 were males and 127 were females. Maximum patients were found in 31-45year age group. Subclinical hypothyroidism was noted in 50% patients followed by overt hypothyroidism (21.3%),overt hyperthyroidism (21.3%) and subclinical hyperthyroidism (6%). Most common symptom of subclinical hypothyroidism was fatigue. 62% patients were positive for Anti-TPO antibody,out of which 90% were females and rest were males. The most common USG finding was diffuse thyroid disease(51.3%), followed by normal USG(19.3%),thyroiditi s(11.3%),multinodular goitre(10%) and single nodule(6%). Among those patients with diffuse thyroid disease on USG,85% patients had positive Anti-TPO antibody levels. CONCLUSION: According to the present study, Anti-TPO antibody has been statistically associated with thyroid disease. Diffuse hypoechogenecity on USG is statistically associated with positive Anti -TPO antibody and thus have a major role in diagnosing etiology and predicting prognosis of patients with thyroid disorders.