Correlation between oxygen saturation of patient and severity index of Covid 19 pneumonia on CT.

OBJECTIVE: To investigate the correlation between capillary blood oxygen saturation and computerised tomography severity index in patients with coronavirus disease-2019 pneumonia. METHODS: The cross-sectional analytical study was conducted at the coronavirus disease-2019 ward of Nishtar Medical University and Hospital, Multan, Pakistan, June 1, 2020, to June 1, 2021. At the time of admission, capillary oxygen saturation of all patients was measured. Pulmonary computerised tomography scans were then performed, and computerised tomography severity index was calculated. Data was analysed using SPSS 18. Results: Of the 170 patients, 90 (52.9%) were males and 80(47%) were females. The overall mean age of the sample was 56.32±12.45 years. At the time of admission, the mean oxygen saturation was 88.9±6.53% and the mean severity index was 15.01±7.79. Overall, 22(12.9%) patients had hypoxia and the severity index reading was significantly high in these patients (p=0.001). Chronic obstructive pulmonary disease, hypertension and diabetes were significantly related to reduced blood oxygen saturation (p<0.05). Patients with hypertension had significantly raised computerised tomography scores. A significant inverse correlation was found between capillary oxygen saturation and computerised tomography severity index (p<0.01). CONCLUSIONS: A significant inverse correlation was found between capillary oxygen saturation and computerised tomography severity index. Underlying comorbidities also affected the severity index.

Vitamin D for the treatment of painful diabetic neuropathy.

OBJECTIVE: To assess the effect of high-dose vitamin D in patients with painful diabetic neuropathy. METHODS: A single intramuscular dose of 600 000 IU vitamin D was administered, and the effects on metabolic parameters and neuropathic pain assessed over 20 weeks. RESULTS: 143 participants with predominantly type 2 diabetes, aged 52.31±11.48 years, with a Douleur Neuropathique 4 (DN4) score (3.0±1.8), total McGill pain score (21.2±14.9), and Short Form McGill Pain Questionnaire (SFMPQ) score (2.1±0.9), were enrolled. The baseline 25-hydroxyvitamin D (25(OH)D) level was 31.7±23.3 ng/mL and 58 (40.5%) patients showed evidence of vitamin D deficiency (25(OH)D<20 ng/mL). Intramuscular administration of vitamin D resulted in a significant increase in 25(OH)D (46.2±10.2 ng/mL, p<0.0001) and a reduction in positive symptoms on the DN4 (p<0.0001), total pain score (p<0.0001), and SFMPQ (p<0.0001). CONCLUSIONS: Treatment with a single intramuscular dose of 600 000 IU of vitamin D in patients with painful diabetic neuropathy is associated with a significant decrease in the symptoms of painful diabetic neuropathy. TRIAL REGISTRATION NUMBER: BIDE-12/2014.

Adherence of Healthcare Professionals to American Diabetes Association 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics in Karachi, Pakistan.

OBJECTIVE: To observe the adherence of Healthcare Professionals to American Diabetes Association (ADA) 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics (PDCs) in Karachi, Pakistan. METHODOLOGY: The study was conducted using a retrospective medical chart review of patients with type 2 diabetes at four PDCs in four townships of Karachi district from January 2005 to December 2006. Entire medical records of patients were evaluated for the evidence of documentation of testing and treatment. RESULTS: Medical records of 691 patients (332 males and 359 females) with type 2 diabetes were reviewed. Mean age of the patients was 50.79 ± 10.75 years. Deficiencies were observed in most areas of diabetes care. Blood pressure was documented in 85.81% patients, whereas, serum creatinine, HbA1c and lipid profile were noted in 56%, 44.57% and 40.08% of the patients respectively. Similarly, lower leg examination was registered in 44% patients, while in 30.53% of the patients fundoscopic examination was recorded. Co-morbid conditions like hypertension and hyperlipidemia were documented in 92.7% and 84.6% patients respectively. HbA1c < 7% was achieved by 59.04% patients, while 27.50% of the patients attained the recommended level of serum cholesterol. Likewise, ADA recommended goal for blood pressure and LDL was achieved by13.02% and 12.16% patients respectively. CONCLUSIONS: The study showed that adherence of healthcare professionals to ADA guidelines was suboptimal. Moreover, insufficient documentation of medical records reflected inadequate care of patients with type 2 diabetes.