Platypnea-orthodeoxia syndrome: A dangerous detour of intermediate syndrome with organophosphorus poisoning.

Dyspnea experienced in the upright position which is relieved in the supine position, is known as Platypnea. Accompanying desaturation in the arterial blood associated with Platypnea is known as orthodeoxia. Various causes of Platypnea orthodeoxia syndrome, such as hepatopulmonary syndrome, patent foramen ovale and atrial septal defects, are well described in the literature. However, a rather uncommon and underreported cause of Platypnea orthodeoxia syndrome is organophosphorus poisoning. We report a case series of three cases that were reported after ingestion of organophosphorus compounds and developed breathlessness later in the course of the hospital stay, which was diagnosed as Platypnea orthodeoxia syndrome resulting from organophosphorus poisoning. All three cases were treated with supportive management, incentive spirometry and respiratory physiotherapy and responded well to the treatment.

Association of serum ferritin with COVID-19 in a cross-sectional study of 200 intensive care unit patients in a rural hospital: Is ferritin the forgotten biomarker of mortality in severe COVID-19?

Background: The COVID-19 disease caused by the SARS-CoV-2 virus, has toppled the world since first case noted in 2019, and the cases have been increasing there after. This grave effect is caused by the cytokine storm induced inflammation produced by the noxious virus. As it is an inflammatory state, various acute phase reactants are expected to raise; thus serum ferritin is contemplated to increase. Here we aim to anchor serum ferritin as a way marker for diagnosis and management of COVID-19 patients and study its role as a prognostic marker. Another aspect is the association of COVID-19 with the N: L ratio; observation has stated that higher N: L ratio results in more severe outcome. The study aimed to establish a correlation of COVID-19 severity with serum ferritin in the form of HRCT Score, N: L Ratio and Clinical Outcome in the patients admitted in Intensive Care Unit. Result: Out of 200 patients who were admitted in the intensive care unit with COVID-19, the association of serum ferritin with N: L Ratio and HRCT Score was significant, and the association of serum ferritin with clinical outcome in terms of discharged and expired was found to be statistically significant. Conclusion: Serum ferritin was found to be a potent marker for clinical outcome in intensive care unit patients in terms of death versus treated. HRCT Score and N:L ratio were found to be correlated with serum ferritin. Therefore, we conclude that serum ferritin may determine the severity of COVID-19 infection and it can be used as a marker for Clinical Outcome thereby making it an often neglected biomarker for predicting prognosis in COVID-19 with most of the physicians focusing mostly on interleukin 6, C Reactive protein and d dimer as a marker of severe COVID infection.