Chest X-Ray Severity Index as a Predictor of Requiring Invasive Positive Pressure Ventilation in COVID-19 Positive Patients.

The aim of this study is to see the role of the chest X-ray severity index (Brixia score) as a predictor of requiring invasive positive pressure ventilation in COVID-19-positive patients. This descriptive cross-sectional prospective study were carried out in the Department of Pulmonology and Radiology, Mayo Hospital, Lahore. The data were collected from 1st May to 30th July 2020 from 60 consecutive COVID-19 positive patients. Analysis was conducted using each patient's age, gender, clinical presentation, and the report of CXR containing the most elevated score. The mean age of the study participants was 59.43±11.27, and 81.7% of patients had positive Brixia scores (≥8). Brixia score had high sensitivity (93.886) and specificity (90.91%) to predict the need for IPPV using chest X-rays. It showed excellent predictive power, having a high numerical AUC (0.870) and a statistically significant p-value (<0.0001). High Brixia score conferred a high risk of the need for invasive positive pressure ventilation due to COVID-19. Key Words: Chest X-ray, Brixia score, COVID-19, Invasive positive pressure ventilation.

Effects of visual aid on state anxiety, fear and stress level in patients undergoing endoscopy: a randomized controlled trial.

OBJECTIVES: The present study aimed to calculate the estimated size and confidence interval for the effects of adding visual aid to counselling on anxiety, stress and fear of patients undergoing upper gastrointestinal endoscopy. The secondary aim was to calculate confidence interval for endoscopy-related variables that predict which patients are likely to benefit from visual aids. METHOD: In a randomized, single-blind, two arm, parallel group, superiority trial, 232 consecutive patients who were scheduled to undergo either gastroscopy or colonoscopy were randomly divided into two intervention groups; counselling with video of endoscopic procedure and counselling with no-video (n = 116 in each group). Primary outcome was anxiety and secondary outcomes were stress and fear. RESULTS: One-way ANCOVA showed that there was significant between group differences of anxiety, stress and fear after controlling for the effect of covariates. Planned contrasts revealed that counselling along with visual aid of endoscopy procedure significantly decreased anxiety [Mean difference at post; -4.26 (-4.47, -4.05), p < .001, partial η2 = 0.88], stress [-5.35 (-5.63, -5.07), p < .001, partial η2 = 0.86] and fear [-2.82 (-2.97, -2.67), p < .001, partial η2 = 0.86] compared to counselling alone. Linear regression showed that gender, nature of complaints and concern over seniority of endoscopist were significant negative predictors, however, satisfaction on briefing of endoscopy procedure was significant positive predictor of outcome variables in visual aid condition. CONCLUSION: The increase in anxiety, acute stress and fear related to endoscopic procedures can be alleviated with psychological counselling coupled with visual aids before the procedure. Visual aid could lead to supplementary benefits in reducing anxiety scores. TRIAL REGISTRATION: ClinicalTrial.gov Number: NCT05241158. Registered 16/11/2022; https://clinicaltrials.gov/ct2/show/NCT05241158KEY MESSAGESCounselling along with visual aid of endoscopy procedure significantly decreased anxiety, stress and fear as compared to counselling alone.Male patients were less stressed after visual aid intervention as compared to female patients. Patients who had chronic GI symptoms were less stressed after visual aid intervention as compared to those who had acute GI symptoms. Patients who had concern over seniority of endoscopist were less stressed after visual aid intervention as compared to those who had no concerns over seniority.Satisfaction on briefing of endoscopy procedure was significant positive predictor of stress and fear.