Barotrauma and its complications in COVID-19 patients: a retrospective study at tertiary care hospital of Eastern India.

Background: The development of barotrauma in COVID-19 patients who were ventilated and admitted to the intensive treatment unit seemed to have been a problematic issue in the COVID era. This study aimed to explore the possibility of developing the barotrauma-related issues with mechanical ventilation in the cases of individuals suffering from COVID-19. Results: Out of 48 patients who developed barotrauma, 30 (62.5%) presented with pneumothorax, 22 (45.8%) with pneumomediastinum, 10 (20.8%) with subcutaneous emphysema, and 2 (4.1%) with pneumopericardium. Of those that developed barotrauma, 45 (93.7%) patients were in acute respiratory distress syndrome. In patients with and without barotrauma, significant factors were white blood cell count (p = 0.001), neutrophil percentage (p = 0.012), and lymphocyte percentage (p = 0.014). There were no statistically significant differences in CRP, procalcitonin, d-dimer test, LDH, or ferritin. Conclusions: Patients infected with COVID-19 have a high risk of barotrauma when on mechanical ventilation. As a result, the death rate in this patient group is higher.

Emphysematous epididymo-orchitis: An unusual case report.

INTRODUCTION: Emphysematous epididymo-orchitis in the young to middle age groups without any comorbidity like diabetes or metabolic disorders is an uncommon entity. CASE REPORT: We present a case of a nondiabetic young patient, diagnosed with emphysematous epididymo-orchitis as a sequela to urinary tract infection. DISCUSSION: Clinically differentiating diagnoses of the acute scrotum may be difficult and ultrasound can be used reliably as the initial modality showing the presence of air for early diagnosis. CONCLUSION: Nondiabetic young patients without any metabolic disorder should also be suspected for emphysematous epididymo-orchitis in the setting of the acute scrotum. An ultrasound examination can predict its presence with confidence.

Ultrasonography: An Unchartered Modality in the Current Pandemic - A Study among Patients Admitted in the COVID-19 Intensive Care Unit.

BACKGROUND: The objectives were to perform an analysis of lung ultrasonography (LUS) findings in severely ill patients with novel coronavirus disease-2019 (COVID-19) and to compare the accuracy with high-resolution computed tomography (HRCT) of the thorax. METHODS: Sixty-two intensive care unit (ICU) patients with COVID-19 were evaluated during their hospital stay. LUS was performed with convex and linear transducers using a designated ultrasonography machine placed in the COVID-19 ICU. The thorax was scanned in 12 areas. Initial LUS was performed on admission and follow-up LUS was done in 7 (mean) days. At the time of the initial LUS, HRCT was performed in 28/62 patients and a chest radiography in 19/62 patients. RESULTS: On admission, LUS detected pleural line thickening (>6 lung areas) in 49/62, confluent B-lines in 38/62, and separate B-lines in 34/62, consolidation in 12/62, C prime profile in 19/62, and pleural and cardiac effusions in 4/62 and 1/62, respectively. The single beam "torchlight" artifact was seen in 16/62, which may possibly be a variation of the B-line which has not been described earlier. Follow-up LUS detected significantly lower rates (P < 0.05) of abnormalities. CONCLUSION: Ultrasound demonstrated B-lines, variable consolidations, and pleural line irregularities. This study also sheds light on the appearance of the C prime pattern and "torchlight" B-lines which were not described in COVID-19 earlier. LUS findings were significantly reduced by the time of the follow-up scan, insinuating at a rather slow but consistent reduction in some COVID-19 lung lesions. However, the lung ultrasound poorly correlated with HRCT as a diagnostic modality in COVID-19 patients.

Evaluation of intrahepatic and extrahepatic biliary tree anatomy and its variation by magnetic resonance cholangiopancreatography in Odisha population: a retrospective study.

Intrahepatic and extrahepatic anatomical knowledge is essential for pre procedural planning of liver transplantation, liver resection, complex biliary reconstruction and radiological biliary tree intervention. Indian data of biliary anatomy and its variation is scant in literature. The aim of our study is to find out the prevalence of common and uncommon pattern of biliary tree anatomy in magnetic resonance cholangiopancreatography (MRCP) in our population. A total of 1,038 cases of MRCP of population of Odisha were obtained from Picture Archiving and Communication System of the department and were reviewed by two senior radiologists for anatomical pattern and variations. The typical and most common pattern of right hepatic duct (RHD) branching was seen in 72.8% cases. The most common variant of RHD was trifurcation pattern of insertion of right anterior sectoral duct (RASD), right posterior sectoral duct and left hepatic duct (LHD) forming common hepatic duct (CHD) in 11.3% of cases. The common trunk of segment (SEG) II and III ducts joining the SEG IV duct was the most common LHD branching pattern in 90.3% of cases. The most common pattern of cystic duct was posterior insertion to middle third of CHD (42.8%). MRCP is the non-invasive imaging modality for demonstration of biliary duct morphology to prevent iatrogenic injury during hepatobiliary intervention and surgery.

A comparative study of antibacterial and antifungal activities of extracts from four indigenous plants.

A repetitive and wide use of chemical antibiotics has brought a serious threat in the biomedical and clinical sectors by the emergence of multidrug resistant pathogens. Plants have secondary metabolites that make them suitable candidate for natural antimicrobial agent without any side effect. In this study, we assessed comparative antibacterial and antifungal effects of extracts from four Indigenous plants (Nerium sp; Mentha sp; Aloe vera and Eucalyptus sp). Total phenolic and flavonoid content were extracted by microwave-assisted extractor and used for phytochemical assay. Antimicrobial experiment was done by micro dilution technique. A post hoc analysis inbuilt with one-way ANOVA test was used for the compilation of antibiotic sensitivity data and percent inhibition. Total phenolic content was significantly high in Mentha sp. and low in Nerium sp. (All p < 0.05). In antibacterial and antifungal activity higher concentrations of extracts showed a strong activity, which was as good as antibiotics used as control. Results from Eucalyptus sample showed a significant growth reducing capability even at lower concentrations. This study concludes that the plant extracts can be used to treat microbial infections with almost same efficacy as antibiotics and with a lower chance of resistance development.

Physiological and biochemical responses of Amaranthus cruentus to polycyclic aromatic hydrocarbon pollution caused by thermal power units.

Pollution due to release of polycyclic aromatic hydrocarbons from thermal power plants is a major global issue as the same is highly toxic and carcinogenic. The current research aims to investigate the responses of a dietary plant Amaranthus cruentus towards PAH pollution. For the said purpose, the plant was collected from agricultural land in close vicinity to thermal power units and the effects of PAH pollution on its chlorophyll and various nutraceutical content was evaluated. Oxidative stress biomarkers and antioxidant defense enzymes status and PAH accumulation was quantified as well. Real-time evidence of cell death, depletion of nutraceutical resources, and stomata configuration was generated through various histochemical studies and SEM analysis. Results indicated significant decline of chlorophyll a to the extent of 77% when compared to control. Oxidative stress markers, namely, superoxide radical, H2O2, and hydroxyl radical in pollution exposed plants were 12.7, 2.2, and 2.4 times respectively higher over the control which eventually resulted in 35% more cell death for the pollution exposed group. Total phenolics and flavonoids showed a decline of 57.6% and 41.3% respectively in the group exposed to PAH pollution. Similar decreasing trend was also observed for ascorbic acid, α-tocopherol, ß-carotene, total proteins, and carbohydrate contents as well. PAH-induced stress also resulted in complete imbalance in the redox homeostasis of the plant which was evident from increase in super oxide dismutase, catalase, and peroxidase antioxidant enzymes by more than 2-fold when compared to control. PAH accumulation in sample group was 10-20 times more when compared to control. Proteomic analysis also indicated upregulation of some proteins related to stress situation. Results are evident of the fact that severe depletion of nutraceutical resources of dietary plants can take place if subjected to oxidative stress arising from PAH pollution.

Critical analysis and mapping of research trends and impact assessment of polyaromatic hydrocarbon accumulation in leaves: let history tell the future.

The article is basically an attempt to provide a consolidated report on impact assessment and trends in research pertaining to accumulation and curbing the menace of polyaromatic hydrocarbon (PAH) accumulation in leaves. Emphasis is given to understand the consequences of the fact that edible/medicinal plants cultivated in PAH contaminated soil or close to such places which are potential liberators of PAHs can virtually act as transporters for direct PAH entry into biological systems. An attempt has been made to predict the future by digging out golden facts from history. Extensive Scopus-based data mining has been done to dig out research data since last 10 years (2006-2016) pertaining to the said area. Critical analysis of statistical data on research trends highlighting the different aspects of evaluation of PAH accumulation in leaves has been described. The concentrate of all researches for the said period have been presented as few golden principles which shall serve as important facts for researchers and policy makers for curbing the menace of PAH-induced oxidative stress in plants and shall also provide start-up ideas for researchers new to the area. Critical analysis of trends in phytoremediation aspect has also been duly highlighted to measure the intensity of restoration steps taken by researchers and government to safeguard the future generations.

A Novel Triage Tool: Optic Nerve Sheath Diameter in Traumatic Brain Injury and its Correlation to Rotterdam Computed Tomography (CT) Scoring.

BACKGROUND: Optic nerve sheath diameter (ONSD) evaluated in CT imaging as well as Rotterdam CT Score (RCTS) are proven independent predictors of outcome in patients with traumatic brain injury (TBI). To date, no study has correlated ONSD on admission CT scan with RCTS. MATERIAL/METHODS: Retrospective cohort study comprised of consecutive patients undergoing CT imaging for traumatic brain injury recruited between January and October 2015. Bilateral ONSD was measured 3 mm behind the eyeball in axial and sagittal planes and mean value was calculated. RCTS was assessed on the same CT images, bias was eliminated by blinding RCTS to ONSD measurement. RESULTS: 150 patients were included; mean age in the group was 42.94±16.7 years. ONSD in mild TBI, RCTS 2 and 3 were 3.3 mm (SD 0.39 mm) and 4.1 mm (0.047 mm), respectively. Mean ONSD in moderate and severe TBI (RCTS score 4 and above) was 4.83 mm and above, SD 0.4 mm. Mean ONSD correlated with occurrence of diffuse cerebral oedema, presence of subdural and extradural hematoma; however in isolation there was no statistical significance. CONCLUSIONS: Higher ONSD was observed in patients with moderate and severe TBI, correlating with admission RCTS of 4 and above. Subsequent increase in ONSD was also found with increase in RCTS. ONSD could serve as an initial triage tool in the emergency department as well as a method of determining the need for sequential CT in patients with mild TBI.

Magnetic resonance imaging in obstructive Müllerian anomalies.

Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures. It is characterized by the triad of didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. Magnetic resonance imaging (MRI) is a sensitive, non-invasive diagnostic modality for demonstrating anatomic variation and associated complications.