Introduction
Background
Burden of COVID 19
Need of the study
Rationale of the study
Review of literature
Epidemiology
Hypothesis
Aim and objective
Material and Method
Criteria
Study design
Outcome
Result
Analysis
Discussion
Coronavirus are a large family of viruses that causes illness ranging from the common cold to more serve disease such as middle east respiratory syndrome(MERS-COV) and sever acute respiratory syndrome (SARS-COV).
A novel corona virus (nCOV) is a new strain that has not been previously identified in humans.
SARS-CoV-2 belongs to the Single Standing RNA Viruses class of coronaviruses, but the infection had been rapidly spreading around the world and World Health Organization (WHO) declared a pandemic .
The document discusses kidney involvement in COVID-19 patients. It notes that acute kidney injury (AKI) occurs in 3-9% of early COVID-19 patients, rising to 19-50% of ICU patients. AKI is associated with higher mortality, between 35-90% among those with COVID-19. Pathological findings include collapsing glomerulopathy and acute tubular injury. Viral particles have been found in podocytes and tubular cells on postmortem and kidney biopsy studies.
PCR Assay Turned Positive in 25 Discharged COVID-19 PatientsValentina Corona
1) The study found that 14.5% (25/172) of discharged COVID-19 patients in China later tested positive again for the virus based on RT-PCR testing after being discharged from the hospital.
2) These patients met criteria for discharge but tested positive again within 2-13 days without worsening symptoms.
3) The study suggests that more than two negative RT-PCR tests separated by 48 hours or combining RT-PCR tests with antibody and other immunological markers may be needed to confirm viral clearance before discharge.
Γρηγόριος Γεροτζιάφας, Health Innovation Conference 2021Starttech Ventures
Ομιλία – Παρουσίαση:“Artificial intelligence and personalised medicine for patients at high risk of severe COVID-19”
Γρηγόριος Γεροτζιάφας, Καθηγητής Αιματολογίας, Ιατρική σχολή της Σορβόνης, Υπεύθυνος, Τμήμα Θρόμβωσης, Νοσοκομείο Tenon, Παρίσι & Διευθυντής, Ερευνητική Ομάδα Καρκίνος και Θρόμβωση INSERM U938
The document summarizes the link between hypertension (HTN) and COVID-19. It finds that approximately 22.5% of COVID-19 patients have HTN, making it the most common comorbidity. Patients with HTN who contract COVID-19 have a higher risk of severe outcomes like intensive care unit admission and death. The document also discusses how the renin-angiotensin-aldosterone system, which HTN medications target, may impact the interaction of the COVID-19 virus with the body. Specifically, angiotensin-converting enzyme 2 is utilized by the COVID-19 virus to enter cells and HTN medications like ACE inhibitors may alter ACE2 expression levels.
Outcome of 16 years of hemodialysis infection controlJAFAR ALSAID
The study analyzed the outcomes of a tight infection control protocol over 16 years in a hemodialysis unit. The protocol was successful in limiting hemodialysis-related bloodstream infections and admissions. Specifically:
- The rate of hemodialysis-related bloodstream infections was 0.003 per 100 patient months, far below the international reported rate of 0.75-4.4 infections per 100 patient months.
- The admission rate for hemodialysis-related bloodstream infections was 0.4 per 1000 patient years, much lower than the international rate of 108 admissions per 1000 patient years.
- Only 12 patients experienced hemodialysis-related bloodstream infections over nearly 19 years and
Presentation of Dr. Lluis Blanch at 10th Pulmonary Medicine Update Course, Cairo, Egypt. Pulmonary Medicine Update Course is organized by Scribe : www.scribeofegypt.com
The document discusses kidney involvement in COVID-19 patients. It notes that acute kidney injury (AKI) occurs in 3-9% of early COVID-19 patients, rising to 19-50% of ICU patients. AKI is associated with higher mortality, between 35-90% among those with COVID-19. Pathological findings include collapsing glomerulopathy and acute tubular injury. Viral particles have been found in podocytes and tubular cells on postmortem and kidney biopsy studies.
PCR Assay Turned Positive in 25 Discharged COVID-19 PatientsValentina Corona
1) The study found that 14.5% (25/172) of discharged COVID-19 patients in China later tested positive again for the virus based on RT-PCR testing after being discharged from the hospital.
2) These patients met criteria for discharge but tested positive again within 2-13 days without worsening symptoms.
3) The study suggests that more than two negative RT-PCR tests separated by 48 hours or combining RT-PCR tests with antibody and other immunological markers may be needed to confirm viral clearance before discharge.
Γρηγόριος Γεροτζιάφας, Health Innovation Conference 2021Starttech Ventures
Ομιλία – Παρουσίαση:“Artificial intelligence and personalised medicine for patients at high risk of severe COVID-19”
Γρηγόριος Γεροτζιάφας, Καθηγητής Αιματολογίας, Ιατρική σχολή της Σορβόνης, Υπεύθυνος, Τμήμα Θρόμβωσης, Νοσοκομείο Tenon, Παρίσι & Διευθυντής, Ερευνητική Ομάδα Καρκίνος και Θρόμβωση INSERM U938
The document summarizes the link between hypertension (HTN) and COVID-19. It finds that approximately 22.5% of COVID-19 patients have HTN, making it the most common comorbidity. Patients with HTN who contract COVID-19 have a higher risk of severe outcomes like intensive care unit admission and death. The document also discusses how the renin-angiotensin-aldosterone system, which HTN medications target, may impact the interaction of the COVID-19 virus with the body. Specifically, angiotensin-converting enzyme 2 is utilized by the COVID-19 virus to enter cells and HTN medications like ACE inhibitors may alter ACE2 expression levels.
Outcome of 16 years of hemodialysis infection controlJAFAR ALSAID
The study analyzed the outcomes of a tight infection control protocol over 16 years in a hemodialysis unit. The protocol was successful in limiting hemodialysis-related bloodstream infections and admissions. Specifically:
- The rate of hemodialysis-related bloodstream infections was 0.003 per 100 patient months, far below the international reported rate of 0.75-4.4 infections per 100 patient months.
- The admission rate for hemodialysis-related bloodstream infections was 0.4 per 1000 patient years, much lower than the international rate of 108 admissions per 1000 patient years.
- Only 12 patients experienced hemodialysis-related bloodstream infections over nearly 19 years and
Presentation of Dr. Lluis Blanch at 10th Pulmonary Medicine Update Course, Cairo, Egypt. Pulmonary Medicine Update Course is organized by Scribe : www.scribeofegypt.com
1) Diabetes is identified as a risk factor for worse outcomes from COVID-19 based on studies from China. Mortality was 10% in COVID-19 patients with diabetes versus 2.5% for non-diabetic patients.
2) People with diabetes have an increased risk of severe COVID-19 infection due to defects in innate immunity from hyperglycemia and an increased inflammatory response.
3) The interaction between the SARS-CoV-2 virus and the renin-angiotensin-aldosterone system, which regulates blood pressure and fluid balance, may help explain the link between diabetes, hypertension, and increased COVID-19 severity. The virus relies on binding to ACE2 receptors to infect
Recently published papers have defined the clinical characteristics and overall outcomes of COVID-19 patients with the influence on the healthcare system. Especially, general surgeons are uniquely affected due to the broad range of procedures they perform, many of which are conducted routinely in the outpatient setting. This report aims to represent the clinical presentation and outcomes of elective surgical patients during the COVID-19 epidemic.
Evaluation of Cardiac Complications in Pateint Undergoing COVID 19 Treatment:...DrHeena tiwari
This study evaluated cardiac complications in 45 COVID-19 patients admitted to the intensive care unit. Electrocardiography and Holter monitoring found various arrhythmias in patients, with atrial fibrillation, premature ventricular contraction, and tachycardia being most common. The mortality rate of arrhythmias in COVID-19 patients was 17.77%. Although arrhythmias are not very frequent in COVID-19, they can be fatal and have a high mortality rate. Early detection of arrhythmias can help prevent deaths.
The document discusses CO-RADS, a scoring system used to report the level of suspicion for COVID-19 based on chest CT scans. A CO-RADS level of 5 indicates very high suspicion of typical COVID-19 findings, as seen in the patient's scan showing atypical viral pneumonia. The patient's CT severity score of 9 out of 25 indicates moderate lung involvement by COVID-19. The document provides guidance on interpreting HRCT reports, including how to assess severity based on lobe-by-lobe scoring of lung infiltration from COVID-19.
This document summarizes evidence on the risks of COVID-19 for people with diabetes and considerations for managing diabetes during the pandemic. It finds that people with diabetes appear to be at increased risk of severe COVID-19 outcomes. Higher BMI and poorer long-term glucose control are linked to worse COVID-19 outcomes. The pandemic also poses indirect risks to diabetes management through disruptions to healthcare, diet, exercise and increased stress. Countries have adopted strategies like telehealth and educational materials to support diabetes care during this time. More evidence is still needed on reducing infection risk and optimal self-management for people with diabetes during the pandemic.
The document summarizes key information for radiographers on imaging patients with COVID-19, including:
- Medical imaging plays an important role in diagnosing and managing COVID-19, with chest X-rays, CT scans, lung ultrasounds, and MRI used.
- Safety protocols for decontaminating equipment and using proper PPE like gowns, gloves, and masks are crucial to protect patients and radiography staff.
- Guidelines from organizations recommend imaging only critically ill patients or when clinical decisions need to be made, to avoid cross-infection risks.
- Portable X-rays allow imaging in isolation rooms without transporting infectious patients, while CT scans have higher sensitivity but risk of cross
The document provides recommendations from a panel of Italian urologists on managing urology practice during the COVID-19 pandemic. It distinguishes between urgent procedures that should still be performed, such as treating upper urinary tract obstruction or gross hematuria. It also separates urological cancer procedures into non-deferrable, semi-non-deferrable, deferrable and replaceable categories to help guide rescheduling of surgical activities. The panel aims to facilitate reorganization of urology departments while ensuring urgent and important cancer cases continue to be treated during the pandemic.
The coronavirus disease outbreak has proven to be a major health crisis affecting virtually every facets of our lives.
Coronavirus disease is an ongoing pandemic disease. The disease which is caused by a new type of virus, known as severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many patients hospitalized with COVID-19 will develop muscle
weakness particularly those admitted in intensive care unit (ICU). Studies have shown that muscle weakness is one of the
direct consequences of critical illness. We systematically reviewed literature that quantified changes in muscle strength and it
relationship with COVID- 19 in Intensive care unit in humans.
COVID-19 AND UROLOGY: A Comprehensive Review of the LiteratureValentina Corona
This article reviews the impact of the COVID-19 pandemic on the practice of urology. It discusses how the pandemic has led to the postponement of non-urgent surgeries and changes in residency training. It also examines the potential effects of COVID-19 on the urinary tract, noting that the kidneys and bladder may be at risk of viral invasion due to the presence of ACE2 receptors. The article reviews recommendations regarding kidney transplantation during the pandemic and reports limited cases of COVID-19 infection in renal transplant recipients.
This document discusses cytokine storm syndrome in patients with COVID-19. It defines cytokine storm as an uncontrolled release of inflammatory cytokines that can lead to organ damage. COVID-19 is proposed to progress through four stages, with stage II involving an excessive immune response and cytokine release. Cytokine storm is associated with acute respiratory distress syndrome and multi-organ failure in COVID-19 patients. The document outlines treatments for cytokine storm including immunomodulators, anticoagulants, antivirals, and extracorporeal therapies.
Treatment for severe acute respiratory distress syndrome from covid 19Valentina Corona
The document discusses treatment recommendations for patients experiencing severe acute respiratory distress syndrome (ARDS) from COVID-19. It provides guidance on use of extracorporeal membrane oxygenation (ECMO) and other evidence-based options for managing hypoxemia and respiratory failure in COVID-19 patients, including high-flow nasal oxygen, mechanical ventilation strategies, prone positioning, neuromuscular blockade, inhaled nitric oxide, fluid management, and antibiotics. It acknowledges challenges in scaling up ECMO globally and emphasizes optimizing other established treatment protocols.
Endourogical Stone Management in the Era of the COVID-19Valentina Corona
This document discusses recommendations for endourological stone management during the COVID-19 pandemic. It suggests minimizing elective surgeries to preserve resources for COVID-19 patients. For stone patients requiring surgery, it proposes carefully selecting those at highest risk of complications. It also recommends conservative management when possible to reduce hospital visits and utilizing telemedicine. The aim is to minimize virus spread while preventing severe stone complications from overwhelming healthcare systems.
The COVID-19 pandemic has significantly impacted urology services in northern Italy. In the province of Bergamo in Lombardy, over 50% of urologists are now infected with COVID-19. Urology departments have had to dedicate resources to treating COVID-19 patients, reducing operating capacity and outpatient services. Prioritizing and scheduling cancer surgeries is now difficult given limited resources. The long-term effects of delays in urology treatments are unknown, but could negatively impact patient outcomes.
90222 texto del artículo-506762-4-10-20210316Santiago Vasco
This document presents a living systematic review of clinical, radiological, and laboratory characteristics of pediatric patients with COVID-19. Thirteen studies including a total of 9,152 patients were analyzed. Bayesian meta-analysis found that males were more affected with an odds ratio of 1.24. Frequentist meta-analysis estimated cough in 52% of patients, no reported deaths, elevated aspartate aminotransferase levels in 16%, and lung changes on imaging in 60%. While an accurate clinical profile cannot yet be determined, evidence suggests males are more affected and lung abnormalities are more common than symptoms like cough and fever. Laboratory results were inconclusive and multiple organ systems can be impacted.
newly diagnosed diabetes in patients with mild COVID19Dr-Ajay Tripathi
This study analyzed 1020 patients with mild to moderate COVID-19 infections and found that 210 (20.6%) had newly diagnosed diabetes based on blood glucose or HbA1c levels. Nearly all (90.4%) of these 210 patients had an HbA1c of 6.5% or higher, suggesting they likely had previously undiagnosed diabetes. The study aims to determine if COVID-19 infection itself increases the risk of diabetes.
The Efficacy and Safety of Convalescent Plasma for COVID-19 Patients: A Meta-...semualkaira
Convalescent plasma (CP) was demonstrated
promising benefit for clinical practice involved in efficacy and
safety in previous coronavirus pandemics, however, the efficacy of
CP from COVID-19 sufferers are still controversial and unascertainable based on current randomized controlled trials (RCTs). The
urgent needs for affirmative replies on the efficacy and safety of
CP for COVID-19 patients must be developed as soon as possible.
Four Unique Laboratory Characteristics Applied to Assess the Severity of COVI...semualkaira
The sudden outbreaking of COVID-19 worldwide has
brought into sharp increased burden of economic and treatment.
How to simply, quickly and accurately assess the severity of patients with COVID-19 in the early stage after hospital admission is
essential for healthcare systems
1) Diabetes is identified as a risk factor for worse outcomes from COVID-19 based on studies from China. Mortality was 10% in COVID-19 patients with diabetes versus 2.5% for non-diabetic patients.
2) People with diabetes have an increased risk of severe COVID-19 infection due to defects in innate immunity from hyperglycemia and an increased inflammatory response.
3) The interaction between the SARS-CoV-2 virus and the renin-angiotensin-aldosterone system, which regulates blood pressure and fluid balance, may help explain the link between diabetes, hypertension, and increased COVID-19 severity. The virus relies on binding to ACE2 receptors to infect
Recently published papers have defined the clinical characteristics and overall outcomes of COVID-19 patients with the influence on the healthcare system. Especially, general surgeons are uniquely affected due to the broad range of procedures they perform, many of which are conducted routinely in the outpatient setting. This report aims to represent the clinical presentation and outcomes of elective surgical patients during the COVID-19 epidemic.
Evaluation of Cardiac Complications in Pateint Undergoing COVID 19 Treatment:...DrHeena tiwari
This study evaluated cardiac complications in 45 COVID-19 patients admitted to the intensive care unit. Electrocardiography and Holter monitoring found various arrhythmias in patients, with atrial fibrillation, premature ventricular contraction, and tachycardia being most common. The mortality rate of arrhythmias in COVID-19 patients was 17.77%. Although arrhythmias are not very frequent in COVID-19, they can be fatal and have a high mortality rate. Early detection of arrhythmias can help prevent deaths.
The document discusses CO-RADS, a scoring system used to report the level of suspicion for COVID-19 based on chest CT scans. A CO-RADS level of 5 indicates very high suspicion of typical COVID-19 findings, as seen in the patient's scan showing atypical viral pneumonia. The patient's CT severity score of 9 out of 25 indicates moderate lung involvement by COVID-19. The document provides guidance on interpreting HRCT reports, including how to assess severity based on lobe-by-lobe scoring of lung infiltration from COVID-19.
This document summarizes evidence on the risks of COVID-19 for people with diabetes and considerations for managing diabetes during the pandemic. It finds that people with diabetes appear to be at increased risk of severe COVID-19 outcomes. Higher BMI and poorer long-term glucose control are linked to worse COVID-19 outcomes. The pandemic also poses indirect risks to diabetes management through disruptions to healthcare, diet, exercise and increased stress. Countries have adopted strategies like telehealth and educational materials to support diabetes care during this time. More evidence is still needed on reducing infection risk and optimal self-management for people with diabetes during the pandemic.
The document summarizes key information for radiographers on imaging patients with COVID-19, including:
- Medical imaging plays an important role in diagnosing and managing COVID-19, with chest X-rays, CT scans, lung ultrasounds, and MRI used.
- Safety protocols for decontaminating equipment and using proper PPE like gowns, gloves, and masks are crucial to protect patients and radiography staff.
- Guidelines from organizations recommend imaging only critically ill patients or when clinical decisions need to be made, to avoid cross-infection risks.
- Portable X-rays allow imaging in isolation rooms without transporting infectious patients, while CT scans have higher sensitivity but risk of cross
The document provides recommendations from a panel of Italian urologists on managing urology practice during the COVID-19 pandemic. It distinguishes between urgent procedures that should still be performed, such as treating upper urinary tract obstruction or gross hematuria. It also separates urological cancer procedures into non-deferrable, semi-non-deferrable, deferrable and replaceable categories to help guide rescheduling of surgical activities. The panel aims to facilitate reorganization of urology departments while ensuring urgent and important cancer cases continue to be treated during the pandemic.
The coronavirus disease outbreak has proven to be a major health crisis affecting virtually every facets of our lives.
Coronavirus disease is an ongoing pandemic disease. The disease which is caused by a new type of virus, known as severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many patients hospitalized with COVID-19 will develop muscle
weakness particularly those admitted in intensive care unit (ICU). Studies have shown that muscle weakness is one of the
direct consequences of critical illness. We systematically reviewed literature that quantified changes in muscle strength and it
relationship with COVID- 19 in Intensive care unit in humans.
COVID-19 AND UROLOGY: A Comprehensive Review of the LiteratureValentina Corona
This article reviews the impact of the COVID-19 pandemic on the practice of urology. It discusses how the pandemic has led to the postponement of non-urgent surgeries and changes in residency training. It also examines the potential effects of COVID-19 on the urinary tract, noting that the kidneys and bladder may be at risk of viral invasion due to the presence of ACE2 receptors. The article reviews recommendations regarding kidney transplantation during the pandemic and reports limited cases of COVID-19 infection in renal transplant recipients.
This document discusses cytokine storm syndrome in patients with COVID-19. It defines cytokine storm as an uncontrolled release of inflammatory cytokines that can lead to organ damage. COVID-19 is proposed to progress through four stages, with stage II involving an excessive immune response and cytokine release. Cytokine storm is associated with acute respiratory distress syndrome and multi-organ failure in COVID-19 patients. The document outlines treatments for cytokine storm including immunomodulators, anticoagulants, antivirals, and extracorporeal therapies.
Treatment for severe acute respiratory distress syndrome from covid 19Valentina Corona
The document discusses treatment recommendations for patients experiencing severe acute respiratory distress syndrome (ARDS) from COVID-19. It provides guidance on use of extracorporeal membrane oxygenation (ECMO) and other evidence-based options for managing hypoxemia and respiratory failure in COVID-19 patients, including high-flow nasal oxygen, mechanical ventilation strategies, prone positioning, neuromuscular blockade, inhaled nitric oxide, fluid management, and antibiotics. It acknowledges challenges in scaling up ECMO globally and emphasizes optimizing other established treatment protocols.
Endourogical Stone Management in the Era of the COVID-19Valentina Corona
This document discusses recommendations for endourological stone management during the COVID-19 pandemic. It suggests minimizing elective surgeries to preserve resources for COVID-19 patients. For stone patients requiring surgery, it proposes carefully selecting those at highest risk of complications. It also recommends conservative management when possible to reduce hospital visits and utilizing telemedicine. The aim is to minimize virus spread while preventing severe stone complications from overwhelming healthcare systems.
The COVID-19 pandemic has significantly impacted urology services in northern Italy. In the province of Bergamo in Lombardy, over 50% of urologists are now infected with COVID-19. Urology departments have had to dedicate resources to treating COVID-19 patients, reducing operating capacity and outpatient services. Prioritizing and scheduling cancer surgeries is now difficult given limited resources. The long-term effects of delays in urology treatments are unknown, but could negatively impact patient outcomes.
90222 texto del artículo-506762-4-10-20210316Santiago Vasco
This document presents a living systematic review of clinical, radiological, and laboratory characteristics of pediatric patients with COVID-19. Thirteen studies including a total of 9,152 patients were analyzed. Bayesian meta-analysis found that males were more affected with an odds ratio of 1.24. Frequentist meta-analysis estimated cough in 52% of patients, no reported deaths, elevated aspartate aminotransferase levels in 16%, and lung changes on imaging in 60%. While an accurate clinical profile cannot yet be determined, evidence suggests males are more affected and lung abnormalities are more common than symptoms like cough and fever. Laboratory results were inconclusive and multiple organ systems can be impacted.
newly diagnosed diabetes in patients with mild COVID19Dr-Ajay Tripathi
This study analyzed 1020 patients with mild to moderate COVID-19 infections and found that 210 (20.6%) had newly diagnosed diabetes based on blood glucose or HbA1c levels. Nearly all (90.4%) of these 210 patients had an HbA1c of 6.5% or higher, suggesting they likely had previously undiagnosed diabetes. The study aims to determine if COVID-19 infection itself increases the risk of diabetes.
The Efficacy and Safety of Convalescent Plasma for COVID-19 Patients: A Meta-...semualkaira
Convalescent plasma (CP) was demonstrated
promising benefit for clinical practice involved in efficacy and
safety in previous coronavirus pandemics, however, the efficacy of
CP from COVID-19 sufferers are still controversial and unascertainable based on current randomized controlled trials (RCTs). The
urgent needs for affirmative replies on the efficacy and safety of
CP for COVID-19 patients must be developed as soon as possible.
Four Unique Laboratory Characteristics Applied to Assess the Severity of COVI...semualkaira
The sudden outbreaking of COVID-19 worldwide has
brought into sharp increased burden of economic and treatment.
How to simply, quickly and accurately assess the severity of patients with COVID-19 in the early stage after hospital admission is
essential for healthcare systems
Four Unique Laboratory Characteristics Applied to Assess the Severity of COVI...komalicarol
The sudden outbreaking of COVID-19 worldwide has
brought into sharp increased burden of economic and treatment.
How to simply, quickly and accurately assess the severity of patients with COVID-19 in the early stage after hospital admission is
essential for healthcare systems.
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...JohnJulie1
This study aimed to determine if the extent of lung involvement seen on CT scans can predict short-term outcomes in COVID-19 patients. The researchers reviewed CT scans and medical records of 253 COVID-19 patients, 63 of whom died. Non-survivors were older, more often male, and more likely to have comorbidities, hypoxemia, lymphopenia, and bacterial coinfections. On CT scans, non-survivors had higher lung involvement scores, and were more likely to have bronchial dilation, emphysema, and diffuse opacities. Higher lung involvement scores, lower oxygen levels, bacterial coinfections, and preexisting comorbidities were associated with higher odds of death based
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study enrolled 253 patients (63 died in the hospital, 190 were discharged). Compared to survivors, non-survivors were older, mostly male, had a higher prevalence of preexisting comorbidity, higher incidences of hypoxemia, lymphopenia and bacterial coinfection (p<0.001 for each). Regarding CT evaluations, non-survivors had higher CT scores (14.3±3.4 vs. 8.1±2.9), higher incidences of bronchial dilation with mosaic (34.9% vs. 10.5%), emphysema (28.6% vs. 10.5%), and diffuse opacity distribution (76.1% vs. 36.8%; all p<0.001).
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study aimed to determine if the extent of lung involvement on CT scans can predict short-term outcomes in COVID-19 patients. The study analyzed 253 COVID-19 patients in China, 63 of whom died in the hospital. Non-survivors were older, more often male, and had more preexisting health conditions compared to survivors. On CT scans, non-survivors had higher lung involvement scores, and were more likely to have findings like bronchial dilation and diffuse opacity. Higher lung involvement scores, lower oxygen levels, bacterial coinfection, and preexisting conditions were associated with higher odds of death based on statistical analysis. The study suggests that thoroughly assessing CT scans together with patient details may help predict outcomes and optimize COVID
Constance Benson, MD
Professor of Medicine and Director of the UC San Diego
AntiViral Research Center
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
1) The study assessed predictors of death in severe COVID-19 patients admitted to a care center in Ethiopia by comparing characteristics of patients who died (cases) to those discharged alive (controls).
2) Significant predictors of death were found to be having diabetes, fever at admission, and shortness of breath, while having a fever was associated with being discharged alive.
3) Patients who were older (≥70 years), had pre-existing comorbidities, diabetes, or hypertension were more likely to die from severe COVID-19.
Application of ordinal logistic=China.pdfHenokBuno
This study aimed to identify determinants of illness severity for COVID-19 patients in China. Medical records from 598 COVID-19 patients admitted to four hospitals in China between January and March 2020 were analyzed. Patients were divided into moderate (n=400), severe (n=85), and critical (n=113) illness groups based on their condition. Ordinal logistic regression was used to identify predictors of more severe illness. The analysis found that older age, hypertension, abnormal liver enzymes and cardiac markers, longer time from illness onset to diagnosis and admission were associated with increased risk of more severe illness.
This document discusses the role of CT chest imaging in the management of COVID-19. It provides details on the virus, clinical features, imaging findings, diagnostic challenges, and appropriate use of imaging. CT can detect pneumonia in asymptomatic or early cases when PCR may be negative. Imaging is most useful when it could guide management decisions, such as in worsening respiratory status. Avoiding unnecessary imaging is important to minimize exposure risk and conserve PPE during the pandemic.
This document reviews potential pharmacologic treatments for COVID-19. It summarizes the virology of SARS-CoV-2 and potential drug targets. It reviews the in vitro activity and clinical experiences of repurposed drugs including chloroquine/hydroxychloroquine, lopinavir/ritonavir, and umifenovir. It also discusses investigational agents such as remdesivir. Over 300 clinical trials are evaluating potential COVID-19 treatments but currently no therapies have proven effective based on randomized clinical trial data.
This document reviews potential pharmacologic treatments for COVID-19. It summarizes the virology of SARS-CoV-2 and potential drug targets, including viral entry proteins and immune pathways. Several repurposed drugs are discussed, including chloroquine/hydroxychloroquine which may inhibit viral entry and immune responses. Over 300 clinical trials are investigating potential COVID-19 treatments but currently no therapies have proven effective. The most promising is remdesivir, which has strong antiviral activity but requires further clinical trial evaluation.
This document reviews potential pharmacologic treatments for COVID-19. It summarizes the virology of SARS-CoV-2 and potential drug targets. Currently, there are no proven effective therapies but remdesivir shows promise based on in vitro activity. Over 300 clinical trials are investigating potential treatments including repurposed drugs like chloroquine/hydroxychloroquine and lopinavir/ritonavir. The review summarizes the mechanisms and pharmacology of select proposed treatments and provides an overview of ongoing clinical trials.
This study analyzed clinical data from 101 COVID-19 patients hospitalized in Wuhan, China between February and April 2020. The patients were classified as having moderate (n=47), severe (n=36), or critical (n=18) illness. Older age, pre-existing conditions like diabetes and hypertension, and higher blood levels of inflammatory markers were associated with more severe illness. Multivariate analysis identified older age, diabetes, chronic liver disease, and elevated neutrophil, C-reactive protein, D-dimer, and interleukin levels as independent risk factors for severe COVID-19.
This study aims to correlate CT severity scores based on chest CT scans with clinical outcomes in COVID-19 patients admitted to the ICU. The study will collect data on 500 ICU patients including demographics, medical history, lab results, oxygen requirements, treatments, and outcomes at discharge and 6 months. CT severity scores will be assigned by a radiologist based on a previously established 25-point scoring system. The primary objective is to correlate CT scores with mortality, and secondary objectives are to examine relationships between CT scores and other clinical parameters and outcomes. Previous studies have found associations between worse CT findings, older age, comorbidities, and poorer prognosis in COVID-19 patients.
Characteristics of COVID-19 and Tuberculosis Co-Infection: A Cross-Sectional ...semualkaira
Coronavirus disease 2019 (COVID-19) and Tuberculosis (TB) are two major infectious diseases posing significant
public health threats. This study aimed to investigate the clinical
features of COVID-19 and TB co-infected patients.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
This document discusses using convalescent plasma therapy to treat critically ill COVID-19 patients. It provides background on using convalescent plasma to treat emerging infectious diseases. Limited data from China suggests convalescent plasma therapy provided clinical benefits for COVID-19 patients, including reduced viral loads and improved survival. However, there are challenges in recruiting eligible donors and ensuring the plasma contains sufficient neutralizing antibodies against SARS-CoV-2.
Similar to Investigation of Long term Hazards and Multi organ Impact of SARS COV-2 in Post Covid Patients (20)
Skin Pigmentation disorders and its management .pptxJagruti Marathe
Some of the most common are pigmented birthmarks, macular stains, hemangiomas, port wine stains, while disorders include albinism, melasma, vitiligo and pigmentation loss due to skin damage. Birthmarks and other skin pigmentation (coloration) disorders affect many people.
Skin pigmentation disorders are conditions that affect the color of the skin. Some common types of skin pigmentation disorders include:
Pigmented birthmarks
Macular stains
Hemangiomas
Port wine stains
Albinism
Melasma
Vitiligo
Skin pigment loss due to sun damage
Other factors that can affect skin pigmentation include: Pregnancy, Addison's disease, Sun exposure.
Some treatments for skin pigmentation disorders include:
Over-the-counter or prescription creams
Topical pimecrolimus or tacrolimus
Light therapy
Melanocytes in the basal epidermis control skin pigmentation through synthesis of melanin, a complex process thought to be primarily regulated by alpha-melanocyte stimulating hormone (αMSH)
Light therapy exposes your skin to a type of ultraviolet (UV) light that can restore your natural skin color. If a large area of your body needs treatment, your dermatologist may prescribe a type of light therapy called phototherapy. During phototherapy, you expose your skin to UV light for a specific amount of time.
Dermatological testing as perBISpecification.pptxJagruti Marathe
Bureau of Indian Standards (BIS) is the National Standard Body of India.
BIS is responsible for the harmonious development of the activities of standardization, marking and quality certification of goods and for matters connected therewith or incidental thereto.
BIS through its core activities of standardization and conformity assessment, has been benefiting the national economy by providing safe, reliable and quality goods; minimizing health hazards to consumers; protecting the environment, promoting exports and imports substitute; controlling over proliferation of varieties etc.
Dermatological testing assesses a product's potential to cause skin irritation or allergic reactions. A product is considered dermatologically tested if a qualified dermatologist supervises the testing and verifies the results. Some dermatological tests include: Repeat-insult patch testing: Stability testing: Cosmetics toxicology test:
Cosmetic pharmacology refers to the use of drugs to improve cognition in normal healthy individuals, for the purpose of enhancement rather than treatment of a formal pathology.
Some case reports with the antidepressant Prozac indicated that patients seemed "better than well," and authors hypothesized that this effect might be observed in individuals not afflicted with psychiatric disorders.
Following these case reports much controversy arose over the veracity and ethics of the cosmetic use of these antidepressants.
Opponents of cosmetic pharmacology state that such drug use is unethical and dangerous, and that the concept of cosmetic pharmacology is a manifestation of naive consumerism resulting from pharmaceutical marketing campaigns.
Proponents state that drugs used to treat many pathologies are just as dangerous, it is an individual's (rather than government's, or physician's) decision whether to use a drug for cosmetic purposes, and there are few if any legitimate ethical qualms with cosmetic pharmacology.
The urinary system consists of the kidneys, ureters, bladder, and urethra. The kidneys filter waste from the blood to produce urine. Each kidney contains around 1 million nephrons, the functional units of the kidney. Nephrons filter blood in the glomerulus and remove waste while reabsorbing useful substances. Hormones regulate urine concentration and volume. Urine is stored in the bladder and expelled through the urethra in a process called micturition.
A closed system of the heart and blood vessels
The heart pumps blood
Blood vessels allow blood to circulate to all parts of the body
The function of the cardiovascular system is to deliver oxygen and nutrients and to remove carbon dioxide and other waste products
The heart contributes to homeostasis by pumping blood through blood vessels to the tissues of the body to deliver oxygen and nutrients and remove wastes.
Blood to reach body cells and exchange materials with them, it must be pumped continuously by the heart through the body’s blood vessels.
The heart beats about 100,000 times every day, which adds up to about 35 million beats in a year, and approximately 2.5 billion times in an average lifetime.
The left side of the heart pumps blood through an estimated 100,000 km (60,000 mi) of blood vessels, which is equivalent to traveling around the earth’s equator about three times.
The right side of the heart pumps blood through the lungs, enabling blood to pick up oxygen and unload carbon dioxide.
The nervous system is divided into the central nervous system (CNS) and peripheral nervous system (PNS). The CNS consists of the brain and spinal cord and processes sensory input and coordinates motor output. The PNS consists of nerves that connect the CNS to the rest of the body and allows for sensation and muscle/gland control. Neurons are the basic functional units that transmit electrochemical signals and communicate via synapses. The nervous system maintains homeostasis, provides sensation, higher functions, and activates muscles and glands through a complex interplay between its various parts.
Hair grows in cycles of anagen, catagen, and telogen phases. Hair color is created by melanin and turns gray with age. There are four types of integumentary glands - sudoriferous glands produce sweat, sebaceous glands produce oil, ceruminous glands produce earwax, and mammary glands produce milk. Sweat glands help regulate body temperature, sebaceous glands inhibit bacteria and keep skin moist, ceruminous glands lubricate and protect the ear, and mammary glands nourish infants with milk.
Definition :
Tissue is a group of cells that have similar structure and that function together as a unit. A nonliving material, called the intercellular matrix, fills the spaces between the cells.
Histology (his′-TOL-oˉ-jē; histo- = tissue; logy = study of) is the science that deals with the study of tissues.
A pathologist (pa-THOL-oˉ - jist; patho- = disease) is a physician who examines cells and tissues to help other physicians make accurate diagnoses.
1. Epithelial tissue covers body surfaces and lines hollow organs, body cavities, and ducts; it also forms glands. This tissue allows the body to interact with both its internal and external environments.
2. Connective tissue protects and supports the body and its organs. Various types of connective tissues bind organs together, store energy reserves as fat, and help provide the body with immunity to disease-causing organisms.
3. Muscular tissue is composed of cells specialized for contraction and generation of force. In the process, muscular tissue generates heat that warms the body.
4. Nervous tissue detects changes in a variety of conditions inside and outside the body and responds by generating electrical signals called nerve action potentials (nerve impulses) that activate muscular contractions and glandular secretions.
In biology, cell signaling or cell communication is the ability of a cell to receive, process, and transmit signals with its environment and with itself.
ell signaling is a fundamental property of all cellular life in prokaryotes and eukaryotes .
Signals that originate from outside a cell (or extracellular signals) can be physical agents like mechanical pressure, voltage, temperature, light, or chemical signals (e.g., small molecules, peptides, or gas).Signaling molecules can be synthesized from various biosynthetic pathways and released through passive or active transports, or even from cell damage.
Receptors play a key role in cell signaling as they are able to detect chemical signals or physical stimuli.
Receptors are generally proteins located on the cell surface or within the interior of the cell such as the cytoplasm, organelles, and nucleus.
Cell surface receptors usually bind with extracellular signals (or ligands), which causes a conformational change in the receptor that leads it to initiate enzymic activity, or to open or close ion channel activity. Some receptors do not contain enzymatic or channel-like domains but are instead linked to enzymes or transporters.
Other receptors like nuclear receptors have a different mechanism such as changing their DNA binding proper properties and cellular localization to the nucleus.
Structure and functions of cell, transport across cell membrane, cell
division, cell junctions. General principles of cell communication,
the smallest unit that can live on its own and that makes up all living organisms and the tissues of the body
The basic tenets of the cell theory are as follows:
All living things are made up of one or more cells.
The cell is the structural and functional unit of all living things.
Cells come from pre-existing cells through the process of division.
All cells are the same in regard to chemical composition.
Cells also communicate with each other. Whether in plants, humans, or animals, they connect to create a solid, well formed organism. In humans, cells build tissues, tissues form organs, and organs work together to keep the body alive.
Experts estimate that there are around 200Trusted Source cell types in the human body.
Allergies are the result of your immune system's response to a substance. Immune responses can be mild, from coughing and a runny nose, to a life-threatening reaction know as anaphylaxis.
A person becomes allergic when their body develops antigens against a substance
The purpose of the immune system is to defend itself and keep microorganisms, such as certain bacteria, viruses, and fungi, out of the body, and to destroy any infectious microorganisms that do invade the body.
The immune system is made up of a complex and vital network of cells and organs that protect the body from infection.
The organs involved with the immune system are called the lymphoid organs. They affect growth, development, and the release of lymphocytes (a type of white blood cell).
The blood vessels and lymphatic vessels are important parts of the lymphoid organs.
They carry the lymphocytes to and from different areas in the body.
Each lymphoid organ plays a role in the production and activation of lymphocytes.
1. Toxicology, Scope of Pharmacology in Cosmetic Tech .pptxJagruti Marathe
The document provides an introduction to pharmacology and toxicology. It defines key terms like:
- Pharmacology is the study of drugs and their effects and mechanisms of action in living systems.
- Toxicology is the study of adverse health effects of chemicals.
- Pharmacokinetics refers to how the body affects a drug while pharmacodynamics is what the drug does to the body.
- Toxicants can enter the body through various routes and affect organs in both reversible and irreversible ways. Treatment involves removing unabsorbed toxins, administering antidotes, and promoting excretion of absorbed toxins.
Alopecia areata is a disease that happens when the immune system attacks hair follicles and causes hair loss. Hair follicles are the structures in skin that form hair. While hair can be lost from any part of the body, alopecia areata usually affects the head and face
The document discusses hair disorders and provides details about hair structure and the hair growth cycle. Some key points:
- Hair is found in mammals and grows from follicles, providing protection and regulating temperature. It grows about half an inch per month.
- The hair growth cycle consists of anagen (growth phase), catagen (transition phase), and telogen (resting phase). Hair disorders can disrupt this cycle.
- Common hair disorders include dandruff, seborrheic dermatitis, alopecia (hair loss), hirsutism (excess hair growth), and hair shaft abnormalities. Treatment depends on the specific disorder.
The earliest indications of the biological nature of viruses came from studies in 1892 by the Russian scientist Dmitry I. Ivanovsky and in 1898 by the Dutch scientist Martinus W. Beijerinck.
Beijerinck first surmised that the virus under study was a new kind of infectious agent, which he designated contagium vivum
fluidum, meaning that it was a live, reproducing organism that differed from other organisms.
Both of these investigators found that a disease of tobacco plants could be transmitted by an agent, later called tobacco mosaic virus, passing through a minute filter that would not allow the passage of bacteria.
Allergies are the result of your immune system's response to a substance. Immune responses can be mild, from coughing and a runny nose, to a life-threatening reaction know as anaphylaxis.
A person becomes allergic when their body develops antigens against a substance.
The purpose of the immune system is to defend itself and keep microorganisms, such as certain bacteria, viruses, and fungi, out of the body, and to destroy any infectious microorganisms that do invade the body.
The immune system is made up of a complex and vital network of cells and organs that protect the body from infection.
The organs involved with the immune system are called the lymphoid organs. They affect growth, development, and the release of lymphocytes (a type of white blood cell).
The blood vessels and lymphatic vessels are important parts of the lymphoid organs.
They carry the lymphocytes to and from different areas in the body.
Each lymphoid organ plays a role in the production and activation of lymphocytes.
Lymphoid organs include:
Adenoids (two glands located at the back of the nasal passages)
Appendix (a small tube that is connected to the large intestine)
Blood vessels (the arteries, veins, and capillaries through which blood flows)
Bone marrow (the soft, fatty tissue found in bone cavities)
Lymph nodes (small organs shaped like beans, which are located throughout the body and connect via the lymphatic vessels)
Lymphatic vessels (a network of channels throughout the body that carries lymphocytes to the lymphoid organs and bloodstream)
Peyer's patches (lymphoid tissue in the small intestine)
Spleen (a fist-sized organ located in the abdominal cavity)
Thymus (two lobes that join in front of the trachea behind the breast bone)
Tonsils (two oval masses in the back of the throat)
Lymphoid organs include:
Adenoids (two glands located at the back of the nasal passages)
Appendix (a small tube that is connected to the large intestine)
Blood vessels (the arteries, veins, and capillaries through which blood flows)
Bone marrow (the soft, fatty tissue found in bone cavities)
Lymph nodes (small organs shaped like beans, which are located throughout the body and connect via the lymphatic vessels)
Lymphatic vessels (a network of channels throughout the body that carries lymphocytes to the lymphoid organs and bloodstream)
Peyer's patches (lymphoid tissue in the small intestine)
Spleen (a fist-sized organ located in the abdominal cavity)
Thymus (two lobes that join in front of the trachea behind the breast bone)
Tonsils (two oval masses in the back of the throat)
Anaphylactic shock, also called anaphylaxis, is a severe, life-threatening reaction to certain allergens.
Body tissues may swell, including tissues in the throat.
Anaphylactic shock is also characterized by a sudden drop in blood pressure.
The following are the most common symptoms of anaphylactic shock.
However, each person may experience symptoms differently.
Bacteria are small single-celled organisms. Bacteria are found almost everywhere on Earth and are vital to the planet's ecosystems. Some species can live under extreme conditions of temperature and pressure. The human body is full of bacteria, and in fact is estimated to contain more bacterial cells than human cells.
Microbiology is the study of all living organisms that are too small to be visible with the naked eye. This includes bacteria, archaea, viruses, fungi, prions, protozoa and algae, collectively known as 'microbes'.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Investigation of Long term Hazards and Multi organ Impact of SARS COV-2 in Post Covid Patients
1. 1
Investigation of Long term Hazards and Multi organ Impact of SARS COV-2 in
Post Covid Patients
R. C. Patel Institute of Pharmaceutical Education and Research
2. 2
Investigation of Long term Hazards and Multi organ Impact of SARS COV-2 in
Post Covid Patients
Presented by :
Jagruti .N. Marathe
Clinical Department
M.Pharm IVth Sem
Guided by:
Mrs. Hemakshi. E. Chaudhari
Assistant Professor
Department of Clinical Pharmacy
R. C. Patel Institute of Pharmaceutical Education and Research
HOD: Dr Savita Patil
3. Content
3
Introduction
Background
Burden of COVID 19
Need of the study
Rationale of the study
Review of literature
Epidemiology
Hypothesis
Aim and objective
Material and Method
Criteria
Study design
Outcome
Result
Analysis
Discussion
4. Introduction
Coronavirus are a large family of viruses that causes illness ranging from the common cold to
more serve disease such as middle east respiratory syndrome(MERS-COV) and sever acute
respiratory syndrome (SARS-COV).
A novel corona virus (nCOV) is a new strain that has not been previously identified in
humans.
SARS-CoV-2 belongs to the Single Standing RNA Viruses class of coronaviruses, but the
infection had been rapidly spreading around the world and World Health Organization (WHO)
declared a pandemic .
4
5. Background
○ According to A recent report of in Indian Express 20 March2021
showed that about 80 percent of the participants had major
complaints of fatigue (similar to post-SARS fatigue) and the rest, a
small percentage had critical manifestations such as lung fibrosis,
kidney failure, myocarditis and stroke.
○ Therefore, further investigations are needed to detect the exact
mechanisms of pathogenesis.
○ Hence this study aims to add onto the ever-emerging landscape of
medical knowledge on COVID-19, encapsulating its multiorgan
impact in post Covid patients. 5
6. Burden of Covid-19
The coronavirus (COVID-19) is spreading rapidly across the country but testing regime of India
is far from the global standards.
It is important to identify the states where testing needs expansion and the magnitudes of active
COVID cases are higher focusing on current health infrastructure to meet the pandemic.
The data on COVID-19 was extracted from the Application Programming Interface.
Test positive rate, test per confirmed case, recovery rate, case fatality rate, and percent
distribution of active cases were computed.
6
10. Need of the study
COVID-19 patients can suffer long-term multi organ effects. The findings of this study show
the importance of implementing structured follow-up care for patients suffered from COVID-
19 infection.
10
11. 11
11
Endocrine
complication
Renal
complication
Lung
complication
Cardiac
complication
The pulmonary pathobiology of Covid-19 from that of equally severe influenza virus
infection.
cardiac cases showed higher rates of organ failure and mortality than non-cardiac
cases. Hence need more supervision
patients with AKI during severe SARS-CoV-2 infection is higher death rate reported
COVID-19 patients with CKD presented high incidence of neutrophilia, poor prognosis and in-
hospital death
ICU cases showed higher rates of organ failure and mortality than non-ICU cases.
Hence need more supervision
Review of literature
17. Aim:
Investigation of Long term Hazards and Multi organ Impact of SARS COV-2 in Post Covid Patients
Objectives
This study will help to…
Conduct the longitudinal study to assess the health status of the COVID-19 recovered patient
Generate the validated data on Possible influence of COVID-19 to cause multiorgan damage
Conduct Follow-up survey of COVID-19 recovered patients will be helpful to evaluate any
changes in the other organs in human systems
Conduct Follow-up study will be useful to design a possible vaccine for this dreadful infection.
Report Recommendation for COVID-19 recovered patients
17
18. 18
Criteria Particulars
Research Method Experimental method
Study Site Indira Gandhi Memorial Hospital, Shirpur, Dist.-Dhule, Maharashtra
Study Type Case Control, Observational, Non Interventional, Comparative Study
Study Subjects Post Covid and Normal Patients
Sample Size 200
Sample Volume 2 ml(blood sample)
Duration of study 1 year
Study Parameters Demographic Parameters, Anthropometric
Parameters, Socioeconomic Parameters
Name, Age, Weight, Height, Sex, Gender,
Occupation, Past Medical History
Lung Function FVC , FEV, FEV/FVC, PEF, FEF25-75
Liver Function LDH-p
Cardiac Function CK-MB
Kidney Function CRE
Inflammation CRP
19. 19
Instrument Required:
Lung Function Test: Software based Ultrasonic Flow Meter (Easy on
Spirometer)
Hematological parameters : Hematological Autoanalyzer
Other parameters : Microplate reader, Microplate
20. 20
○ INCLUSION CRITERIA
Post covid 19 patients .
Normal patients .
Patients with associated disease like , Heart disease, Kidney
disease , Lung disease , Endocrine disease . .
○ EXCLUSION CRITERIA
Small children
Pregnant women
Old people(more than 70)
Patients associated with untreatable disease like cancer,
HIV
21. 21
Normal of Population Post COVID -19popolation
Socioeconomic
Demographic
Anthropometric Anthropometric
Demographic
Socioeconomic
Collection of Blood
Lung function test
P
A
R
A
M
E
T
E
R
P
A
R
A
M
E
T
E
R
Collection of Blood
Lung function test
Study design and out come
25. 25
N
o
r
m
a
l
P
o
p
u
l
a
t
i
o
n
P
o
s
t
-
C
o
v
i
d
-
1
9
p
o
p
u
l
a
t
i
o
n
0
10
20
30
40
CK-MB
Normal Population
Post-Covid-19 population
Graph:2 table Analyzed of (CK-MB) Column A
(Normal Population)vs Column B (Post-Covid-19
Population) unpaired t-test Value=<0.0001 significant,
t=4.845 df=214, Mean of column A=18.69 and mean of
column B=26.76, difference between means(B-
A)±SEM8.068±0.0220095%confidence interval 0.2645 to
0.3512 R squared(eta squared) 0.4779
CK-MB in the Control Group and Post-Covid-19 Patients The CK-MB biomarker patients with post
COVID-19 in elements of direct infection of myocardial injury, specific binding to functional receptors
and cardiomyocytes, and immune-mediated myocardial injury in post-Conid-19 patients.. During
hospitalisation, laboratory myocardial damage markers should be monitored more closely in post-
COVID-19 patients
26. 26
LDH-P
Norm
al Population
Post Covid
19 population
0
100
200
300
400
LDH-P
Graph:3 table Analyzed of LDH-P) Column A (Normal
Population)vs Column B (Post-Covid-19 Population)
unpaired t-test Value=<0.0001 significant, t=9.366
df=214, Mean of column A=174.8and mean of column
B=236.7, difference between means(B-
A)±SEM61.96±6.615 95%confidence interval 48.92 to
75.00 R squared(eta squared) 0.2908,
F, DFn, Dfd=4.750,101,110
LDH-P in Normal Population and Post-Covid-19 patients. In the case of post-Conid-19 patients, the
LDH-P biomarker patients with post COVID-19 in aspects of Lactate dehydrogenase (LDH) is one such
biomarker of interest, especially since elevated LDH levels have been associated with worse outcomes
in patients with other viral infections in the past
27. 27
Norm
al Polulation
Post-Covid
Population
0.0
0.5
1.0
1.5
2.0
CRE
Graph:4 table Analyzed of (CRE) Column A (Normal
Population)vs Column B (Post-Covid-19 Population)
unpaired t-test Value=<0.0001 significant, t=13.50
df=214, Mean of column A=0.8011and mean of column
B=1.367, difference between means(B-
A)±SEM0.5662±0.04195 95%confidence interval 0.4835
to 0.6488 R squared(eta squared) 0.4598,
F, DFn, Dfd=6.750,101,110
CRE in Normal Population and Post-Covid-19 patients. In the case of post-Conid-19 patients, the CRE
biomarker increases it shows patients with post COVID-19 high risk of renal disorder.
28. 28
N
orm
al
P
ost C
O
VID
-19
0
1
2
3
4
FVC
Normal
Post COVID-19 Graph:5 table Analyzed of (FVC) Column A (Normal
Population)vs Column B (Post-Covid-19 Population) unpaired t-
test Value=<0.0001 significant, t=8.833 df=214, Mean of
column A=2.147and mean of column B=2.843, difference
between means(B-A)±SEM0.6960±0.07880 95%confidence
interval 0.5407 to 0.8513 R squared(eta squared) 0.2672,
F, DFn, Dfd=1.055,101,110
29. 29
N
o
r
m
a
l
P
o
s
t
C
O
V
I
D
-
1
9
0
1
2
3
FEV1
Graph:7 table Analyzed of FEV1 Column A (Normal Population)vs
Column B (Post-Covid-19 Population) unpaired t-test Value=<0.0001
significant, t=12.47 df=214, Mean of column A=1.754 and mean of
column B=2.251, difference between means(B-A)±SEM0.469±0.03986
95%confidence interval 0.4183 to 0.5735 R squared(eta squared)
0.4207,
F, DFn, Dfd=1.111,101,110
30. 30
N
orm
al P
opulation
P
ost-C
ovid-19
population
0.0
0.5
1.0
1.5
FEV1/FVC
Normal Population
Post-Covid-19 population Graph:6 table Analyzed of FEV1/FVC Column A (Normal
Population)vs Column B (Post-Covid-19 Population) unpaired t-
test Value=<0.0001 significant, t=2.159 df=214, Mean of
column A=0.8427and mean of column B=0.9073, difference
between means(B-A)±SEM0.6463±0.02994 95%confidence
interval 0.005612 to 0.1236 R squared(eta squared) 0.02131,
F, DFn, Dfd=7.671,101,110
FEV1/FVC suggests that the lungs are the organ most affected by COVID-193 with different
pathophysiological events that include diffuse alveolar epithelium destruction, hyaline membrane
formation, capillary damage and bleeding, alveolar septal fibrous proliferation, and pulmonary
consolidation. Post-infection COVID-19 patients showed impaired lung function; the most important of the
pulmonary function tests affected was the diffusion capacity
32. 32
N
orm
al P
opulation
P
ost-C
ovid-19
population
0
1
2
3
4
5
PEF[L/s]
Normal Population
Post-Covid-19 population Graph:7 table Analyzed of (PEF) Column A (Normal
Population) vs Column B (Post-Covid-19 Population)
unpaired t-test Value=<0.0001 significant, t=3.911 df=214,
Mean of column A=3.745and mean of column B=3.225,
difference between means(B-A)±SEM-
0.5203±0.133095%confidence interval -0.07825 to -0.2580
R squared(eta squared) 0.06670,
F, DFn, Dfd=1.376,101,110
The suggested pathogenic mechanism proposes that COVID-19 causes first damage, similar to SARS, as a
result of a microvascular injury with initial interstitial thickening and clean lungs on radiological tests, as
well as significant hypoxaemia.
33. 33
N
o
r
m
a
l
p
o
p
o
l
a
t
i
o
n
P
o
s
t
C
O
V
I
D
-
1
9
0
1
2
3
4
5
FET
Normal popolation
Post COVID-19
Graph:7 table Analyzed of (PEF) Column A (Normal
Population) vs Column B (Post-Covid-19 Population)
unpaired t-test Value=<0.0001 significant, t=8.833
df=214, Mean of column A=2.147and mean of column
B=2.843, difference between means(B-A)±SEM-
0.6960±0.07880%confidence interval -0.5407 to -0.8513
R squared(eta squared) 0.2672,
F, DFn, Dfd=1.055,104,110
35. Discussion
35
23 high quality retrospective studies systematically evaluated the risk of severe
disease, ICU admission, or death associated with COVID-19-related cardiac injury
performance. Their findings are as follows:
(1) COVID-19 patients with elevated TnF alpha levels are at significantly higher risk
of developing severe disease, requiring ICU admission, or death;
(2) elevated CK, CK-MB, LDH, and IL-6 levels and emerging arrhythmia are
associated with the development of severe disease or requirement for ICU admission;
and mortality rates are significantly higher among patients with elevated LDH and IL-
6 levels.
36. 36
Post-infection COVID-19 patients showed altered respiratory function. The most important of the PFTs
affected was the diffusion capacity in close to 40% of patients. The results of PFTs must be analysed with
caution and considering the respiratory comorbidities and the possible impairment generated by smoking and
air pollution. Well-designed studies conducted in post-COVID-19 infection patients, taking into consideration
the infection severity and based on the pulmonary function guidelines are required.
Future research should be focused on the characterisation of short and long-term respiratory function sequelae
to optimise the decision-making in clinical practice. The data collected to date in this systematic review could
be a useful starting point for further studies. of 69%. The incidence of LDH was associated with presence of
diabetes, this phenomenon might be due to reduced glycogen synthesis, change in glucose
37. 37
These mechanisms because elevated lactate in patients with insulin resistance compared with those without.
LDH has been found to affect the prognosis of various diseases, including cancers.32 LDH elevation in
patients with COVID-19 indicates lung and tissue injuries.19 COVID-19 may lead to inadequate tissue
perfusion and multiple organ failure due to various mechanisms, including thrombosis, which lead to LDH
elevation. Thus, high LDH serves as a biomarker of the disease extent
. But in present study we have actually performed these all parameters in post covid patients and tried to find
the impact of SAARS Cov 2 on different organs. This study has generated the data on organ function due to
Covid 19.
The care should be taken at lea t for 1 year after covid 19 to prevent relaps of this infection further.
38. Outcome
This study has generated the systematic data on……….
Comparison of lung pattern alteration between post COVID 19 patients and normal patients
Level of CRP, LDH, Creatinine Kinase, Creatinine, and Complete Blood Count in Post-Covid
Patients.
Long term hazards of Sars Cov-2 in Post-covid patients
Impact of Saars-Cov2 on Lung, Heart, Liver Blood and Kidney.
Levels of FVC FEV PEF FEF in post covid patients compared with normal
38
39. 39
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