Aim: To investigate the change in a serum level of copeptin, a neuroendocrine biomarker, in differentiating grades of COVID-19 severity on admission time and to find its diagnostic potential. Materials & Methods: 160 COVID-19 patients were classified according to disease severity into 80 mild to moderate and 80 severe patients. Serum copeptin level was assessed by ELISA on their admission time. Besides, serum CRP, ferritin and D-dimer were estimated. Results: Severe COVID-19 patients showed higher serum copeptin level in comparison to mild to moderate cases, with diagnostic potential to distinguish disease severity with 93.33% sensitivity and 100% specificity at cut-off value >18.5 Pmol/l. Conclusion: Serum copeptin was remarkably increased with COVID-19 severity with reasonable differentiation potential for recently admitted patients.
Background Dysregulated immunity is a hallmark of SARS-CoV-2 infection. Immune suppression is indicated by low monocyte expression of human leukocyte antigen D-related (mHLA-DR). T cells are important antiviral cells. We aimed to assess the role of mHLA-DR and T lymphocyte frequency in predicting COVID-19 severity. Patients and Methods This cross-sectional study enrolled 97 SARS-CoV-2 positive patients, including mild to moderate (n = 49) and severe cases admitted to intensive care unit (ICU) (n = 48). These ICU cases were further subdivided into survivors (n = 35) and non-survivors (n = 13). Results Severe cases had a significant decrease in the mHLA-DR mean fluorescence intensity (MFI) and T lymphocyte percentage compared to mild to moderate cases ( P <0.001). Non-survivors had a lower T lymphocyte percentage ( P =0.004) than survivors. The mHLA-DR MFI and T lymphocyte percentage correlated with oxygen saturation (r=0.632, P <0.001) and (r=0.669, P <0.001), respectively. According to the ROC curves, mHLA-DR MFI, at a cutoff of 143 and an AUC of 0.9, is a reliable biomarker for distinguishing severe COVID-19 cases, with 89.6% sensitivity and 81.6% specificity, while T lymphocyte frequency had 81.3% sensitivity and 81.6% specificity at a cutoff of 54.4% and an AUC of 0.9. The T lymphocyte percentage as a predictor of ICU survival at a cutoff of 38.995% exhibited 100% sensitivity and 57.1% specificity. According to multivariate regression analysis, reduced mHLA-DR MFI and T lymphocyte percentage are independent predictors of COVID-19 severity (OR = 0.976, 95% CI: 0.955–0.997, P = 0.025) and (OR = 0.849, 95% CI: 0.741–0.972, P = 0.018), respectively. Conclusion Reduced mHLA-DR expression and T-lymphocyte percentage are independent predictors of COVID-19 severity. Oxygen saturation percentage is correlated with mHLA-DR MFI and T lymphocyte frequency. The T lymphocyte frequency is a proposed predictor of COVID-19 survival in ICU admitted patients.
Background: the sacroiliac joint (SIJ) is the largest axial joint in the body, with an average surface area of 17.5 cm 2 , it is an accepted source of low back and/or buttock pain with or without lower extremity pain. Based upon history and physical examination findings, the prevalence of sacroiliac joint pain in chronic low back pain population has been shown to range from 22.5% to 62.8%. Aim of this work: to evaluate the therapeutic benefit of intra articular corticoid injections into the sacroiliac joints in a standardized fashion. Patients and Methods: This study included 20 adults with SIJ pain due to different reasons and who were scheduled to undergo SIJ injection of corticosteroids and local anesthetic. Demographic data to consider includes sex, age, weight, occupation, affected side, co morbidity and suggested pathology of the examined SIJ. Results: there is significant decrease of the inflammatory back pain in 85% of patients; on mean post 2.00±1.86 compared to pre 7.50±1.24 according to VAS of patients after 6 months follow up (p-value <0.001 HS). Its minimally invasive procedure & good result by single injection to all patients during 6 months follow up. Conclusion: CT guided sacroiliac joint minimally invasive, short time, very accurate and good results obtained. Intra articular SIJ injection is an effective method for alleviating pain in patients suffers from SIJ pain at least in short term.
Background:clinical outcome data was analyzed for 100 patients withcontained disc herniation who underwent percutaneous discdecompression procedure using Coblation® technology,after failing to respond toconservative management. Patients and Methods: Patients presented with clinicalsymptoms of discogenic low back pain and/or leg painFollow-up data was collected up to 12 months.Patient gender distribution was 68% female, 32% male, witha mean age of 39 years.With mean duration of back pain of 8.57 ,ranging from 3 to 17 month and mean duration of leg pain of 4.36 .ranging from 2 to 10 monthaccording to visual analogue scale for pain assessment.The mean pre-procedure pain level for all patients wasReported as 7.56 for back and 7.72 for leg while average pain level was 4.86 for back and 3.42 for leg at the 12-month follow-up post procedure period. And according to Oswestry disability index for functional assessment. The mean pre procedure index was 31.48 range from 23-40. It decreased after 12 month to 13.82 range from 5-32. Results:The results of this analysis indicated that PDD usingCoblation technology, isan effective procedure for patients presenting withdiscogenic back and/or leg pain who have failed conservativetherapies.
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