Background: The COVID-19 pandemic has claimed millions of lives. A tool for early prediction of severity and mortality risk is desirable for better utilization of health care facilities. Several biomarkers like D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP) and some recently explored biomarkers like serum cystatin C and serum calprotectin have been proposed as prognostic markers of COVID-19, but their role as prognostic markers is so far undefined. The present work attempted to investigate the possible role of serum cystatin C and serum calprotectin as prognostic tools to predict severity and outcome ahead of time. Material and Methods: This observational cohort study was carried out on 95 COVID-19 patients admitted to a dedicated COVID care facility from mid-October 2020 to January 2021. Serial estimations of serum cystatin C and serum calprotectin levels were done and assessed for significant difference between severe (NEWS 2 score ≥5) and non-severe (NEWS 2 score <5) groups, survivors and deceased and on the basis of comorbidities at each time points. Survival analysis was done based on the optimal thresholds for severity and mortality, calculated from the receiver operating characteristic (ROC). Result: The results showed that median cystatin C levels were significantly higher on the first day in the severe group ( P < 0.001) and in patients with cardiovascular disease ( P < 0.05), chronic lung disease ( P = 0.009) and among patients who died ( P < 0.05). It remained raised on day 3 in severe ( P < 0.05) and deceased ( P < 0.05) group. Serum calprotectin levels were significantly higher in patients with chronic lung disease ( P = 0.008) and in those who died ( P < 0.05). Conclusion: Serum cystatin C could be used as a tool for early prognosis and therapeutic decision-making for COVID-19 patients. Serum calprotectin seems to be a better marker of critical illness.
The effects of the coronavirus disease 2019 (COVID-19) pandemic on male fertility have received considerable attention because human testes contain high levels of angiotensin-converting enzyme-2 receptors, through which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can enter. Early studies showed decreases in semen quality during and after recovery from COVID-19. However, no semen quality studies have examined the effects of widespread subclinical and mild disease, as well as changes in lifestyle, psychosocial behavior, intake of dietary supplements, and stress. This cross-sectional study compared semen quality parameters in male partners of infertile couples between men who underwent semen analysis before the COVID-19 pandemic (prepandemic group) and men who underwent semen analysis during the pandemic period (pandemic group); the analysis sought to clarify the overall effects of the pandemic. No participants in the pandemic group had experienced clinically overt disease. Among the 239 participants, mean body weight ( P = 0.001), mean body mass index ( P < 0.001), median sperm concentration ( P = 0.014), total sperm count ( P = 0.006), and total percentages of motile ( P = 0.013) and abnormal cells ( P < 0.001) were significantly greater in the pandemic group ( n = 137) than those in the prepandemic group ( n = 102). Among abnormal cells, the percentages of cells with excess residual cytoplasm ( P < 0.001), head defects ( P < 0.001), and tail defects ( P = 0.015) were significantly greater in the pandemic group than those in the prepandemic group. With the exception of morphology, the overall semenogram results were better in the pandemic group than those in the prepandemic group.
BACKGROUND Protein Energy Malnutrition (PEM) is the most widespread condition affecting the health of children in developing countries. Malnutrition in early childhood is characterized by nutritional deficiency at a crucial time in the development of the peripheral nerves. Nerve conduction studies can detect conduction changes in the peripheral nerves by measuring nerve conduction velocity. This study has been carried out to compare and analyse the Sensory Nerve Conduction Velocity (SNCV) between healthy controls and malnourished children. MATERIALS AND METHODS The present study was conducted on 60 children under five years of age with PEM who were divided into three age groups for statistical analysis:-Group 1: 01 year-02 years, Group 2: > 02 years-03 years, and Group 3: > 03 years-04 years. Within each age group the patients were further divided into 2 groups on the basis of severity of malnutrition, first as suffering from mild-tomoderate malnutrition (grade 1 and 2 malnutrition) and second as suffering from severe malnutrition (grades 3 and 4 malnutrition). 45 healthy children (n= 15 for each age group) without any nutritional problems served as control subjects. Assessment of nutritional status was done according to the guidelines of the Nutrition Subcommittee of the Indian Academy of Paediatrics. Nerve conduction study was performed on median, ulnar and sural nerves with neuroperfect EMG/NCV/EP System and SNCV was measured. One-Way ANOVA and Tukey-Kramer post-hoc test was applied to analyse the statistical significance of changes in the SNCV. RESULTS The SNCV was significantly reduced in children with severe malnutrition. No significant difference in SNCV was found in children with mild-to-moderate malnutrition. CONCLUSION The results of this study show significant reduction in SNCV in children with severe PEM which may be due to nutritional deficiency affecting myelination of peripheral nerves. Moreover, no significant difference in SNCV in children with mild to moderate PEM indicate an association between severity of malnutrition with changes in nerve conduction.
INTRODUCTION: Malnutrition in children affects the development and function of every organ system including the peripheral and central nervous systems. Hoffmann reex (H-reex) is an important neurological screening tool, especially in the paediatric population. Conduction velocity over the H-reex arc has been used to assess proximal motor and sensory pathways. The present study attempted to demonstrate slowed conduction over H-reex arc in malnourished children below ve years of age. MATERIALAND METHODS We studied 82 under-ve children with protein-energy malnutrition. 60 age-matched healthy children served as control subjects. As proximal conduction velocity over H-reex arc changes with age, study subjects were divided into four groups on the basis of age. Based on the degree of malnutrition, the patients were further divided into two groups. The H-reex was recorded from soleus muscle by stimulating posterior tibial using Neuro perfect EMG/NCV/EPSYSTEM (Medicaid systems, Chandigarh,160002, India). RESULTS The conduction velocity over the soleus H-reex arc was signicantly decreased in severely malnourished children. However, conduction velocity over the soleus H-reex arc in the children suffering from mild-to-moderate malnutrition was comparable with normal children. CONCLUSION The ndings suggest that severely malnourished children demonstrate slowed postnatal peripheral neural maturation. Conduction over the soleus H-reex arc was signicantly decreased in severely malnourished children.
Background: Peripheral nervous system development begins in prenatal period and continues after birth up to 5 years of age. As a result, Sensory nerve conduction velocity (SNCV) varies during first five years of life of children. Aims and Objectives:The purpose of this study is evaluation of the SNCV of median, ulnar and sural nerve during the first five years of life.Material and Method: SNCV of median, ulnar and sural nerves was measured antidromically in 104 normal under-five children. Statistical analysis of the results was done using SPSS 17.0 software. Results:There was a progressive increase in SNCV of median, ulnar and sural nerves with age. SNCV of all three nerves showed significant positive correlation with age factor. Conclusion:There is significant increase in SNCV of median, ulnar, and sural nerves with age in under-five children. Therefore, age-specific reference values of SNCV for the different nerves in children below 5 years of age are important to evaluate nerve injury or maturational deficit.
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