Background: Pleural effusion is a common diagnostic dilemma for the pulmonologist. A histological diagnosis would many a time steer the way to an accurate diagnosis of the aetiologies of pleural effusions. This study has compared two methods for obtaining histological specimens in cases of undiagnosed pleural effusions.
Background and aims
Corona virus disease 2019 (COVID-19) has been an extremely difficult pandemic to contain and it has affected more than 148 countries worldwide. The main aim of this systematic review is to provide a comprehensive summary of clinical and laboratory parameters that are associated with and indicative of increased severity among COVID-19 patients.
Material and methods
All the available data from high-quality research articles relevant to the epidemiology, demographics, trends in hospitalization and outcomes, clinical signs and symptoms, diagnostic methods and treatment methods of COVID-19 were retrieved and evaluated for inclusion.
Results
As per our review, the mean age of patients in the severe group was 59.3 years compared to 46.5 years in non severe group. COVID-19 was more severe among men than women. Clinical presentation was variable among different studies. and dyspnea was the factor indicating severe disease. Laboratory parameters associated with increased severity were lymphopenia <0.8 × 10
9
/L, thrombocytopenia 100 × 10
9
/L, leucocytosis TC > 11 × 10
9
/L, procalcitonin >0.5 ng/mL, d dimer >2 mcg/mL, aspartate transaminase elevation >150U/L, LDH >250U/L.
Conclusion
This systematic review suggests that COVID-19 is a disease with varied clinical presentation and laboratory parameters. The commonest clinical symptoms were fever, cough and dyspnea. The laboratory parameters associated with severe disease were lymphopenia, elevated LDH, D dimer and Procalcitonin.
Melanoma differentiation-associated protein 5 (MDA5) antibody-positive dermatomyositis (DM) displays unique cutaneous and pathologic features. We describe two cases of myositis-associated rapidly progressive interstitial lung disease (RP-ILD). The patients were two women from Kerala, India. Both patients had anti-MDA5 antibody-positive myositis. Both patients presented with RP-ILD without any clinical features of myositis and succumbed to their illness despite aggressive medical treatment. Anti-MDA5-antibody-positive DM is characterised by amyopathic disease with rapidly progressive and fatal ILD.
COVID-19pandemic was started in December 2019. It has variable presentation from mild sore throat to severe respiratory distress. It is important to identify individuals who are likely to worsen. The Research question is how to identify patients with COVID-19 who are at high risk and to predict patient outcome based on a risk stratification model? We evaluated 251 patients with COVID-19 in this prospective inception study. We used a multi-variable Cox proportional hazards model to identify the independent prognostic risk factors and created a risk score model on the basis of available MuLBSTA score. The model was validated in an independent group of patients from October2020 to December 2021. We developed a combined risk score, the MuLBA score that included the following values and scores: Multi lobar infiltrates (negative0.254, 2), lymphopenia (lymphocytes of <0.8x109 /L, negative0.18,2), bacterial co- infection (negative, 0.306,3). In our MuLB scoring system, score of >8 was associated with high risk of mortality and <5 was at mild risk of mortality (P < 0.001). The interpretation was that The MuLB risk score model could help to predict survival in patients with severe COVID-19 infection and to guide further clinical research on risk-based treatment.
To assess the awareness regarding pulmonary rehabilitation among medical practitioners and perceived barriers for referral METHODS: We did a cross-sectional study by using self-administered validated questionnaire containing 20 questions for assessing knowledge and perceived barriers which were distributed to medical practitioners of modern medicine in Kerala state, India Responses summarized in frequencies and percentages using SPSS Software.
Background:The occurrence of exacerbation in these patients may result in worsening quality of life and a faster decline in lung function. Amongst the Indian population the prevalence of COPD is about 3% to 8% in males and 2.5% to 4.5% in females .Objective: The purpose of this study was to analyze the effectiveness of treatment and the quality of life of those patients who were admitted with a diagnosis of AECOPD to Amrita Institute of Medical Sciences and Research Centre, Kerala between October 2018 and April 2019. The patients selected were those who had received a combination of formoterol with budesonide to the standard treatment of salbutamol with ipratropium bromide nebulization.Methods: A total of 75 patients with diagnosis of acute exacerbation of COPD met the inclusion criteria. Their dyspnea symptoms, Arterial blood gas (ABG) values, PEFR values and their quality of life were compared on day of admission and day of discharge. The ADRs that occurred were also monitored during their stay at the hospital.Result: There was a significant change in the effectiveness parameters and the quality of life of the patients who were taking the treatment together. The ADRs observed were not severe
Conclusion:The use of the treatment combination showed a statistical significance in the patient's condition hence showing that the addition of formoterol and budesonide to the standard therapy may be considered in the treatment of patients suffering from acute exacerbated COPD.
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