Background:Nerve conduction studies are performed to diagnose the disorders of the peripheral nervous system. The reference values for nerve conduction velocity (NCV) and late responses for different nerves considerably vary in different group and type of population. Physiological factors such as age, temperature, height, and gender affect the NCV. However, there are very few studies which show the age group at which these changes become significant.Aim and Objectives:The aim of the study was to establish the electrophysiological data of the specific age group at which changes in NCV as well as late responses of median common peroneal nerve and also see the late response in the form of F-waves and H-reflex.Methodology:Study groups were divided into three categories based on the age: Group I (18–30 years) (n = 80), Group II (31–45 years) (n = 43), and Group III (46–60 years) (n = 27). Out of which, 93 patients were male and 57 were female. The NCVs were determined for median, common peroneal nerve (motor component and sensory component) along with late responses in the form of H-reflex and F-waves.Results:The mean and standard deviation of median, ulnar, peroneal, and tibial nerve was studied for latencies, amplitude, and velocities for both sensory and motor components. Patients with older age had longer latencies, smaller amplitudes, and slower conduction velocities compared with the younger age group. The change with age was greater in sensory nerve conduction and late responses in all the peripheral nerves.Conclusions:Aging has a definite correlation with the NCV and late responses of different peripheral nerves. There is a need to have reference values with relation to age.

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Background: Neuropathy is one of the common complications of diabetes, in which the patient's quality of life is compromised. Nerve conduction studies (NCS) are not commonly employed to detect the neuropathy. Aims & Objective: To find out the utility of Nerve conduction studies (NCS) as early indicator of neuropathy in diabetic patients. Materials and Methods: 50 diabetes mellitus patients with normal HbA1c levels and 50 diabetes mellitus patients with elevated HbA1c levels were selected, making it a total of 100 diabetes mellitus patients. 50 non-diabetic, healthy subjects were chosen as a control group. The nerve conduction velocity was tested in all the diabetic subjects and the healthy controls. Results: The analysis showed that the nerve conduction velocity progressively decreased from the controls (49.0 ± 3.9) to the diabetics with a good glycaemia control (47.2 ± 2.8), to the diabetics with a poor glycemic control (45.3 ± 3.1). Conclusion: There is a progressive neuronal involvement in the diabetic process which is accelerated by poor glycemic control. Therefore, nerve conduction studies can be employed for testing and for the early indication of neuropathy in diabetic patients.

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Background: Carpal tunnel syndrome (CTS) is the commonest median nerve entrapment neuropathy with preponderance in females. Aims & Objective: The present study was carried out for early conformation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS) by electrodiagnostic tests which include motor conduction, sensory conduction, and F-wave studies. Materials and Methods: Early confirmation of clinically suspected patients of CTS by performing electrodiagnostic tests of median and ulnar nerves. 100 subjects of age group 30-50 years (50 clinically suspected patients of CTS, 50 as control group) were studied. Motor and Sensory conduction velocities, distal motor and sensory latencies and F wave latencies were performed using Medtronic Keypoint @ 2 EMG EP software. Results: Statistically significant (P<0.001) slowing of motor conduction velocities for median nerve was seen in the CTS group as compared to control group. Statistically significant (P<0.001) increase in distal motor and sensory latencies was observed for both median and ulnar nerves in CTS group with more increase in distal motor latency than sensory latency. Increase in F wave latencies of both nerves was seen in CTS group. Conclusion: Electrophysiological studies confirmed the early diagnosis of CTS with a high degree of sensitivity. Present results confirm selective slowing of sensory and motor conduction within wrist to palm segment in patients of CTS due to compression by the transverse carpel ligament or to disease process of terminal segment.

BackgroundMaharashtra is one of the worst affected states in this pandemic.2 As of 30th September, Maharashtra has in total 1.4 million cases with 38,000 deaths. Objective was to study associations of severity of disease and need for ICU treatment in COVID-19 patients.MethodsA retrospective study of clinical course in 800 hospitalized COVID-19 patients, and a predictive model of need for ICU treatment. Eight hundred consecutive patients admitted with confirmed COVID-19 disease.ResultsAverage age was 41 years, 16% were <20 years of age, 55% were male, 50% were asymptomatic and 16% had at least one comorbidity. Using MoHFW India severity guidelines, 73% patients had mild, 6% moderate and 20% severe disease. Severity was associated with higher age, symptomatic presentation, elevated neutrophil and reduced lymphocyte counts and elevated inflammatory markers. Seventy-seven patients needed ICU treatment: they were older (56 years), more symptomatic and had lower SpO2 and abnormal chest X-ray and deranged hematology and biochemistry at admission. A model trained on the first 500 patients, using above variables predicted need for ICU treatment with sensitivity 80%, specificity 88% in subsequent 300 patients; exclusion of expensive laboratory tests did not affect accuracy.ConclusionIn the early phase of COVID- 19 epidemic, a significant proportion of hospitalized patients were young and asymptomatic. Need for ICU treatment was predicted by simple measures including higher age, symptomatic onset, low SpO2 and abnormal chest X-ray. We propose a cost-effective model for referring patients for treatment at specialized COVID-19 hospitals.Key MessagesOf 800 patients, 73% had mild, 6% moderate and 20% had severe disease.Seventy-seven patients (9.6%) required ICU treatment, 25 (3%) died.ICU treatment was predicted by higher age, more symptomatic presentation, lower SpO2 and pneumonia on chest X-ray at admission.A machine learning model features in first 500 patients accurately predicted ICU treatment in subsequent 300 patients.A good clinical protocol, SpO2 and chest X-ray are adequate to predict and triage COVID-19 patients for hospital admissions in resource poor environments.

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