Background Diabetes mellitus (DM) is a decisive risk factor for severe illness in coronavirus disease 2019 (COVID-19). India is home to a large number of people with DM, and many of them were infected with COVID-19. It is critical to understand the impact of DM on mortality and other clinical outcomes of COVID-19 infection from this region. Aims The primary objective of our study was to analyze the mortality rate in people with DM infected with COVID-19. The secondary objectives were to assess the effect of various comorbidities on mortality and study the impact of DM on other clinical outcomes. Methods This is a retrospective study of COVID-19 infected patients admitted to a tertiary care hospital in north India in the early phase of the pandemic. Results Of the 1211 cases admitted, 19 were excluded because of incomplete data, and 1192 cases were finally considered for analysis. DM constituted 26.8% of total patients. The overall mortality rate was 6.1%, and the rate was 10.7% in the presence of diabetes (p < 0.01, OR 2.55). In univariate analysis, increased age, chronic kidney disease (CKD), coronary artery disease (CAD), stroke, and cancer were associated with mortality. On multiple logistic regression, the independent predictors of mortality were CAD, CKD, and cancer. Breathlessness and low SpO2 at presentation, extensive involvement in CXR, and elevated ANC/ALC ratio were also significantly associated with mortality. Conclusions The presence of comorbidities such as DM, hypertension, CAD, CKD, and cancer strongly predict the risk of mortality in COVID-19 infection. Early triaging and aggressive therapy of patients with these comorbidities can optimize clinical outcomes.
Askin tumour, a primitive neuroectodermal tumour of the thoracopulmonary region, is a rare tumour presenting in childhood. Its presentation in adults is rare. We report a case of an Askin tumour in an adult patient who presented to us with worsening breathlessness and vague chest pain. Investigations including immunohistochemistry confirmed the diagnosis of Askin tumour.
Background: Spontaneous intracranial haemorrhage (ICH) is the most severe type of stroke with high mortality rates. This entity accounts for 17 to 33% of all strokes and is associated with a higher mortality rate. Approximately, 35–50% of patients with ICH die within the 30 days after event. Long-term survivors are often remaining with permanent deficits, with up to 75% suffering permanent disability and only 12% to 39% of the survivors have favourable outcomes. Several studies aiming to explore the efficacy of surgery for patients with ICH have been carried out. However, the results were inconclusive. To provide evidence for clinical practice, here we present a retrospective study to explore the effect of surgery for patients with spontaneous basal ganglia haemorrhage. Methods: The present study was conducted in the Neurosurgery Department of a tertiary care hospital in the Northern part of India from January 2018 to March 2020. Sixty-one patients aged between 20-70 years of basal ganglia haemorrhage who presented within 24 hours of ictus and operated were included in this study. Results: A total of 61 patients underwent surgical intervention consisting of 49 (80%) males and 12 (20%) females. Their age varied from 27 to 70 with mean age ± SD 51.93 ± 13.19 years. Thirty-six patients were ≥ 50 years of age, out of which 72% patients had unfavourable outcomes (GOS 1-3) and 28% had favourable outcome (GOS 4-5). There were 31 patients with GCS 5-8. Most patients (81%) had GOS 1-3(at the time of discharge). Out of 25 patients with GCS 9-12; 64% had GOS 4-5. The patients with volume of haematoma 40-60 ml, 82% patients had GOS 4-5. The patients with midline shift > 5 mm; 78% patients had GOS 1-3. Patients with midline shift < 5 mm; 82% had GOS 4-5 (P=0.005). The mean hospital stays of unfavourable outcomes group was 28.71 ± 10.25 days and of favourable outcomes group was 22.07 ± 6.32 days (0.000). Conclusions: Early surgery (within 6 hours) along with multi-modality medical management has definite positive role in the outcome of patients with spontaneous basal ganglionic haemorrhage. Patients ≥ 50 years, signs of brain herniation, volume of haematoma ≥ 60ml, hydrocephalic dilatation due the intraventricular haemorrhage, midline shift > 5 mm, and GCS ≤ 8 at presentation had poor prognosis.
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