To evaluate the hearing status of COVID-19 patients and compare with control group. Prospective study carried out in 9 institutes. The pure tone audiogram and impedance audiometry of COVID-19 patients performed initially and at 3 months follow up. The control group consisted COVID-19 negative individuals with no history of ear related diseases. The average of air and bone conduction threshold (AC and BC) were compared between the COVID-19 patients and control group using independent t-test with a p value of less than 0.05 considered significant. Total of 331 patients, age 32 ± 4.3 years, 66.7% males and 33.3% females were included in the study. There were 80 individuals in the control group. Aural symptoms were, tinnitus in 1.8%, aural fullness in 1.4%, hearing loss in 3. 9%, and ear ache in 1.8% were present initially, resolved at 3 months follow up. The impedance audiometry demonstrated type B and type C curve in 5.1% and 1.15% ears, and out of these 64.7% and 40% improved at 3 months follow up respectively. No significant difference observed between the average AC and BC of the COVID-19 patients and control group. The COVID-19 infection may present with aural symptoms; however, it was concluded that there was no significant difference in the hearing status of the COVID-19 positive patients in comparison to the control group. The presence of some changes in the normal functioning of the eustachian tube and middle ear in the COVID-19 infection was also highlighted.
ABSTRACT Introduction: Depression and Anxiety symptoms are widely prevalent in the geriatric population and the prevalence is higher in those suffering from any kind of medical illness. Although the prevalence of anxiety and depression among elderly medical patients have been evaluated in a few studies from developed countries in Europe and the Americas, data from a developing country like Nepal is lacking. The main aim of our study was to estimate the burden of these psychiatric morbidities in our setting. Materials and methods: A cross sectional analytical study where 42 geriatric inpatients admitted to the Department of Internal Medicine of Tribhuvan University Teaching Hospital during the period from April 1st to May 20th 2009 were studied for the prevalence of depressive and anxiety symptoms using the Beck Depression Inventory and Beck Anxiety Inventory respectively. 23 healthy geriatric community dwellers from a senior citizen centre in Kathmandu were taken as the control group. Data was analyzed using SPSS 14.0. Results: Significant anxiety symptoms were present in 76.1% (N=32) of the hospitalized geriatric patients and significant depressive symptoms in 57.1% (n=24) as compared to 21.7% (n=5) and 17.3% (n=4) of healthy community dwellers respectively. Between the hospitalized geriatric medical inpatients and elderly healthy community dwellers, there was statistically significant differences in anxiety scores (F=26.06, p<0.01) and depression scores (F=22.97, p<0.01) as measured by one way analysis of variance (ANOVA). Conclusion: There is a very high prevalence of depressive and anxiety symptoms among hospitalized geriatric medical inpatients as compared to healthy community dwellers in Nepal. Presence of these psychiatric morbidities can further exacerbate the physical illness slowing down recovery and adversely affecting a wide range of outcomes. Such a high amount of psychiatric morbidity in this population needs to be addressed by appropriate mental health interventions
To study the incidence of the smell and taste disturbance in the COVID-19 patients and a follow up at 4 months to observe for the duration of resolution of these symptoms. This is a multicentric prospective study carried out in 3 different countries, from April, 2020 to January, 2021. The COVID-19 positive patients, aged between 15 and 60 years, were inquired about the presence of any smell or taste related symptoms. The same patients were followed up with the telephonic interview after 2 months and then after 4 months, respectively. The duration of resolution of the smell and taste disturbance symptoms was noted. Total of 188 COVID-19 positive patients, average age 33.1 ± 1.7 years, 54.2% males and 45.8% female were included in the study. The smell disturbance was present in 60.6% (hyposmia 36.1%, anosmia 20.2%, and parosmia 4.2%) and taste disturbance in 28.7% of patients (hypogeusia 20.2%, ageusia 6.9%, and parageusia 1.6%). There was improvement of anosmia by 97.4, hyposmia by 95.6%, parosmia by 100%, ageusia by 100%, hypogeusia 94.8%, and parageusia by 66.7%, at 4 months follow up. The present study concludes that the smell and taste disturbances are one of the main early presenting features of the COVID-19 infection. The temporary effect of the COVID-19 infection on the olfactory and gustatory pathway was also highlighted with more than 95% patients improving at 4 months of follow up.
Tetrology of Fallot's (TOF) is the most common cause of cyanotic congenital heart disease, and accounts for 10% of all congenital heart diseases. Right to left shunting and hyperviscosity of blood predisposes these patients to brain abscess. Perioperative management of these patients with uncorrected TOF for noncardiac surgery is a challenge for the anesthesiologists owing to the long-term effects of hypoxia and decreased pulmonary blood flow, resulting in considerable modification of the physiology and neurological complications. We are hereby reporting the anaesthetic management of an 8 year old child with uncorrected TOF presenting with multiple brain abscesses who underwent craniotomy with uneventful recovery.
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