Asian Journal of Medical Research

Unsolved Problems Treatment of Patients with Thermal Inhalation Injuries (Literature Review)

Ishnazar Boynazarovich Mustafakulov — 2021-06-21

Despite the achieved certain successes in the treatment of victims with combined thermal trauma, a wide arsenal of modern pharmacological agents and medical equipment, it should be recognized that the existing principles of treatment of this severe category of victims are mainly syndromic in nature, and treatment-tactical algorithms require further development, depending on the severity of damage to the respiratory system and prognostic assessment of the outcome of combined thermal injury.

Role of D-Dimer and LDH in Assessment of Severity of Covid-19

Maharudra Shekhanawar — 2021-06-21

Background: COVID-19 disease due to coronavirus 2 (SARS-CoV-2) infection has been widely spread in India and worldwide. Laboratory investigation values are mainly attributed to the increased inflammatory biomarkers, tissue injury indicators and coagulation parameters. Hence we aimed to investigate D-Dimer and serum LDH and to correlate them amongst non- ARDS cases and ARDS cases which may help to predict severity and outcome of COVID-19. Subjects and Methods: Total number of 100 cases enrolled for the study, admitted on priority basis. Consecutive blood tests that included D-Dimer and serum LDH in the study period were reviewed. Patients diagnosed with SARS-CoV-2 infection, diagnosed by RT-PCR and CORAD scaling, in whom, CBC, platelet count, RFT, LFT, RBS, serum D-Dimer and serum LDH had been analysed at the time of admission were selected. For assessment of severity and behaviour of the factors to be analysed the COVID-19
patients were grouped into Non-ARDS (mild) and ARDS (severely ill) cases, factors analysed in both groups and correlated. Results: For Non-ARDS patients, the median age was 48 years and for ARDS patients, 60 years. Out of 42 ARDS cases 28 are diabetic (66.7%) p<0.001. Out of 39 ARDS cases 35 had mild to severe dyspnea which accounts for 83.3% with p value <0.001. Lymhocyte count and platelet counts are drastically decreased in ARDS cases (Mean=10; 6-14 p<0.001 and Mean=1.6X103cells/cu.mm p<0.001 respectively). There is decrease in the. ESR is raised in most of the covid cases, a significant increase in ARDS patients (Mean=36; 31.8-42.3 p<0.05). In LFT, Bilirubin levels raised significantly (Mean=1.8 and 0.8 p<0.001 respectively) along with SGPT significantly increased (Mean=40.3 p< 0.001). In all ARDS cases there is significant increase in D-Dimer and serum LDH values (100% and 97.6%). Also in ARDS cases the association between D-Dimer and
serum LDH and correlation between these two factors with routine investigations is stronger. Conclusion: In summary, this study showed that D-Dimer and LDH could be identified as powerful predictive factors for early recognition of thrombosis and organ injury and thus can predict the severity of COVID-19. Lymphopenia, Thrombocytopenia, with more prominent laboratory abnormalities may be a potential indicator for diagnosis. Older age, high number of comorbidities were associated with severe patients.

Serum Ferritin and C - Reactive Protein as Prognostic Factors in Patients with Novel Coronavirus 2019

Maharudra Shekhanawar — 2021-06-21

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in Coronavirus disease 2019 (COVID-19) which has been widely spread in India and worldwide. We have aimed to investigate serum ferritin and CRP along with routine investigations and to correlate them amongst non- ARDS cases and ARDS cases which may help to predict severity and outcome of COVID-19. Subjects and Methods: Total number of 100 cases taken for study, admitted on priority basis. Consecutive blood tests that included ferritin and CRP in the study period were reviewed. Patients diagnosed with SARS-CoV-2 infection in whom, CBC, platelet count, RFT, LFT, RBS, serum ferritin and CRP had been analysed at the time of admission were selected. For assessment of severity and behaviour of the factors to be analysed the COVID-19 patients were grouped into Non-ARDS (mild) and ARDS (severely ill) cases, factors analysed in both groups and correlated. Results:For Non-ARDS patients, the median age was 48 years 72% were men. For ARDS patients, 60 years, and 74% were men. Out of 42 ARDS cases 28 are diabetic (66.7%) as compared to 11 cases being diabetic in total 58 Non-ARDS cases (19%) p<0.001. Out of 39 ARDS cases 35 had mild to severe dyspnea which accounts for 83.3% with p value <0.001. Lymhocyte count is drastically decreased in ARDS cases (Mean=10; 6-14 p<0.001). ESR is raised in most of the Covid cases, a significant increase in ARDS patients (Mean=36; 31.8-42.3 p<0.05). In LFT, T.Bilirubin and D.Bilirubin raised significantly (Mean=1.8 and 0.8 p<0.001 respectively) along with SGPT significantly increased (Mean=40.3 p< 0.001). Also, there is drastic decrease in platelet counts in these ARDS cases (Mean=1.6X103cells/cu.mm p<0.001) suggesting thrombotic storm and inflammatory signs in ARDS cases. In all ARDS cases there is significant increase in serum ferritin and CRP values (100%) whereas in
Non-ARDS cases these values were raised in 84.5% of cases. we found that in COVID-19 patients the association between ferritin levels and CRP levels was stronger. Conclusion: Detailed investigation of 100 hospitalized COVID-19 cases suggests that the serum ferritin test and CRP test should be used for screening in patients with COVID-19 to evaluate the severity and to predict the prognosis and mortality in hospitalized COVID-19 patients. Lymphopenia, Thrombocytopenia, with more prominent laboratory abnormalities may be a potential indicator for diagnosis. Older age, high number of comorbidities were associated with severe patients.

Comparative Study of Automated Cell Counter Generated Data and Peripheral Smear Evaluation in Cases of Anaemia

O.P. Bhargava — 2021-06-20

Introduction: In developing countries Anemia is major public health problem. Females are more commonly affected by anemia. Iron deficiency is the main cause of anemia. It was estimated that preschool children and pregnant woman are more commonly affected by anemia. Subjects and Methods: It is hospital based prospective observational study. Total number of cases was 400.The study duration is for a period of one and half years. The study was carried out at our tertiary care center in Department of Pathology and in patients of clinical departments of Netaji Subhash Chandra Bose Medical College & Hospital, Jabalpur (M.P.) Patients diagnosed anemia in central laboratory of age above 14 year and Indoor patients in NSCB Medical College & Hospital Jabalpur were included in this study. Ethical permission was taken from Institutional Ethics Committee. Result: In our study 15-25 year of age group are more affected in both females 105 (45.5%) and males 80 (47.3%). As per the above table, on the basis of interpretation of auto analyzer generated data, the most common type of anemia in females is microcytic hypochromic 102 (68.5%) and in male macrocytic anemia 74(56.5%) that is statistically significant p<0.05. Conclusion: Our study concludes that the two methods of morphological typing of anemia having “moderate agreement” with each other according to kappa (κ) Analysis.