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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.

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.

IntroductionMyocardial infarction, a major consequence of coronary artery disease, is an important cause of in-hospital mortality and morbidity worldwide. Blood neutrophil-to-lymphocyte ratio (NLR) is a novel laboratory marker of systemic inflammation that can predict the severity and mortality in various non-cardiovascular illnesses, including malignancy and infective pathology. We sought to evaluate its potential in predicting the outcome in hospitalized patients with myocardial infarction. Material and methodsThe index study was conducted at Silchar Medical College and Hospital from June 1, 2021 to May 31, 2022, with the aim of evaluating the role of NLR in determining the outcomes of ST-elevation myocardial infarction (STEMI). A total of 110 patients fulfilling the requisite criteria and admitted to the cardiology and medicine departments of the hospital with evidence of STEMI were included in the study and evaluated for the relationship of NLR with various outcome variables in STEMI. ResultsOut of 110 patients, 69.1% were males. The mean age of the study population was 58.2±15.3 years. The baseline characteristics and risk factors of patients who survived the acute attack of STEMI and those who died from complications of STEMI were similar. Laboratory parameters which correlated with worse outcomes included a higher fasting triglyceride level (173.4 mg vs. 215.6 mg, p < 0.001), a higher blood neutrophil count at baseline, 24 hours and 72 hours (70.1% vs. 69.04%, 66.3% vs. 75.2%, 81.6% vs. 73.8%, p<0.05), a higher NLR value at baseline, 24 hours and 72 hours (2. 91 ± 1.13 vs. 3.19 ± 2.32, 2.39 ± 0.74 vs. 5.56 ± 4.11, 5.1 ± 4.38 vs. 3.01 ± 1.02, p < 0.05). Among patients hospitalized with STEMI who had high NLR, had significantly elevated incidence of complications, including a higher acute, left ventricular failure (42.8% vs. 35.9%; p < 0.05) as well as increased risk of mortality (66.7% vs. 33.3%; p < 0.05) compared to low NLR group. ConclusionNLR can predict the outcome among STEMI patients in terms of morbidity and mortality and correlates with poor left ventricular function. NLR can serve as a potential tool for early identification and efficient triage of STEMI patients during initial presentation to the ED. Its utility is more so in resource-constrained developing countries with limited access to health care. The significant advantage of NLR is its easy accessibility, rapid turnaround time, and inexpensiveness.

Atherogeneis is a chronic progressive syndrome caused by endothelial dysfunction, vascular inflammation, vessel wall remodeling and eventual vascular flow compromise. Emerging data suggest that arterial compliance inversely correlates with atherogenesis and cardiovascular (CV) events. However, information is scant on the association of chronic systemic inflammation with arterial elasticity in young asymptomatic adults. The association of hsC-reactive protein (CRP) and central-vascular compliance was studied in 641 individuals (45.2% males; 71.8% whites), aged 31-43 years enrolled in the Bogalusa Heart Study. The measured variables included large-artery compliance (capacitive, C1), representative of the aorta and its major branches; and small-artery compliance (oscillatory, C2), representative of the distal part of the circulation; hsCRP, as a measure of systemic inflammation; along with traditional CV risk factor variables. Significant race and sex differences were noted for C1 (white males>black males P-value <0.0001; males>females P-value 0.04), C2 (whites>blacks P-value 0.0004; males>females P-value<0.0001) and hsCRP (blacks>whites P-value 0.03; females>males P-value 0.002). Mean values of C1 in subjects with high hsCRP levels (>3 mg l(-1)) were significantly lower than those with average (1-3 mg l(-1)) and low levels (<1 mg l(-1)) (14.2 ml per mmHg × 10 versus 15.2 ml per mm Hg × 10 versus 15.7 ml per mmHg × 10, P for trend=0.02), after adjusting for age, race, sex and body surface area (BSA). hsCRP showed a trend toward inverse correlation with C1 (-0.07, P=0.07) but no such trend for C2, after adjusting for race and sex. In the multivariate linear regression model, adding age, race, sex, BSA, mean arterial pressure, insulin resistance, lipoprotein variables and smoking status, the effect persisted between C1 and hsCRP (β=-0.35, P=0.01). In an asymptomatic population of young adults, hsCRP predicts reduced large-artery compliance (C1). These findings support the role of systemic inflammation in early pathological changes in artery wall in atherogenesis. Small-artery compliance (C2) however did not correlate with hsCRP.