No abstract

Background The current COVID-19 pandemic has become a global public health crisis and presents a serious challenge in treatment of severe COVID pneumonia patients. With an imperative need for an effective treatment, we aimed to study the effectiveness of Pentaglobin, an intravenous immunoglobin in the treatment of severe Covid-19 pneumonia patients. Methods This is an open-label non-randomised controlled study. Patients in the study group (n=17) received Pentaglobin in addition to standard therapy and the control group (n=19) received only the standard of care treatment. Severity of illness were quantified by severity scores and inflammatory laboratory parameters were compared between the two groups. Results The average length of hospital stay in pentaglobin group were 12.35±6.98 days compared to 10.94±4.62 days in standard treatment group with mean difference of 1.4 days (p value=0.4). Pentaglobin did not provide an added advantage in terms of reducing the duration of hospital stay. There was no significant difference between both the groups in terms of requirement of invasive ventilation (p=0.56) and mortality (p=0.86). CT Severity score (OR= 1.39 95% CI= 1.09-1.77, P=0.01), APACHE II score (OR=1.16 95% CI= 0.99-1.35, P=0.05) and the SOFA score (OR=2.11 95% CI=1.13-3.93, P=0.02) were independent predictors of mortality. Conclusion The administration of pentaglobin in COVID -19 patients has no significant effect in reducing the risk of mechanical ventilation or death, in disease worsening or in reduction of inflammation.

No abstract

Background: COVID-19 has forced us to alter, or perhaps it’s better said that we have had to adapt. Within the Indian context, telemedicine has the potential to extend access to quality healthcare for all Indians. New evidence and technological improvements in the Telecovid application were to spot the role of its services to screening, monitoring, and follow-up of the patients during the COVID-19 outbreak. Subjects and Methods: U. N. Mehta Institute of Cardiology and Research Center has developed “TELECOVID”. Platform with the help of HOPS by SLK Techlab, the software. Telecovid study was started from the second wave of COVID 19 pandemic from 20th April 2021 to 27th May 2021; 24x7 hours. Patients were treated on OPD and admission according to the institutional standard protocol which follows the guideline of the Indian Council of Medical Research. Results: Total 1249 COVID patients were attended in “COVID-19 screening OPD”. There were 729(58%) males and 520(42%) females. Out of 182 admitted patients, 168(92.31%) were discharged and 14(7.69%) were expired. More numbers of patients (83%) came from urban and only 17% were from the rural area. Comorbidities like hypertension were seen in a total of 97(7.77%), diabetes mellitus-II 52(4.16%) patients were suffered. Ischemic heart disease was seen in only 10(0.8%). Conclusion: There is an untapped opportunity to build our ‘UNM telemedicine’ application into a world-class teleconsultation platform. This is potential by incorporating it within the larger healthcare ecosystem that connects hospitals, clinics, pharmacies, laboratories, diagnostic centers, and doctors who deal with in-person consultations.

Context: In patients with rheumatic heart disease (RHD), left atrial appendage (LAA) dilation and thrombus formation is widely known. LAA thrombus formation is a risk factor for stroke even in patients with sinus rhythm. The aim of this study was to determine an association between LAA structure and function with respect to thrombus formation and differences in LAA size and velocity between patients with sinus rhythm and those with atrial fibrillation (AF). Materials and Methods: We prospectively studied LAA structure and function in 120 patients with RHD by transthoracic echocardiography and/or transesophageal echocardiography by measuring left atrial (LA) dimension, LA area, LAAmax/min, LAA ejection fraction (EF), and LAA emptying velocity. Results: Four out of 48 patients with sinus rhythm had LAA thrombus. In 72 patients with AF, 32 had LAA thrombus. Patients with LAA thrombus had lower mean LAA EF and emptying velocity both variables P-value is same (P<0.0001 and P<0.0001) Patients with LAA thrombus had increased mean LAA max and LAA min as compared to LAA max and LAA min in patients without LAA thrombus (P 0.008 for mean LAA max and P<0.0001 for LAA min respectively). Patients with AF with LAA thrombus had greater LAAmax compared to that in patients with AF without LAA thrombus (P < 0.0001). Doppler demonstrated a recognizable sawtooth LAA outflow velocity pattern in 32 of 36 (88.9%) patients with LAA thrombus versus 32 of 84 (38.1%) patients without LAA thrombus. Conclusions: We conclude that LAA contractility is reduced in RHD with LAA thrombus, and loss of both contractility and LAA dilation is associated with increased risk of thrombus formation and hence the risk of stroke.