Objective: The purpose of study was to assess the role of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) and hydrocortisone in patients with COVID-19 and their outcome during hospitalization. Materials and Methods: A clinical comparative prospective hospital-based study was conducted in the Department of Pulmonology & Intensive Care Unit (ICU) of Dow University of Medical & Health Sciences, Karachi in patients positive for COVID-19 infection during their hospitalization. A comparative analysis was performed between two groups, i) those who received an injection of hydrocortisone and ii) those who received oral ACEi/ARB. All the baselines and clinical variables were recorded in a structured questionnaire and the data were evaluated in the Statistical Package for the Social Sciences (SPSS) version 22.0. A p-value of <0.05 is considered statistically significant. Results: The final analysis was performed on 130 patients among them 68 patients received an injection of hydrocortisone and 62 patients received the tablet ACEi/ARB, which ever indicated. Patients who need injection hydrocortisone were older than patients who received ACEi/ARB, 58.37±15.20 and 51.01±90.22. Patients who received injection hydrocortisone were more likely to receive mechanical ventilation support as compared to other groups, 11.7% vs. 4.8%, respectively, p-value 0.02. The overall mortality rate was 10% (n = 13) in both groups in which a higher number of deaths was observed in patients who were taking ACEi/ARB as compared to patients who were receiving injection hydrocortisone, 12.9% vs. 7.3%, respectively, but it had an insignificant association, p-value 0.17. Conclusion: We have observed in our study that patients who received an injection of hydrocortisone had lower rates of mortality irrespective of their gender and age while patients who received ACEi/ARB during hospitalization had lower complications rate but higher mortality rates.

Objective: To investigate the relationship between neck circumference (NC) and continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), as well as to assess CPAP requirements based on the neck circumference. Material and methods: This study was carried out in the pulmonary, vascular, and sleep disorders department of the Dow University Hospital in Karachi. The study was done for six months of duration from January 2022 to June 2022. All of the patients who had obstructive sleep apnea (OSA), between the ages of 18 and 60 years, both genders and underwent CPAP therapy were chosen for this study. The polysomnography database was utilized in order to do an analysis on the Apnea-Hypopnea Index for the OSA. Neck circumference was measured at the neck’s middle sit in every participant. The neck circumference was correlated with the CPAP therapy. The structured study proforma was used to collect all the data. Results: A total of 181 individuals who presented with OSA were studied. Mean age of the cases were 52.86+12.26 years and mean neck circumference was 43.45+3.58 cm. Males were 58.0% and females were 42.0%. Majority of the cases 56.4% had severe OSA. There was a strong significant positive correlation between neck circumference and CPAP (r= 0.177, p-value 0.017) and significant positive correlation between neck circumference and CPAP (r= 0.366, p-value 0.001). Average of CPAP pressure was significantly high according to severity of OSA (p-0.0001). Conclusion: The neck circumference was observed to be the most reliable marker that significantly positively correlated with CPAP therapy and measurements of OSA and its severity, by AHI alone, seem to have a positive correlation with CPAP therapy. However, OSA evaluation and treatment can be measured for their responsiveness to CPAP based on their neck circumference. Keywords: OSA, NC, CPAP, Relationship