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   Table of Contents - Current issue
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July-December 2021
Volume 8 | Issue 2
Page Nos. 79-165

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REVIEW ARTICLE  

The role of nursing professionals and challenges encountered in the effective containment of the ongoing COVID-19 pandemic p. 79
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/amit.amit_10_21  
The coronavirus disease-2019 (COVID-19) outbreak, which emerged in the form of a cluster of cases in a single city has spread around the globe at a rapid pace. The contribution of the nursing professionals in the effective containment of the ongoing pandemic has been immense. The purpose of the current review is to explore the role of nursing professionals in the effective containment of the ongoing COVID-19 pandemic. An extensive search of all materials related to the topic was carried out in the PubMed search engine and the World Health Organization website and a total of 19 articles were selected based on the suitability with the current review objectives. It will not come as a surprise that almost all the nations across the world were not well prepared to effectively respond to the outbreak and that was quite evident in terms of lacunae in planning, preparation, organization, and leadership. In fact, owing to the shortage of personal protective equipment, there was always a threat that any of the healthcare professionals would might become the next statistics in the ongoing pandemic. The issues encountered by the nursing professional were not simple and they essentially demand serious consideration to have a better response in the future. To conclude, the dynamics of life have changed and it is no longer the same. The nursing professionals displayed immense resilience and mental strength regardless of the workload and ethical dilemma. It is the need of the hour to support them and improve their quality of lives to sustain our battle against the ongoing pandemic.
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ORIGINAL ARTICLES Top

The impact of interaction with orphanage children on quality of life of elderly females residing in old-age homes in a South Indian District: A comparative study p. 82
Devika Pandurang Jeeragyal, Sharvanan Eshwar Udayar, Rachana R Annadani, Malatesh Undi
DOI:10.4103/amit.amit_165_21  
Introduction: Improving the quality of life (QOL) of the elderly has been one of the crucial challenges of public health with increasing life expectancy. The study was done to assess the impact on QOL and psychiatric morbidities among elderly females in old age homes (OAH) who had interaction with orphanage children. Materials and Methods: An analytical cross-sectional study was conducted among 105 elderly females who were residing in OAHs in Chittoor District, India, from Sep–Dec 2019. Data were collected using older people's QOL scale, Hamilton's Scales (HAM-A and HAM-D). Ethical approval was obtained from the Institutional Ethics Committee. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), software version 20. Results: About 82.9% of elderly females in OAHs who were interacting with orphanage children had good QOL when compared to those who were not (8.6%). A significant difference was observed in domains scores for overall life, independent home and neighborhood, psychological and emotional well-being, and religion in the elderly who were interacting with orphanage children when compared to those who did not. Mean scores for depression and anxiety were significantly higher (P = 0.001) in those who were not interacting with the orphanage children (23.23, 43.74) than with interaction (13.46, 43.74). Conclusions: Overall QOL was better in elderly females who had interaction with orphanage children when compared to those who did not. Furthermore, psychiatric morbidities (depression and anxiety) were significantly higher in those who were not having interaction with orphanage children than those with interaction (P = 0.001).
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Clinical and cytomorphological patterns of granulomatous inflammation and its correlation with Ziehl–Neelsen staining p. 88
Sangita Bohara, Rumpa Das, Neeraj Tripathi, Lawanya Verma
DOI:10.4103/amit.amit_145_21  
Introduction: Tuberculosis (TB) is one of the leading causes of mortality and morbidity in India, and extrapulmonary cases from the lymph nodes account for one-fifth of the overall disease burden. TB is known for its varied clinical presentations as well as different sites (organs) of involvement. Fine-needle aspiration cytology (FNAC) plays an important role in diagnosing a significant number of cases which present as granulomatous lesions. Here, we study the cytomorphological and clinical presentation of swellings showing granulomatous pattern of inflammation and correlate them with acid-fast bacilli (AFB) positivity. Materials and Methods: A retrospective study of 3-years duration was done from January 2018 to December 2020 in a tertiary care hospital. Slides of 356 cases showing epithelioid granulomas on cytology were taken out. The clinical data were collected from patient requisition forms. All the available clinical and cytological findings were recorded. The slides were re-examined and characterized into specific patterns of granulomatous inflammation on the basis of predominant background population of cells, necrosis, and hemorrhage. These were correlated with the presence of positive AFB staining on Ziehl–Neelsen (ZN) stain. Chi-square test was used for comparison between groups and P < 0.05 was taken to be statistically significant. Results: The mean age of presentation was 25 years (ranging from 5 months to 75 years) with a slight female preponderance (male-to-female ratio being 0.9:1). The cervical lymph nodes were the most common site. The sites of presentation were varied. The aspirates were gray–white to blood mixed on gross and cytological examination in 186 cases (52.25%). On microscopy, the suppurative pattern was seen in 202 cases (56.74%) and necrosis was seen in 182 cases (51.12%). The AFB positivity on ZN staining was seen in 96 (26.96%) cases in FNAC smears. There was a significant association of positive AFB staining with younger age group (<25 years), larger sized swellings (>2 cm), fixed and matted swellings, longer duration of symptoms (>2 weeks), and absence of pain and fever. The whitish/purulent aspirates on gross examination as well as suppurative and necrotic patterns on cytomorphology on microscopic examination showed a highly significant positive correlation with AFB staining. Conclusion: The gross and microscopic patterns of suppuration and necrosis on FNAC in combination with clinical signs and symptoms are highly suggestive of TB. ZN staining on cytology smears is a very simple and useful investigation, especially in suppurative and necrotic patterns of cytology, for clinching an early diagnosis, which goes a long way in the management of tuberculosis.
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Symptomatology and outcome of acute COVID-19 illness in children at Faridabad, India p. 94
Priyanka Gupta, Onkar Singh Bhinder, Vipul Gupta, Abhinav Ahuja, Anil Kumar Pandey, RN Mandal Ravi
DOI:10.4103/amit.amit_138_21  
Introduction: The surveillance case definitions for coronavirus disease 2019 (COVID-19) in children adapted from adult guidelines emphasized the presence of fever and/or respiratory symptoms as the criteria for suspicion and testing. The clinical course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in Indian children is still not well described. Materials and Methods: This observational study was done at a dedicated COVID-19 tertiary care hospital of Haryana, India, between April 1, 2020 and December 31, 2020, with due approval of Institutional Ethics Committee. A total of 86 SARS-CoV-2 positive inpatient children in the age group of 1 month − 12 years were enrolled to outline the clinical course and outcome of acute illness longitudinally over initial 2 weeks of infection. Clinical management and hospital discharge policy was guided by public health authorities and prevailing scientific evidence which were updated and notified time to time as the pandemic evolved. Descriptive statistics were applied to analyze the study variables. Results: Majority children (48/86; 56%) remained asymptomatic throughout 2-week surveillance period, 35 (41%) suffered mild, 2 (2%) moderate, and 1 (1%) severe disease. All children had intact survival. Comorbid condition(s) were present in five (6%) children. Among infants and the subset of children with premorbid condition(s), the proportion of children suffering symptomatic illness (88% and 80%, respectively) and moderate-severe illness (25% and 40%, respectively) was quite high. Respiratory symptoms (68%) and fever (50%) were the most common symptoms. Gastrointestinal symptoms were present in 26% symptomatic children. Fever was the only symptom in 11% children; and 16% children had only gastrointestinal symptoms without any fever or respiratory symptom(s). Conclusion: Acute SARS-CoV-2 infection in children is commonly asymptomatic, or a mild illness with not only respiratory but also non-respiratory manifestations. Thus, a high index of suspicion for SARS-CoV-2 infection is required by the treating physicians in this subgroup of population as they might play an important role in virus transmission and amplification. In case the testing is deferred among asymptomatic contacts or children with mild symptoms, they may be presumed SARS-CoV-2 infected, isolated, and managed accordingly.
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Study of laboratory parameters in COVID-19 patients at a tertiary care teaching hospital in Uttar Pradesh p. 100
Sarandeep Singh Puri, Parul Singhal, Seema Singhal
DOI:10.4103/amit.amit_137_21  
Introduction: COVID-19 infection has been affecting vast population all over the world since 2019. It is very important to make optimum use of routine laboratory parameters in evaluating severity of COVID-19 disease. This will help the clinicians to improve allocation of technical human resources to patients who require it the most. During the path of the COVID-19 disease, inflammatory indices such as lactate dehydrogenase (LDH), C-reactive protein (CRP), interleukin-6 (IL-6), biomarkers like serum procalcitonin (PCT), and ferritin and indices of coagulation profile like D-Dimer, PT levels, and hematological parameters like total leukocyte count, platelets carry prognostic value. The objective of the study is to estimate the utility of various laboratory Biochemical and Hematological parameters in COVID-19 disease. Materials and Methods: The present study is a retrospective cross-sectional observational study conducted in tertiary care rural teaching hospital. The study was conducted from September 1, 2020, to January 31, 2021. The study was carried out on the patients who were hospitalized in Isolation Ward and COVID ICU in our L3 COVID hospital. All patients with positive SARS-CoV-2 nucleic acid test results were included in the study. A sample size of 310 patients was taken. The basic demographic details were collected from the admission records. The confirmatory test for SARS-CoV-2 was done using the WHO-approved kits based on real-time reverse transcription polymerase chain reaction for which suspected cases underwent nasopharyngeal/oropharyngeal swab testing. The levels of CRP, IL-6, PCT, ferritin LDH, D-dimer, complete blood counts, PT were based on standardized methods obtained using various biochemical and hematological laboratory analyzers. Data of investigation reports were gathered from electronic patient record system. Statistical analysis was performed using the Statistical Package for the Social Sciences for Windows (version 25.0). Results: Our study clearly shows that levels of IL-6, D Dimer, PT, and LDH are quite significantly raised in majority of patients while PCT and ferritin being somewhat nonspecific show an increase but not to that significant numbers. The hematological parameters show levels which indicate mild anemia, leukocytosis, neutrophilia , lymphopenia, and thrombocytopenia in patients infected with COVID-19 disease. Conclusion: COVID-19 is an unexplored, new entity with a sudden worldwide onset. The medical fraternity is yet to conquer and analyse this novel virus.
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Association of temporal bone pneumatization and dehiscence of facial nerve canal: A cadaveric study p. 107
Hina Nafees, Dilshad Ahmed Usmani, Sonika Sharma, SK Jain
DOI:10.4103/amit.amit_119_21  
Introduction: Facial nerve runs an extensive and complicated course through the temporal bone. Integrity of this nerve is affected by the anatomy of temporal bone. Hence, in-depth knowledge of facial canal and its surrounding structures is of utmost importance to avoid any iatrogenic injury during surgery of the middle ear. Temporal bone pneumatization has a great influence on pathogenesis and prognosis of temporal bone diseases. Hence, this study was planned to observe the pneumatization status of the temporal bone and whether there is any association between pneumatization of temporal bone and dehiscence of facial canal. Materials and Methods: The present study was conducted on 30 formalin-fixed adult temporal bones. Dissection of temporal bone was done in the Anatomy Department, TMMC and RC, TMU, Moradabad. Various cells groups were observed in the temporal bones. Facial canal was exposed, and any dehiscence present was then noted. Results: Out of total temporal bones studied, 20 belongs to the right side and 10 of the left side. Pneumatization status of bones was observed by the assessment of different cells present in the bone. Out of 30 bones, 19 (63.3%) bones were well pneumatized, in which 14 bones were of right side and five were of left side. About 11 (36.6%) bones were poorly pneumatized. In which, six were of the right side and five of the left side. In this study, dehiscence of the facial canal was observed in 9 (30%) temporal bones in which eight bones were well pneumatized and one bone was nonpneumatized. In our study, 21 (70%) bones showed no or insignificant dehiscence. Fisher exact test and Spearman's correlation test were applied to observe any association between the two variables. Conclusion: No association exists in between pneumatization of temporal bone and dehiscent facial nerve canal.
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Perceived stress, hardship, and self-reported health status of persons living with diabetes mellitus during Coronavirus Disease-19 pandemic and lockdown: A descriptive study p. 111
Masuma Yasmin, Gargi Dutta Bhattacharyya, Sujoy Ghosh, Kajari Bandyopadhyay, Dipta Kanti Mukhopadhyay, Asit Kumar Biswas
DOI:10.4103/amit.amit_111_21  
Introduction: Coronavirus disease-19 (COVID-19) pandemic and subsequent complete lockdown have resulted in a lot of difficulties in availing essential services including medical care, especially among the persons living with Type 2 diabetes mellitus (DM). The situation was complicated by stress and fear due to unknown nature of the pandemic during initial phases. This study aimed at measuring the perceived stress and hardship faced by persons living with DM and assessing their health status during COVID-19 pandemic and lockdown in a tertiary care hospital in West Bengal. Materials and Methods: An institution-based, cross-sectional, descriptive study was conducted among diagnosed cases of Type 2 DM attending diabetic clinic outpatient department using an interview technique with the help of a predesigned pretested questionnaire that consisted of variables such as perpetual and experiential stress, hardship, and selected self-reported health parameters. Results: Out of a total of 304 study participants, majority responded positively regarding the items of perpetual and experiential stress. However, 80.8% of participants reported the reduction of income, and about 75% of them faced hardship of various extent to manage medicine and diet with low income. Only 9.1% of participants used teleconsultation as a sole method for health checkups. About one-third of participants considered their mental health status as poor or very poor, whereas two-third considered their physical health as good or excellent. Conclusion: Although our study participants did not have much stress or deterioration of health during lockdown, their income and regular care were affected to a certain extent. This emphasizes the need for context-specific measures.
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Inter-relationship between gaming addiction, emotional intelligence, and psychological well-being of playerunknown's battlegrounds and non-playerunknown's battlegrounds online mobile game players: A comparative cross-sectional study p. 117
Avnika Jain, Preeti Jain
DOI:10.4103/amit.amit_84_21  
Introduction: Recently, increasing trend in popularity of online gaming has been seen worldwide. Online games such as PlayerUnknown's Battlegrounds (PUBG) and first-person shooter (FPS) games top the popularity chart among young population. Problematic Internet gaming is also being increasingly reported. The aim of this study was to evaluate the inter-relationship between gaming addiction, emotional intelligence (EI), and psychological well-being in players of PUBG and non-PUBG online shooter mobile games. Materials and Methods: Sixty-four male students (18–22 years) who had played either PUBG or non-PUBG FPS games for ≥3 h/week during the previous 6 months were included. Addictive potential of PUBG (played by n = 33) was compared with that of non-PUBG games (played by n = 31) using Gaming Addiction Scale (GAS). Psychological health and EI were assessed using Depression, Anxiety, and Stress Scale 21 (DASS-21) and Trait Emotional Intelligence Questionnaire-Short Form, respectively. Results: The prevalence of gaming addiction and psychological morbidity was significantly higher in PUBG compared to non-PUBG players. EI was comparable in both the groups. Correlational analysis in PUBG players showed a positive association between GAS and anxiety subscale and a negative association between EI and the depression and anxiety subscales. In non-PUBG players, a positive association between GAS and depression subscale and a negative association between EI and the depression, stress, and total DASS-21 scores was observed. Conclusion: These results suggest that addictive online gaming behavior has detrimental effect on the psychological well-being of players. Furthermore, EI has a potential protective impact against psychological morbidity in these subjects. Future studies may be planned to explore the influence of interventional EI training on psychological health and addictive gaming behavior of online gamers.
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Lockdown and its impact on food and exercise study p. 125
Amrutha Varshini Vimalraj, Neethu George, Vivek Sundaram, M Anbarasi, R Manoranjitham, Vimalraj Bogana Shanmugam
DOI:10.4103/amit.amit_61_21  
Introduction: The COVID-19 pandemic had enforced several restrictions which were necessary to abate the spread of the virus, however, the blow of these limitations on health behaviors and lifestyles remains vague. Therefore, this study was carried out to assess the behavioral and lifestyle consequences of complete lockdown during the pandemic. Materials and Methods: The Lockdown and its Impact on Food and Exercise study was a pilot study conducted in the form of a questionnaire which was handed out to the public and circulated electronically. The questions regarding exercise were adapted from the International physical activity questionnaire and those regarding food habits were taken from the Public Library of Science and the Self-regulation of Eating Behavior Questionnaire. This survey was conducted from March 28 to April 14, 2020, during which a complete lockdown prevailed. Results: The COVID-19 complete lockdown had a negative impact on all intensity exercise levels, vigorous exercise (64.34% vs. 41.20%, P ≤ 0.00001), moderate exercise (95.67% vs. 84.57%, P ≤ 0.00001), and walking (55.42% vs. 42.89%, P = 0.0003). Food consumption and meal patterns (58.55% vs. 47.95%, P = 0.0022) were also more unhealthy (78.60% vs. 87.94%, P = 0.0096) during complete lockdown with only the consumption of late night snack decreasing significantly. Conclusion: The results of this analysis indicate that physical activity had decreased significantly and eating behaviors were unhealthy. Hence, our survey will help to develop interventions which would potentially alleviate these negative lifestyle and nutrition behaviors.
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Markers of myocardial dysfunction in neonates with sepsis of various gestational age p. 132
Natalia Kretsu, Olena Koloskova, Tetiana Bilous
DOI:10.4103/amit.amit_53_21  
Introduction: Nowadays, the issues of early diagnostics of cardiovascular disorders in neonates with sepsis with the use of up-to-date methods of examination that can be applied as screening methods with the aim to verify the possible development of cardiovascular dysfunction remain urgent. To study certain clinical-instrumental parameters and biochemical markers in neonates depending on the gestational age to improve the prognosis with neonatal sepsis (NS). Materials and Methods: To realize the objective, 57 neonates were under our observation with verified diagnosis “NS.” I Group (23 patients – 40.3%) included neonates with the term of gestation 37–42 weeks, II Group– 34 preterm neonates (59.7%) with gestational age under 36 weeks inclusive. The latter group was subdivided depending on the term of gestation into IIA subgroup including 21 preterm neonates with NS and the term of gestation 32–36 weeks, IIB-subgroup included 13 neonates born in the term under 32 weeks of gestation. Results: Term males were found to suffer from sepsis more often (odds ratio = 5.19). Delivery by cesarean section for preterm neonates increased reliably the risk of NS development compared with term neonates (OR = 2.7). It was found that the average values of LDH activity in the groups were not higher than normal parameters with a tendency to decrease as the duration of pregnancy decreased. At the same time, in almost all examined patients, there was an excess of serum activity of Creatine phosphokinase-MB fraction (CPK-MB) (86.96% of cases in Group I and in 91.18% of cases in Group II) and in some patients an increase in serum aspartate aminotransferase (ACT) activity in 52.17% of patients with Group I, in 47.06% of cases from Group II, P > 0.05). The correlation analysis conducted showed that in preterm neonates suffering from NS increase of the myocardial functional ability of the left ventricle was associated with females and the number of days of inotropic support. Conclusions: Analysis of clinical-anamnestic findings determined that term males suffer from NS reliably more frequent which is clearly associated with the risk of NS development. Increase of CPK-MB serum activity can be considered as a sign of myocardial dysfunction development caused by NS. The analysis of echocardiographic parameters conducted in the group or preterm neonates found a direct correlation of the ejection fraction with initiation of cardiovascular resuscitation immediately after birth and the period of introduction of inotropic drugs.
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Effectiveness of standard hand hygiene procedure versus use of hand rub in reducing transient bacterial colony from hands of health professionals working in critical care units: Quasi-experimental study p. 138
Betcy Pappachan, Anil Sharma, Anil Kumar Patidar
DOI:10.4103/amit.amit_16_21  
Introduction: Hand sanitation is the key measure suggested to counteract and control the spread of pathogens within the hospital setup to safeguard the patients and health professionals from disease. The purpose of this research is to see the effect of two different hand hygiene measures (soap-water, hand rub) on the level of bacterial colony among healthcare personnel's hands. Materials and Methods: A total of 44 health care workers were equally divided into two groups using nonprobability convenient sampling technique from various critical care units and approach utilized was quasi-experimental design. Using Pretest posttest design 88 culture swabs were obtained from the hands of participants before and after handwashing with soap and water and hand rub respectively and sent to microbiology laboratory for further testing for the presence of transient bacterial colonies. Results: Paired t-test was used to compare between the two groups. It showed that the mean difference of hand rub group is greater than that of soap and water group (27.9 > 5.7). Paired t-test value is 2.3 and P = 0.028 (P < 0.05). Hence, it was considered statistically significant. Moreover, Fischer's exact test was used to find out the association between pre-interventional bacterial count with selected demographic variable (P > 0.05). Hence, it was considered statistically insignificant. Conclusions: Hand hygiene with hand rub is more effective than handwashing with soap and water in transient bacterial colony reduction from hands of health care personnel.
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COVID-19 and obstetricians and gynecologist: The Indian perspective p. 142
Radhika Anand, Rehana Najam
DOI:10.4103/amit.amit_150_21  
Introduction: Since its emergence, COVID 19 caused by severe acute respiratory syndrome coronavirus 2, turned out to be a health threat throughout the world. The degree of risk for the health-care workers who are dealing with the COVID-19 patients is uncertain. Questionnaire-based prospective cross-sectional study was done to assess the extent to which the Indian obstetrics and gynecology practice has been affected by the pandemic. Materials and Methods: From August to October 2020, 309 obstetricians (OBs) and gynecologists took part in the survey via Google forms. Impact on the present working scenario during the pandemic compared to the Pre-COVID era was evaluated. The categorical variables got illustrated through frequency (%). The association among the variables Chi-square test was utilized. Statistical significance was contemplated by the P < 0.05. Graphs were prepared using Google Sheets and Microsoft Excel 365. Results: There was drastic fall in parameters of obstetric practice. Over half of the OBs witnessed fall in outpatients over 90%. Significant association seen reduction in earnings with the sector, type of set-up, and duration of practice (P < 0.001) was found. Apprehension among the study group was present still majority 54.8% said that they were working voluntarily in this time of national crisis. Conclusions: This research indicates that the pandemic has entailed practice of obstetrics and gynecology in India. However, the smooth functioning was maintained due to the high degree of knowledge and preparedness among the doctors and the well-laid guidelines by the authorities.
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Medical student's preference of educational resource usage during COVID-19 pandemic from Northern India p. 149
Rohit Kumar Phulsunga, Sunil Kumar, Avinash Surana, Vikas Gupta
DOI:10.4103/ami.ami_66_20  
Introduction: Coronavirus disease (COVID-19) posed an extraordinary situation in front of humankind with the onset of the year 2020. The Government of India, on March 16, 2020, announced closure of all the educational institutions. The aim of this study was to investigate the accessible and preferable educational resources among medical students during this pandemic phase. Materials and Methods: This web-based cross-sectional study was conducted among 392 undergraduate medical students after obtaining informed consent using a structured questionnaire with close-ended responses. Existence of clustering within the student's preferred educational resources was investigated. Results: The mean age of the study participants was 20.71 ± 1.65, with 51.3% males and 48.7% females. The major responses regarding educational resources were online lectures, online teaching videos, reading textbooks, and written notes. Wilcoxon signed-rank test revealed preference for online lectures, online teaching videos, interactive online materials, and medical apps. Conclusion: As the count of users for educational resources available over the Internet is uprising, now, it is vital to generate evidence-based systems which support teaching merits and provide guidance for efficient teaching material available for online learning.
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Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients p. 155
Yogender Aggarwal, Ankur Malhotra, Deepti Arora, Shruti Chandak, Ashutosh Kumar, Vivek Bhandari
DOI:10.4103/amit.amit_27_21  
Introduction: The pandemic of coronavirus disease 19 (COVID-19) has engulfed most of the world and has constrained already overburdened health care systems, especially in developing countries. There is an urgent need of a rapid investigation to assess disease severity in suspected patients and the baseline chest radiograph may serve as a triage tool. The aim is to correlate chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients. Materials and Methods: This was a retrospective observational study which comprised 100 reverse transcription-polymerase chain reaction positive COVID-19 cases which were clinically stratified into three groups based on clinical parameters. Baseline chest radiograph and serum D-dimer levels at the time of admission for all the patients were reviewed. A radiographic severity score (Radiographic Assessment of Lung Edema [RALE]) was determined for all four quadrants of both lungs. The scores of each quadrant were added to yield the final severity score. Results: Baseline chest radiograph was abnormal in 75% of patients, whereas 25% of patients had normal chest radiograph. Most frequent radiographic abnormality was ground-glass opacity (GGO) (n = 31, 41.3%) followed by lung consolidation (n = 19, 25.3%), while 7 patients (9.3%) had both GGO and consolidation. The most common pattern of disease distribution was bilateral 34 (57.7%) and peripheral in 58 (69%). The optimal cut-off RALE score for identifying symptomatic patients was ≥3 (area under the curve [AUC] 0.760) and for identifying severe cases was ≥7 (AUC 0.870). Similarly, the optimal cut-off D-Dimer value for identifying symptomatic patients was ≥567 ng/ml (AUC 0.836) and for diagnosing severe disease was ≥1200 ng/ml (AUC 0.99). Conclusions: Radiographic RALE score and elevated serum D-Dimer levels correlate strongly with disease severity in COVID-19 patients and can be utilized for early identification of high-risk cases which can ultimately reduce mortality and morbidity.
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Cytological grading of prostate carcinoma: A comparative study with the international society of urologic pathology grading system p. 163
Chayanika Kala, Ashutosh Bajpai, Sanjay Kala, Lubna Khan
DOI:10.4103/amit.amit_148_21  
Introduction: The Gleason grading system is one of the most powerful prognostic predictors of carcinoma prostate. In 2014, a newer grading system, the International Society of Urologic Pathology (ISUP) grading system was proposed. The present study is a retrospective study conducted to compare the cytological grading of prostate carcinoma with the newly proposed ISUP grading system for prostate carcinoma. Materials and Methods: The present study is a retrospective study that included 42 cases of carcinoma prostate. The clinical data of the cases, fine-needle aspiration cytology slides, and histological slides were retrieved and reviewed. The cases were regraded using the ISUP grading system for prostate carcinoma. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS). Data were statistically analyzed and Chi-square testing was used to compare the two grading systems. Results: A total of 42 cases were studied. The preoperative grade was assigned to the smears and 26.19% (11 cases) were categorized as grade 1, 40.47% (17 cases) as grade 2, and 33.3% (14 cases) as grade 3. Histological sections were also graded according to the ISUP/grade groups (GG) system and 26.19% (11 cases) were graded as GG 1, 33.3% (14 cases) as GG2, 19.04% (8 cases) as GG3, 16.67% (7 cases) as GG4, and 4.47% (2 cases) as GG5. Conclusion: In the present study, it was concluded that there is a direct concordance between the histologic grade as proposed in the ISUP grading system and the cytologic grade on FNA.
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