Diagnostic performance of ocular ultrasonography compared to fundoscopy to predict papilledema

BAC KGR OUND: The aim of this study was to determine the association between the diameters of optic nerve sheath assessed by ultrasonography, grading of papilledema in fundoscopy among patients suspected to raising intracranial pressure and determining the sensitivity and specificity of ultrasonography to detect optic nerve sheath dilatation. MET HODS: This prospective blinded cohort study was performed on 223 consecutive patients with clinical suspicion to optic papilledema. The patients were assessed using direct fundoscopy. The diameter of the optic nerve sheath was determined by ocular ultrasonography. RESULTS: In fundoscopy, 46 patients were revealed to have papilledema in at least one of the two eyes. A significant correlation was found between diameter of optic nerve sheath and age in total population as well as in those without papilledema, but not in the group with papilledema. The mean diameter of optic nerve sheath in bilateral assessment was significantly higher in the group with papilledema. The association between the mean diameter of optic nerve sheath and grade of papilledema was strongly significant. The assessment of the area under ROC analysis showed that measuring diameter of optic nerve sheath could effectively discriminate papilledema from normal condition. CONCL USIONS: Ultrasonography can effectively discriminate papilledema from normal condition by measuring diameter of optic nerve sheath. (Cite this article as: Namdar P, Yousefian S, Farzaneh Khanshir Z, Zohal MA, Kazemifar AM, Torabi Goodarzi Z. Diagnostic performance of ocular ultrasonography compared to fundoscopy to predict papilledema. Minerva Oftalmol 2017;59:1-6. DOI: 10.23736/S0026-4903.17.01770-6) Key words: Ultrasonography - Papilledema - Intracranial hypertension - Optic nerve. Minerva Oftalmol 2017 March;59(1):1-6 DOI: 10.23736/S0026-4903.17.01770-6 © 2017 EDIZIONI MINER VA MEDICA Online version at http://www.minervamedica.it COPYRIGHT© 2017 EDIZIONI MINERVA MEDICA This documen

Safety and efficacy of Favipiravir in moderate to severe SARS-CoV-2 pneumonia

Background: We examined the safety and efficacy of a treatment protocol containing Favipiravir for the treatment of SARS-CoV-2. Methods: We did a multicenter randomized open-labeled clinical trial on moderate to severe cases infections of SARS-CoV-2. Patients with typical ground glass appearance on chest computerized tomography scan (CT scan) and oxygen saturation (SpO2) of less than 93 were enrolled. They were randomly allocated into Favipiravir (1.6 gr loading, 1.8 gr daily) and Lopinavir/Ritonavir (800/200 mg daily) treatment regimens in addition to standard care. In-hospital mortality, ICU admission, intubation, time to clinical recovery, changes in daily SpO2 after 5 min discontinuation of supplemental oxygen, and length of hospital stay were quantified and compared in the two groups. Results: 380 patients were randomly allocated into Favipiravir (1 9 3) and Lopinavir/Ritonavir (1 8 7) groups in 13 centers. The number of deaths, intubations, and ICU admissions were not significantly different (26, 27, 31 and 21, 17, 25 respectively). Mean hospital stay was also not different (7.9 days SD = 6 in the Favipiravir and 8.1 SD = 6.5 days in Lopinavir/Ritonavir groups) (p = 0.61). Time to clinical recovery in the Favipiravir group was similar to Lopinavir/Ritonavir group (HR = 0.94, 95% CI 0.75 � 1.17) and likewise the changes in the daily SpO2 after discontinuation of supplemental oxygen (p = 0.46) Conclusion: Adding Favipiravir to the treatment protocol did not reduce the number of ICU admissions or intubations or In-hospital mortality compared to Lopinavir/Ritonavir regimen. It also did not shorten time to clinical recovery and length of hospital stay. © 2021 Elsevier B.V