Radiological evaluation of soft-tissue swellings

Background: Soft-tissue swellings (STSs) are commonly encountered by a radiologist in routine practice, either as the principal indication for diagnostic examination or as an incidental finding during an examination performed for other indications. Aims and Objectives: The aim of the study was to design a basic approach for the evaluation of STS with the help of available imaging modalities (ultrasound [USG], computed tomography [CT], and magnetic resonance imaging [MRI]) and analyzes its imaging characteristics so as to arrive at its final diagnosis. Materials and Methods: This prospective study (CTRI/2023/01/048933) was conducted in the Department of Radio-diagnosis, MLBMC, Jhansi, Uttar Pradesh, with 100 cases of STS were primarily evaluated by high-resolution grayscale USG, out of 100 cases, 72 diagnosed on USG and rest equivocal cases were secondarily evaluated with MRI, out of which 25 diagnosed and three cases needed CT evaluation. Three cases were evaluated with MRI+CT scan and finally diagnosed. Diagnosed cases followed by histopathology and surgery. Results: In our study, we found that USG is helpful in benign and superficial STS, as 72/100 cases diagnosed with the help of USG. In equivocal, deeply located, and malignant cases, MRI is more helpful in making a final diagnosis. In our study out of 28 cases, 25 diagnosed on MRI. CT scan used as accessory modality in the diagnosis of STS. Conclusion: USG remains the first-line imaging modality for the assessment of STS. MRI is an excellent modality in equivocal or suspicious lesion for characterisation of nature and extension. CT can be used for the detection of calcification and bone involvement

Effects of inhalational anti-asthmatic medications on oral health between 7 and 14 years of age

Introduction: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. The World Health Organization considers asthma as the most important chronic respiratory disease of the childhood. Aim: The aim of this study was to observe the changes in oral health and salivary pH, of asthmatic children aged between 7 and 14 years, treated with different combinations of inhaled medication. Materials and Methods: A total of 120 children aged between 7 and 14 years were divided into two groups of which 60 were asthmatic children and the rest 60 were nonasthmatic which were served as control group. Dental caries was assessed using decayed missing filled tooth (DMFT) index for permanent teeth and decayed extracted filled tooth (DEFT) index for primary teeth. Oral hygiene status was determined by simplified oral hygiene index (OHI-S) and modified (OHI-S) index for primary teeth. The resting salivary pH was estimated using pH strips and comparison was made between both groups. Results: The mean value of dental caries (DMFT and DEFT) was found to be significantly higher among study group compared to control group (P < 0.05), while for salivary pH, it was significantly lower among the study group compared to control (P < 0.05), whereas oral hygiene status was statistically not significant in relation to anti-asthmatic medications. Conclusions: Children with asthma have higher caries prevalence, lower salivary pH compared to the control group, which can be due to use of anti-asthmatics medications

Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers

COVID-19 is characterized by marked variability in clinical severity. Vitamin D had recently been reviewed as one of the factors that may affect the severity in COVID-19. The objective of current study is to analyze the vitamin D level in COVID-19 patients and its impact on the disease severity. After approval from Ethics Committee, M.L.B Medical College the current study was undertaken as continuous prospective observational study of 6 weeks. Participants were COVID-19 patients of age group 30–60 years admitted during the study period of 6 weeks. Study included either asymptomatic COVID-19 patients (Group A) or severely ill patients requiring ICU admission (Group B). Serum concentration of 25 (OH)D, were measured along with serum IL-6; TNFα and serum ferritin. Standard statistical analysis was performed to analyze the differences. Current Study enrolled 154 patients, 91 in Group A and 63 patients in Group B. The mean level of vitamin D (in ng/mL) was 27.89 ± 6.21 in Group A and 14.35 ± 5.79 in Group B, the difference was highly significant. The prevalence of vitamin D deficiency was 32.96% and 96.82% respectively in Group A and Group B. Out of total 154 patients, 90 patients were found to be deficient in vitamin D (Group A: 29; Group B: 61). Serum level of inflammatory markers was found to be higher in vitamin D deficient COVID-19 patients viz. IL-6 level (in pg/mL) 19.34 ± 6.17 vs 12.18 ± 4.29; Serum ferritin 319.17 ± 38.21 ng/mL vs 186.83 ± 20.18 ng/mL; TNFα level (in pg/mL) 13.26 ± 5.64 vs 11.87 ± 3.15. The fatality rate was high in vitamin D deficient (21% vs 3.1%). Vitamin D level is markedly low in severe COVID-19 patients. Inflammatory response is high in vitamin D deficient COVID-19 patients. This all translates into increased mortality in vitamin D deficient COVID-19 patients. As per the flexible approach in the current COVID-19 pandemic authors recommend mass administration of vitamin D supplements to population at risk for COVID-19

Long-term quality of life and work ability among severe COVID-19 survivors: A multicenter study

Background: Coronavirus disease 2019 (COVID-19), is known for its variable severity and high infectivity. Though fewer than 15% of infected cases develop severe disease, a major proportion had prolonged stay in the intensive care unit (ICU). Prolonged ICU stay is known to have a long-term impact on behavior and quality of life.8 Therefore, it is likely that patients discharged after severe COVID-19 have issues that persist for long term. The current study aimed to assess the long-term impact of severe COVID-19 on the Quality of life (QOL), sleep pattern, behavior, and workability. Methods: The current multicenter study adopted a cross-sectional design to analyze data from two tertiary care COVID-19 dedicated hospitals. All experimental procedures were approved by the ethics committee of the M.L.B Medical College. Participants were 20–60 age group who had been admitted to the ICU because of severe COVID-19 and had elapsed at least one and a half year since their discharge. After informed written consent the participants were assessed for: EUROHIS-QOL 8-item index; Workability Score; Quality of sleep; The major depression inventory (MDI) questionnaire; Generalized anxiety disorder 7 item scale (GAD-7); Current global health status score: an innovative subjective scale (1 –10) to determine the current global health status when 5 is the status before COVID-19. Findings: 491 participants were assessed, the median follow-up time after discharge from the hospital was 561·0 days (range, 548–580 days). The mean duration of ICU stay was 8.72 ± 2.85 days. There was significant reduction in the prevalence of obesity, diabetes, and hypertension as compared with discharge time. The mean of EUROHIS-QOL score, workability score, current global health status score was 3.28 ± 0.98, 6.87 ± 0.85, 4.53 ± 1.36 respectively. The mean MDI and anxiety scores were 4.12 ± 1.45 and 18.63 ± 3.28, respectively. Interpretation: Severe COVID-19 survivors have new-onset psychological disorders and sleep disturbances. Long term quality of life and work ability remains poor after prolong ICU admission secondary to severe COVID-19