A retrospective observational study of utility of nonrebreathing mask in moderate to severe hypoxemic COVID-19 pneumonia

Introduction: The pulmonary manifestations of covid-19 disease may range from mild pneumonia to severe acute respiratory distress syndrome (ARDS) complicated by shock or multiorgan failure. Proper selection and utilization of oxygen delivery system is the key factor in treating the hypoxemic respiratory failure in severe covid-19 disease. Here by, we present a retrospective observational study of utility of NRBM (Non Rebreathing Mask) in 1876 moderate to severe hypoxemic Covid-19 pneumonia patients in a single centre and its outcome. Objectives: To study the utility of NRBM in moderate to severe hypoxemic COVID-19 pneumonia Patients. Material and Methods: This was a single centre retrospective observational study. Out of 5024 microbiologically confirmed (by Rapid antigen test/RTPCR/TRUENAT) covid-19 pneumonia patients admitted since September, 2020 to May 2021,1876 patients of age >14 years admitted in the department of Respiratory medicine with moderate to severe hypoxemia (SpO2 90% (corresponds to Pao2 >60 mmhg), respiratory rate (<16/min) and heart rate <100 bpm. About 9.3% of the patients (173) who were provided NRBM support who further deteriorated or showed poor response even after maximum period of 7 days were provided with NIV support (130 patients i.e. 6.92%), HFNC support (14 patients i.e. 0.74%) and invasive mechanical ventilation (29 patients i.e. 1.54%).66 patients who were initially provided NRBM support, recovered and 107 patients (2.129%) succumbed to their illness. smoking (table-4)has been observed to be the major risk factor in majority of the patients (43.7%). As per the data of this study there is significant correlation between the utilization of NRBM and advanced age, early initiation of NRBM rather than directly initiating NIV/HFNC/Invasive mechanical ventilation and duration of presentation to the hospital with symptoms. Smokers were observed to be associated with more severe presentation and longer time for weaning. Hypertension and Diabetes were observed to most commonly associated comorbidities in the study population. Hypoxemic covid-19 patients who were provided NRBM support were having better outcome and reduced mortality risk compared to patients who were provided NIV/HFNC/Invasive mechanical ventilation. Conclusion: In reference to the results in our study, we recommend the use of NRBM in moderate to severe hypoxemic patients of covid-19 disease at the early course of the disease

Single nucleotide polymorphisms at interleukin (IL)-1β + 3954 and vitamin D receptor (VDR) TaqI in chronic periodontitis patients: A pilot study in North Indian population

Background: Increasing evidences support the role of genetic factors in susceptibility to chronic periodontitis. The aim of the present pilot study was to explore the association of two potential single nucleotide polymorphisms (SNPs): Interleukin (IL)-1β + 3954 (rs1143634, C > T) and vitamin D receptor (VDR) TaqI (rs731236, T > C) with chronic periodontitis in a North Indian population. Materials and Methods: Twenty-eight chronic periodontitis subjects and 47 periodontally healthy controls were recruited. Individual samples of venous blood were obtained from each subject. Genotyping was done by polymerase chain reaction, followed by restriction fragment length polymorphism (PCR-RFLP). Logistic regression and chi square test were used for genetic association analysis and a P value less than 0.05 taken as statistical significance. Statistical Analysis Used: Chi square test and odds ratio (OR) was used. Results: Genotypes and alleles of SNP IL-1β + 3954 did not show a significant association (P > 0.05) with chronic periodontitis. Genotype CC and allele C of VDR TaqI were significantly associated with a higher risk for chronic periodontitis as compared to subjects with TT genotype (CC/TT OR = 4.615; 95% confidence interval [CI]: 1.17 to 18.078 P = 0.028) and allele T (C/T OR = 2.423; 95% CI: 1.179 to 4.980). Conclusion: In North Indian population, genotype CC and allele C of VDR TaqI were associated with risk of chronic periodontitis. No significant correlation was found for IL-1β + 3954 polymorphism and chronic periodontitis