For the immune system to protect the body from infectious diseases such as COVID-19, it needs the ideal amount of vital trace elements. Trace element levels, especially, zinc (Zn), copper (Cu), ...magnesium (Mg), manganese (Mn), chromium (Cr), and iron (Fe) levels, may affect how sensitive an individual is to COVID-19 and other viruses. The current study evaluated the level of those trace elements during stays in the isolation center and investigated their association with vulnerability to COVID-19.
A total of 120 individuals, 49 males and 71 females aged between 20 and 60 years, were included in this study. Forty individuals infected with COVID-19, 40 individuals who had recovered from it, and 40 healthy individuals, were all evaluated and studied. By using a flame atomic absorption spectrophotometer, levels of Zn, Cu, and Mg were assessed for all samples, whereas levels of Mn, and Cr were determined by a flameless atomic absorption spectrophotometer.
The infected individuals had significantly lower levels of Zn, Mg, Mn, Cr, and Fe than recovered individuals and healthy control individuals (P < 0.0001). On the other hand, the total number of infected patients was found to have much higher levels of Cu than those in the recovered group and the control group. For the recovered and healthy control groups, no significant differences were observed in the levels of trace elements (P > 0.05), except for Zn (P < 0.01). Also, the findings indicated no association of trace elements with age and BMI (P > 0.05).
These results show that an imbalance in the levels of essential trace elements could be associated with increasing the risk of COVID-19 infection. However, additional thorough research of greater scope is required considering the severity of the infection.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
3.
Decortication as an Option for Empyema Thoracis Majeed, Farhan Ahmed; Zafar, Usama; Chatha, Sohail Saqib ...
Journal of the College of Physicians and Surgeons--Pakistan
30, Issue:
3
Journal Article
Peer reviewed
Open access
To analyse the outcome and morbidity associated with decortication in empyema thoracis.
A case series.
Departments of Surgery, Combined Military Hospitals (CMH) of Rawalpindi, Quetta and Lahore, from ...January 2006 to March 2018.
This is a retrospective study of 812 cases of open and VATS (video-assisted thoracic surgery) decortication for empyema thoracis, operated by the same consultants. Only patients with established empyema were included. Those who were unfit for one-lung ventilation, undergoing local anesthesia procedures like rib resection, clagget window or tube windows, with clotted hemothorax and malignant pathology were excluded. Posterolateral serratus sparing thoracotomy was used in open decortications. Multiportal or uniport VATS was employed for video-assisted thoracoscopic decortications (VATD). Histopathology and microbiological sampling was also done in all cases.
There were 537 (66.1%) males and 275 (33.9%) females. Age ranged from 1 to 80 years with a mean of 37 years. Open decortication was done in 650 (80%), standard decortication with posterolateral thoracotomy in 458 (56.4%), minithoracotomy was done in 69 (8.4%) patients with loculated empyema, thoracotomy and open decortication with conventional thoracoplasty was done in 21 patients. Twenty-two patients required open decortications with tailored thoracoplasty and muscle flap. Open decortication with intercostal muscle (ICM) flap or primary closure of bronchopleural fistula was performed in 55 patients. VATD was done in 162 cases, out of which 120 were early empyema, and 42 were of chronic empyema; of which 22 required a further utility thoracotomy. Decortication with lung resection and muscle flap reinforcement to bronchial stump was done in 25 patients. Blood transfusion was required in 331 (40.7%). Twenty-six (3.4%) patients developed residual space and collection requiring intervention; and 384 (47.3%) patients had a histopathology diagnostic for tuberculosis. There were 11 (1.3%) deaths.
Open decortication is still one of the preferred procedures in developing countries. VATD is also increasingly utilised for empyema.
To determine the outcome of muscle flap to cover the bronchial stump in the resectional surgery for bronchiectasis for prevention of bronchopleural fistula.
Case series.
Combined Military Hospitals ...of Quetta, Lahore, and Rawalpindi from January 2006 to August 2017.
Patients with localised bronchiectatic changes were included. Patients with carcinoma and without flap resection were excluded. Resectional surgery was performed through posterolateral thoracotomy approach, under general anesthesia with one lung ventilation. Pediculated or bipediculated intercostal muscle flap (ICM) was used to reinforce the bronchial stump. Pediculated ICM flaps were utilised for reinforcement of bronchial stump and bipediculated flaps were used over lesser.
Three hundred and ninety-eight cases of bronchiectasis with average age of patients 38.5 ±19.8 years and male to female ratio of 2:1 were included. Bronchiectasis was unilateral in 377 cases. Tuberculous was found in 278 of the cases. Thirty-five had poor lung function tests (FEV1 <1.5%). Eighty-two patients underwent pneumonectomy, 228 patients had lobectomy and 88 patients underwent segmentectomy. Posterior-based pediculated ICM flap was used in 365 patients, and bipediculated ICM flaps in 30 cases. The most common complication was post-thoracotomy neuralgia 53. Bronchopleural fistula, despite transposition of intercostal muscle flap on bronchial stump, was present in 4 patients.
Application of muscle flap over bronchial stump after resection surgery for bronchiectasis, is simple, safe and effective surgical option to avoid complication of bronchopleural fistula.
To compare the effectiveness of open thoracotomy and video assisted thoracic surgery (VATS) for empyema thoracis in paediatric population.
Observational study.
This observational study was conducted ...at Department of Thoracic Surgery, CMH, Lahore, from October 2013 to August 2018.
Medical record of children up to the age of 14 years who were operated for empyema thoracis was reviewed. Patients were divided into two groups: Open thoracotomy, and VATS; and compared for etiology, preoperative treatment, grade of empyema, procedure performed; histopathology and complications, e.g. post-thoracotomy neuralgia, surgical site infection, recurrence over 6 months.
A total of 61 paediatric patients were operated for empyema thoracis. Age ranged between 1 to 14 years (mean = 10.25 ±3.30 years). Most common etiology of empyema was tuberculosis in 24 (39.3%) cases, followed by pneumonia in 22 (36.1%). Surgical treatment consisted of open thoracotomy in 40 (65.5%) cases, while 21 (34.5%) underwent VATS. Postoperative X-ray was satisfactory in 38 (95%) cases undergoing open thoracotomy as compared to 21 (100%) cases undergoing VATS (p=value 0.29). There was no recurrence in either of the two groups over a follow-up period of six months. Overall complication rate was 32.5% (13 cases) in cases undergoing open thoracotomy, while 33.3% (7 cases) in VATS group (p=value 0.95). There was one (2.5%) mortality in open thoracotomy group, while no death occurred in VATS group.
Early surgical treatment, both open as well as VATS, gives satisfactory results in management of paediatric empyema. VATS is a safe alternative to open thoractomy with good success rate and less incidence of complications.
Primary tumours of the trachea are rare. Adenoid cystic carcinoma (ACC) constitutes less than 1% of these tumours. They occasionally masquerade as asthma. We are presenting a case of a young female, ...who had been treated for 3 years as asthma. She presented in emergency with severe respiratory difficulty, stridor and decreasing saturation of 85% on room air. Two weeks back, she had a CT scan in a local hospital, but they did not notify the tracheal mass. Her clinical picture and CT scan helped us diagnose the case. She was treated in emergency with primary resection of tracheal mass and anastomosis. The tumor was diagnosed as ACC. Postoperative recovery was uneventful. Continuity of the trachea was restored and adjuvant radiotherapy was given.
To analyse the experience of empyema thoracis management using video-assisted thoracoscopic surgery.
The retrospective study was conducted at the Combined Military Hospitals, Rawalpindi and Lahore, ...Pakistan, and comprised data of empyema thoracis cases who underwent thoracoscopic decortications by the same consultant surgeon between January 2009 and 2018. Uniportal or multiportal video-assisted thoracoscopic decortications was performed. Histopathology and microbiological sampling were done in all cases.
Of the 162 cases, 114(70.4%) were males and 48(29.6%) were females. The overall mean age was 44±16.37 years. Three ports were utilised in 58(36%) patients. Hospital stay of 122(75.3%) patients was <5 days post-procedure. Post-thoracotomy neuralgia occurred in 19(11.7%) patients, while 9(5.5%) had surgical site infection. Overall complications were 30(18.5%). There was no mortality.
Video-assisted thoracoscopic decortications was found to be a safe, effective and efficient procedure.
Objective: To find out the pattern of foreign bodies inhaled or ingested in a series of patients.
Study Design: Case series.
Place and Duration of Study: Ear, Nose and Throat (ENT) department, Pak ...Emirates Military Hospital (PEMH)Rawalpindi, Jan 2016 to Dec 2016.
Methodology: A total of 46 cases of foreign body upper aero digestive tract who presented in the ENTDepartment, PEMH Rawalpindi in 2016 were included in this study. Twenty eight cases were of foreign bodyesophagus and 18 were of foreign body airway. The age, gender, duration of foreign body lodgment, types offoreign body’s physical signs and symptoms were recorded. Relevant radiographic studies were performed.
Results: Out of 46 patients of foreign body aero digestive tract 33 were males and 13 were females. The overallfrequency of foreign bodies’ upper aero digestive tract was 46 (0.14%) with 28 (0.08%) being foreign bodiesesophagus and 18 (0.06%) foreign bodies airway. In 50% cases of bronchial foreign bodies were in age group 0-3 years. The most frequent foreign body in the esophagus was coin in 13(46.4%) followed by chicken bone 5 (17.8%) and fish bone 3 (10.7%). Peanuts, peas, and beans were predominant component of the airway foreign bodies constituting 6 (33.3%), 3 (16.6%) and 3 (16.6%) respective of the total. Most frequent sites of impaction of the foreign body were cervical esophagus 16 (34%), right main bronchus 11 (23.9%) and left main bronchus 3 (6.5%).
Conclusion: Foreign body aero digestive tract is an uncommon but potentially life...
Full text
Available for:
IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UL, UM, UPUK
Objective: To determine the relation of baseline serum albumin levels with the duration of neutropenia after induction chemotherapy in acute leukaemia.Study design: Prospective longitudinal study.
...Place and Duration of Study: Department of Medical Oncology, Combined Military Hospital, Rawalpindi Pakistan, Dec 2018 and Dec 2020.
Methodology: Ninety-one patients with newly diagnosed acute leukaemia who were planned to receive induction chemotherapy were included. Before starting chemotherapy, blood counts and serum albumin levels were determined in each patient. The tests were monitored during treatment, and the duration of days when the patient experienced neutropenia was noted.
Results: The mean age of participants was 29.70±9.50 years. 64(70.3%) were males and 27(29.7 %) were female. At presentation, the mean white blood cell (WBC) count in peripheral blood was 16.70±39.60 x109/L. 29 (31.9%) patients had hypoalbuminemia with serum albumin <3.5g/dL, while 62 (68.1%) patients had normal serum albumin ≥3.5g/dL. The mean duration of neutropenia in the Low Albumin Group was 8.20±5.30 days. The mean duration of neutropenia in Normal Albumin (≥3.5g/dL) Group was 7.50±6.30 days. There was no Statistical difference between low serum albumin and the duration of neutropenia (p-value 0.605).
Conclusion: This study shows that the pre-chemotherapy serum albumin level has no significant relation with the duration of neutropenia experienced by the patient after induction chemotherapy of acute leukaemia.
Full text
Available for:
IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UL, UM, UPUK
Background:
The aim of this study was to compare 1-year outcomes for patients with femoropopliteal in-stent restenosis using directional atherectomy guided by intravascular ultrasound (IVUS) versus ...directional atherectomy guided by angiography.
Methods and results:
This was a retrospective analysis for patients with femoropopliteal in-stent restenosis treated with IVUS-guided directional atherectomy versus directional atherectomy guided by angiography from a single center between March 2012 and February 2016. Clinically driven target lesion revascularization was the primary endpoint and was evaluated through medical chart review as well as phone call follow up.
Conclusions:
Directional atherectomy guided by IVUS reduces clinically driven target lesion revascularization for patients with femoropopliteal in-stent restenosis.
PDF
