European Journal of Molecular & Clinical Medicine

Background: The COVID-19 pandemic has led to an unprecedented surge in hospitalised patients with viral pneumonia. Chest X-Ray (CXR) is one of the important, non-invasive methods and used as a preliminary investigation to detect different pulmonary abnormalities. Present study was aimed to study X-ray findings of COVID 19 from Assam medical college and hospital, Dibrugarh. Assam.
Material and Methods: Present study was single-center, prospective, observational study, conducted in patients 18-65 years age, who were confirmed cases of COVID 19 by RT PCR or RAT testing.
Results: In present study, 220 patients satisfying study criteria were evaluated. Chest X ray abnormalities were noted in 48.18% cases initially, while in 2.73% cases, initial normal CXRs later became abnormal. 5.91% CXRs had unilateral abnormalities while 42.27% CXRs had bilateral abnormalities. Symmetrical abnormal findings was noted in 21.82% as compared to asymmetrical abnormal findings in 20.45% cases. CXRs lesion distribution was peripheral location (35.91%), central location (5.91%) & combined peripheral and central location (6.36%). Localization of abnormalities in CXRs was in Lower, Middle & upper zone in 32.73%, 10.45% & 5% respectively. Common specific radiographic abnormalities were Ground glass opacities (GGOs) (42.73%), Consolidation (23.64%), Nodularity (0.91%), Reticular opacity (5.91%) & Pleural effusion (9.55%), Severity score in present study was mild, moderate & severe in 33.18%, 11.82% & 3.18% cases respectively.
Conclusion: Chest X-ray is a valuable tool in better management of patients during the COVID-19 pandemic. Despite its lower sensitivity compared with CT scans, its inherent advantages such as reasonable cost, broad range of use, and rapid speed make it indispensable.

Background:To study the prevalence of Pulmonary Hypertension (PH) in patients with Chronic Kidney Disease (CKD).
Materials and Methods: The present study assessed the prevalence of PH in 50 patients with CKD, at DR.PSIMS & RF, Chinnavutpalli, Gannavaram.
Results: The commonly affected age group in study population was 31-50 years. The mean age of patients was 48.98±12.53years. Diabetes Mellitus was present in 15 (30%) and Hypertension in 48 (96%).  Majority of the patients were in CKD stage 5, i.e.,46 (92%), CKD stage 4 -3 (6%), CKD stage 3- 1(2%). The prevalence of PH in CKD is 22 (44%). PH was not found in the patient with CKD stage 3. PH was found in 2 of the 3(66.6%) patients with CKD stage 4. Out of the 46 CKD stage 5 patients, 20 (43.4%) had PH. With reference to the severity of PH with CKD, the two patients of PH  CKD stage 4 had moderate PH . Out of the 20 patients of PH with CKD stage 5, 10 patients had mild PH, 9 with moderate PH and 1 with severe PHOn Chest X ray, descending right pulmonary artery dilatation and cardiomegaly were seen in more number of patients with PH, compared to those without PH. (p<0.001). In this study, LV systolic dysfunction was present in 18 out of 50 patients (36%). Among 22 patients with PH, it was present in 13 (59.09%). Among 28 patients without PH, it was present in 5 (17.85%). LV systolic dysfunction was significantly higher among the patients with PH compared to those without PH. The mean EF of all patients with CKD is 55.62± 9.54. The mean EF of patients with PH and without PH in the study was 50.50±9.78% and 59.64±7.26% respectively. (p<0.02). LV diastolic dysfunction was present in 41 out of 50 patients (82%). Among 22 patients with PH, it was present in 20 (90.9%). Among 28 patients without PH, it was present in 21 (75%). Prevalence of LV diastolic dysfunction was significantly higher among the patients with PH, compared to those without PH. RV dysfunction was present in 1(3.6%) and in 10 (45.5%) in patients without PH and in patients with PH respectively. Significant difference was found with RV dysfunction more prominent in patients with PH than in patients without PH (p<0.001). 64%of the patients studied had CKD of less than 6 months including 24%of new cases. 16%of the patients had CKD between 6 months and 1year. 20% had CKD of more than 1yr. In relation to PH, out of the 12 new cases of CKD,7 (31.8%) had PH and 5(17.9%)were without PH. Of the 20 patients having history of CKD less than 6 months (excluding new cases), 7 (31.8%) had PH and 13 (46.4%) were without PH. Out of the 8 patients  of CKD between 6 months and 1 year,4(18.2%) had PH and  4(14.3%)were without PH. In patients having CKD of more than 1 year, 4 (18.2%) had PH and 6 (21.4%) were without PH.
Conclusion: The study showed that PH is common in patients with CKD. Left Ventricular systolic and diastolic dysfunctions are strongly related to the outcome of these patients. Unexplained dyspnoea in patients with CKD must be evaluated for PHPulmonary Hypertension, CKD, Chest X-Ray, Left Ventricle, Mortality, ECG, 2D-Echo

Background: Bronchiolitis usually occurs during the first year of life, with a peak
incidence between 3 and 6 months of age. Chest Ultrasound has been proposed as a
diagnostic tool in many diseases in the pediatric and neonatological settings. The
aim of the present study was to differentiate simple versus complicated cases of
bronchiolitis in infant by chest ultrasound. Patients and methods: A prospective
observational study was conducted in Pediatric Department, Zagazig University
Hospitals.Inclusion criteria included infants aged 1 month to 2 years fulfilling
clinical criteria of acute bronchiolitis. Steps of performance included consent from
relatives to participate in the study, complete history taking, full clinical
examination, laboratory investigations, chest X-ray, chest Ultrasound and chest CT.
Results: Our results showed that wheeze was the commonest presentation (100.0%)
of the studied group followed by crepitation (12.3%) of them then Refusal of
feeding (9.2%) and lastly fever (5.0%) of the studied group. There was (55.4%) of
cases were complicated bronchiolitis by U/S and (44.6%) were simple. The
commonest cases (96.9%) were discharged with only (3.1%) death rate. The X-ray
was able to detect only (50.0%) of complicated cases and 29 cases (100.0%) were
excluded by both. Conclusion: Chest ultrasound is considered more sensitive and
specific than CXR in the diagnosis of complicated cases of acute bronchiolitis.
These data suggest that a positive chest ultrasound may avoid the need to perform
CXR in these patients.