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Mishra, Prashant
- Sensitivity and Specificity of High-Resolution Computed Tomography in Diagnosis of COVID-19 in Emergency Department: A Single Centre Study
Authors
1 SIR H N Reliance Foundation Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 5 (2021), Pagination: 23-27Abstract
Aim: To evaluate the performance of chest computed tomography (CT) scan in the preliminary diagnosis of suspected coronavirus disease 2019 (COVID-19).
Material and methods: Suspected 1149 COVID-19 patients who underwent both chest CT and RT-PCR tests were included. Considering RT-PCR as a reference standard, the performance of chest CT in diagnosing COVID-19 was evaluated. Obtained data was statistically analysed for sensitivity, specificity and accuracy for the diagnosis of COVID-19 cases.
Results: Out of 1149 patients RTPCR was positive in 188 (16.36%) of patients and CT findings were positive in 368 (32.03%) of patients. The majority (21.15%) of the patients’ CT scan revealed sub-pleural ground-glass opacities (GGO), consolidation was seen in 76 (6.61%), pleural effusion in 73 (6.35%) and interstitial oedema in 41 (6.35%) respectively. Considering RT-PCR results as the reference standard, the chest CT revealed a sensitivity of 73.40%, specificity of 76.07% and accuracy of 75.63% in identifying COVID 19.
Conclusion: Chest CT revealed diagnostic accuracy (75.63%) in diagnosing COVID-19 and it could be considered as a basic modality for detecting COVID-19 cases early. This can be valuable to initiate early triage and infection control practices and appropriate isolation strategies in Emergency Department.
Keywords
Reverse transcription polymerase chain reaction, chest CT imaging, diagnostics.References
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- Thrombolysis in a Case of Cardiac Arrest due to Massive Pulmonary Embolism with Ongoing CardioPulmonary Resuscitation: a Case Report
Authors
1 Consultant Emergency Medicine, Paras Hospital, Gurugram, India, IN
2 Class 1 Specialist medical officer, Dept of medical health and family welfare, Uttar Pradesh, IN
3 Chief Intensivist Critical Care Department, Sir H N Reliance Foundation Hospital, Mumbai, India, IN
Source
The Indian Practitioner, Vol 75, No 3 (2022), Pagination: 27-30Abstract
Pulmonary embolism (PE) is a life-threatening condition which often gets missed due to non-specific initial presentation in the Emergency Department (ED). We report a case of a young male who presented to the ED with sudden onset breathlessness and diaphoresis. Appropriate resuscitation was initiated. Soon after patient started gasping and had a cardiac arrest with first monitored rhythm being pulseless electrical activity (PEA). Cardio-pulmonary resuscitation (CPR) was initiated and continued as per ACLS protocol. Portable Echocardiograph revealed severe pulmonary hypertension with right ventricular dysfunction. Provisional diagnosis of PE was made and patient was managed with immediate thrombolysis with ongoing CPR. Brief episodes of cardiac arrest occurred which were successfully revived following which he remained hemodynamically stable. Diagnosis was confirmed by Colour Doppler of bilateral lower limbs and pulmonary angiogram. Patient was weaned off ventilator within 24 hours and discharged home after a week with full neurological recovery. Timely diagnosis and management were key in this patient’s survival.
Keywords
Pulmonary embolism, cardiac arrest, thrombolysisReferences
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