Percentage Of Oxygen Saturation Research Articles

Association between various breathing indexes during sleep and the Epworth Sleepiness Scale score in adults

Some breathing indexes during sleep, including the apnea-hypopnea index, oxygen desaturation index, and oxygen saturation during sleep, can be recorded by overnight polysomnography. We aimed to investigate the association of various breathing indexes during sleep with the Epworth Sleepiness Scale (ESS) score in adults. We retrospectively collected the clinical and overnight polysomnography data of 2829 adults aged 20 years or older from November 2011 to June 2017. The association of various breathing indexes during sleep and ESS score was analyzed using univariate and multivariate logistic regression analysis for all adults (20-91 years), and in each sex and of body mass index (<26 kg/m2 vs ≥26 kg/m2). The mean ESS score was 6.2 (standard deviation = 4.3; range = 0-24) for all adults. After adjustment for age, sex, many common diseases, and health-related habits, apnea-hypopnea index, oxygen desaturation index, percentage of oxygen saturation below 90% during sleep, and percentage of oxygen saturation below 85% during sleep were significantly positively associated with ESS score in all adults, whereas mean oxygen saturation during sleep, minimal oxygen saturation during sleep, and awake oxygen saturation during sleep were significantly negatively associated with ESS score in all adults. In subgroup analysis, we found that the association between breathing indexes during sleep and ESS score was similar in both sex, but was significant in subjects of body mass index ≥ 26 kg/m2. All breathing indexes during sleep had significant positive or negative correlation with ESS score in all adults, especially in obese subjects.

The Effects of hydroalcholic extract polyherbal formulation on improving the symptoms of patients with COVID-19 in hospital

Objectives: The pandemic of Coronavirus disease and severity of the infection and high mortality have almost unprecedented challenges in the health systems of most countries around the world. The present study aimed to evaluate the effect of hydroalcholic extract polyherbal formulation as entitled Imfluna on symptoms of COVID-19 infected patients. The polyherbal remedy for Imfluna had a significant effect on pulmonary involvement and reduced pulmonary involvement, the severity of shortness of breath, alanine aminotransferase (ALT), sodium (Na) in the post-test phase. Also, the average CBC count and percentage of blood oxygen saturation increased in both experimental and control groups. In addition to, the mean CBC count and percentage of blood oxygen saturation of the control group increased significantly. Methods: In this randomized double-blind placebo-controlled clinical trial a total of 60 voluntary confirmed COVID-19 patients were randomly assigned to placebo and Imfluna groups. Patients in each groups, in addition to receiving standard medications, took two 500 mg Imfluna capsules or placebo every 8 hours for 2 weeks. The patient's vital signs, pulmonary involvement, severity of shortness of breath, average blood CBC count, Percentage of blood oxygen saturation, liver and kidney function tests and study Na were evaluated. Results: The results showed that patients in the Imfluna-treated group had significantly greater improvement in pulmonary involvement, severity of shortness of breath, average blood CBC count, Percentage of blood oxygen saturation compared with the placebo group. Conclusion: Patients with COVID-19 who were treated with a Imfluna for 2 weeks had better comfort and fewer symptoms associated with the disease with no drug side effects.

The role of systemic immune activation in the development of thyroid dysfunction in COVID-19

The research of cytokine-induced thyropathies in the midst of continuing coronavirus infection (COVID-19) pandemic is a very important and urgent problem. On the one hand, COVID-19 is often accompanied by a massive overproduction of cytokines, so we can expect an enhanced cytokines effects impact on the thyroid gland. On the other hand, it is possible that biological therapy with tocilizumab, which has a powerful immunosuppressive effect, plays a protective role to the development of cytokines-induced thyropathies amidst COVID-19. The results of the study should be the starting point for understanding the mechanisms of possible compromise of thyroid function during COVID-19. The primary endpoint is to assess the relationship between the levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) with the inflammatory process markers. The secondary endpoint is the identification of an association between TSH, FT3 and FT4 values, and patient survival. This retrospective, single-center study included 122 patients hospitalized at the National Medical Research Center for Endocrinology with a clinical and laboratory analysis of COVID-19 and bilateral polysegmental viral pneumonia. To assess the functional status of the thyroid gland all patients underwent observation of the TSH, FT3, FT4, antibodies to thyroid peroxidase, antibodies to the TSH receptor (AT-recTSH). The markers of the inflammatory process were assessed: interleukin-6, C-reactive protein, the degree of lung tissue damage according to multispiral computed tomography of the lungs, the percentage of blood oxygen saturation (SpO2), the treatment outcomes. Five (4%) patients were found with subclinical thyrotoxicosis. Serum TSH values were inversely correlated with interleukin-6 (r=-0.221; p=0.024). Analysis of the level of hospital mortality, stratified by TSH, revealed statistically significantly lower TSH values in the group of deceased patients (p=0.012). The median TSH in surviving patients was 1.34 [0.85; 1.80], for the deceased 0.44 [0.29; 0.99]. Our research shows that the trigger of thyropathies in coronavirus infection is most likely thyroid tissue damage by the proinflammatory cytokines. This study shows some specific clinical aspects regarding the clinical relevance in patients with thyrotoxicosis and COVID-19, namely, the high hospital mortality rate.

The Different Clinical Characteristics of COVID-19 Patients Between Pediatric and Adults

Background: In December 2019, a novel coronavirus (a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) emerged in Wuhan, China. Objectives: The current research aimed to evaluate the clinical features of COVID-19 infection in pediatric patients and compare them with those of adult patients in Sanandaj, Iran. Methods: Retrospectively, 56 hospitalized cases, including 32 adult and 24 pediatric patients with COVID-19 from March 7th, 2020, to June 5th, 2020, were enrolled in this study. The clinical and laboratory findings of the pediatric patients with COVID-19 infection were analyzed and compared with those of the adult patients. Results: The average number of fever days in adults was higher than that of pediatric patients (P = 0.04). Cough was more severe in adults than in pediatric patients (P = 0.03). Diarrhea was not statistically different between the two groups. Dizziness was far more common in adults than pediatric patients (P = 0.01). The percentage of blood oxygen saturation decreased in both groups, but there was no statistically significant difference between the two groups. C-reactive protein (CRP) was positive in many patients in both groups; however, there was no difference between the pediatric and adult patients. Lymphopenia was significantly higher in adults than in pediatric patients (P = 0.02). As in pediatric patients, an increase in liver enzymes was seen in adults. However, there was no statistically significant difference between the two groups. Conclusions: The present study showed that pediatric patients with COVID-19 infection have milder clinical symptoms than adults. However, according to the laboratory findings, pediatric patients need to be followed up as well as adult patients.

Oxygen Saturation Profiles in Healthy Term Infants in Early Postnatal Life.

Oxygen saturation profiles generated by pulse oximetry are used as a clinical tool in the neonatal intensive care unit (NICU). There is limited evidence on normal oxygen saturation profile values in term infants. This study aimed to determine oxygen saturation profiles over an 8-hour monitoring period among healthy term neonates between 24 and 48 hours after birth. A prospective cohort study of healthy term neonates born at 37 to 41 weeks of gestation. Preductal oxygen saturations were continuously monitored for an 8-hour period between 24 and 48 hours of life using pulse oximetry. Oxygen profile histograms were recorded for analysis. The average percent oxygen saturation (SpO2) was measured over the entire study duration for each neonate and was characterized as the fraction of time of their SpO2 reading was in each of five intervals: ≤80, 81 to 84, 85 to 89, 90 to 94, and 95 to 100%. Seventy-five neonates were included in the study. Median SpO2 was 95.4%. Percentage time spent in each of the five SpO2 intervals was as follows: 0.07 (≤80), 0.15 (81-84), 0.88 (85-89), 26.9 (90-94), and 67.3% (95-100%). Eighteen infants (24%) spent the highest percentage of time in SpO2 of 90 to 94%. This study provides reference ranges for oxygen profiles in healthy term neonates during 24 to 48 hours of life. Nearly one-quarter of newborns spent the highest percentage of time in SpO2 of 90 to 94%. This data is important when interpreting oxygen saturation profiles of term neonates admitted to the NICU. · This study provide reference ranges for oxygen profiles in healthy term neonates during 24 to 48 hours.. · Median SpO2 was 95.4%.. · Nearly one quarter of newborns spent the highest percentage of time in SpO2 of 90 to 94%..

Poor prognostic factors in patients hospitalized for COVID-19

The clinical spectrum of COVID-19 varies from no or mild symptoms to pneumonia with fatal complications. The aim of the study was to find predictors of mortality and admission in the intensive care unit (ICU) in patients hospitalized for COVID-19. Retrospective study of a cohort of patients admitted for COVID-19 between March 2020 and February 2021. Demographic, clinical, radiological and laboratory variables were described at admission. Independent predictors of mortality and ICU admission were identified by means of backward stepwise logistic regression and described in terms of odds ratio (OR) and 95% confidence interval (95%CI). A total of 883 patients were included, 51.8% men with a mean age of 68; 1.8% readmissions. 17.6% of patients died (n=154). The independent predictors of mortality were age (OR=1.071; 95%CI: 1.046-1.095), percentage of oxygen saturation (SatO2) (OR=0.938; 95%CI: 0.903-0.974), diastolic blood pressure (DBP, OR= 0.972; 95%CI: 0.955-0.989), creatinine (OR=1.516; 95%CI: 1.088-2.113), INR (OR=1.199; 95%CI: 1.012-1.419) and sodium (OR=1.082; 95%CI: 1.037-1.128). Eight percent of patients were admitted to ICU; the independent predictors were: male sex (OR=2.079; 95%CI: 1.099-3.935), age (OR=0.960; 95%CI: 0.942-0.979), SatO2 (OR=0.925; 95%CI: 0.889-0.962), creatinine (OR=1.551; 95%CI: 1.118-2.152) and C-reactive protein (CRP, OR=1.003; 95%CI: 1.000-1.007). The identification of independent predictors of mortality (age, SatO2, DBP, creatinine, INR, sodium) and ICU admission (sex, age, SatO2, creatinine, and CRP) allowed for the stratification of patients to adapt clinical care protocols to these findings, thereby improving medical decisions.

Oxygen efficient respiratory Aid (OxEraTM) device: A safety study.

Severe Coronavirus Disease 2019 (COVID-19) can develop pneumonia with severe complications. The Oxygen Efficient Respiratory Aid (OxEraTM) device has been granted SAPHRA approval for emergency COVID-19 pandemic use. The device has the potential to be used widely in the healthcare sector due to its efficient oxygen supply and adjustable wall positive expiratory pressure (PEP). We assessed whether the OxEraTM device was safe to use in a healthy adult volunteer population. Our primary objective was to ensure there was no asphyxiation, as assessed by changes observed from baseline End Tidal Carbon Dioxide (ETCO2) exceeding 6.3mmHg and above the 45mmHg threshold. We also monitored changes in vital organ signs and assessed the pain and comfort of the participant at various intervals with changes in PEPs. This was an experimental safety study of the OxEraTM Device on 30 healthy participants at the ICU training centre of Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. Each participant had basic vital-signs, ETCO2, and Oxygen saturation percentages (SpO2%) taken at baseline until the end of 2h. In the first 20min, the PEP was increased by 5cmH20 until 20min, then continued for the rest of the time on a PEP of 5cmH20. At each interval, vital signs, subjective comfort, pain, and visual scores were measured. Thirty healthy participants were enrolled. There was no significant difference in ETCO2 from baseline until 2h. No participant experienced an increase in measured ETCO2 greater than 45mmHg and no increase in ETCO2 from baseline was greater than 6.3mmHg. The median increase in ETCO2 over the study period was 2mmHg. There were no significant changes in respiratory rate and blood pressure. The heart rate decreased significantly (73-68bpm). The VAS and comfort score had a significant increase over the 2h from baseline of 0-2 at maximum; however, the PAS scores showed no significant increase. Overall the OxEraTM device achieved the safety endpoints set out. There was no sign of asphyxiation and there were appropriate physiological responses to changes in PEP once applied. The comfort of the mask did worsen over the 2h; however, the scores were minimally worse on PEP application but improved once-off PEP. No adverse event was recorded at all.

Utility of Monocyte Expression of HLA-DR versus T Lymphocyte Frequency in the Assessment of COVID-19 Outcome.

BackgroundDysregulated immunity is a hallmark of SARS-CoV-2 infection. Immune suppression is indicated by low monocyte expression of human leukocyte antigen D-related (mHLA-DR). T cells are important antiviral cells. We aimed to assess the role of mHLA-DR and T lymphocyte frequency in predicting COVID-19 severity.Patients and MethodsThis cross-sectional study enrolled 97 SARS-CoV-2 positive patients, including mild to moderate (n = 49) and severe cases admitted to intensive care unit (ICU) (n = 48). These ICU cases were further subdivided into survivors (n = 35) and non-survivors (n = 13).ResultsSevere cases had a significant decrease in the mHLA-DR mean fluorescence intensity (MFI) and T lymphocyte percentage compared to mild to moderate cases (P<0.001). Non-survivors had a lower T lymphocyte percentage (P=0.004) than survivors. The mHLA-DR MFI and T lymphocyte percentage correlated with oxygen saturation (r=0.632, P<0.001) and (r=0.669, P<0.001), respectively. According to the ROC curves, mHLA-DR MFI, at a cutoff of 143 and an AUC of 0.9, is a reliable biomarker for distinguishing severe COVID-19 cases, with 89.6% sensitivity and 81.6% specificity, while T lymphocyte frequency had 81.3% sensitivity and 81.6% specificity at a cutoff of 54.4% and an AUC of 0.9. The T lymphocyte percentage as a predictor of ICU survival at a cutoff of 38.995% exhibited 100% sensitivity and 57.1% specificity. According to multivariate regression analysis, reduced mHLA-DR MFI and T lymphocyte percentage are independent predictors of COVID-19 severity (OR = 0.976, 95% CI: 0.955–0.997, P = 0.025) and (OR = 0.849, 95% CI: 0.741–0.972, P = 0.018), respectively.ConclusionReduced mHLA-DR expression and T-lymphocyte percentage are independent predictors of COVID-19 severity. Oxygen saturation percentage is correlated with mHLA-DR MFI and T lymphocyte frequency. The T lymphocyte frequency is a proposed predictor of COVID-19 survival in ICU admitted patients.

Epidemiology and Clinical Characteristics of People with Confirmed SARS-CoV-2 Infection during the Early COVID-19 Pandemic in Saudi Arabia.

This study provides epidemiologic and clinical characteristics of 492 consecutive patients diagnosed with SARS-CoV-2 infection at King Faisal Specialist Hospital and Research Centre in Saudi Arabia between March and September 2020. Data were collected from electronic case reports. The cohort was 54% male, with 20.4% aged >60 years, 19.9% aged 31–40 years, and 17% aged 41–50 years. The median incubation period was 16 days, with upper and lower 95% quartiles of 27 and 10 days, respectively. Most patients (79.2%) were symptomatic. Variables significantly different between symptomatic and asymptomatic patients were age, blood oxygen saturation percentage, hemoglobin level, lymphocyte count, neutrophil to lymphocyte (NTL) ratio, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level. Asymptomatic patients were mostly younger, with lower body mass index and ALT and AST levels but higher lymphocyte counts, NTL ratio, and CD4, CD8, natural killer cell, IgG, and IgM levels. Factors associated with increased risk of mortality were age (>42 years) and comorbidities, particularly diabetes mellitus and hypertension. Patients who were not given an antiviral regimen were associated with better prognosis than patients who received an antiviral regimen (HR, 0.07; 95% CI, 0.011–0.25). These findings will help clinicians and policymakers adopt best management and treatment options for SARS-CoV-2 infection.

Conservation of a flagship species: Health assessment of the pink land iguana, Conolophus marthae.

The pink land iguana, Conolophus marthae, is one of four species of iguanas (three terrestrial and one marine) in the Galápagos Islands, and the only one listed as critically endangered by the IUCN. The species can only be found on the north-west slopes of the highest volcano on Isabela Island and was first described to science in 2009. As part of a population telemetry study, a health assessment was authorized by the Galápagos National Park. Wild adult iguanas were captured on Wolf Volcano in September 2019 and April 2021 to record morphological and physiological parameters including body temperature, heart rate, intraocular pressures, tear formation, and infrared iris images. Blood samples were also collected and analyzed. An i-STAT portable blood analyzer was used to obtain values for base excess in the extracellular fluid compartment (BEecf), glucose (Glu), hematocrit (HctPCV), hemoglobin (Hb), ionized calcium (iCa), partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2), percent oxygen saturation (sO2%), pH, potassium (K), and sodium (Na). When possible, data were compared to previously published and available data for the other Galápagos iguanas. The results reported here provide baseline values that will be useful in detecting changes in health status among pink land iguanas affected by climate change, invasive species, anthropogenic threats, or natural disturbances. The collected data also provide an invaluable resource for conservation scientists planning to implement conservation strategies, like translocations, that may temporarily alter these baseline values.

Comparison between pulse oximetry and venous blood gas analyses to assess lamb asphyxia at parturition

Early detection of fetal distress at lambing is essential to reduce mortality. Practicality and accuracy of pulse oximetry to assess oxygenation status in newborn lambs under field conditions was evaluated. Oximetry was compared with blood gas analyses and included assessment of vitality (Apgar test) and vigour (attempt to and successful standing and suckling) of 135 Finnish by Polwarth lambs. Sampling of data was obtained immediately after fetal expulsion; percentage of oxygen saturation (satO2) was measured using a pulse oximeter clamped to an ear, and was compared with gas analyses variables measured from a jugular vein sample (Gas Analyser: Siemens-Rapidlab 248®). Correlations between satO2 measured by pulse oximetry and venous blood gas parameters either directly (partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2) and pH) or estimated (bicarbonate concentration, extracellular fluid base excess, and oxygen saturation) were studied. Considering pH as a good indicator of hypoxia at parturition, data was grouped as: G1 = pH < 7.1; G2 = 7.1 ≤ pH < 7.2; G3 = 7.2 ≤ pH < 7.3 and G4 = pH ≥ 7.3. Saturation of oxygen measured by pulse oximetry correlated significantly with pCO2 (r = −0.50; P < 0.001), pH (r = 0.36; P < 0.001) and pO2 (r = 0.2, P = 0.04) measured by blood gas analyses. Lambs with low pH values (G1 = pH ≤ 7.1, acidosis) showed the lowest percentage to attempt and success to stand and suck, lowest Apgar score (G1 = 6.7, G2 = 8.6, G3 = 8.6, G4 = 8.5, P = 0.025), lowest percentage of satO2 measured by oximetry (G1 = 78.8%, G2 = 87.5%, G3 = 87.7%, G4 = 92.1%, P = 0.011) and highest pCO2 (G1 = 78.5, G2 = 73.8, G3 = 65.8, G4 = 53.8 mmHg, P < 0.001). Pulse oximetry appears an accurate method to evaluate lamb birth asphyxia, helping to identify oxygenation constraints during labour, facilitating priority of perinatal handling, and thus improving lamb survival.

Abstract No.: ABS1979: Effects of dexmedetomidine versus fentanyl combined with target controlled infusion of propofol for laproscopic surgery under general anaesthesia

Background & Aims:1.The primary objective of the present study wasto compare anaesthetic efficacy of dexmedetomidine versus fentanyl in terms of : Perioperative hemodynamics, Propofol consumption, Requirment of Rescue analgesia and also to compare postoperative analgesia and sedation between the two while the secondary objective was to assess any undesirable side effects if any 2.Methods:The present study was a prospective, randomized, double blind study conducted on 60 patients of American Society of Anesthesiologists ASA I&II aged between 20-60 years undergoing elective laproscopic surgeries. Patients were divided in two groups. GroupD received Dexmedetomidine 1mcg/kg loading dose over 10 min, followed by 0.5 µg/kg/hr continous infusion &GroupF received fentanyl 2 µg/kg bolus followed by 0.5 µg/kg/hr by continous infusion. Target controlled infusion (TCI) Propofol infusion was given to achieve target site concentration of 3-4 µg/kg in both groups. Heart rate (HR), mean arterial pressure (MAP),systolic pressure, diastolic pressure, percentage saturation of oxygen (Spo2), bispectral index monitoring (BIS) were recorded at induction,intubation, at pneumoperitoneum, 5 min, 15 min, 30 min, 45 min, 60 min, 120 min, 180 min & at extubation.Adverse haemodynamic events were noted.Results:Group D showed significant fall in HR, BP whereas it remained constantly high in Group F. Total mean requirement of propofol, in Group D patients was found to be 57.99% lower than GroupF. Requirement of rescue analgesia in form of opioid was significantly less in Group D 18% as compared to 30% in Group F. Post-operative analgesia requirement was earlier in group F. Sedation scores were higher in group D at all time points. Patients had bradycardia and hypotension in Group D. Postoperative nausea vomiting (PONV) was 3 times lower in Group D.Conclusion:Dexmedetomidine is better adjuvant compared to fentanyl when combined with target-controlled infusion of propofol. Iteffectively blunts various stress responses during surgery and maintains hemodynamic stability,reducespropofol requirements, provides better analgesia with few side effects.

A single-center non-blinded randomized clinical trial to assess the safety and effectiveness of PhR160 spray the treatment of COVID-19 pneumonia

COVID-19 is an emerging pandemic that caused a very widespread infection with more than 1000000 cases in Iran within a year. The main cause of mortality among patients with COVID-19 is pulmonary failure. In Iranian Traditional Medicine, essences have been used for curing pulmonary diseases. Pinen-Hydeonoplacton-Ribonucleic acid (PHR) is an inhaler spray made of seven different plants, which all are used by humans, have desirable pharmacological features for treating pulmonary symptoms of COVID-19 patients. This study was conducted to assess the safety and effectiveness of PHR160 spray in improving pulmonary symptoms of COVID-19 patients. This was a single-center, non-blinded randomized clinical trial with two parallel groups in two different wards of Baqiyatallah hospital, Tehran, Iran. Participants were 51 male patients, diagnosed with COVID-19 pneumonia, divided into 2 groups of 32 in the intervention group and 31 in the control group. The intervention group received 5 days of PHR160 spray, 10 puffs each day, 300 micrograms in each puff in addition to the routine treatment. Oxygen saturation was measured by a pulse oximeter, every 6 hours and recorded daily This study showed that the intervention increased significantly the arterial oxygen saturation percentage in COVID-19 patients. In addition, it decreases hospitalization duration, dyspnea score and cough score significantly in the patients. The statistical modeling test, with adjusting the age and respiratory rate for baseline and 4 days of the intervention, shows that the oxygen saturation percentage mean was significantly more in the intervention group by 5.14 units (p<0.001).

Ratio of Mixed Venous Oxygen Saturation-to-Pulmonary Capillary Wedge Pressure: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

Hemodynamic values from right heart catheterization aid diagnosis and clinical decision-making but may not predict outcomes. Mixed venous oxygen saturation percentage and pulmonary capillary wedge pressure relate to cardiac output and congestion, respectively. We theorized that a novel, simple ratio of these measurements could estimate cardiovascular prognosis. We queried Veterans Affairs' databases for clinical, hemodynamic, and outcome data. Using the index right heart catheterization between 2010 and 2016, we calculated the ratio of mixed venous oxygen saturation-to-pulmonary capillary wedge pressure, termed ratio of saturation-to-wedge (RSW). The primary outcome was time to all-cause mortality; secondary outcome was 1-year urgent heart failure presentation. Patients were stratified into quartiles of RSW, Fick cardiac index (CI), thermodilution CI, and pulmonary capillary wedge pressure alone. Kaplan-Meier curves and Cox proportional hazards models related comparators with outcomes. Of 12 019 patients meeting inclusion criteria, 9826 had values to calculate RSW (median 4.00, interquartile range, 2.67-6.05). Kaplan-Meier curves showed early, sustained separation by RSW strata. Cox modeling estimated that increasing RSW by 50% decreases mortality hazard by 19% (estimated hazard ratio, 0.81 [95% CI, 0.79-0.83], P<0.001) and secondary outcome hazard by 28% (hazard ratio, 0.72 [95% CI, 0.70-0.74], P<0.001). Among the 3793 patients with data for all comparators, Cox models showed RSW best associated with outcomes (by both C statistics and Bayes factors). Furthermore, pulmonary capillary wedge pressure was superior to thermodilution CI and Fick CI. Multivariable adjustment attenuated without eliminating the association of RSW with outcomes. In a large national database, RSW was superior to conventional right heart catheterization indices at assessing risk of mortality and urgent heart failure presentation. This simple calculation with routine data may contribute to clinical decision-making in this population.

Clinical and Laboratory Differences between Delta and UK Variants of SARS-CoV-2: B.1.617.2 and B.1.1.7

At the end of 2019, the world met with the coronavirus disease 2019 (COVID-19), which will affect all humanity. Later in the course, the genetic variants of SARS-CoV-2 have emerged, bringing new questions and concerns. This study investigated differences between patients infected with the B.1.1.7 (UK variant) and the B.1.617.2 (Delta variant) regarding patient complaints, intensive care unit (ICU) admission and stay time, intubation, severe disease, mortality rates, and laboratory parameters. Hospitalized 205 patients infected with B.1.1.7 and 207 patients infected with B.1.617.2 were included in the study. Laboratory parameters, admission complaints, and the percent saturation of oxygen in the blood (SpO2) were recorded on the same day as the diagnosis and clinical findings during their follow-up. Cough and fever were more common complaints in the B.1.1.7 infected group, whereas tiredness, joint pain, and gastrointestinal complaints were more frequent in patients infected with B.1.617.2. The B.1.617.2 infected group had higher severe disease, acute coronary syndrome (ACS), mortality rates, neutrophil, troponin, and ferritin levels. In conclusion, patients infected with B.1.617.2 had a higher risk of intubation, ACS, and mortality rates. Cough and fever were more common in B.1.1.7 infected group, whereas tiredness was more frequent in B.1.617.2 infected group. Vaccination with at least one dose of Pfizer-BioNTech or CoronaVac is independently associated with a decreased mortality risk caused by two variants (Odds Ratio 0.4).

The Effect of Tharthar-Tigris Canal on the Environmental Properties of the Tigris River Northern Baghdad, Iraq

The present study is considered the first on this sector of the Tigris River after 2003. It is designed for two aims, the first is to demonstrate the seasonal variations in physicochemical parameters of Tharthar-Tigris Canal and Tigris River; the second is to explain the possible effects of canal on some environmental properties in the Tigris River. Water samples were being collected monthly. Six sampling sites were selected, two on Tharthar Canal and four along the Tigris River, one before the confluence as a control site and the others downstream the confluence with the canal. For a period from January to December 2020, nineteen physicochemical parameters were investigated including air and water temperature, turbidity, electrical conductivity, salinity dissolved oxygen, percent oxygen saturation, biological oxygen demand, pH, total hardness, calcium, magnesium, sulphate, total dissolved solids, total suspended solids, total alkalinity, bicarbonate, nitrate and phosphate. The results showed that air and water temperatures were close in both Tigris and canal. The waters were well aerated, slightly alkaline and over saturation was recorded several times, while biological oxygen demand values did not exceed 5 mg/L along study period. The high values of conductivity, salinity, total dissolved solids, total hardness, calcium and sulphate ions in Tharthar water increased in the Tigris River below the confluence. Whereas, the low values of turbidity, TSS, total alkalinity and bicarbonate in the arm diluted in the main river. It has been concluded that Tharthar Canal affected the Tigris River by either increasing or diluting of the Tigris chemical components.

Comparison between the Effects of Acetaminophen, Dexmedetomidine, and Normal Saline Infusion on Pain Severity after Cataract Surgery.

Cataract surgery is one of the most common eye surgeries, which is currently performed under topical anesthesia using sedative medications. Dexmedetomidine and acetaminophen are good candidates for analgesia in other circumstances, however, this study aimed to evaluate the effect of dexmedetomidine or acetaminophen infusion and normal saline (NS) alone compared with the control group on the severity of pain in cataract surgery. In this parallel randomized controlled clinical trial, the effect of dexmedetomidine or acetaminophen infusion and NS on level of pain, vital signs, recovery status, and surgeon satisfaction during cataract surgery were assessed. One hundred and thirty-five patients between the age of 50-80 years undergoing cataract surgery were recruited on a consecutive basis and randomized into three groups receiving acetaminophen (15 mg/kg), dexmedetomidine (0.5 μgr/kg), and NS. Baseline vital signs, blood pressure, arterial oxygen saturation, respiratory and heart rate at certain time-points including the start of surgery, 5, 10, and 15 min after surgery, after arrival to the recovery room, 20, 40, 60 min after recovery were measured. Pain intensity and drugs side effects were also recorded after surgery. Level of respiratory depression was higher in patients receiving dexmedetomidine. Heart rate and oxygen saturation percentage had no significant differences in the three groups as well as pain intensity. Acetaminophen was as effective as dexmedetomidine with lower side effects and higher surgeons' satisfaction, without any interference with cardiovascular and respiratory parameters. Acetaminophen infusion should be considered as an acceptable analgesic drug for cataract surgery.

Morbidity Pattern, Physiologic Parameters and Outcome among Elderly Patients Attending Selected Primary Healthcare Facilities in an Urban Region of Lagos

Background: In Nigeria, the elderly account for 4.97% of the total population and as one ages, the physiological status of the body gradually declines.Hypertension, cataract, osteoarthritis and neurological problems, constitute the commonest cause of morbidity among elderly. This results in inadequate medical attention leading to development of multiple health conditions and the inability to control certain physiological functions. Objective: This study aimed to describe the morbidity pattern, physiologic parameters and outcome among elderly patients attending the primary healthcare centres in Kosofe Local Government Area of Lagos State, Nigeria. Methods: The study was a descriptive cross-sectional consisting of 210 participants selected through systematic sampling. Data on morbidity pattern, physiologic parameters and disposition decisions were collected and analyzed using Epi-info, version 7.2. Proportions, means and frequencies were calculated and presented with Tables while Chi-square was used to test for association between morbidity and gender, age and outcome, vital signs and age, and disposition decision and sex. P-value &lt; 0.05 was considered statistically significant. Results: Disease such as hypertension (51.4%), malaria (18.5%) and osteoarthritis (6.6%) constituted the major reasons of visit of the elderly to primary healthcare facilities. There were statistically significant associations between cardiovascular condition and gender (p=0.005), and between musculoskeletal condition and age of the respondents (p=0.005). There were statistically significant associations between the urological conditions and outcome of the respondents (p= 0.001), between the pulse and age of the respondents (p=0.001), between respiratory rate and age (p=0.001) and between percentage oxygen saturation of haemoglobin and age (p=0.001). Conclusion: Diseases such as hypertension, osteoarthritis and malaria constitute the major cause of visits to primary healthcare facilities among the elderly. Those with cardiovascular disease were more likely to be females. Those with age range of 75-79 years may likely have a pulse rate less than 60 bpm. Those within the age of 70–74 years are more likely to have a low blood oxygen saturation level. Those with urological condition were more likely to be referred.

Water Quality of Bagmati River in Kathmandu Valley, Nepal

Abstract Background: Water quality degradation is one of the major challenges especially in under developed and developing countries and Nepal is no exception from it. Adequate water quality and quantity is one of the greatest factors affecting human and ecosystem health, and is essential for socio-economic growth and the improvement in the quality of life. This study aims to assess the water quality of Bagmati River in Kathmandu, the capital city of federal Nepal.Methods: Water quality of the Bagmati River in Kathmandu Valley was analyzed to assess the river water pollution. A total ten sites from Sundarijal to Sundarighat along the Bagmati river corroder was selected for sample collection. The samples were analyzed for physical (pH, Temperature, Conductivity), and chemical (dissolved oxygen, oxygen saturation percentage, biological oxygen demand, chloride, nitrate-N, phosphate-P and ammonia-N) parameters in pre-monsoon and post-monsoon seasons using standard methods. Results: The result reveals that water quality of the Bagmati River has degraded due to physical, chemical and biological contaminants. Discharge of untreated sewers, industrial effluents, unmanaged location of solid waste transfer station, dumping and burning of plastic waste and garbage near to the river bank. In both the season pollution was found to be increasing from upstream to downstream as indicated by Bach water quality index. The paired sample t-test of physicochemical parameters in two different seasons showed that all tested parameter were significantly different except dissolved oxygen and phosphate concentration. parameters pH, range between 7.55 to 6.33, temperature 30 °C to 26.23 °C, electrical conductivity 43.73 µS/cm to 810.5 µS/cm, dissolved oxygen 0 mg/L to 9.52 mg/L, oxygen saturation percentage 0 to 119.75 %, biological oxygen demand 2 mg/L to 400 mg/L, chloride 4.97mg/L to 132.54mg/L, nitrate-N 9 mg/L to 110 mg/L, phosphate-P 0.26 mg/L to 2.95 mg/L and ammonia-N range between 0.41 mg/L to 42 mg/L. Conclusion: Untreated sewerage, industrial effluents, dumping and burning of waste, unmanaged location of solid waste transfer stations, poor management of cremation ash has resulted in the excessive water pollution in Bagmati river. Treatment of waste water before discharge to the river and proper management of cremation ash and garbage, and prevention of illegal dumping of solid waste and burning of garbage and plastic materials along the river can alleviate the water pollution in Bagmati river.

Effect of Local Cold Therapy on Arterial Blood Oxygen Saturation and Temperature Changes in Patients Undergoing Surgery

Background: Postoperative complications can endanger the patient's life and disrupt the recovery process if not properly managed. Local cold therapy can be a safe non-pharmacologic method to manage these side effects; however, it has not been highly considered. Objectives: This study was done to determine the effect of local cold therapy on arterial blood oxygen saturation and temperature changes in patients undergoing surgery. Methods: This quasi-experimental study was performed at Shahrekord University of Medical Sciences in 2019 on 60 patients undergoing thoracic and abdominal surgery selected by convenience sampling, and they were randomly assigned to the intervention and control groups. The intervention (local cold therapy) was performed for 48 hours after full consciousness, three times a day for 20 minutes to the intervention group. Data were collected before and after the intervention using a demographic questionnaire, pulse oximetry device, and thermometer. The data were analyzed based on the independent samples t-test, paired-samples t-test, and chi-square and Fishers’ exact tests by SPSS version 20 software. Results: The mean arterial blood oxygen saturation percentage (O2Sat%) during the intervention significantly increased in both groups (P &lt; 0.05), but the rate of increase was significantly higher in the local cold group (P &lt; 0.05). The results of within-group research showed that the mean temperature had significant differences in the local cold therapy group (P &lt; 0.05), but the mean body temperature did not show a significant difference between the two groups (P &lt; 0.05). Conclusions: Local cold therapy can be effectively trained and used by nurses to improve the O2Sat%. It did not affect postoperative body temperature. Further studies must be conducted to investigate the effects of local cold therapy on postoperative body temperature changes.