Browsing by Author "Sharma, Prakhar"

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    Predictors of Poor Outcome in Patients with COVID-19 associated Respiratory Failure: A Retrospective Observational Study
    (Association of Physicians of India, 2023-04) Rajpoot, A; Mishra, M; Banerjee, S; Kumar, Arjun; Panda, Prasan K; Sindhwani, Girish; Saini, Lokesh K; Sharma, Prakhar
    Background: Coronavirus disease 2019 (COVID-19) is majorly known to cause mild to moderate disease, but a small fraction of patients may develop respiratory failure due to diffuse lung injury, requiring management in the intensive care unit (ICU). This study attempts to identify factors that can predict unfavorable outcomes in moderate to severe COVID-19 patients. Methods: Hospital records of 120 COVID-19 patients admitted to the ICU were retrospectively analyzed and data pertaining to demographic, clinical, and laboratory parameters were obtained. These data were then compared with outcome parameters like survival, duration of hospital stay, and various adverse events. Results: Out of 120 patients, 70% were male, with a mean age of 54.44 years [standard deviation (SD) ± 14.24 years]. Presenting symptoms included breathlessness (100%), cough (94.17%), fever (82.5%), and sore throat (10.83%). Diabetes, hypertension, and chronic obstructive pulmonary disease (COPD) were the common comorbidities associated. Increased serum D-dimer, ferritin, interleukin-6 (IL-6) levels, and unvaccinated status were associated with higher mortality. Overall, 25.83% of patients survived, 24.41% of patients developed septic shock, and 10.6% of patients were discharged on oxygen. World Health Organization (WHO) clinical progression scale score ? 6 had 57 and 82% sensitivity and 83 and 77% specificity on days 7 and 14 after admission, respectively, for predicting mortality. A baseline National Early Warning Score 2 (NEWS 2) ? 9 had 48% sensitivity and 88% specificity for predicting mortality. Conclusion: Advanced age and associated comorbidities are linked to adverse outcomes in moderate to severe COVID-19. Persistently high D-dimer levels, despite standard treatment, may also contribute to increased mortality. WHO clinical progression scale and NEWS 2 have high specificity for predicting mortality.
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    Test-retest Repeatability and Minimal Detectable Change of 1-minute Sit-to-Stand Test for the Ability to Detect Exercise-induced Oxygen Desaturation in Patients with Interstitial Lung Diseases
    (Jaypee Brothers Medical Publishers Pvt. Ltd., 2024-06) Panjiyar, Vickey; Sharma, Prakhar; Banerjee, Saikat; Sanjan, Ganesh; Bahurupi, Yogesh A; Joshi, Narayan; Dua, Ruchi; Saini, Lokesh K; Mishra, Mayank; Sindhwani, Girish
    Background: While methods like the 6-minute walk test, shuttle walk test, and cardiopulmonary exercise testing (CPET) are available to assess exercise limitation, they need a large space to perform/advanced lab settings which makes 1-minute sit-to-stand test (1STST) a feasible option in office practice. Data on test-retest reliability and the minimal detectable change (MDC) of 1STST is lacking in both national and international literature. Materials and methods: In this prospective observational study, our objective was to assess test-retest reliability and the MDC of the 1STST in patients with ILD and to determine the correlation of 1STST with the severity of interstitial lung disease (ILD) by spirometry and mGAP index. Results: A total of 65 ILD patients underwent 1STST during the study duration. The mean number of repetitions during the test retest 1STST and were 20 ± 6 and 21 ± 6 respectively (p = 0.029). The intraclass correlation coefficient (ICC) between a number of repetitions during 1STST and retest 1STST was 0.914 with SEM of 1.551 repetitions and a MDC of 4 repetitions. Statistically significant poor correlation was observed between test and retest 1STST repetitions with diffusion capacity of lung for carbon monoxide (DLCO) predicted z score (r = 0.428 and p = 0.006). modified gender age lung physiology index score (r = –0.195, p = 0.142), SpO2 drop (r = –0.301; p = 0.013), BMI of patients (r = –0.287; p = 0.02), and baseline hemoglobin level (r = –0.095; p = 0.504) had a negative poor correlation with number of repetitions during 1STST. Conclusion: The 1-minute sit-to-stand test is a valuable tool for detecting exercise-induced desaturation in ILD patients, showing reliability and a MDC of approximately 4 repetitions.