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Purpose: Enlightening the changes in the usual clinical practices, working environment, and social life of Intensivists working in noncoronavirus disease intensive care units (non-COVID ICU) during the COVID pandemic. Materials and methods: Observational cross-sectional study for Indian intensivists working in non-COVID ICUs conducted between July and September 2021. A 16-question online survey consisting of the work and social profile of the participating intensivists, changes in the usual clinical practices, working environment, and impact on their social life was administered. For the last three sections, intensivists were asked to compare pandemic times to prepandemic times (pre-mid-March 2020). Results: The number of invasive interventions performed by intensivists working in the private sector with lesser clinical experience (<12 years) were significantly less as compared to the government sector (p = 0.07) and clinically experienced (p = 0.07). Intensivists without comorbidities performed significantly lesser number of patient examinations (p = 0.03). The cooperation from healthcare workers (HCWs) decreased significantly with lesser experienced intensivists (p = 0.05). Leaves were significantly reduced in case of private sector intensivists (p = 0.06). Lesser experienced intensivists (p = 0.06) and intensivists working in the private sector (p = 0.06) spent significantly lesser time with family. Conclusion: Coronavirus disease-2019 (COVID-19) affected the non-COVID ICUs as well. Young and private sector intensivists were affected due to less leaves and family time. HCWs need proper training for better cooperation during the pandemic time. [ABSTRACT FROM AUTHOR]

Background: Our understanding of the pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still evolving and is limited for prognostication. The study was performed to predict severity and mortality based on hematology parameters in coronavirus disease (COVID-19). Material and Methods: The study was a single-center retrospective analysis of 240 patients with COVID-19. The hematological parameters were compared between different grades of severity. The receiver operating characteristics (ROC) curve along with the Classification and Regression Trees (CART) methods were used for the analysis. Result: The total leukocyte count, absolute neutrophil count, neutrophil-lymphocyte ratio (NLR), and neutrophil-monocyte ratio (NMR) were increasing along with an increase in severity; while the absolute lymphocyte count and lymphocyte-monocyte ratio (LMR) were decreasing (P < 0.001). For prediction of severity and mortality on admission, the NLR, NMR, and LMR were significant (P < 0.001). The NLR, NMR, and LMR had an area under the receiver operating characteristics curve (AUROC) of 0.86 (95% CI of 0.80-0.91), 0.822 (95% CI of 0.76-0.88), and 0.69 (95% CI of 0.60-0.79), respectively, for severity. While the NLR, NMR, and LMR had an AUROC value of 0.85 (95% CI of 0.79-0.92), 0.83 (95% CI of 0.77-0.89), and 0.67 (95% CI of 0.57-0.78), respectively, for mortality. Conclusion: With the increase in severity there was an increase in the total leukocyte count and absolute neutrophil count while the absolute lymphocyte count decreased. On admission, the cut-off value of NLR >5.2, NMR >12.1, while LMR <2.4 may predict severity and mortality in COVID-19. [ABSTRACT FROM AUTHOR]

Background Most of the reported risk score models for coronavirus disease 2019 (COVID-19) mortality are based on the levels of inflammatory markers, comorbidities or various treatment modalities, and there is a paucity of risk score models based on clinical symptoms and comorbidities. Methods To address this need, age, clinical symptoms and comorbidities were used to develop a COVID-19 scoring system (CSS) for early prediction of mortality in severe COVID-19 patients. The CSS was developed with scores ranging from 0 to 9. A higher score indicates higher risk with good discrimination quality presented by Mann Whitney U test and area under receiver operating characteristic curve (AUROC). Results Patient age of ≥60 y, cough, breathlessness, diabetes and any other comorbidity (with or without diabetes) are significant and independent risk factors for non-survival among COVID-19 patients. The CSS showed good sensitivity and specificity (i.e. 74.1% and 78.5% at CSS≥5, respectively), with an overall diagnostic accuracy of 82.8%, which was close to the diagnostic accuracy detected in the validation cohort (81.9%). In the validation cohort, high (8–9), medium (5–7) and low (0–4) CSS groups had 54.80%, 28.60% and 6.5% observed mortality, respectively, which was very close to the predicted mortality (62.40%, 27.60% and 5.2%, respectively, by scoring cohort). Conclusions The CSS shows a positive relationship between a higher score and proportion of mortality and, as its validation showed, it is useful for the prediction of risk of mortality in COVID-19 patients at an early stage, so that referral for triage and admission can be predetermined even before admission to hospital. [ABSTRACT FROM AUTHOR]

Background: Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)–associated diseases is still not very clear. Aims: In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19–associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days. Setting and Design: The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021. Materials and Methods: Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors. Statistical Analysis: Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's t-test/Mann–Whitney U-test or Chi-square test/Fisher's exact test. Results: Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL−1) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL−1) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 103 cells.mm−3), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (P < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups. Conclusion: Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors. [ABSTRACT FROM AUTHOR]

Byline: Tanmoy. Ghatak, Banani. Poddar, Arvind. Baronia Sir, Methylene blue has been used as a treatment for drug induced methemoglobinemia for the past 100 years. [sup][1] We are reporting a [...]

Byline: Tanmoy. Ghatak, Sukhen. Samanta, Sujay. Samanta, Hemant. Bhagat Sir, Acromegaly is a well-recognized cause of difficulty in airway management both during mask ventilation and tracheal intubation. [sup][1] But, scarcity [...]

Byline: Tanmoy. Ghatak, Afzal. Azim, Arvind. Baronia, Neelima. Ghatak Sir, Medicolegal issues and iatrogenic origin make guide-wire loss during central venous catheterisation an under- reported topic. [sup][1] We are reporting [...]

Byline: Tanmoy. Ghatak, Afzal. Azim, Arvind. Baronia, Banani. Poddar, Mohan. Gurjar Sir, With the increasing use of femoral vascular catheter in intensive care unit (ICU), the insertion related complications of [...]

Byline: Tanmoy. Ghatak, Ratender. Singh, Arvind. Baronia Nonocclusive mesenteric ischemia is a type of acute mesenteric ischemia with high mortality seen mostly in elderly cardiac patients. We present a 21-year-old [...]

Byline: Tanmoy. Ghatak, Ratender. Singh, Arvind. Baronia Voriconazole is a newer effective antifungal agent currently available for the treatment of invasive aspergillosis. The case we present describes an episode of [...]

Byline: Tanmoy. Ghatak, Ratender. Singh, Arvind. Baronia, Sandeep. Sahu Anisocoria is an uncommon entity in general postoperative intensive care. We present a case of a 45-year-old man suffering from severe [...]

Byline: Tanmoy. Ghatak, Girish. Chandra, Anita. Malik, Dinesh. Singh, Vinod. Bhatia For treatment of intra and postoperative pain, no drug has yet been identified that specifically inhibits nociception without associated [...]