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The most frequent criterion for defining obstructive sleep apnea was apnea-hypopnea index (AHI)>1 per hour. The prevalence found ranged from 32.3 to 100% and the pooled prevalence was 65% (I

=53.4%), considering AHI>1, and 52% (I

=89.4%) for AHI>2 per hour. It was not possible to verify the association between obstructive sleep apnea and clinical variables.

A high prevalence of obstructive sleep apnea in children and adolescents with cystic fibrosis was found, regardless of age and lung function impairment, reinforcing the importance of investigating sleep-disordered breathing during clinical visits even when lung function is not yet compromised.

A high prevalence of obstructive sleep apnea in children and adolescents with cystic fibrosis was found, regardless of age and lung function impairment, reinforcing the importance of investigating sleep-disordered breathing during clinical visits even when lung function is not yet compromised.

Obstructive sleep apnea (OSA) is independently associated with dyslipidemia, a surrogate marker of atherosclerosis. Low-density lipoprotein (LDL)-cholesterol is accepted as a major independent risk factor for cardiovascular disease. However, non-high-density lipoprotein (HDL)-cholesterol is a better marker of atherogenic dyslipidemia and recommended as a target of lipid lowering therapy. We aimed to assess the prevalence of atherogenic dyslipidemia, and relationship between OSA severity and serum LDL-cholesterol and non-HDL cholesterol levels in OSA patients.

We retrospectively evaluated treatment naïve 2361 subjects admitted to the sleep laboratory of a university hospital for polysomnography. All subjects’ lipid profile including total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and non-HDL-cholesterol were measured.

Out of 2361 patients (mean age 49.6±11.9 years; 68.9% male, apnea-hypopnea index 36.6±28.4/h), 185 (7.8%) had no OSA and 2176 (92.2%) had OSA. Atherogenic dyslipidemia psterol levels are significantly increased, predominantly in severe OSA patients. Non-HDL-cholesterol but not LDL-cholesterol, is significantly correlated with OSA severity and hypoxia parameters. Therefore, it could be better to use non-HDL-cholesterol, which is a guideline recommended target of lipid therapy, as a marker of atherosclerotic cardiovascular risk in OSA patients.

The COVID-19 pandemic has turned the world topsy turvy since its emergence and has claimed innumerable lives worldwide. Neurological manifestations of the disease have raised several eyebrows around the world among which Guillain-Barré syndrome (GBS) deserve special mention. Although majority of the cases of the coronavirus disease 2019 (COVID-19) present with respiratory symptoms, extrapulmonary manifestations are being increasingly reported. We conducted this study to analyze detailed clinical presentations and outcome in a series of eight cases (n=8) with COVID-19 associated GBS.

An observational prospective study was conducted among patients with post-infectious/para-infectious GBS. 8 patients were subclassified into acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor and sensory axonal neuropathy (AMSAN) as per electrodiagnostic criteria and were followed up from admission to 6 months post discharge, to obtain a comprehensive clinical profile and outcome in these patients.

The diagnosis of GBS was confirmed as per Asbury criteria, supported by electrodiagnostic features in nerve conduction velocity test. Among the series of 8 patients, 3 were diagnosed as AIDP, 3 had AMAN and the remaining 2 patients had AMSAN. 3 patients of GBS were afebrile and were diagnosed as COVID-19 after a positive assay on routine screening. Cerebro-spinal fluid analysis for SARS-Cov-2 RT-PCR and serum anti-ganglioside antibodies were negative in all the patients.

GBS in patients with COVID-19 should be differentiated from critical illness neuropathy and myopathy. Early diagnosis is important as it is associated with poor outcome and prolonged invasive ventilation.

GBS in patients with COVID-19 should be differentiated from critical illness neuropathy and myopathy. Early diagnosis is important as it is associated with poor outcome and prolonged invasive ventilation.Comparison of first and second waves of Coronavirus disease (COVID-19) showed varied differences including the peak and time distribution. Contrary to published reports of comparing two waves in India wherein the younger age group was affected more in the second wave in India; a secondary data analysis of around 0.5 million real-time reverse transcription-polymerase chain reaction tests conducted in COVID-19 diagnostic laboratory in eastern Uttar Pradesh, India showed an increase in positivity rate in older age groups in the second wave. The positivity rate among symptomatic cases was found to be three times higher in second wave compare to the first wave. Higher positivity rates were seen across older age groups, with a shift of 11 years in the mean age of positivity in the second wave compared to the first.

The novel coronavirus disease 2019 (COVID-19) has rapidly spread through the whole globe. Since the beginning of the outbreak, some individuals were more likely to manifest more severe outcomes. Diabetic patients were of that sort; however, the severity of COVID-19 in prediabetic ones remained less identified. This study aimed to systematically review and conduct a meta-analysis of the previously published observational studies investigating the severity of COVID-19 in prediabetic patients.

Medline/PubMed, Scopus, EMBASE, Web of Science, Cochrane library, and google scholar databases were queried to identify relevant studies concerning prediabetes and serious COVID-19 outcomes. The Newcastle-Ottawa scale was used to assess the quality of the included studies. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the likelihood of severe presentations in prediabetic patients.

A total of 3027 patients were included in the meta-analysis. A random-effects model was used regarding the high heterogeneity (I

=55%). Prediabetes was significantly associated with adverse outcomes of COVID-19 with an OR of 2.58 (95%CI, 1.46-4.56).

Prediabetes could act as a risk factor for the severity of COVID-19. Early detection of prediabetic patients might be helpful to adopt preventive and protective strategies to improve the prognosis of the infected individuals.

Prediabetes could act as a risk factor for the severity of COVID-19. Early detection of prediabetic patients might be helpful to adopt preventive and protective strategies to improve the prognosis of the infected individuals.

Coronavirus disease (COVID-19) still becomes a global burden that affected people in different groups. The aim of this study was to evaluate the association between thyroid disease and the outcome of COVID-19 patients.

This was a meta-analysis study from articles obtained through a systematic literature search to investigate the relationship between thyroid disease and COVID-19 outcomes. Composite poor outcomes comprised of severity, mortality, intensive care unit (ICU) admission, and hospitalization.

A total of 31339 patients from 21 studies included in this study. Thyroid disorder was associated with increased composite poor outcome (risk ratio (RR) 1.87 [95% confidence interval (CI) 1.53, 2.27], p<0.001; I2=84%, p<0.01), this included higher disease severity (RR 1.92 [1.40, 2.63], p<0.05; I2=86%, p<0.01), ICU admission (RR 1.61 [1.12, 2.32], p>0.05; I2=32%, p<0.05), mortality (RR 2.43 [1.44, 4.13], p<0.05; I2=83%, p<0.01), and hospitalization (RR 1.28 [1.17, 1.39], p<0.05; I2=0%, p<0.96). Meta-regression analysis indicated that age (p=0.002) was a significant influence that affects the association. Also, the presence of unspecified thyroid disease (RR 1.91 [1.38, 2.65], p<0.05; I2=81%, p<0.01) and hypothyroidism (RR 1.90 [1.45, 2.55], p<0.05; I2=85%, p<0.01) during admission were associated with poor outcomes.

Thyroid abnormalities increased the risk of COVID-19 composite poor outcomes and were influenced by the patient’s age. Abnormal thyroid and hypothyroidism, but not hyperthyroidism, were associated with poor COVID-19 outcomes.

Thyroid abnormalities increased the risk of COVID-19 composite poor outcomes and were influenced by the patient’s age. Abnormal thyroid and hypothyroidism, but not hyperthyroidism, were associated with poor COVID-19 outcomes.

Hyperosmolar diabetic ketoacidosis (H-DKA), a distinct clinical entity, is the overlap of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).

We describe the clinical presentation, metabolic aberrations, and associated morbidity/mortality of these cases with H-DKA. CI1040 We highlight the problem areas of medical care which require particular attention when caring for pediatric diabetes patients presenting with H-DKA.

In our study we reviewed the literature back to 1963 and retrieved twenty-four cases meeting the criteria of H-DKA glucose >600mg/dL, pH<7.3, bicarbonate <15 mEq/L, and serum osmolality >320 mOsm/kg, while adding three cases from our institution.

Average age of presentation of H-DKA was 10.2 years±4.5 years in females and 13.3 years±4 years in males, HbA1c was 13%. Biochemical parameters were consistent with severe dehydration serum osmolality=394.8±55 mOsm/kg, BUN=48±22mg/dL, creatinine=2.81±1.03mg/dL. Acute kidney injury, present in 12 cases, was the most frequent end-organ complication.

Multi-organ involvement with AKI, rhabdomyolysis, pancreatitis, neurological and cardiac issues such as arrhythmias, are common in H-DKA. Aggressive fluid management, insulin therapy and supportive care can prevent acute and long term adverse outcomes in children and adolescents.

Multi-organ involvement with AKI, rhabdomyolysis, pancreatitis, neurological and cardiac issues such as arrhythmias, are common in H-DKA. Aggressive fluid management, insulin therapy and supportive care can prevent acute and long term adverse outcomes in children and adolescents.Premna microphylla Turcz. is a commonly used traditional Chinese medicine totreatdysentery and appendicitis. Present study is focused to explore antioxidants and other compounds in the Premna microphylla Turcz. stem. Assessment of chemical composition was done with high sensitivity UPLC-LTQ-Orbitrap-MS and for Separation Thermo Hypersil Gold (100 mm × 2.1 mm, 1.9 µm) was used while electrospray ionization (ESI) was used for the mass spectrometry. 18 compounds were identified including Vitexin (1), Schaftoside (2), Vicenin-2 (3), Apigenin-6, 8-di-C-arabinoside (4), Apigenin-7-O-β-d-glucoside (5), Carnosic acid (6), Apigenin-8-C-β-d-xylopyranoside (7), Prostratin (8), Aurantio-obtusin-β-d-glucoside (9), Royleanone (10), 5-hydroxy-7,3′,4′-Trimethoxy flavonols (11), 6-Hydroxy-5,6-dehydrosugiol (12), 14-deoxycoleon (13), Arucadiol (14), Obtusinone-B (15), Trehalose (16), Citric acid (17) and Betaine (18). Among these, 6 compounds including (6), (8), (9), (16), (17) and (18) were identified first time within this genus and plant. Study highlights the importance of Premna microphylla Turcz. stem extract for strong therapeutic potential against oxidation-related diseases.