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# INTERPRETATION #

A 69 year old male presents with fatigue and light headedness . I have updated the initial ECG. INTERPRET the ECG pls. 

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HOW TO ADVISE THE PERSONS WHO ARE ANTIBODY POSITIVE FOR SARS -CoV -2 ABOUT FUTURE INFECTION RISK? 

•• Underlying the question of whether the presence of antibodies provides protection against future infections are 3 questions: are antibodies protective, how good are the available tests for accurately detecting antibodies, and how long does protection last? To address the first question, we know that most patients who recover from COVID-19 have antibodies and that reinfection (as opposed to extended symptoms or ongoing viral shedding) is rare, at least at this date. However, even if antibodies are protective, there remains a question of how accurate commercial tests are for detecting antibodies.

The study in this issue of JAMA Internal Medicine by Harvey and colleagues1 provides reassuring answers to the first and second questions. Using a national database with more than 3 million unique patients, the authors found that patients with a positive antibody test result were more likely than those with a negative test result to have a subsequent positive nucleic acid amplification test result for SARS-CoV-2 in the first 30 days from the test result (viral shedding), but that starting at beyond 30 days, the risk of a positive nucleic acid amplification test declined every 30 days, until the risk ratio for those with an initial positive test at 90 days or greater follow-up was only 0.10 compared with those with a negative test. Antibody tests, in this study, appeared accurate and the antibodies protective. Their findings are consistent with a study of health care workers that found that the incidence of SARS-CoV-2 infection in 1265 workers with antispike antibodies was 0.13 per 10 000 days at risk compared with 1.09 for 11 364 workers who were seronegative for these antibodies.

Unfortunately, neither study can answer how long antibody protection will last because of natural infection. For this reason, vaccination against SARS-CoV-2 is recommended regardless of antibody status. How long the antibody protection provided by vaccines will last is also unknown. To know how long protection will last with antibodies because of natural infection or vaccination is something only time will tell.

REFERENCE : Harvey RA, Rassen JA, Kabelac CA, et al. Association of SARS-CoV-2 seropositive antibody test with risk of future infection.  JAMA Intern Med. Published online February 24, 2021.

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A 52 year old male presents to us with complaints of shortness of breath. We have proceeded the Case with CXR. What are your findings over X-ray? 

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Sai Shraddha
Opacity is Increased in left mid and upper zones with some lucency sorrounding the aortic knuckle. ?? Luftsichel Sign.  
 
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A 45 year old male presented with 3 weeks history of halitosis. He was also concerned about irregular appearences of his tongue which he has noticed past 3 years. He has no history of wearing any dentures or any skin disorders. 

On examinations he has poor oral hygiene, Considering the presentation what are the Broad differentials to consider or keep in mind? 

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Nisha
Fissured tongue  
 
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Eczema Vs scabies?? 

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Nisha
It looks like scabies with secondary infections... 
 
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Sai Shraddha
Scabies  
 
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