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Background: During the ongoing pandemic of corona virus disease 2019 (COVID-19), prompt diagnosis is crucial to achieve swift and optimal clinical decision making and judge the precaution level necessary on a mission to help prevent nosocomial infections in the hospital. Various evidences have documented that early diagnosis and intervention are associated with a better prognosis. The reference standard diagnostic method for COVID-19 is reverse-transcription polymerase chain reaction (RT-PCR) that directly quantifies viral load from a nasopharyngeal swab, sputum, or endotracheal lavage. However, the sensitivity of this method is unclear because false-negative results have been reported in patients with insufficient specimens or those in the initial stage of infection. The turnaround time is also long, ranging from a few hours to days. Hence the need for a Diagnostic Test with Quick turnaround, which has good Sensitivity and has acceptable Specificity, and is also able to quantify the Disease load, and therefore help in clinical decision making and prognostication. Initial studies had revealed that HRCT Chest ticks all the above boxes, and hence this Study was taken up at our Institution to assess the Utility of the initial CT scans, and to grade the pulmonary involvement using a marking system devised by us, and compare it with the Clinical and Biochemical parameters for reliability. [ABSTRACT FROM AUTHOR]

Background: Renal fibrogenesis is the final common pathway to all renal injuries that leads to Chronic Kidney Disease (CKD) consequently. Renal fibrosis encompasses glomerulosclerosis, interstitial fibrosis, tubular atrophy, and vascular changes. Chronic kidney injury is manifested by a variety of histological structural alterations, including the accumulation of extracellular matrix (ECM). The accumulation of ECM is colloquially termed Interstitial fibrosis. Tubular atrophy (TA) often accompanies IF and, when occurring together, IF and TA are collectively termed IFTA Imaging of the kidney is mainly based on the evaluation of the renal parenchyma, excretory system, and renal vasculature using imaging modalities such as USG, CT, and MRI. Aim and objective: To establish the normal values of renal cortical elasticity using dynamic shear wave elastography and to establish the influence of factors affecting the renal cortical elasticity. Materials and methods: The study was conducted in our institute for 6 months and included 177 normal population in the year 2019 at Barnard Institute of Radiology, Madras Medical College. Patients underwent abdominal sonographic examination and shear wave ultrasound elastography using a convex probe (1-5 MHz) in the HITACHI ALOKA ARIETTA S70 machine. The renal measurements such as length, width, parenchymal thickness, cortical thickness, and skin to cortex distance are measured by a single observer. Before the study, All patients were screened for any residual urine in the supine position. All measurements were taken in the lateral decubitus position after emptying the urinary bladder. The length of the kidney was measured from the superior pole of the kidney to the inferior pole of the kidney on the coronal plane. The width of the kidney was measured from the renal hilum to the renal capsule at the mid pole on the coronal plane. Parenchymal thickness was measured on the coronal plane at the mid pole between the outer margin of the renal sinus and the renal capsule. The measurement from the renal capsule to the medullary pyramid base at the mid pole gives the cortical thickness. At last, the distance of skin to the outer margin of the renal cortex was measured at the mid pole. The probe was placed steadily with minimum compression in lateral decubitus position and the person was asked to hold his/her breath for a few seconds in full inspiration. This is to minimize the movement of the kidney with respiration. Then, a predefined region of interest (ROI) box (predefined by the manufacturer) of 1 x 1.5 cm was placed in the renal cortex at the mid pole of the kidney excluding the renal medulla as much as possible. The axis of the ROI box should be kept parallel as much as possible to the main axis of the pyramids of the renal medulla in the mid pole and SWV values are measured in terms of m/s in each kidney. Six valid elasticity measurements in terms of shear wave velocity were measured for the right kidney followed by the left kidney. Results: The mean parenchymal thickness of the right and the left kidney was 1.81 ± 0.34 and 1.92 ± 0.31 cm respectively. On statistical analysis, there exists a highly significant statistical difference between the parenchymal thickness of the right and left kidneys. The mean cortical thickness of the right and the left kidney was 0.90 ± 0.17 and 0.95 ± 0.19 cm respectively. On comparison between right and left kidneys by statistical analysis using paired t-test, it was found that there is a highly significant statistical difference between the cortical thickness of both kidneys (p-value 0.0005). The mean skin to cortex distance of the right kidney was 4.42 ± 1.01 cm and the left kidney was 4.37± 1.02. However, there was no statistically significant difference observed between skin to cortex distance of right and left kidneys. The average renal elasticity value of the right kidney was 1.53 ± 0.20 m/s and the left kidney was 1.51 ± 0.15 m/s. There was no significant statistical difference between the mean renal cortical shear wave velocities of the right and left kidney (p-value 0.341). There was no statistically significant correlation noted between the renal cortical plasticity (expressed in m/s) and the length of the right and left kidneys. The p-value was 0.906 and 0.958 in right and left kidney when analyzed using Pearson's correlation. There was a statistically highly significant negative correlation noted between renal cortical elasticity and width of the right kidney (p-value 0.002), when analyzed using Pearson's correlation. However, no statistically significant correlation was noted between renal elasticity and the width of the left kidney (p-value 0.186). Conclusion: Normal Renal cortical shear wave values can be used as reference values to assess early renal damage and assess renal disease progression Renal cortical shear wave velocity can be used as a non-invasive biomarker of renal disease. [ABSTRACT FROM AUTHOR]