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Pleural effusion was observed in only 10% of the patients while pericardial effusion and hiatal hernia were present in 5%. In RT-PCR-positive patients, the posterior basal segment of the lower lobe of the right and left lungs were found to be dominantly involved; however, the upper and middle lobes of the right lung were more commonly involved than the left lung. The mean CTSS was significantly higher in patients aged above 50 years (p less then 0.001). The mean CTSS of RT-PCR-negative patients was higher than that of RT-PCR-positive patients (15.18 vs. 14.31, p=0.537). Conclusion RT-PCR has a limited role in the diagnosis of COVID-19. The HRCT scan can detect typical COVID-19 findings even in patients with negative RT-PCR results. Moreover, the use of HRCT scan in determining the disease severity and extent of lung damage can lead to a better assessment of critically ill patients.The novel Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome Coronavirus-2, emerged in China in late 2019, and a variety of clinical symptoms and signs were reported following patients' clinical presentation. By contrast, human Brucellosis is a worldwide zoonosis that may present with general symptoms including fever, dry cough, malaise, and arthralgia, making it indistinguishable from other causes of respiratory infection. Here, an 18-year-old man who was hospitalized with a suspected COVID-19 infection, but finally confirmed as having Brucellosis with positive blood culture for Brucella melitensis is presented. This case is a reminder for healthcare workers to consider the diagnosis of Brucellosis in patients exhibiting febrile syndromes in endemic regions during the COVID-19 pandemic.Stimulant laxatives are a common class of laxatives that is abused by patients with eating disorders. We present a case of a 30-year-old female who presented with dyspnea, peripheral edema and weight gain who had been chronically using laxatives. Her symptoms were consistent with rebound edema caused by sodium and free water shifts with abrupt cessation of excessive stimulant laxative use. This case highlights the use of furosemide as the mainstay treatment for rebound edema and weight gain.
Hypercalcemia is a common electrolyte abnormality presenting with a variety of symptoms. The common causes are primary hyperparathyroidism and malignancy associated with hypercalcemia. However, iatrogenic hypercalcemia with the overzealous use of vitamin D has now emerged as another important cause of hypercalcemia over the past decade.
This study aims to evaluate the causes of hypercalcemia, management strategies, and outcomes in patients admitted with hypercalcemiain a tertiary care hospital. MethodIt is a retrospective study done at Aga Khan University Hospital (AKUH), Karachi after taking approval from the ethical review committee (ERC). Data were gathered about all patients admitted from 1st
January 2008 to 31st
December 2018. A total of 1142 patients were included in the study and their calcium levels were noted. Along with demographic details, data pertaining to their diagnosis and all investigations done to evaluate the causes of hypercalcemia were noted in a pre-defined questionnaire.
A totalge ofhypercalcemia's causesis of great importance so that targeted investigations can be done. Not only will it minimize the cost burden and shorten the hospitalization of patients; it will also help the physicians to decide the appropriate management accordingly. Moreover, vitamin D toxicity was also observed in a significant number of patients which highlights the common practice of using higher doses of vitamin D by physicians.
Malignancy is the most common cause of hypercalcemia in admitted patients. The knowledge of hypercalcemia's causes is of great importance so that targeted investigations can be done. Not only will it minimize the cost burden and shorten the hospitalization of patients; it will also help the physicians to decide the appropriate management accordingly. Moreover, vitamin D toxicity was also observed in a significant number of patients which highlights the common practice of using higher doses of vitamin D by physicians.Immune thrombocytopenia (ITP) is a hematological condition that is characterized by a low platelet count. ITP can be primary or secondary. Secondary causes are diverse and include viral infections. The novel coronavirus has rarely been recognized as cause of ITP. https://www.selleckchem.com/products/t-5224.html This is a case of an 82-year-old Caucasian male who was infected by the novel coronavirus four weeks prior. His platelet count on admission was 1,000/mm3. He was diagnosed with ITP caused by the novel coronavirus as there were no other causes for his thrombocytopenia. The patient was treated with platelet infusions, high-dose corticosteroids, and intravenous immunoglobulin infusions.Introduction Management of periprosthetic hip infections (PHIs) generally consists of implant removal and thorough debridement, accompanied by appropriate antibiotic therapy. Daptomycin (DAP) is a novel antibiotic, which allowed for implant retention in several patients after treating their infected joints. However, there is no consensus about implant retention or removal during the treatment of PHIs. The aim of this study was to examine the effect of DAP and to determine a surgical treatment strategy. Methods This study retrospectively evaluated 20 patients between August 2014 and December 2018, divided into implant retention (n=9) and implant removal groups (n=11). Infection control and risk of recurrent infection were evaluated. Infection control was defined as not requiring implant removal after the final treatment. Results Infection control rates in implant retention and implant removal groups were 67% and 90%, respectively. All late chronic infections resulted in failure cases within the implant retention group. In the implant retention group, mean preoperative risk scores for successful cases were significantly higher than those for failure cases (p less then 0.05). Conclusions Patients with low risk did not require implant removal, suggesting that DAP may be a breakthrough alternative to traditional PHI management.Objective The population's ever-growing concern with genital aesthetic dysfunctions reflects an increasing demand in the field of intimate aesthetics. For this reason, as well as the lack of a standardized evaluation, this paper aims to develop a form that facilitates the initial investigation of aesthetic genital dysfunctions. Methods An evaluation form for female and male genital dyschromia was developed between July and November 2018. Following initial development, the form was evaluated for quality and was updated by a panel of specialists (a psychologist, two pelvic dysfunction physiotherapists, and two dermato-functional physiotherapists) via email and through a content validity questionnaire. The face validity of the form was assessed by five physiotherapy and medical students who were randomly selected. The students answered a questionnaire evaluating the proposed form. The reliability of the form was established through the test-retest procedure by evaluating its reproducibility over time. Results The "Genital Dyschromia Evaluation Form'' (composed of identification, anamnesis, and physical examination sections) was approved by the specialist panel. They suggested questions to be added in the anamnesis (dermatological lesions or fungal and bacterial infections) and physical examination (hyperemia, edema in the perianal and internal thigh region) sections. As for the image analysis, an increase in quality, resolution, and sharpness was suggested. Lastly, for the cutaneous phototype evaluation, the DoctorSkinFototipo® digital analyzer device was chosen since it is small, portable, easily positioned on the genital area, and can be readily cleaned between patients. Conclusion The "Genital Dyschromia Evaluation Form" is a questionnaire approved by specialists and could represent a suitable option for health professionals.Typhlitis, also known as neutropenic enterocolitis, is a rare but serious condition characterized by inflammation of the cecum causing right lower quadrant (RLQ) pain and fever. It typically affects immunocompromised patients with neutropenia, hematologic malignancies, AIDS, or those on immunosuppressive therapy. This is an entity that should be considered in any differential for a patient with febrile RLQ pain, not just those with obvious immunosuppression.Tibial plateau fractures are quite common among lower limb fractures. Several fracture classifications exist including Schatzker classification, in which tibial plateau fractures are divided into six types where each increasing numerical category indicates increasing severity of the injury and worsening prognosis. Arthroscopic-assisted techniques using a lateral or medial metaphyseal window have shown results comparable to open internal fixation methods with multiple advantages. We present a case of a medically and surgically free 40-year-old lady who presented to our emergency department complaining of left knee pain following a fall from the stairs. Clinically there was significant swelling and tenderness over the lateral aspect of the left proximal tibia, radiographs showed a Schatzker type III tibial plateau fracture, confirmed by computed tomography (CT). A combined intraoperative arthroscopic- and fluoroscopic-guided reduction of the articular depression through a lateral cortical window was achieved and the fracture was fixed using a minimally invasive fixation technique. The postoperative course was uneventful. The patient had recovered full range of motion and the wounds were barely visible. One-year X-ray showed healed fracture without any evidence of displacement or subsidence.Introduction The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on daily life. Restrictions imposed to help minimise virus transmission have limited both population movement and employment, as well as altering the potential mechanisms of high-energy trauma. The objective of this study was to assess the impact of the COVID-19 pandemic on pelvic and acetabular trauma. Materials and methods A retrospective observational study of the incidence, causality, patient profile, fracture morphology, and treatment strategy of pelvic and acetabular trauma managed in a national tertiary referral specialist pelvic and acetabular centre between the 1st of March and 1st of August 2020 was undertaken and compared to corresponding time periods in the two preceding years. Results A total of 78 patients were referred for management following pelvic and acetabular trauma during the study period with a mean age of 52 years (SD +/- 24.2). Overall, 45% and 42% of patients were referred following isolated pellocation as the pandemic continues.Anesthetic management of achondroplastic patients warrants special anatomical and physiological considerations due to significant variations in the airway as well as the spine in regional techniques. In this report, we present the case of a 30-year-old morbidly obese male with achondroplasia, end-stage renal disease (ESRD) on hemodialysis, and renal osteodystrophy, who was scheduled for incision and drainage of a rectal abscess. Preoperative evaluation revealed Mallampati IV airway with a short neck and a scoliotic spine with possible atlantoaxial instability.
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