This case report describes a 45-year-old female who presented with transverse myelitis. MRI revealed abnormalities in her thoracic spinal cord. She tested positive for COVID-19 during workup. The patient did not improve with steroids but did improve after a course of plasmapheresis. This case suggests that COVID-19 should be considered as a potential cause of transverse myelitis, as the virus can cause neurological manifestations through various mechanisms. More research is still needed but physicians should be aware of unusual neurological presentations potentially associated with COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportpateldrona
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs
Guillain Barre Syndrome & Covid-19: A Case Reportkomalicarol
Besides respiratory symptoms, coronavirus disease 2019
(COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia,
headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder
that usually follows a viral infection, it is possible that COVID-19
infection and GBS are closely related. In this case report, we try to
elucidate the relation between SARS-CoV-2 and GBS.
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.
Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...clinicsoncology
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...SarkarRenon
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportpateldrona
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs
Guillain Barre Syndrome & Covid-19: A Case Reportkomalicarol
Besides respiratory symptoms, coronavirus disease 2019
(COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia,
headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder
that usually follows a viral infection, it is possible that COVID-19
infection and GBS are closely related. In this case report, we try to
elucidate the relation between SARS-CoV-2 and GBS.
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.
Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...clinicsoncology
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...SarkarRenon
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...georgemarini
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...AnonIshanvi
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...pateldrona
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy..
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...komalicarol
Medulloblastoma is the most common malignant solid tumor
in childhood, with the highest frequency among other brain tumors accounting for 30% of pediatric brain tumors and 7% to 8%
of all brain tumors. According to the World Health Organization
(WHO), medulloblastoma is classified as a grade IV tumor and
defined as “a malignant, invasive embryonal tumor of the cerebellum with preferential manifestation in children, predominantly
neuronal differentiation and an inherent tendency to metastasize
via cerebrospinal (CSF) pathways
Thrombophylia and COVID-19. A case report of young man 53 years old whith acu...komalicarol
A 57-year-old male was admitted to our Hospital on March 2020
for SARS-Cov2 related interstitial pneumonia. Chest x-ray showed
a bilateral interstitial-alveolar pneumonia and Blood gas analysis
(BGA) in room air highlighted a severe respiratory failure (pO2 46
mmHg, pH 7.41). Due to clinical and biohumoral worsening (stable CRP at 24 mg/dL), tocilizumab (800mg) was performed after
acquiring patient’s informed consensus. In the evening, after 96
hours of hospitalization, the patient presented a clear hyposthenia
/ hemiparesis of the right hemisome whit hyperreflexia, confusion
and slowed speech
Subclinical thyroiditis related to COVID-19: A case report and literature reviewkomalicarol
COVID-19 can cause different clinical manifestation by affecting
different organs in the body. Involvement of thyroid gland is very
rare in COVID-19 infection than any other systems of the body.
We described a 41-year-old female with subclinical thyroiditis
most likely related to corona virus infection and reviewed literatures regarding cases of thyroiditis due to COVID-19 have been
reported. The objective of this article is to create awareness regarding this novel entity and the association with thyroid dysfunction
Critical Illness Polyneuromyopathy (CIPNM) is frequently present in critically ill as a certain degree of symmetric extremity paresis and respiratory muscle weakness. The consequences of this complication may last for months or years after severe illness. It prolongs the stay in ICU and dependence onmechanical ventilation, increases long-term disability and care costs. We report a 58-year old female patient admitted to our Intensive Care Unit for acute respiratory insuffi ciency due to infl uenza pneumonia and acute respiratory distress syndrome. Thirty-three days of mechanical ventilation and 11 days of extracorporal membrane oxygenation were complicated by severe CIPNM, tetraparesis, mental disorders, and diffi culties in weaning off mechanical ventilation. No specifi c therapy is available for treatment of CIPNM. Preventive, supportive and rehabilitation measures are discussed in the article.
Neurological Manifestations of COVID-19 InfectionSudhir Kumar
COVID-19 primarily affects respiratory system, however, it can affect other systems too, including nervous system. This presentation offers details about neurological symptoms and disorders seen in patients with COVID-19.
Scott Letendre, MD
Professor in Residence
Division of Infectious Diseases & Global Public Health
Departments of Medicine and Psychiatry
University of California, San Diego
The coronavirus disease outbreak has proven to be a major health crisis affecting virtually every facets of our lives.
Coronavirus disease is an ongoing pandemic disease. The disease which is caused by a new type of virus, known as severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many patients hospitalized with COVID-19 will develop muscle
weakness particularly those admitted in intensive care unit (ICU). Studies have shown that muscle weakness is one of the
direct consequences of critical illness. We systematically reviewed literature that quantified changes in muscle strength and it
relationship with COVID- 19 in Intensive care unit in humans.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Transverse myelitis is a pathology, whose etiology is associated with autoimmune or infectious diseases, which directly affects the spinal cord, coursing with motor, sensory and acute or subacute dysfunction9. We report a case of a 32-year-old multiparous woman who, after the first postpartum day, reported pain and paresthesia in the lumbar and lower limbs with progressive worsening. Patient started clinical investigation, with orthopedic causes ruled out, together with the neurology and neurosurgery team. She underwent magnetic resonance imaging of the thoracic and lumbar spine where infectious neuropathy was evidenced at L4-L5. Patient was transferred to a referral hospital where Mycobacterium tuberculosis was evidenced as the cause and, when performing a rapid test for SARS-CoV-2, it was positive.
Managment Of Long Term Care In Era Covid-19komalicarol
COVID-19 gives the chance to address long-term care categories
that are sometimes disregarded and undervalued, such as nursing
and residential homes, as well as homecare. Each method of delivering long-term care must meet the highest possible standards
of ongoing care and quality of life. More study and evaluation are
needed to aid decision-making and policy-making, particularly on
the cost-effectiveness and cost-quality elements for each country,
region, or system.
Renal failure and Quality ofLlife Indicators in Kidney Transplantationkomalicarol
Health-related quality of life (HRQL) contains many aspects of
patients' health such as physical, psychological, social functioning
and a general well-being. Progress in renal transplantation and immunosuppressive therapies have increased significantly in recent
decades, resulting in allograft survival rates at one year is now
over 90%. Numerous clinical trials have established the importance of quality of life in a variety of diseases, and it is extremely
popular to evaluate quality of life in clinical trials as a measure of
patients' subjective state of health. The purpose of the study was
to identify factors associated with quality of life after renal transplantation.
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Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...georgemarini
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...AnonIshanvi
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
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Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy..
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...komalicarol
Medulloblastoma is the most common malignant solid tumor
in childhood, with the highest frequency among other brain tumors accounting for 30% of pediatric brain tumors and 7% to 8%
of all brain tumors. According to the World Health Organization
(WHO), medulloblastoma is classified as a grade IV tumor and
defined as “a malignant, invasive embryonal tumor of the cerebellum with preferential manifestation in children, predominantly
neuronal differentiation and an inherent tendency to metastasize
via cerebrospinal (CSF) pathways
Thrombophylia and COVID-19. A case report of young man 53 years old whith acu...komalicarol
A 57-year-old male was admitted to our Hospital on March 2020
for SARS-Cov2 related interstitial pneumonia. Chest x-ray showed
a bilateral interstitial-alveolar pneumonia and Blood gas analysis
(BGA) in room air highlighted a severe respiratory failure (pO2 46
mmHg, pH 7.41). Due to clinical and biohumoral worsening (stable CRP at 24 mg/dL), tocilizumab (800mg) was performed after
acquiring patient’s informed consensus. In the evening, after 96
hours of hospitalization, the patient presented a clear hyposthenia
/ hemiparesis of the right hemisome whit hyperreflexia, confusion
and slowed speech
Subclinical thyroiditis related to COVID-19: A case report and literature reviewkomalicarol
COVID-19 can cause different clinical manifestation by affecting
different organs in the body. Involvement of thyroid gland is very
rare in COVID-19 infection than any other systems of the body.
We described a 41-year-old female with subclinical thyroiditis
most likely related to corona virus infection and reviewed literatures regarding cases of thyroiditis due to COVID-19 have been
reported. The objective of this article is to create awareness regarding this novel entity and the association with thyroid dysfunction
Critical Illness Polyneuromyopathy (CIPNM) is frequently present in critically ill as a certain degree of symmetric extremity paresis and respiratory muscle weakness. The consequences of this complication may last for months or years after severe illness. It prolongs the stay in ICU and dependence onmechanical ventilation, increases long-term disability and care costs. We report a 58-year old female patient admitted to our Intensive Care Unit for acute respiratory insuffi ciency due to infl uenza pneumonia and acute respiratory distress syndrome. Thirty-three days of mechanical ventilation and 11 days of extracorporal membrane oxygenation were complicated by severe CIPNM, tetraparesis, mental disorders, and diffi culties in weaning off mechanical ventilation. No specifi c therapy is available for treatment of CIPNM. Preventive, supportive and rehabilitation measures are discussed in the article.
Neurological Manifestations of COVID-19 InfectionSudhir Kumar
COVID-19 primarily affects respiratory system, however, it can affect other systems too, including nervous system. This presentation offers details about neurological symptoms and disorders seen in patients with COVID-19.
Scott Letendre, MD
Professor in Residence
Division of Infectious Diseases & Global Public Health
Departments of Medicine and Psychiatry
University of California, San Diego
The coronavirus disease outbreak has proven to be a major health crisis affecting virtually every facets of our lives.
Coronavirus disease is an ongoing pandemic disease. The disease which is caused by a new type of virus, known as severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many patients hospitalized with COVID-19 will develop muscle
weakness particularly those admitted in intensive care unit (ICU). Studies have shown that muscle weakness is one of the
direct consequences of critical illness. We systematically reviewed literature that quantified changes in muscle strength and it
relationship with COVID- 19 in Intensive care unit in humans.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Transverse myelitis is a pathology, whose etiology is associated with autoimmune or infectious diseases, which directly affects the spinal cord, coursing with motor, sensory and acute or subacute dysfunction9. We report a case of a 32-year-old multiparous woman who, after the first postpartum day, reported pain and paresthesia in the lumbar and lower limbs with progressive worsening. Patient started clinical investigation, with orthopedic causes ruled out, together with the neurology and neurosurgery team. She underwent magnetic resonance imaging of the thoracic and lumbar spine where infectious neuropathy was evidenced at L4-L5. Patient was transferred to a referral hospital where Mycobacterium tuberculosis was evidenced as the cause and, when performing a rapid test for SARS-CoV-2, it was positive.
Managment Of Long Term Care In Era Covid-19komalicarol
COVID-19 gives the chance to address long-term care categories
that are sometimes disregarded and undervalued, such as nursing
and residential homes, as well as homecare. Each method of delivering long-term care must meet the highest possible standards
of ongoing care and quality of life. More study and evaluation are
needed to aid decision-making and policy-making, particularly on
the cost-effectiveness and cost-quality elements for each country,
region, or system.
Renal failure and Quality ofLlife Indicators in Kidney Transplantationkomalicarol
Health-related quality of life (HRQL) contains many aspects of
patients' health such as physical, psychological, social functioning
and a general well-being. Progress in renal transplantation and immunosuppressive therapies have increased significantly in recent
decades, resulting in allograft survival rates at one year is now
over 90%. Numerous clinical trials have established the importance of quality of life in a variety of diseases, and it is extremely
popular to evaluate quality of life in clinical trials as a measure of
patients' subjective state of health. The purpose of the study was
to identify factors associated with quality of life after renal transplantation.
A case of childhood Burkitt's lymphoma with gingival swelling as the first sy...komalicarol
Burkitt's lymphoma (BL) is a highly infiltrative malignant lymphoma caused by germinal B-cell differentiation. There are several oral symptoms of BL, including tooth mobility, pain, gingival swelling, maxillofacial swelling and pain, and facial sensory
disturbances. In this paper, we report a case of BL in a 4-year-old
child who initially presented with gingival swelling. The diagnosis of BL/leukemia (stage IV) was confirmed by the bone marrow
examination, bone marrow flow cytometry, and B lymphocytoma
mutation gene screening test. After chemotherapy, the general
condition improved, and then there was swelling and pain in the
right cheek. Considering the recurrence of the disease, the patient
died half a year later. This case is characterized by BL with oral
symptoms as the first symptom, emphasizing the important role of
physicians in early detection of systemic disease
Neuropsychiatric Profiles of Brivaracetam: A Literature Reviewkomalicarol
Anti-seizure medications (ASMs) can cause cognitive or behavioral adverse drug reactions, which is a significant consideration
when selecting an appropriate ASM. Brivaracetam (BRV) is a
newer synaptic vesicle protein 2A ligand, which is expected to
have less neuropsychiatric adverse effects due to its mechanism of
action. To understand the impact of BRV on cognition and behavior compared with other ASMs, we conducted literatures searching
from PubMed and MEDLINE databases. After the screening process, a total of two animal studies, one randomized controlled trial, one pooled-analysis of clinical trials, one controlled study and
nine observational studies were included. Animal studies showed
that BRV did not worsen cognition or behavior performance in rodents. Human studies showed that BRV had less cognitive adverse
events compared with other second or third generation ASMs. In
addition, currently available evidence suggests that behavioral disturbance is less common with BRV compared with levetiracetam.
This review revealed that BRV has a limited impact on cognition
and behavior. For patients who are intolerant to levetiracetam
and have levetiracetam-related behavioral side effects, switching
to BRV could be beneficial. However, the heterogeneity between
studies makes the quality of the evidence weak and further trials
are needed to confirm the findings.
Clinical and evolutionary features of SARS CoV-2 infection (COVID-19) in chil...komalicarol
Starting with December 2019 the medical world has faced a
new challenge as a consequence of a new type of coronavirus-2019-nCoV, similar to several familiar strains that determine
a comparable symptomatology (SARS- severe acute respiratory syndrome, MERS- Middle East severe acute respiratory syndrome), subsequently named SARS CoV-2, while the disease it
causes- COVID-19. The virus is of animal origin and through an
intermediate host (probably also a mammal) it suffered genetic
changes thus acquiring human cells receptors. In consequence,
SARS CoV-2 virus affects both children and even more frequently where it determines more severe clinical forms of disease. In
children, COVID-19 has various clinical forms, from asymptomatic ones to severe ones, complicated by multisystem inflammatory
syndrome (MIS-C Multisystem Inflammatory Syndrome – Child
or PIMS - TS (Paediatric Multisystem Inflammatory Syndrome
temporally associated with COVID-19) that sometimes can lead
to death
Viral load and antibody responses in an asymptomatic/minimally symptomatic SA...komalicarol
Asymptomatic patients with severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), are silent carriers of the disease. We
aimed to characterize their dynamics of disease occurrence, viral
shedding and antibody responses using a cohort of asymptomatic/
minimally symptomatic patients from Sri Lanka during the first
wave of COVID-19.
Vonlay; A paradigm shift in post endodontic restoration: A case report.komalicarol
Porcelain veneers have long been a popular restorative option that
have evolved into a well- accepted treatment that can be fabricated
in various ways. Onlays are another common treatment modality
used in contemporary dentistry to restore large areas of decay and
to replace old restorations. With the availability of newer highstrength materials such as lithium disilicate and processing technologies like CAD/CAM and heat pressing, dental professionals
are now able to produce highly esthetic, high-strength restorations
that blend seamlessly with the natural dentition while also withstanding posterior occlusal forces. A tooth more complex restoration is required after endodontic treatment when compared to normal tooth restoration, because of factors such as extensive caries,
post-treatment root canal dentin and even the economics condition
of the patient.One such design proposed by Dr.Ronald E Goldstein
is “Veenerlay”or “Vonlay”. Vonlay is a blend of an onlay with an
extended buccal veneer surface for use in premolar region, where
there is sufficient enamel present to bond. This restorative option
requires a much less invasive preparation than a full coverage
crown but provides the same structural benefits. Thus, the aim of
this case report is to present a case of Vonlay following endodontic
treatement of lower mandibular premol
A COVID Journey in Diabetes: T1D Diabetes Patient 44 years - Winning in Insul...komalicarol
Complications of Hypoglycaemia, Hypoglycaemia
and Neuroglycopenia are often encountered by patients treated
with insulin. It is feared by patients and families often leading to
emotional and mental scars and can affect lifestyle and confidence.
Hypoglycaemia can occur in premature babies, persons with hypopituitarism and Addison’s Disease. Low blood glucose can affect
athletes and the elderly leading to falls. Cases are individual and
often difficult for families, clinicians, lawyers and courts to understand.
Loops Around the Heart – A Giant Snakelike Right Coronary Artery Ectasia with...komalicarol
Coronary artery dilatation is an uncommon finding and is incidentally found during diagnostic coronary angiography or at necropsy.
The pathogenesis of dilatation of coronary arteries is still not very
well understood and therapeutic strategies are not clear. It is useful to know the difference between aneurysm and ectasia. In this
report we demonstrate the diagnostic workup of an asymptomatic
patient with a remarkable snakelike dilatation of the right coronary
artery with unique convolute. For the first time we used intracoronary injection and simultaneous echocardiographic visualization
of contrast agent (Sonovue) to proof a fistula to the coronary sinus.
Like our patient, most of the patients are asymptomatic in absence
of coronary artery disease and we decided on a conservative approach because of his very complex anatomy
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Although papillary thyroid carcinoma is a relatively common form of malignancy, metastatic spread to the skull
is exceptional. Here, we report a case of papillary thyroid carcinoma revealed by frontal skull metastasis.
Diabetes and Covid-19 Pandemic - A T1 Patient Perspective - Derek C Beattykomalicarol
A patient treated and cared for by NHS Scotland and NHS England
the author has in his 44 years T1D Diabetes journey experienced
surgery provided by the NHS by way of Vitrectomy, Ophthalmic
laser and correction, and Orthopedic knee correction following
a balance issue associated with IV antibiotic treatment for Otitis
Externa and Osteomyelitis associated with long term T1 Diabetes
with neuropathy. Interestingly IV antibiotic treatment led to glycemic issues offering explanation as to why on occasion glycaemia
abnormalities can occur with antibiotic treatment for infection.
Growth Charts-Curves of Children's Height - How to Construct Themkomalicarol
A person born in 1990, for example, grew to one year old on his/
her birth day in 1991 and 17 years old in 2007. No one grows
to their 17 or 20 years old instantaneously. It takes a long-capricious time of mental and physical activities to grow. As regards
children’s milk consumption, for example, school lunch programs
were put into in practice on national scale only in the late 1990s.
Those in their late adolescence in 2007 were not the beneficiaries
of free milk, when they were in primary school.
Dermatological health in the COVID-19 erakomalicarol
COVID-19 and its impact on dermatological health was reviewed
from theoretical and statistical frameworks in the present study. A
cross-sectional and retrospective work was documented with a selection of sources indexed to Scopus, considering the period from
2019 to 2022, as well as the search by keywords. Approaches were
discussed in order to outline a comprehensive model that considered the differences between the parties involved, as well as their
relationships in a risk context. The proposal contributes to the state
of the question in terms of the prediction of contingencies derived
from the probability and affectation of dermatological health
The Importance of Framing at the Beginning of an Review Dialoguekomalicarol
Long-term care of patients with chronic conditions in general practice rarely focuses on the treatment process. A specific interaction
tool, the Review Dialogue (RD), has been developed to integrate
patients’ health-related problems/risks as well as coping strategies
and to agree upon shared treatment objectives assuming that periodical RDs will help to achieve them. Initiated by the GP, the RD
changes the role expectations of the patient and doctor. Therefore,
the framing of the encounters is of particular importance.
Early detection of interstitial lung disease in asymptomatic patients with 2-...komalicarol
Pulmonary involvement is a common manifestation of Dermatomyositis (DM), the most frequent histologic pattern being Interstitial Lung Disease (ILD) which is a major contributor to
morbidity and mortality in these patients. Therefore, this disease
should be investigated and it is essential to perform pulmonary
function tests (PFTs) and High-Resolution Computed Tomography
(HRCT) early in the course of the disease to make a definitive
diagnosis. Nowadays, 2-deoxy-2-[18F] fluoro-D-glucose positron
emission tomography/computed tomography
Association between Galectin-3 and oxidative stress parameters with coronary ...komalicarol
Galectin-3 (Gal-3), as a mediator of inflammation and fibrosis, has been reported to be a biomarker of severity in
coronary artery disease (CAD). The study aimed to assess the relationships between coronary artery disease (CAD) and risk factors,
including parameters of oxidative stress in Tunisian patients CAD.
The risks of using 2,4?dinitrophenol (2,4?DNP) as a weight loss agent: a lite...komalicarol
The prevalence of obesity has steadily increased in response to
changes in diet and physical activity patterns over the past 10
years, becoming one of the leading causes of morbidity and mortality worldwide. In addition, the popularity of social networks
has increased social and cultural pressure for the search for the
“perfect body”. These factors result in the search for fast and unconventional methods of weight loss, such as the use of weight
loss accelerating drugs. 2,4-Dinitrophenol (2-4-DNP or DNP) is
an industrial chemical used to lose weight quickly. Due to its great
potential for toxicity, its use has been banned in several countries
since 1938
Height is a measure of consumption that incorporates nutritional needs: When ...komalicarol
Japan suffered heavily from WWII. Per capita food supply was
1,450 and 1,700 kcal/day in 1946 and 1947, respectively. Japan’s
economy quickly recovered to the pre-war level in 10 years after
the war, 2,200 kcal/day in average food supply in 1955, making
steady progress toward the end of the century. People in Japan,
the younger generations, in particular, learned to eat more animal
products and children started growing taller in height
Successful management of a broken stylet retained in tracheobronchial tree-a ...komalicarol
In Covid-19 pandemic, the use of video laryngoscope for tracheal
intubation is highly recommended due to the increasing distance
between patient’s airway and operator. An endotracheal tube with
an intubating stylet has been proposed to facilitate tracheal tube
insertion, especially when video laryngoscope was used. Thus in
routine anesthesia practice intubating stylet is used as an aid in tracheal intubation for confirmed or suspected Covid-19 infected patients. At the present time, the disposable plastic covered or plastic
bougie is more recommended but in some institutes, the malleable
aluminum stylets are still in use. Though shearing of part of the
stylet has been reported in past but we report a case with as unrecognized broken piece of stylet into his right main bronchus, which
was later extracted immediately and successfully before causing
adverse symptoms or hurts.
Risk Analysis of Secular Trends for a Later Age at MPV of Weight in an Earthq...komalicarol
The Great East Japan Earthquake occurred in 2011, bringing unprecedented damage to the Tohoku region of Japan. Today, after 11
years, the scars from that tremendous damage remain. The health
damage to young school children has been particularly great. One
may imagine a slowing trend in physical growth from the effects
of that disaster, but no clear findings have been reported.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. http://www.acmcasereport.com/ 2
Volume 6 Issue 5 -2021 Case Report
dence of demyelinating disease or space occupying lesion. MRI
dorsal spine with contrast showed an abnormal long segment sig-
nal in thoracic cord extending from C7-T1 through T12 with simi-
lar patchy signal in conus medullaris and mild cord expansion and
enhancement from T5 till T9 segment (Figure 1 and 2).
Figure 2
Figure 1
CSF collected from lumbar puncture revealed normal cell count,
proteins, glucose and normal IgG index. There were no oligoclo-
nal bands detected. CSF cultures and blood cultures showed no
growth.
Furthermore, her ESR, C-reactive protein, thyroid function tests,
vitamin B12 levels and ACE levels were normal. Hepatitis B and
C serology, anti HIV antibody, anti aquaporin-4 antibodies and
ANA were negative. Pan CT scan with contrast showed no evi-
dence of malignancy.
She was given intravenous methylprednisolone 1000 mg for 5
days but there was no improvement in her symptoms. She was
then planned to have plasmapheresis. As a prerequisite before any
procedure, her COVID-19 PCR was sent, which came out to be
positive. This patient did not have any history of fever, respiratory
or gastrointestinal symptoms. Her plasmapheresis was started and
she underwent five sessions of plasmapheresis on alternate day.
She started showing improvement on her third session. After fifth
session she had completely recovered. Hence our diagnosis was
Para-infectious transverse myelitis associated with COVID-19.
4. Discussion
Patient was finally diagnosed as COVID related transverse myeli-
tis. Two rare entities present in our patient were multi-level spinal
cord involvement and improvement with plasmapheresis and not
with intravenous steroids.
Transverse myelitis is a heterogenous neurological disease in
which there is inflammation of spinal cord usually involving the
whole cross section of spinal cord. It is characterized by acute or
subacute spinal cord dysfunction causing weakness and numbness
of limbs, sensory and motor deficit, and autonomic dysfunction
(sexual, bowel and bladder). Its etiologies are acquired demyelin-
ating disorders (multiple sclerosis, neuromyelitis optica, ADEM),
systemic inflammatory autoimmune disorders, para-infectious (vi-
ral; HIV, HSV, EBV, CMV, VZV, bacterial, fungal and even para-
sitic), para-neoplastic, drugs and toxins induced and atopy.
Pandemic of COVID-19 emerged from Wuhan city of China in
December 2019 and thereby spread throughout the world within a
span of few months. It has claimed many lives, and also has caused
significant morbidity in patients who develop ischemic stroke or
who remain on domiciliary oxygen despite resolution of initial
disease.
Exact pathogenesis of acute transverse myelitis secondary to
COVID-19 is unknown. Interleukin-6 is also involved in organ
damage by causing endothelial damage, activation of complement
and coagulation cascade [2, 3]. Cytokine storm is also a pathogen-
ic cause in transverse myelitis [2, 3].
SARS-COV-2 has emerged as a fearful pandemic throughout the
world engulfing many lives.
It is also associated with unusual and unexpected pulmonary and
extrapulmonary manifestations [2]. Most common presenting
symptoms are fever, cough and fatigue but there is also increased
incidence of neurological symptoms including anosmia and dys-
geusia with COVID-19 infection [1]. It clinically presents as var-
ious neurological deficits [2]. Patients usually present with neuro-
logical features such as headache, dizziness, anosmia, taste distur-
bance, ischemic or haemorrhagic strokes, Guillain-barre syndrome
or acute transverse myelitis [2, 4-6].
Probable mechanisms of neurological symptoms are described as
hypoxic metabolic acidosis or immune mediated neuronal dam-
age induced by viral replication as SARS-COV2 binds to ACE 2
receptors and results in their activation and cause increased blood-
brain barrier and immune mediated inflammation [1, 5]. Most like-
ly cause of neurological symptoms is thought to be direct invasion
3. http://www.acmcasereport.com/ 3
Volume 6 Issue 5 -2021 Case Report
of SARS-COV2 on the central nervous system during inflammato-
ry response of body [1]. Corona virus can involve central nervous
system by hematogenous spread or by neuronal transmission [3].
Improvement of symptoms with steroids indicate transverse my-
elitis as immune-mediated response [2]. Elevated ferritin levels are
associated with severe infection and worse outcomes [1, 2].
COVID-19 should be considered as a differential diagnosis in pa-
tients presenting with neurological signs [5, 7, 8]. As patients can
also present with loss of consciousness, ataxia, convulsions and
status epilepticus, so one should be alert regarding COVID-19 as
a cause of transverse myelitis [5]. This pandemic has also caused
increased burden of patients with neurological symptoms [9]. Neu-
rologist and physician should be aware of COVID-19 associated
neurological presentation [8].
5. Conclusion
There are only a few case reports of transverse myelitis associated
with COVID-19. However, keeping in mind that we are still learn-
ing about how differently this virus affects every organ system,
one should keep COVID-19 as a differential and a suspected cause
of causing transverse myelitis.
References
1. Chow CCN, Magnussen J, IP J, Su Y. Acute transverse myelitis in
covid-19 infection. BMJ Case Rep. 2020; 13(8). e236720.
2. Chakraborty U, Chandra A, Ray AK, Biswas P. COVID-19–associ-
ated acute transverse myelitis: a rare entity. BMJ Case Rep. 2020;
13(8).
3. Baghbanian SM, Namazi F. Post COVID-19 longitudinally extensive
transverse myelitis (LETM)–a case report. Acta Neurol Belg. 2020;
18; 1-2.
4. Durrani M. Infectious Acute Transverse Myelitis Secondary to COV-
ID-19, REBEL EM blog, August 27, 2020.
5. AlKetbi R, AlNuaimi D, AlMulla M, AlTalai N, Samir M, Kumar N,
et al. Acute myelitis as a neurological complication of Covid-19: A
case report and MRI findings. Radiol Case Rep. 2020; 15(9): 1591-
1595.
6. Munz M, Wessendorf S, Koretsis G, Tewald F, Baegi R, Krämer S, et
al. Acute transverse myelitis after COVID-19 pneumonia. J Neurol.
2020; 267(8): 2196-2197.
7. Zachariadis A, Tulbu A, Strambo D, Dumoulin A, Virgilio GD.
Transverse myelitis related to COVID-19 infection. J Neurol. 2020;
1-3.
8. Ahmad I, Rathore FA. Neurological manifestations and complica-
tions of COVID-19: A literature review. J Clin Neurosci. 2020; 77:
8-12.
9. Needham EJ, Chou SHY, Coles AJ, Menon DK. Neurological Impli-
cations of COVID-19 Infections. Neurocrit Care. 2020. 32(3): 667-
671.