Oral Manifestations in Covid-19 Patients Among the Bangladeshi Population: A Cross-Sectional Study

Background: COVID-19 is a multi-system all-pervasive disease with protean manifestations, and its major signs and symptoms, such as incessant dry cough, fever, and pneumonia, are well known. Yet, its mucocutaneous manifestations, particularly those of the oral cavity, appear to be little recognized. This may be due either to the rarity of oral manifestations of COVID-19, or poor detection of such symptoms by attending physicians who may do only a cursory examination of the oral mucosa because of the overwhelming gravity of the other major systemic presentations. Nevertheless, there are now a considerable number of reports, including systematic reviews, on oral manifestations of COVID-19 in the literature. This observational study was performed to determine the oral manifestations among COVID?19 patients. Material & Methods:A cross?sectional study was carried out among COVID?19 recovered patients. 120 Covid 19 recovered patients were purposively selected as study samples. All the samples diagnosed as mild and moderate cases of COVID?19 disease were selected based on inclusion and exclusion criteria.Results:The study comprised the majority of males (68%) where females represent (32%) of the study population and the mean age was 39.3±12.4. Oral manifestations among study subjects during and after the disease illness including loss of taste being the commonest symptom (40%), followed by erythema and coated tongue (7.5%), mouth ulcerations (6.7%) and dry mouth (1.7%). The study revealed that the 41-60 age group subjects represented the highest (43%) oral manifestations.Conclusions:Early identification of oral symptoms in COVID?19 recovered or suspected cases can help a dentist or a general physician to diagnose high?risk groups, mitigate transmission, and promote overall health.

Analgesic, antipyretic, anti-inflammatory, and hepatoprotective activities of Pulicaria crispa (Forssk. ) Oliv. (Asteraceae)

Abstract Some plants of the genus Pulicaria have been used in traditional medicines for treating back pain and inflammation. They possess various bioactivities such as antipyretic, analgesic, and hepatoprotective. This study aimed to investigate the potential analgesic, antipyretic, anti- inflammatory, and hepatoprotective activities of Pulicaria crispa (P. crispa) extract (PCE). Analgesic activity was evaluated using the hot plate and acetic acid-induced writhing tests. Antipyretic and anti-inflammatory activities were evaluated using rectal temperature and carrageenan-induced hind paw edema methods, respectively. CCl4-intoxication was used for hepatoprotective activity. Also, liver histopathology was assessed. PCE, at 500 mg/kg, exhibited significant analgesic, antipyretic, and anti-inflammatory effects. The increased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bilirubin of CCl4-exposed rats reflects their liver injury. PCE significantly decreased the elevated liver markers. The hepatoprotective effect of PCE was confirmed, as it successfully reversed the altered levels of total protein, malondialdehyde (MDA), and non-protein sulfhydryls (NP-SH) in the liver tissues of CCl4-exposed rats. Histopathological studies confirmed the hepatoprotective nature of PCE. Pretreatment of rats with PCE reduced the severity of CCl4-induced liver damage. These findings concluded that PCE possesses analgesic, antipyretic, anti-inflammatory, and hepatoprotective activities.

Pneumothorax secondary to acupuncture in an adolescent girl

Although acupuncture is a form of traditional Chinese medicine that is gaining popularity and usage in children, the relevant complications are rarely reported. We present a case of 17-year-old girl who underwent acupuncture. The girl visited the emergency department with chest pain and dyspnea on the day after receiving the acupuncture. A chest radiograph showed a left-sided pneumothorax. She was hospitalized for observation and supplemental oxygen, and improvement was noted on follow-up radiograph. She continued to follow up in the outpatient clinic until complete resolution of the pneumothorax. Raising awareness of the potential complications of acupuncture is crucial to aid in patient education and establishment of safety guidelines.

Pneumothorax secondary to acupuncture in an adolescent girl

Although acupuncture is a form of traditional Chinese medicine that is gaining popularity and usage in children, the relevant complications are rarely reported. We present a case of 17-year-old girl who underwent acupuncture. The girl visited the emergency department with chest pain and dyspnea on the day after receiving the acupuncture. A chest radiograph showed a left-sided pneumothorax. She was hospitalized for observation and supplemental oxygen, and improvement was noted on follow-up radiograph. She continued to follow up in the outpatient clinic until complete resolution of the pneumothorax. Raising awareness of the potential complications of acupuncture is crucial to aid in patient education and establishment of safety guidelines.

Molecular characterization of goose parvovirus in geese of Turkey

ABSTRACT: Goose parvovirus (GPV), also called Derzsys disease, is a viral pathogen that causes high morbidity and mortality in goslings and ducklings. In this study, we perform the molecular characterization of the GPV in Turkey. The definition of similarity to the world of GPV isolates in Turkey and construction of a phylogenetic tree was aimed. For this purpose, the presence of GPV in the liver, spleen, and intestine tissues of nine goslings with symptoms such as dysphagia, bilateral ocular swelling, eye discharge, diarrhea, and fatigue were investigated by real-time PCR method and all samples were detected as positive. According to the data obtained by molecular characterization, phylogenetic analysis of GPV has been presented in Turkey. As a result of this study, it was determined that the GPVs available in Turkey are virulent strains.

RESUMO: O parvovírus do ganso (GPV), também chamado de doença de Derzsy, é um patógeno viral que causa alta morbidade e mortalidade em gansos e patinhos. Neste estudo, objetivou-se a determinação da caracterização molecular do GPV na Turquia, a definição da similaridade com o mundo dos isolados de GPV na Turquia e a construção de uma árvore filogenética. Para tanto, a presença de GPV no fígado, baço e tecidos do intestino de nove gansos com sintomas como disfagia, edema ocular bilateral, secreção ocular, diarreia e fadiga foram investigados pelo método de PCR em tempo real e todas as amostras foram detectadas tão positivo. À luz dos dados obtidos por caracterização molecular, a análise filogenética do GPV foi apresentada na Turquia. Como resultado deste estudo, foi determinado que os GPVs disponíveis na Turquia são cepas virulentas.

Molecular characterization of goose parvovirus in geese of Turkey / Caracterização molecular de parvovírus de ganso em gansos da Turquia

Goose parvovirus (GPV), also called Derzsy's disease, is a viral pathogen that causes high morbidity and mortality in goslings and ducklings. In this study, we perform the molecular characterization of the GPV in Turkey. The definition of similarity to the world of GPV isolates in Turkey and construction of a phylogenetic tree was aimed. For this purpose, the presence of GPV in the liver, spleen, and intestine tissues of nine goslings with symptoms such as dysphagia, bilateral ocular swelling, eye discharge, diarrhea, and fatigue were investigated by real-time PCR method and all samples were detected as positive. According to the data obtained by molecular characterization, phylogenetic analysis of GPV has been presented in Turkey. As a result of this study, it was determined that the GPVs available in Turkey are virulent strains.(AU)

O parvovírus do ganso (GPV), também chamado de doença de Derzsy, é um patógeno viral que causa alta morbidade e mortalidade em gansos e patinhos. Neste estudo, objetivou-se a determinação da caracterização molecular do GPV na Turquia, a definição da similaridade com o mundo dos isolados de GPV na Turquia e a construção de uma árvore filogenética. Para tanto, a presença de GPV no fígado, baço e tecidos do intestino de nove gansos com sintomas como disfagia, edema ocular bilateral, secreção ocular, diarreia e fadiga foram investigados pelo método de PCR em tempo real e todas as amostras foram detectadas tão positivo. À luz dos dados obtidos por caracterização molecular, a análise filogenética do GPV foi apresentada na Turquia. Como resultado deste estudo, foi determinado que os GPVs disponíveis na Turquia são cepas virulentas.(AU)

Association between the Academic Stress Level and Skin Disorders among Albaha University Medical Students, Saudi Arabia

Objectives: Medical students are usually exposed to academic and social isolation in addition to environmental and financial stressors. There is a growing concern about an association between increased academic stress levels and several skin disorders. This paper aimed at assessing perceived stressors and their origins by examining the relationship between academic stress and skin disorders among medical students at the University of Albaha. Methods: A cross-sectional study consisting of 251 medical students from both the male and female sections was conducted. The participants received a self-administered questionnaire consisting of sociodemographic profile and origin of stressors, such as academic, psychosocial, and environmental stressors, and a Perceived Stress Scale (PSS) with a modified form of the self-reported skin disorders. Skin examinations were done via dermatological consultant at Albaha University Medical Centre. Results: Academic stress, in comparison to other types of stressors, represents 80.5% of the origin of stressors affecting stressed medical students. Being female in academic years above the third year was associated with the highest, most significantly perceived stress levels among all students. Loss of hair, pimples beside oily, waxy patches on scalp, itchy skin and troublesome sweating were the top common highly significant dermatological symptoms among all students at different levels of perceived stress. Conclusion: Several skin disorders occur in response to academic stress among medical students.

Prevalent Beliefs and Attitude toward Vitiligo among Public in Al Baha Province, Southern Saudi Arabia

ntroduction: Vitiligo is an apparent skin condition that has a psychological impact on the affected individuals and their families. Its prevalence is estimated to be about (0.5-2%) globally. Misunderstandings, and negative attitudes toward vitiligo patients are the most important factors affecting the quality of life of vitiligo patients. Objective:The objective of this study was to identify the common misconceptions and attitudes about the nature, causes and prognosis of vitiligoin Al-Baha region, Saudi Arabia. Methods:A cross sectional study collected data from the general population in the public malls in Al-Baha region, Saudi Arabia. We used a questionnaire which was developed by the authors, the questionnaire included questions regarding vitiligo cause, nature, prognosis and the attitude toward vitiligo Results:A total of (453) responses were analysed, of which (53%) were females, and (90.9%) were Saudis. Theparticipants’ ages ranged from (16 -64) with a mean of (28.3). The majority of our sample had a high level of education; university (65.1%), High school (26%) and less than high school (6%). Our population believed that gecko and its saliva were the commonest cause (38.1%). Most of the respondents (44.4%) thought that the condition is exaggerated by stress and anxiety. Regarding attitude; (31.5%) are unwilling to marry a vitiligo patient. Conclusion:The results of the present study show that the misconceptions and attitudes toward vitiligo are prevalent. Health awareness campaigns should be implanted to educate the people and improve the quality of life of the affected individuals

Effect of addition of intrathecal midazolam to 0.5% hyperbaric bupivacaine to prolong the post-operative analgesia in lower abdominal surgeries

Background: Bupivacaine when used alone produces analgesia for 2.5 to 3 hours, making it unsuitable in cases where the duration of surgery is longer and in cases which require further analgesia during post-operative period. Present study is intended to evaluate the effect of addition of intrathecal midazolam to bupivacaine to prolong the post-operative analgesia.Methods: Present clinical study was conducted in Kamineni Institute of Medical Sciences, Narketpally, Nalgonda District, Andhra Pradesh, India. After obtaining approval from institutional ethical committee, present clinical study was undertaken to evaluate the effects of addition of intrathecal midazolam to bupivacaine 0.5% (heavy). The study was conducted on 60 patients undergoing lower abdominal surgeries.Results: Mean onset of analgesia was 190.5 with SD 21.3 in group-C whereas in group-M, mean onset of analgesia was 185.3 with SD 26.81. Mean difference between the groups not showing statistical significance. In the present study the Maximum height of sensory blockade in control and midazolam group was T7 (T6-T8) compared to T7 (T6-T8) midazolam group. Mean duration of sensory blockade was 130.4 with SD 36.36 in group-C whereas in group-M, mean duration of sensory blockade was 191.9 with SD 36.4. Mean difference between the groups showing statistical significance. Mean duration of motor blockade was 176.3 with SD 23.7 in group-C whereas in group-M, mean duration of motor blockade was 208.1 with SD 18.21. Mean difference between the groups showing statistical significance.Conclusions: Midazolam is a useful adjuvant to bupivacaine in subarachnoid block. Intrathecal midazolam combined with intrathecal bupivacaine produces a longer and more effective anaesthesia and analgesia. It also prolongs post-operative analgesia without increasing adverse effects.

Pulmonary arteriovenous malformation: a culprit of middle lobe syndrome?

Middle lobe syndrome [MLS] refers to lobar atelectasis and bronchiectasis and is either obstructive or non-obstructive type. A 63-year-old asthmatic female patient presented with recurrent pneumonia and unrelenting cough which proved to be due to pulmonary arteriovenous malformation that led to obstructive MLS. CT scan showed right middle lobe volume loss, bronchiectasis and dilated pulmonary vessels. The patient was operated for right middle lobectomy. The pathological examination revealed pulmonary arteriovenous malformation with post obstructive changes. Pulmonary arteriovenous malformation should be part of the differential diagnosis of MLS and should prompt early referral for surgery. Middle lobe is anatomically susceptible to obstruction of the bronchus and to atelectasis due to its poor drainage and ventilation. Conservative treatment with antibiotics, bronchodilators, and chest physiotherapy are effective in 33.3 to 66.6% of patients. Lobectomy is required in a third of MLS patients who fail conservative management or have persistent symptoms that last more than 6 months or have malignant obstruction

Correlation between Anthropometric Measures, Lipid Profile and Serum Adiponectin and Steatosis in Nondiabetic Nonalcoholic Fatty Liver Disease.

Aims: To assess the relation between the grade of steatosis and anthropometric measures, lipid profile and serum adiponectin in non-diabetic patients with nonalcoholic fatty liver. Study Design: Cross sectional study. Place and Duration of Study: Department of Tropical Medicine and Gastroenterology, Qena faculty of medicine, South Valley University. Methodology: Fifty patients with US evidence suggestive of fatty liver disease and normal fasting and post-prandial serum glucose were included. No past or current history of alcohol consumption. Blood samples were taken to detect liver function tests, fasting lipogram, complete blood count and serum adiponectin. Body mass index (BMI) and waist circumferences (WC) were measured for all patients. Liver biopsy was done to detect the presence and the degree of steatosis. Results: The mean age of patients was 40+/-12 years. Patients with steatosis showed significantly higher value for BMI and WC than those without (P value =0.000). Cholesterol, triglyceride and Low density lipoprotein-cholesterol (LDL-C) also were significantly higher in patients with steatosis (P value =0.00). High density lipoprotein-cholesterol (HDL-C) and serum adiponectin were significantly lower in patients with steatosis (P value =0.00). Patients with severe steatosis showed significantly higher values for BMI and WC, cholesterol, triglyceride, LDL-C and lower values for HDL-C and adiponectin (P value = 0.05) than those with mild or moderate steatosis. Positive correlations were detected between the age, BMI and WC, cholesterol, triglyceride, LDL-C and the grade of steatosis and negative correlations with HDL-C and adiponectin. Conclusion: Anthropometric measures, lipogram and serum adiponectin are associated with progression of steatosis in nondiabetic patients with NAFLD. So their detection is important for evaluation and management.

Laboratory diagnosis of urinary tract infections using diagnostics tests in adult patients.

Background: The primary aim of this study was to evaluate laboratory diagnosis of urinary tract infection using diagnostics tests in adult patients. Methods: Among the diagnostic tests, urinalysis is useful mainly for excluding bacteriuria. For isolation of pathogenic bacteria semiquantitative culture techniques was used and biochemical tests were done to differentiate Gram +ve and Gram –ve bacteria. Results: The incidence of pathogenic infection caused by Escherichia coli accounts for 216 cases (60%) followed by Pseudomonas, Staphylococcus aureus and Klebsiella. Conclusion: Physicians should distinguish urinary tract infections caused by different organisms for an effective treatment and appropriate clinical information gives clues for better diagnostic evaluation and their susceptibility to antimicrobial agents as well addressing host factors that contribute to the occurrence of infection.

Role of CT scan in the Evaluation of Lung Tumor with Cytopathilogical Correlation.

Lung cancer is an important & widespread disease that contributes a major health problem worldwide. Lung cancer kills over 1 million people per year. Cigarette smoking is the major cause of lung cancer. CT scan is the principal radiological examination adjunct to X-Ray chest examination in diagnosis & management of lung cancer. The main Objective of the study was to assess the diagnostic usefulness of CT scan in evaluating & characterize the different types of lung tumors and to correlate CT findings of lung tumors with that of cytopathology. This study was carried out in the department of Radiology & Imaging, Dhaka medical college hospital, Dhaka during the period from 1st January 2007 to March 2008. It was a cross sectional study. Total 51 patients were selected conveniently, detailed history particularly symptoms related to lung tumors was carefully elicited to obtain maximum possible information regarding the illness. Possible diagnosis was established by the combination of history, physical examination, laboratory & radiological investigations. Then patients were underwent CT examination of lung. Cytopathological sample were obtained from the lesion by guided aspiration. Collected FNAC samples were send for cytopathology & collected reports were compared with CT scan reports. Sensitivity of CT to diagnose lung tumor was 97.4%, specificity 76.9% & accuracy 92.2 %.

Role of portal haemodynamic parameters in prediction of oesophageal varices in cirrhotic patients

Screening all cirrhotic patients by endoscopy for detection of varices is not cost-effective as the number of patients increases by time and half of them still would not have developed varices 10 years after being diagnosed with cirrhosis. Therefore, this study aimed to evaluate hepatic haemodynamic Doppler parameters in predicting the presence of oesophageal varices [OVs] in cirrhotic patients for better selection of those actually needed for screening endoscopy. Eighty-one patients with liver cirrhosis, 32 females and 49 males, with a mean age of 50.7 +/- 11.7 years were recruited for the study. They included 61 patients with OVs and 20 patients without varices. The diagnosis of liver cirrhosis was based on clinical history, examination, and investigations. Liver function and kidney function tests and complete blood count [CBC] were performed for all patients. All patients underwent abdominal ultrasound [US], upper endoscopy, and hepatic Doppler US examination. The portal vein velocity [PVV] and liver vascular index [LVI] showed statistically significantly lower values in patients with OVs than those without OVs [p value = 0.02 and 0.000, respectively]. The congestion index [CI] of the portal vein, the portal hypertension index [PHI], and the splenoportal index [SPI] showed statistically significantly higher values in patients with OVs than those without OVs [p value = 0.006, 0.001, and 0.001, respectively]. CI and SPI were the best parameters that could predict the presence of OVs with high sensitivity, specificity, and diagnostic accuracy when cutoff values were set at >0.069 and 3.57, respectively [area under the curve = 0.864 and 0.894, respectively]. The CI of the portal vein and SPI are good predictors for the presence of OVs in cirrhotic patients, and could be used noninvasively to decrease the burden on the upper endoscopy unit by proper selection of those who are candidates for screening endoscopy

Trends In Firearm Injuries Related To Accidental Causes: A Study.

Gunshot wounds are the second leading cause of death after road traffic accidents within young population in many countries which is the most productive section of the society. This study describes demographics, causative factors, intent, incident locations of firearm injuries and gun-related activities in which patients were engaged at the time of injury among patients treated in hospital emergency departments for unintentional firearm-related injuries. It is a prospective study conducted over a period of 1 year i.e. May 1, 2007 to April 31, 2008 and all the cases of Gunshot Injuries (GSI) that presented to the casualty department of Jawaharlal Nehru Medical College & Hospital (JNMCH), Aligarh, INDIA were analysed. The information of the cases was obtained from casualty records, history and examination of patient and photograph of the patient's wounds. Parameters studied are age, sex, site of wounds, weapon used, circumstances leading to injury and shot by whom. A total of 198 cases of firearm related injuries reported and 50 were found to be due to unintentional causes. These injuries are most common in children (28%) and most common cause was ceremonial firing (40%). Head and neck region is most commonly affected (34%) followed by trunk (30%). Most frequently used weapon is shotgun (50%). Firearm injuries are one of the emerging causes of unintentional injuries to children and youth. This study suggests that efforts should be made to limit unsupervised access to firearms, to promote safe storage of firearm and apart from strict licensing law, medical assessment is recommended.

Do the values of prostate specific antigen obtained from fresh and dried urine reflect the serum measurements?

To investigate if free PSA [fPSA] and total PSA [tPSA] values obtained from simultaneously collected urine, fresh and dried on filter paper, reflect the serum free and total PSA. The sera and 20 cc first voided urine from 33 consecutive men aged between 40 and 84 [mean 61 +/- 12], were collected in the morning and delivered to the laboratory. Three different aliquots of 100 microgram urine were taken with automatic pipette and dropped on 3 certain areas of a filter paper and allowed to dry for each patient. On each paper, borders of dried urine were marked. PSA values were obtained from the sera and fresh urine samples and recorded. Later on particular days dried urine samples were dissolved and eventually PSA values were derived and recorded again. The results were compared to each other. Correlations were evaluated by using an SPSS statistics program. Serum PSA values correlated weakly [r <0.24] with fresh and dried urine PSA values. While PSA in fresh and dried urine samples showed strong correlation [0.5< r < 0.74], a very strong correlation [r >0.75] among PSA values of dried urine samples of 1-day, 7- and 28-days, were seen. We conclude that PSA values obtained from fresh and dried urine could not reflect serum PSA values. But, because dried urine on a filter paper can be stable for years, it could be used for forensic purposes

Percutaneous Needle Biopsy-An Assertive Tool In The Diagnosis of Bone Tumors in Under Developed Countries.

Our study on 106 cases of bone tumors aims at correlating the clinical, radiological and cytological findings of benign and malignant tumors of bone and evaluating the usefulness of percutaneous biopsy as a diagnostic tool in underdeveloped countries. Giant cell lesions were the most common benign tumor, 42 cases (84%) and giant cell tumor was the most common giant cell lesion in our study, 27 (64.3%). Round cell tumor appeared to be the most common malignant tumor of bone, 20 cases (35.7%). Osteosarcoma represented 15 cases (14.2%) of all bone tumors and 26.8% of all malignant bone tumors in our study. Final histopathological diagnosis was available only in 54 cases. Out of which 53 cases showed concordance with previous cytological diagnosis. Only a single case of chondrosarcoma was misdiagnosed as chondroma on FNAC (false negative). The sensitivity and specificity of FNAC was 96.0% and 100% respectively while positive predictive value and negative predictive values were 100% and 96.7% respectively. The diagnostic accuracy in our study was 98.1%.

Antioxidant and antihyperglycemic activities of methanolic extract of Glinus oppositifolius leaves.

The present study was carried out to investigate the antioxidant and antidiabetic potential of methanolic extract of Glinus oppositifolius leaves. The antioxidant potential was examined by DPPH radical scavenging assay, nitric oxide (NO) scavenging assay, determination of total flavonoid content and total antioxidant capacity assay. Antihyperglycemic activity was studied by oral glucose tolerance test (OGTT) in normal mice and in alloxan-induced diabetic mice. In DPPH radical scavenging assay the IC50 value of the extract was found to be greater than 1000 μg/ml (ascorbic acid, IC50 = 14.45 μg/ml) while it was 269 μg/ml in nitric oxide (NO) scavenging assay (quercetin IC50 = 15.24 μg/ml). The amount of total flavonoid was 25 .46 mg/g and total antioxidant activity was 79.48 mg/g equivalent to Quercetin and Ascorbic acid respectively. A significant effect (p<0.05) on oral glucose tolerance was noted at the dose of 200 mg/kg and 400 mg/kg body weight in mice. At the same doses, the extract showed significant (p<0.05) reduction of blood glucose level in Alloxan-induced diabetic mice compared to the standard drug Metformin. Overall, the results of the present study indicate that the methanolic extract of Glinus oppositifolius leaves possess moderate antioxidant activity and significant antihyperglycemic activity.

Effect of Ethanolic Extract of Swietenia mahagoni Seeds on Experimentally Induced Diabetes Mellitus in Rats.

Diabetes mellitus is a heterogeneous group of syndromes characterized by an elevation of blood glucose caused by a relative or absolute deficiency of insulin. The incidence of diabetes is growing rapidly worldwide. Drug treatment for diabetes mellitus is expensive and carries risks for many adverse effects. Bangladesh is a rich emporium of medicinal plants useful in the treatment of diabetes. The study was performed to investigate the blood glucose lowering effect of Swietenia mahagoni seeds in experimentally induced diabetic rats. Twenty four healthy Long Evans Norwegian strain of rats were included in the study and divided into four groups (A, B, C and D) comprising 6 rats each. Diabetes was induced by alloxan (120 mg/kg body weight). Administration of ethanolic extract of Swietenia mahagoni seeds (group-B) produced no significant change in the blood glucose level as compared to control (group-A). Administration of ethanolic extract of Swietenia mahagoni seeds in group-D produced a significant reduction in blood glucose level as compared to diabetic control (group-C). Histological examination of pancreas showed destruction of beta cells in Islets of pancreas in group-C whereas retaining of islets and few degranulations of beta cells of pancreas found in group-D. These observations and results provide information that ethanolic extract of Swietenia mahagoni seeds has hypoglycaemic effect in experimentally induced diabetic rats which requires further investigation.