Burning Feeling Research Articles

Determinants of likelihood and extent of adoption of medicinal plants used for the treatment of cattle diseases in Fufore Local Government Area, Adamawa State, Nigeria

The study analyzed the determinants of likelihood and extent of adoption of medicinal plants used for the treatment of cattle diseases in Fufore Local Government Area, Adamawa state, Nigeria. Semi-structured questionnaire was used to collect personal data of cattle herders, adoption pattern of the medicinal plants by the respondents and constraint against effective utilization of the medicinal plants by the respondents. Frequencies, percentages, mean and probit regression analysis were used to analyzed the data collected. Results of the research revealed that cattle herding in the study is dominated by young adults (71.03%) of between 30 to 59 years of age, majority (75.70%) did not attained formal education, and had 31 years average herding experience. About 94.39% of the respondents were married with average family size 8 people. Majority (85.05%) of the respondents have more 50 heads of cattle with only 11.21% who had at least extension visit once in 6 months. Result of adoption pattern revealed that 90.65% of the respondents adopted both medicinal plants and modern veterinary drugs in treatment of cattle diseases. The coefficient of age (4.8784), family size (0.1675), experience (1.2239) and number of cattle (0.0202) had positive and significant effect on the adoption of medicinal plants. Similarly, marginal effect of the variables determining adoption of medicinal plants by the respondents shows that age (0.0252), family size (0.0008), experience (0.0063) and number of cattle (0.0001) were positively related. Indiscriminate feeling of trees, bush burning and concealment of knowledge were the major problems faced the respondents. It was recommended that, conservation of medicinal plants, documentation and promotion of indigenous knowledge by encouraging research activities is required in the study area. Both community and concerned authorities should enforced to laws that prohibit indiscriminate cutting of trees and bush burning so as curb looming danger of loosing value medicinal plants. Research institute should investigate to ascertain the precise dosage of herbs to be used in the treatment and control of cattle diseases.

Investigation of the psychological factors associated with fissured tongue

ABSTRACT Objective: This study aimed to investigate the correlation between FT and anxiety. Methods: The sample consisted of 95 participants categorized into two groups: a) G-FT, 48 patients with FT and b) CG, 47 healthy participants. All patients were submitted to complete oral and dermatological examinations. The anxiety levels were measured using the State-Trait Anxiety Inventory (STAI). A p-value of < 0.05 was considered significant. Results: Fourteen (30%) patients reported awareness of having FT and 9 (64%) were women. Symptoms like burning feeling were reported by 3 (6%) only patients, all of then women. None of the control group patients presented these symptoms. In both groups, control and FT, the average scores of trait-anxiety were slightly higher than state-anxiety. There were no statistically significant differences between the FT and the control group related to the state-anxiety (p=0.724) and the trait-anxiety (p=0.680) scores. Study limitations: This study was limited by the number of subjects. Conclusion: Although moderate state-anxiety and trait-anxiety scores were determined, anxiety, as an environmental factor may not play a significant role in the development of FT. Considering FT as a multifactorial disease, probably a genetic component is necessary for expression.

RASA TERBAKAR DI MULUT PADA PEMAKAIAN GIGI TIRUAN

Burning sensation in the mouth is a condition that is characterized by spontaneous burning or uncomfortable feeling in the mouth without being followed by the real cause. The predisposing factors are divided into three factors : local factors, systemic and psychogenic. The use of denture is a local predisposing factor of burningsensation in the locally in the mouth. The treatments were performed in patients with a burning sensation in the mouth are is a top priority. Management steps in patient burning sensation in the mouth, are to, find the local etiology factors in oral or systemic and then traet the patient according to the cause.

Application value of the modified Overlap esophagojejunostomy in totally laparoscopic total gastrectomy

Objective To investigate the application value of the modified Overlap esophagojejunostomy in totally laparoscopic total gastrectomy (TLTG). Methods The retrospective cross-sectional study was conducted. The clinicopathological data of 32 patients who underwent TLTG with modified Overlap esophagojejunostomy in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine between January 2015 and December 2017 were collected. The main points of the modified Overlap method: surgeons stood on the right of patients when digestive tract reconstruction, suspension of left half liver and clockwise rotation before esophageal transection were performed, regulating esophageal opening position and building jejunal loop, and then closing openings using 45.0 mm Endo-GIA and barbed wire. Patients who were diagnosed as ⅠA stage by postoperative pathological examination were followed up; patients with lymph node metastases underwent chemotherapy of XELOX regimen and patients in ⅠB and Ⅱ stages without lymph node metastases underwent oral S-1 single agent. Observation indicators: (1) surgical and postoperative recovery situations; (2) follow-up and survival situations. Follow-up using outpatient examination and telephone interview was performed to detect postoperative adjuvant therapy, long-term complications and survival up to March 2018. Measurement data with normal distribution were represented as ±s, and measurement data with skewed distribution were described as M (range). Results (1) Surgical and postoperative recovery situations: all the 32 patients underwent successful TLTG and modified Overlap esophagojejunostomy. The operation time, esophagojejunostomy time, volume of intraoperative blood loss, time to initial anal exsufflation, time for initial fluid diet intake, time for initial semi-fluid diet intake and time of postoperative drainage-tube removal were respectively (227±19)minutes, (22±7)minutes, (69±11)mL, (2.1±0.5)days, (3.4±0.4)days, (4.9±0.6)days and (7.5±1.7)days. There was no anastomotic stoma-related complication in 32 patients. One patient was complicated with duodenal stump leakage at 5 days postoperatively and was cured by continuous three-cavity irrigation and conservative treatment. Results of postoperative pathological examination: number of lymph node dissected in 32 patients was 32±4. TNM staging: 1, 5, 7, 11, 6, 1 and 1 patients were detected respectively in ⅠA, ⅠB, ⅡA, ⅡB, ⅢA, ⅢB and ⅢC. Duration of postoperative hospital stay of 32 patients was (8.1±2.1)days. (2) Follow-up and survival situations: 32 patients were followed up for 3-38 months, with a median time of 18 months. During the follow-up, in addition to 1 patient in IA stage, 31 patients underwent postoperative adjuvant therapy; patients can take the common soft food, without symptoms of choking and burning feelings, and gastroscopy reexamination was performed at 6 months postoperatively and showed anastomosis patency. One patient died of malignant tumor of maxillary sinus at 9 months postoperatively, 1 was detected liver metastasis at 20 months postopeartively and survived with tumor, the other patients had no tumor recurrence or metastasis. Conclusion The modified Overlap esophagojejunostomy is safe and feasible in TLTG, with good short-term outcomes. Key words: Gastric neoplasms; Gastric carcinoma, upper; Carcinoma of esophagogastric junction; Radical resection; Total gastrectomy; Digestive tract reconstruction; Esophagojejunostomy; Laparoscopy

Analysis of Fatty Acid Composition of Crude Seed Oil of Lactuca sativa L. by GC-MS and GC Methods

Lactuca sativa L. (Garden Lettuce), is an edible herb cultivated in Iran and other parts of the world. In Traditional Iranian Pharmacy books, garden lettuce is named Kass Bostani and Hakim Aqili classified it as a Ghazā'ye Dawā'ee (Ghazā means Food; Dawā means Drug). It is said to be soporific, prescribed to cure insomnia and to be useful in thirst and feeling of hotness and burning in the stomach. Seeds of this herb reduce semen, suppress libido and are useful in cases of frequent nocturnal emissions. Fixed oil obtained from seeds of this plant is reputed to have hypnotic and brain moistening properties. In this study we aimed to analyze the fatty acid composition of the crude seed oil of Lactuca sativa L. Methyl esterification of the fatty acids was performed by the method of Ken'ichi Ichihara et al but with a slight modification. Components of the oil were then extracted by n-hexane and analyzed by Gas chromatography-Mass spectroscopy and Gas Chromatography methods. Identified constituents which represented 98.20% of the total elutes were the methyl esters of linoleic (52.38%), oleic (34.42%), palmitic (7.25%), stearic (2.66%), arachidic (1.32%) and myristic (0.17%) acids. Total percentages of methyl esters of the saturated and unsaturated fatty acids identified in our examined oil are 11.4 and 86.80% respectively. In conclusion, seed fat of Lactuca sativa L. like many other plant fats, is rich in unsaturated fatty acids.

Evaluation of selected skin parameters following the application of 5% vitamin C concentrate.

Ascorbic acid is a substance with confirmed anti-free-radical properties. It triggers the collagen synthesis, has a depigmenting effect and seals blood vessels. All these properties have a significant effect of the skin's appearance. The characteristic traits of capillary skin include telangiectasias as well as erythema, which might consolidate in the future, along with the feeling of burning and increased skin sensitivity. Study and evaluation of selected parameters of capillary skin after the application of 5% vitamin C concentrate throughout the period of 6weeks with the use of instrumental tests and questionnaires. The research was conducted on a group of 30 women ranging from 30 to 60years of age with capillary skin indicating visible signs of erythematous plaques. The concentrate was applied once a day. Analyses of skin conditions were conducted four times: before the launch of the research D(0), after two 2D(14), after four 4D(28), and after 6 D(42) weeks of application. The research was conducted with the use of Mexameter MPA equipment, which was used to measure changes in the intensity of erythematous plaques. The depth of wrinkles was measured by PRIMOS system (two times D0 and 6D(42). The research also used VISIA system which allowed to perform visual and numeral skin analyses. Each research was finalized with a questionnaire which provided a subjective evaluation of the examined product among participants. Significant reduction in erythema has been widely recorded. After 2weeks, erythema dropped by 9%. After 4weeks, it decreased by 16% and by 21% after 6weeks. The concentrate's efficiency in diminishing erythematous plaques was confirmed by photographs generated by VISIA photograph system. Thanks to PRIMOS, decrease in both depth and volume of nasolabial folds was recorded in 87% of participants after 6weeks of research. 5% vitamin C concentrate is effective in treating capillary and photograph-aging skin. It decreases erythema and telangiectasias as well as triggers the shallowing of skin wrinkles.

PP-211 - Successful Percutaneous İntervention of Chronic Limb Threatiening İschaemia

Case report: A 64 year old female patient was refered to our clinic with leg pain. She had suffered this pain for 1 year and an increasing severity during the last month made her refer to our hospital. At rest she had a burning and aching feeling especially at the calf and foot that had become prominent at rest since the last month. Her medical history included dibetes mellitus, hypertension and coronary bypass surgery and amputaiton of the left 3rd toe due to a gangrenous infection. On admission her blood pressure was 150/90 mm Hg with a sinus rhythm and heart rate of 90 beats per minute. Lung and cardiac examination was unremarkable. Astonishingly her left foot had marked, large and deep wounds extending to the bone and infectious drainage with unpleasant smell (Figure 1). laboratory showed leucocytosis and high levels of C-reactive protein. The right Ankle branchial index (ABI) was in normal range (1,2), however the left ABI was not proficiently performed due to leg pain during the cuff inflation. So we made duppler ultrasonography showing monophasic flow at the left distal posterior tibialis artery in the ankle location with increased pik systolic flow in the proximal region of the posterior tibialis artery. After that, a detailed cleaning of the wounds and broad spectrum antibiotics were administered. Antiplatelet therapy with antihypertensive and intensive insulin therapy stabilised the patient. After one week of intensive treatment the patient was in a more stable condition with a diminished feeling of pain. Then a peripheral angiography was performed. As both the femoral pulses were weak a radial approach was decided for peripheral angiography. Right leg angiography showed unremarkable atherosclerotic lesions, however a critical stenosis was found in the proximal region of the posterior tibialis artery and other tandem lesions as well in the anterior tibialis anterior of the left leg. These lesions were accurately seen with selective angiography by an antegrade approach introducing a 6 French radial sheath at the left femoral artery. the collaterals between the main arteries however insufficient, maintained the blood flow downstream the foot (Video 1). We decided to relieve the critical stenosis of the proximal posterior tibialis artery as the plantar side of the foot is almostly perfused by this artery. A predilatation with 3,0 × 20 mm bare balloon was performed. The residual stenosis was finally dilated with 3,0 × 80 mm drug coated balloon and a successful intervention with a prominent downstream blood flow was achieved (Videos 2, 3). We decided not to intervene to the anterior tibialis artery as there were multiple collaterals perfusing pre and post oclussion segments of the artery. After the successful intervention a podographic analysis was performed. Pes planus was diagnosed and a special tipe of anti trauma shoes was suggested. The patient was healthily discharded on dual antiplatelet therapy, cilostazol, antihypertensive, statin and intensive insuline therapy. At follow-up her left foot was markedly recovered and the previously deep infectious wounds were closed (Figure 2, Figure 3). Figure 2 View Large Image Figure Viewer Download Hi-res image Figure 3 View Large Image Figure Viewer Download Hi-res image

A case series pilot study on the combination of 5-aminolevulinic acid and photodynamic therapy (ALA-PDT) for treatment of vitiligo

Background:To study the effective therapeutic concentration, drug application duration, irradiation duration and irradiation dosage of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for treating vitiligo and observe its clinical efficacy. Objective:To assess the clinical efficacy of ALA-PDT for treating vitiligo. Methods:ALA with different drug concentrations, drug application durations, irradiation durations and irradiation dosages were adopted to treat skin lesions caused by vitiligo to determine the effective drug concentration, drug application duration, irradiation duration and irradiation dosage for treating three vitiligo volunteers and observe the therapeutic results. Results:The clinical trial suggested that ALA at a drug concentration of 1.5%, drug application duration for 3 hours, irradiation dosage of 80mw/cm2 and irradiation duration for 20 min was effective in treating vitiligo. Under these parameters, ALA-PDT was effective to the three vitiligo volunteers, with mild pain and feeling of burning but no other adverse reaction during treatment. Study limitations:Due to the small sample size in this study for the effectiveness of PDT in treating vitiligo and the potential variations in the efficacy for treating the disease at different areas, further studies shall be conducted for confirmation. Conclusions:ALA with a drug concentration at 1.5%, drug application duration for 3 hours, irradiation dosage of 80 mw/cm2 and irradiation duration for 20 min is effective in treating vitiligo. Therefore, ALA-PDT is safe and effective in treating the disease, with minor adverse events, providing a new method for treating vitiligo in the future.

Herniated Lumbar Disc and Nursing Care

Spinal disc herniation, also known as a slipped disc, is a medical condition affecting the spine in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings. Disc herniation is usually due to age-related degeneration of the outer ring, known as the anulus fibrosus, although trauma, lifting injuries, or straining have been implicated as well. Tears are almost always postero-lateral (on the back of the sides) owing to the presence of the posterior longitudinal ligament in the spinal canal. Disc herniations are normally a further development of a previously existing disc protrusion, a condition in which the outermost layers of the anulus fibrosus are still intact, but can bulge when the disc is under pressure. In contrast to a herniation, none of the central portion escapes beyond the outer layers. Most minor herniations heal within several weeks. Anti-inflammatory treatments for pain associated with disc herniation, protrusion, bulge, or disc tear are generally effective. Severe herniations may not heal of their own accord and may require surgery. The condition is widely referred to as a slipped disc, but this term is not medically accurate as the spinal discs are firmly attached between the vertebrae and cannot "slip" out of place. Lumbar disc herniations occur in the lower back, most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. Symptoms can affect the lower back, buttocks, thigh, anal/genital region (via the perineal nerve), and may radiate into the foot and/or toe. The sciatic nerve is the most commonly affected nerve, causing symptoms of sciatica. The femoral nerve can also be affected[25]and cause the patient to experience a numb, tingling feeling throughout one or both legs and even feet or even a burning feeling in the hips and legs. A hernia in the lumbar region often compresses the nerve root exiting at the level below the disk. Thus, a herniation of the L4/5 disc will compress the L5 nerve root. With the patient and doctor, plan a pain control regimen. Encourage the patient to express his concerns about the disorder. Urge the patient to perform as much self-care as his immobility and pain allow. Use antiembolism stockings, as prescribed, and encourage the patient to move his legs, as allowed. Assess the patient’s pain status and his response to the pain-control regimen. Perform neurovascular checks of the patient’s legs such as color, motion, temperature, and sensation. Monitor vital signs, and check for bowel sounds and abdominal distention. Teach the patient about treatments, which include bed rest and pelvic traction. Urge the patient to maintain an ideal body weight to prevent lordosis caused by obesity. Discuss all prescribed medications with the patient. If surgery is required, explain all preoperative and postoperative procedures and treatments to the patient and his family.

Sensory symptoms in low back pain—how do they matter?

Objective: Successful treatment of chronic low back pain (LBP) is difficult in clinical practice and hard to measure in trials. One reason might be the use of insufficient outcome parameters. The aim was to investigate the importance of typical clinical characteristics of chronic LBP on QoL and functionality.Methods: A total of 51 patients with chronic LBP (19 with, 32 without radiculopathy) were investigated with different questionnaires.Results: Burdening symptoms differed in frequency, intensity and impairment of QoL and functionality between patients with and without radiculopathy and between the area of pain within the same patient, i.e. between back and leg. Symptoms of nerve affection such as prickling pain and numbness were rated higher in the area of radiating pain than on the back in radiculopathy, and typical neuropathic pain symptoms such as burning pain, prickling, spontaneous pain, and feeling of deep pressure and pain at the beginning of movement were rated with a higher impairment of QoL and functionality in patients with compared to those without radiculopathy. Furthermore, intensity, impairment of QoL, and functionality were not necessarily reported in association with one another: some patients were highly impaired in QoL or functionality, despite a moderate-to-low pain intensity, whereas others suffered from severe pain, but were less impaired in QoL or functionality.Conclusion: Results suggest the consideration of impairment of QoL and functionality in addition to symptom intensity for treatment evaluation of chronic LBP. This can help to improve overall well-being of the patients and enhance efficacy in clinical pain trials and patient-centered treatment.

Patient-reported symptoms of radiation dermatitis during breast cancer radiotherapy: a pilot study.

To find out which symptoms most frequently and severely affect breast cancer patients during radiotherapy and how patients manage the symptoms and unmet needs. A cross-sectional survey was conducted with 111 patients who receive radiotherapy for breast cancer from January to April 2015 at Samsung Medical Center in Seoul, South Korea. Participants were asked about symptoms and discomfort due to radiotherapy, management methods for radiation dermatitis, unmet needs for radiation dermatitis care, and clinical and socio-demographic information. Of total, 108 out of 111 patients (97.3%) reported symptoms related to radiation dermatitis. Hyperpigmentation was the most commonly reported uncomfortable symptom followed by erythema. On average, patients reported 8.6 radiotherapy-induced skin problems (range, 0-11). Of total, 59 (53.2%) patients stated that they wanted care for radiation dermatitis, and 80.0, 59.4, and 51% of patients searched for information, used products, and visited the hospital to manage radiotherapy-related skin problems. Patients who experienced dryness, burning feelings, irritation, roughness, and hyperpigmentation were 11.73, 7.02, 5.10, 4.27, and 2.80 times more likely to have management needs than patients without those symptoms, respectively, adjusting age, current cycle of radiation therapy, chemotherapy, and type of surgery. Most of the breast cancer patients experience multiple symptoms associated with radiation dermatitis. Hyperpigmentation was the most common and uncomfortable symptom followed by erythema. Majority of patients wanted management for radiation dermatitis and patients who experienced dryness, burning feelings, irritation, roughness, and hyperpigmentation had higher needs for radiation dermatitis management.

Oral Cavity and Allergy: Meeting the Diagnostic and Therapeutic Challenge

Allergic reactions of the oral mucosa are associated with diverse symptoms and can severely affect patients’ quality of life. Oral mucosa changes such as stomatitis or lichenoid reactions can be the first evidence of a contact allergy, with oral lichenoid reactions after contact with dental restorations, especially amalgam fillings, being among the most common clinical reactions. Additives in foods and oral hygiene products may also cause allergic mucosal reactions. Subjective symptoms, such as pain, burning feeling, or dryness of the oral mucosa, as well as cheilitis or lip and facial swelling, may not only have an allergic component but may also be associated with other diseases that have to be excluded. A complete and thorough clinical examination of the oral mucosa is the first step in the diagnosis of a contact allergy. A detailed history of the patient’s oral care products, drugs, and dental materials is both essential and helpful for the clinician. As a result of the presence of mucosal changes, a patch test can be used for the diagnosis of contact allergy of delayed type. Although the patch test is the standard diagnostic tool for such types of contact allergy, proper interpretation of patch-test results and their clinical relevance can be challenging. As the number of patients with allergies resulting from different materials increases over the years, and a larger number of different dental materials are found to induce an allergy, it is essential for dentists to be aware of the possible allergic reactions to dental materials. Thus, we aimed to develop a systematic approach for contact allergy of the oral cavity, focusing not only on clinical manifestations and diagnosis but also on management and prediction of the risk of oral allergic reactions. A multidisciplinary approach for patients with an oral allergy is essential, with participation of physicians of different specialties, including dentists, allergists and dermatologists.

Awareness and Need for Knowledge of Health and Safety among Dairy Farmers Interviewed in Uganda.

Safe working conditions are essential for healthy living and for ensuring food security among farmers and farm communities in developing countries. There is limited research on this topic, and documentation is essential to understand and change patterns of human health and safety. In May 2014, six male and female farmers on four dairy farms in Uganda and a female veterinarian were interviewed about their awareness and attitudes to agricultural risk factors, health, and safety. In addition, transect walks were conducted on the four dairy farms. The dairy farmers reported health and safety concerns, e.g., diarrhea, coughs, fever, cuts while using machetes in plantations, bruises when handling animals, and dizziness and poisoning symptoms from using different agrochemicals, and considered these an occupational hazard. The most important topic mentioned was the use of agrochemicals and drugs on livestock. The farmers spray their animals with insecticides to prevent ticks, lice, tsetse flies, and other biting nuisance flies, using a backpack or hand sprayer. Spraying is conducted without personal protection equipment, which is considered too expensive and difficult to obtain. The farmers reported that they usually feel dizzy, vomit, and have pain and a burning feeling in their face and eyes after spraying. The symptoms are sometimes so severe that they require treatment. In such cases, the farmers buy medication without a prescription at the local drugstore, where the storekeeper often has limited or no knowledge of agrochemicals or drugs except for dosage. Agricultural health and safety training in the region is non-existent, and the farmers expressed a need and desire for improvements in this area. The level of knowledge and awareness of agricultural health and safety risks, disease, and injury prevention among the Ugandan dairy farmers interviewed was low. The farmers mentioned few agriculture-related complaints, injuries, or diseases except poisoning from using agrochemicals. Training on health and safety in Ugandan agriculture is urgently needed.

Identifying predictors of players’ perception regarding sliding friendliness and the overall field performance of artificial turf systems for soccer

Due to different design parameters, there is a large variety of artificial turf configurations on the market for soccer. The ultimate aim for any player surface is to maximize the performance and to minimize injuries. The aim of this study is to develop and validate the Football Turf Performance Questionnaire which measures the performance of an artificial turf soccer pitch and to identify predictors for both the overall performance and sliding friendliness based on the players’ perceptions. Three types of artificial turf configurations were evaluated by an elite soccer team in five different trials. Statistical analyses were performed to check the reliability, the classification into factors and identification of predictors, respectively. The best predictors of the total judgement are the descriptors ‘hardness of the field during falling and during sprinting’ and ‘traction during stopping’ and the indicators ‘traction’ and ‘shock absorption’. For sliding friendliness solely, the best predictors are the descriptor ‘burning feeling of the skin after a sliding movement’ and the indicators ‘skin irritation’ and ‘traction’.

The Effectiveness of Different Palate Relievers Against a Hot Chili Pepper Sauce

Mexican food is a combination of strong flavors, and of course, spicy ingredients (hot chili peppers). However, not everybody has developed a liking or resistance to hot chili peppers, hence a method for relief from the burning feeling they provoke is necessary. The purpose of this study was to evaluate which palate reliever worked best to mitigate the aftertaste hotness induced by capsaicin, the component responsible for the hot sensation in chili peppers. The hypothesis was that a substance capable of dissolving capsaicin (a nonpolar substance) would be the best palate reliever, making olive oil a prime candidate. Sensory tests were done using 12 untrained panelists with high, medium, and low resistance to hotness, a homemade hot chili pepper sauce, and five palate relievers. Palate relievers with different solubility properties, milk and ice cream (emulsions), olive oil (nonpolar substance), and water and a soft drink (polar substances), were used to alleviate the hotness sensation after trying the hot sauce. Regardless of the panelists’ tolerance towards the hot sauce (low, medium, or high), all rated milk and ice cream to be the best palate relievers and the soft drink to be the worst. The best palate reliever was an emulsion (milk or ice cream) and not olive oil, as was initially hypothesized.

An Unusual Viral Infection in Adults

Clinical Presentation: Vesicles on the soft palate of a healthy 32 year-old man with no personal history. He presented to the ER with a sore throat and burning feeling of the tongue when eating fruit. He mentioned noticing little vesicles on the tip of the tongue the day before. He had no travel history or contact with pets. He had two small children under the age of five who were healthy. On examination there was no exanthema, palms and soles where spared. The soft palate and the right border of the tongue tip had small vesicles that where not spontaneously painful (Figure 1). The diagnosis of Herpangina caused by Coxsackie virus was made on the basis of the contact with children and no other complaints.

Inconceivable Hypokalemia: A Case Report of Acute Severe Barium Chloride Poisoning

Barium is a heavy divalent alkaline earth metal that has been known as a muscle poison. Barium can cause human toxicity, which may lead to significant hypokalemia and have serious consequences. This paper reports a case of unprecedented barium intoxication in which the patient, who suffered from depression, swallowed at least 3.0 g barium chloride to commit suicide. On admission, the patient presented with nausea, vomiting, stomach burning feeling, dizziness, and weakness. Emergency biochemical testing showed that the patient was suffering from severe hypokalemia (K+ 1.7 mmol/L). His electrocardiogram (ECG) prompted atrioventricular blocking, ventricular tachycardia, prolongation of PR interval, ST segment depression with U waves, and T wave inversion. Intravenous potassium supplements were given immediately to correct hypokalemia and regular monitoring of vital signs and fluid balance was arranged. After all-out rescue of our hospital personnel, the condition of the patient is currently stable and he is gradually recovering. This case exemplifies the weaknesses of the management of toxic substances and the lack of mental health education for young people. We hope to get more attention for the supervision of toxic substances and the healthy development of young people.

Individual oral symptoms in burning mouth syndrome may be associated differentially with depression and anxiety

Background Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms. Objective In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms. Methods Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule–Revised). Results Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149–0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148–1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077–0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065–0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036–0.448; p = 0.023) were associated with higher anxiety scores. Conclusion Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.

Respiratory and gastrointestinal symptoms in 7-10 year old children in Reykjavík, Iceland

Asthma and rhinitis are common diseases in children often but not always caused by allergy. Gastroesophageal reflux is also prevalent in children and relationship with respiratory symptoms has been suggested. The aim of this study was to investigate this relationship in schoolchildren. As a part of multi-centre cross-sectional food allergy study (Europrevall), a short questionnaire was sent out to 2895 schoolchildren in Reykjavik 7-10 year old. Of the 2346 (81%) children we received answers from we selected those that answered positively to questions regarding common foods and a random sample of those who denied any symptoms related to food. The selected children were invited to further study where they answered an extensive questionnaire that included questions regarding respiratory and gastrointestinal symptoms. A significant correlation was found between a history of wheezing over the previous year and vomiting, (p<0.001) and feeling nauseous (p<0.001) in the past 6 months. There was also a correlation between asthma in the previous year and feeling nauseous (p<0.05), having a a burning or painful feeling in the middle of the chest (p<0.001) as well as nasal symptoms and vomiting (p<0.01), feeling nauseous (p<0.01), having a burning or painful feeling in the middle of the chest (p<0.01) and having a sour taste, like a taste of vomit in the mouth (p<0.001). This study shows a significant correlation between symptoms of gastroesophageal reflux and respiratory and nasal symptoms. Clinicians should be aware of this association though the nature and direction of this association is still unclear.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a very common condition where the median nerve gets pinched at the wrist and hand. The patient can experience pain, weakness and burning feelings in the hands and fingers. The involved fingers are usually the thumb, index (pointer), long (middle) and half of the ring finger. Causes are due to changes in anatomy, general medical illnesses and possibly work-related conditions. Treatments include supports, therapy, steroid injections or surgery. The diagnosis is usually made by history and physical exam and a nerve conduction study that checks the speed and function of the nerves. Non-operative and operative treatments have been successful in most patients having carpal tunnel syndrome. The treatment outcomes of open and endoscopic carpal tunnel release have been shown to be the same at three months.