Common Clinical Symptoms Research Articles

Clinical Value of Platelets and Coagulation Parameters in Predicting the Severity of Delta Variant SARS-CoV-2

Introduction: The present study aimed to analyze the clinical features and laboratory markers of patients with Delta variant SARS-CoV-2 and explore the role of platelet in predicting the severity of Delta. Methods: This retrospective, observational study was conducted on 863 patients laboratory-confirmed Delta variant SARS-CoV-2. These cases were sub-classified based on disease severity into mild (n = 304), moderate (n = 537), and severe (n = 22). A series of laboratory findings and clinical data were collected and analyzed during hospitalization. Results: Of 863 hospitalized patients with Delta, the median age was 38 years (interquartile range, 30–51 years) and 471 (54.58%) were male. The most common clinical symptoms mainly included cough, fever, pharyngalgia, expectoration, dyspnea, fatigue, and headache, and the commonest comorbidities were hypertension and diabetes. Among the hematological variables, neutrophil count, red blood cell count, and hemoglobin, were found to be statistically significant with regard to subcategories based of disease severity (p < 0.05). Among coagulation parameters, there was a statistically significant difference in D-dimer, fibrinogen, international normalized ratio, and prothrombin time (p < 0.05). Statistically significant differences were observed in platelet markers including platelet count, large platelet count, and plateletcrit (p < 0.05). Additionally, there was strong correlation between platelet and other parameters with disease severity. Logistical regression analysis and ROC curves showed that D-dimer was a single best marker of disease severity (p = 0.005, p < 0.0001); however, platelet (p = 0.009, p = 0.002) and plateletcrit (p = 0.002, p = 0.001) could also predict severe disease. Platelet was identified as an independent risk factor for severe Delta. Conclusion: Low platelet may be a marker of disease severity in Delta variant SARS-CoV-2 and may contribute to determine the severity of patients infected with Delta.

Analysis of Proinflammatory Cytokines in COVID-19 Patients in Baghdad, Iraq.

Due to the pandemic of COVID -19 disease and the fact that the effective variables in the severity and control of the disease have not been established, numerous factors have been investigated, including the study of inflammatory factors. A cross-sectional study was carried out to investigate the proinflammatory cytokines in patients with COVID -19, conducted in Baghdad, Iraq. The age of the patients was above > (15) years old, with confirmed infection documented by polymerase chain reaction (PCR). The subjects were 132 patients, 69 (52.3%) males, and 63 (47.7%) females. Patients were divided into three pathological groups: mild patients (45), moderate patients (34), and severe patients (53), each group was divided into four weeks according to symptoms onset date. The most common clinical symptoms were cough, fever, and headache, while sore throat, gastrointestinal symptoms, chest pain, and loss of taste and smell were less common in COVID -19 patients. Sandwich-Enzyme-Linked Immunosorbent Assay kits were used to evaluate levels of proinflammatory cytokines, including IL-1β, IL-6, IL-8, and TNF-α. The results IL-6 and TNF-α were significantly elevated in mild during the four weeks with (P=0.0071) and (0.0266) respectively, levels of IL-1β were increased with highly significant differences (P=0.0001) while levels of IL-8 were decreased with highly significant differences (P=0.0001) during the four weeks. In moderate patients, levels of (IL-1β, IL-6, and IL-8) increased without significance (P=0.661, 0.074, 0.0651), respectively; in contrast, the levels of TNF-α increased with significant (P=0.0452) across four weeks. Severe COVID-19 patients showed significantly increased differences in levels of (IL-6, IL-8, and TNFα) (P=0.0438, 0.0348, 0.0447), respectively, while no significant differences in the level of IL-1β (P=0.0774). This study showed that investigating inflammatory factors in the COVID-19 pandemic is crucial in controlling and treating.

An Approach to Psychiatric Illness in Rheumatology Clinics.

Rheumatologists encounter patients with psychiatric illnesses daily in their practice; however, formal training in rheumatology does not sufficiently equip rheumatologists with guidance for managing common psychiatric illnesses. This study reviews common clinical situations involving psychiatric symptoms, their relationship with rheumatologic conditions, and their effects on clinical presentation and management. We illustrate key principles in a case-based format and reflect on the management of psychiatric components. Based on these discussions and a brief review of the epidemiology of psychiatric illnesses, we emphasize the prevalence and significance of these problems in daily practice.

Prevalence, Etiology, Antimicrobial Susceptibility Testing and Predictors of Urinary Tract Infection among Neonates with Clinical Sepsis

Background and Aim: The most common pediatric infection is urinary tract infection (UTI). Neonates who suffer from neonatal sepsis remain among the most vulnerable to death and morbidity, especially in developing countries. The present study aimed to determine the prevalence, etiology, and susceptible antimicrobial agents of UTIs among neonates with clinical sepsis. Patients and Methods: This cross-sectional study was carried out on 128 sepsis diagnosed neonates admitted to the Department of Pediatrics, Microbiology and Infectious Diseases, Niazi Welfare Teaching Hospital, Sargodha from September 2021 to May 2022. All neonates aged ≤ 28 days diagnosed of clinical sepsis and consent provided by their parents/guardian were enrolled. An interviewed based questionnaire was used for data collection from neonate’s parents or caregiver. The questionnaire included information on the socio-demographics and clinical presentations of neonates, as well as maternal history and laboratory examinations. The history is taken from prenatal to postnatal, including birth weight analysis and birth conditions. Neonates underwent general and local examinations to determine their state of consciousness, vital signs, and weight. We examined the abdomen (for tenderness and abdominal distention) and the nervous system (to elicit suckling and motor reflexes). A hematological analyzer was used to test the full blood picture (FBP). SPSS version 27 was used for data analysis. Results: Of the total 128 neonates, there were 76 (59.4%) females and 52 (40.6%) male neonates. The overall mean age was 6.4 ± 0.36 days with majority of neonates 112 (87.5%) were &lt; 7 days. The low birth weight and low Apgar score were found in 13 (10.2%) and 16 (12.5%) neonates respectively. Of all neonates, the failure to breastfeed was found in 26 (20.3%) being the most common clinical symptom followed by an increase in breathing rate 21 (16.4%), diarrhea 19 (14.8%), gritting 16 (12.5%), altered mental status 12 (9.4%), and jaundice 11 (8.6%). The incidence of UTI was 20.3% (n=26). The prevalence of separated bacterial agents such as Klebsiella pneumonia and Enterobacter spp. was 61.5% (n=16) and 38.5% (n=10) respectively. Ciprofoxacin and amikacin were both effective against 90% and 60% of the bacterial isolates, respectively. The UTI potential predictors involved prolong labour, positive leucocyte esterase test, Low Apgar score, and positive urine nitrite test. Conclusion: The present study found that the prevalence of UTI was 20.3%. Failure to breastfeed was the most common clinical symptom followed by an increase in breathing rate, diarrhea, gritting, altered mental status, jaundice, convulsion, and cyanosis. Klebsiella pneumonia and Enterobacter spp. were the most prevalent separated bacterial agents. Ciprofoxacin and amikacin were both effective in bacterial isolates. Keywords: UTI, Clinical sepsis, Neonates, Antibiotic sensitivity

Study on HBV-related acute-on-chronic liver failure risk factors and novel predictive survival model

Objective: To identify the predisposing factors, clinical characteristics, and risk factors of disease progression to establish a novel predictive survival model and evaluate its application value for hepatitis B virus-related acute-on-chronic liver failure. Methods: 153 cases of HBV-ACLF were selected according to the guidelines for the diagnosis and treatment of liver failure (2018 edition) of the Chinese Medical Association Hepatology Branch. Predisposing factors, the basic liver disease stage, therapeutic drugs, clinical characteristics, and factors affecting survival status were analyzed. Cox proportional hazards regression analysis was used to screen prognostic factors and establish a novel predictive survival model. The receiver operating characteristic curve (ROC) was used to evaluate predictive value with the Model for End-Stage Liver Disease (MELD) and the Chronic Liver Failure Consortium Acute-on-Chronic Liver Failure score (CLIF-C ACLF). Results: 80.39% (123/153) based on hepatitis B cirrhosis had developed ACLF. HBV-ACLF's main inducing factors were the discontinuation of nucleos(t)ide analogues (NAs) and the application of hepatotoxic drugs, including Chinese patent medicine/Chinese herbal medicine, non-steroidal anti-inflammatory drugs, anti-tuberculosis drugs, central nervous system drugs, anti-tumor drugs, etc. 34.64% of cases had an unknown inducement. The most common clinical symptoms at onset were progressive jaundice, poor appetite, and fatigue. The short-term mortality rate was significantly higher in patients complicated with hepatic encephalopathy, upper gastrointestinal hemorrhage, hepatorenal syndrome, and infection (P < 0.05). Lactate dehydrogenase, albumin, the international normalized ratio, the neutrophil-to-lymphocyte ratio, hepatic encephalopathy, and upper gastrointestinal bleeding were the independent predictors for the survival status of patients. The LAINeu model was established. The area under the curve for evaluating the survival of HBV-ACLF was 0.886, which was significantly higher than the MELD and CLIF-C ACLF scores (P < 0.05), and the prognosis was worse when the LAINeu score ≥ -3.75. Conclusion: Discontinuation of NAs and the application of hepatotoxic drugs are common predisposing factors for HBV-ACLF. Hepatic decompensation-related complications and infection accelerate the disease's progression. The LAINeu model can predict patient survival conditions more accurately.

Endometriosis-associated pain and new therapeutic options: A review

Pelvic pain is one of the most common and significant clinical symptoms of endometriosis. The complex pathogenesis and paradoxical nature of endometriosis-associated pain, its chronicity and centralization, a marked decrease in the quality of life of patients, the lack of an "ideal" and effective remedy with no limitation for all patients, as well as the progressive and recurrent nature of the disease are factors that determine the need for novel, additional therapeutic options. The pain mechanisms in endometriosis and the potential pathogenetic effects of trans-resveratrol and indole-3-carbinol on various aspects of endometriosis-associated pain are addressed based on the literature sources presented in electronic databases PubMed, CyberLeninka, and Google Scholar. The described pharmacological properties of the compounds suggest that the combined use of trans-resveratrol and indole-3-carbinol is a pathogenetically justified and promising treatment for complex endometriosis-associated pain.

Description of Mercury Poison Clinical Symptoms in Workers and Communities Around the Small-Scale Gold Processing Area

The traditional gold processing process in Paya Seumantok Village, Krueng Sabee District, Aceh Jaya Regency, Aceh Province, is carried out using the amalgamation method which still uses mercury in the process, so it poses a risk to the health of workers and the surrounding community. This study aims to obtain an overview of the clinical symptoms experienced by workers and the community around the gold processing area. This study uses qualitative research methods with the number of community respondents were 90 respondents, and the number of worker respondents were 10 workers. Based on the results, the common acute clinical symptoms experienced by the community were headache (48.6%), cough (39.6%), abdominal pain (37.8%), diarrhea (29.7%), and hip pain (25.2%). While the chronic clinical symptoms experienced by the majority of community respondents were headaches (47.7%), irritability (27.9%), insomnia (26.1%), muscle cramps (23.4%), and weight loss (20.7%). Moreover, the most common acute clinical symptoms experienced by workers were cough (8 respondents), pelvic pain, diarrhea, abdominal pain, vomiting, nausea, and headaches were experienced by 7 respondents respectively. While for chronic clinical symptoms, the majority of workers experienced headaches and insomnia (8 respondents), irritability (6 respondents), anxiety (6 respondents), muscle cramps (5 respondents), and tremors (4 respondents). Based on the result, it can be concluded that the clinical symptoms encountered by the community and workers in the gold processing area have not shown clinical signs that are quite dangerous.

The impact of the COVID-19 pandemic on patients with systemic vasculitis: a single-centre retrospective study.

This study aimed to study the impact of the COVID-19 pandemic on patients living with systemic vasculitis in Kazakhstan. A single-centre retrospective study of the medical histories of 82 patients was carried out based on the regional clinical hospital of the city for all admissions with systemic vasculitis in the period from January 2019 to December 2021. The following qualitative (gender, disability, concomitant diseases) and quantitative (age, disease experience, laboratory data, etc.) variables were studied. To conduct the study, the criteria for the inclusion and exclusion of patients in the study were determined. According to the results of the study, there is a decrease in the number of hospitalized patients with vasculitis in the rheumatology department of the regional clinical hospital. Compared to 2019, in 2021, the number of hospitalized patients decreased by almost half (Table 1).Out of 82 cases, the most common was Takayasu disease (nonspecific aortoarteritis) (43.9%), IgA-vasculitis (Schenlein-Genoch disease) (31.71%), and they are typical mainly for females of rural origin, who were admitted to the hospital in a comorbid state (p < 0.001). 41.6% of patients have disabilities, and the majority of patients have a II disability group. The average body mass index is 24.2; 27 patients out of the total number of patients suffer from obesity. The most common clinical symptoms of patients with systemic vasculitis were injuries of the musculoskeletal system (75.6%). A negative average correlation was found between the indicators of the level of ESR and haemoglobin, the correlation coefficient is -0.535. The patients had concomitant diseases, such as diabetes mellitus, iron deficiency anaemia, coronary heart disease, hypertension, gastrointestinal tract diseases and hepatitis. Women of reproductive age from rural areas are often diagnosed with systemic vasculitis. A high rate of disability revealed among the patients can be explained by two main factors, the first is that the patients consulted the doctors untimely and the second is that the medical community are insufficiently informed about the management of autoimmune rheumatic diseases, in particular about systemic vasculitis, which hinders timely diagnosis and treatment, respectively. Patients, included in this survey, were mostly suffering from diseases of the musculoskeletal system, but depending on the type of vasculitis, other organs and systems may be affected. Table 1 Frequency of patients with systemic vasculitis over 3years Year Frequency % p-value 2019 42 51.2 χ2 = 12.463a; p = 0.002 2020 23 28.0 2021 17 20.7 Total 82 100.0.

Association between Serum α-Klotho Levels and Behçet Disease.

Endothelial dysfunction (ED) has a well-known role in promoting vascular inflammation in Behçet disease (BD). α-klotho is involved in regulation of endothelial function, and its reduction has been reported to be associated with ED. To assess serum α-klotho in patients with BD, compared with healthy control individuals. In a cross-sectional study, 55 patients with BD and 30 age- and sex-matched healthy controls were enrolled, and their serum levels of α-klotho were measured. Common clinical symptoms in patients with BD were oral aphthous ulcers, uveitis, and genital ulcers. Median (IQR) serum α-klotho levels in the BD and control groups were 0.30 (0.20-0.70) and 1.00 (0.70-2.52) ng/mL, respectively. The difference was statistically significant (P = .005). No significant correlation was observed between serum α-klotho and age (r = 0.194; P = .14). Serum α-klotho levels in patients with uveitis were significantly lower. α-klotho may have a role in the pathogenesis of ED and is a potential biomarker for uveitis in BD.

Histopathological Disease Spectrum of Cholecystectomy Specimen: A Retrospective Observational Study

Background: Gallstone disease is a common surgical problem requiring cholecystectomy. It is known to produce diverse histopathological changes in the gallbladder ranging from acute or chronic inflammation to metaplasias and even malignancies. Objective: The aim of this study was to emphasize the importance of a detailed microscopic examination and to study the range of histopathological lesions in cholecystectomy specimens. Methods: This is a retrospective study of 1200 cholecystectomy specimens received in the Department of Pathology, Jahurul Islam Medical College Hospital (JIMCH) over a period of 6 years from January 2017 to December 2022. Clinical details and histopathological data were retrieved from the records. The variety of histomorphological changes in the resected gall bladder was studied. Results: There were 1200 cases consisting of 516 (43%) males and 684 (57%) females with M;F ratio of 1: 1.33. Maximum number of patients (28.25%) being 41 to 50 years old. Most common clinical symptom were pain in the upper abdomen and right upper back (91.4%). Histopathologically, the most common diagnosis was chronic cholecystitis (66.75%), followed by acute on chronic cholecystitis (26.25%), gangrenous cholecystitis (3.25%), empyema gallbladder (1.5%), mucocele (0.75%), xanthogranulomatous cholecystitis (0.50%) and adenocarcinoma gallbladder (1%). Conclusion: Cholecystectomy performed for a common condition like gallstone disease can result in a diverse and wide spectrum of histopathological lesions ranging from benign diagnosis to an unexpected gallbladder malignancy. The Journal of Ad-din Women's Medical College; Vol. 11 (1), Jan 2023; p 22-25

Clinical Analysis of Intestinal Tuberculosis: A Retrospective Study.

This study aimed to summarize and analyze the clinical data of intestinal tuberculosis (ITB) in order to provide guidance for accurate diagnosis and treatment of ITB. This study consecutively included patients with ITB who were admitted to our hospital from 2008 to 2021 and retrospectively analyzed their clinical features. Forty-six patients were included. The most common clinical symptom was weight loss (67.4%). Seventy percent of 20 patients were positive for tuberculin skin test; 57.1% of 14 patients were positive for mycobacterium tuberculosis specific cellular immune response test, while 84.6% of 26 patients were positive for tuberculosis infection T cell spot test. By chest computed tomography (CT) examination, 25% and 5.6% of 36 patients were diagnosed with active pulmonary tuberculosis and with inactive pulmonary tuberculosis, respectively. By abdominal CT examination, the most common sign was abdominal lymph node enlargement (43.2%). Forty-two patients underwent colonoscopy, and the most common endoscopic manifestation was ileocecal ulcer (59.5%), followed by colonic ulcer (35.7%) and ileocecal valve deformity (26.2%). ITB most frequently involved the terminal ileum/ileocecal region (76.1%). Granulomatous inflammation with multinucleated giant cells and caseous necrosis was found via endoscopic biopsies, the ultrasound-guided percutaneous biopsy of enlarged mesentery lymph nodes, and surgical interventions. The acid-fast bacilli were discovered in 53.1% of 32 samples. Twenty-one cases highly suspected of ITB were confirmed after responding to empiric anti-tuberculosis therapy. It was necessary to comprehensively analyze clinical features to make an accurate diagnosis of ITB and aid in distinguishing ITB from diseases such as Crohn's disease and malignant tumors.

Clinical characteristic of myelin oligodendrocyte glycoprotein antibody associated cortical encephalitis in adults and outcomes following glucocorticoid therapy.

To describe the clinical and radiological features, as well as outcomes following glucocorticoid therapy and recurrence in adults suffering from cortical encephalitis associated with myelin oligodendrocyte glycoprotein (MOG) antibody. The clinical information of nine adult patients suffering from cortical encephalitis associated with MOG antibody admitted to the Affiliated Brain Hospital of Nanjing Medical University from 2020 to 2022 was systematically reviewed. The clinical symptoms, laboratory data, imaging results, outcomes following glucocorticoid therapy and recurrence were evaluated. A total of 9 patients positive for MOG antibody and suffering from cortical encephalitis were included in our study (55.6% men, median age 29 years, 15-57 years). The most common clinical symptoms included headache (77.8%), fever (66.7%), and generalized seizures (55.6%). Some patients also experienced limb shaking (22.2%), leg numbness (22.2%), transient motor aphasia (11.1%), and vision loss (11.1%). The main features of cerebrospinal fluid () examination were increased intracranial pressure, pleocytosis, and elevated cerebrospinal fluid (CSF) protein. In addition, N-methyl-D-aspartate receptor (NMDAR) and MOG antibodies were found in the CSF of 3 patients, and NMDAR, MOG, and glial fibrillary acidic protein antibodies were found in the CSF of 1 patient. All patients were subjected to magnetic resonance imaging (MRI) and the images of eight of them showed T2 and/flair image hyperintense lesions, three showed meningeal or lesion enhancement and four showed white matter lesions, which were mostly located in the midline structures (75%). All patients received glucocorticoid therapy in the acute phase and in remission, and eight of them received an intravenous high dose of methylprednisolone, including one patient who received a simultaneous immunoglobulin therapy. One patient was treated with low-dose prednisolone tablets. Seven (77.8%) patients were wholly recovered at discharge, and 2 (22.2%) patients were left with slight symptoms. During the median 9-month follow-up (range: 2-36 months), 2 (22.2%) patients developed recurrence. The clinical manifestations of adult MOG antibody-associated cortical encephalitis were significantly different from those of the typical MOG antibody-associated disease (MOGAD). Patients in the acute phase of the disease were prone to show signs similar to central nervous system infection, requiring clinicians to have the ability to recognize the disease to avoid misdiagnosis. In addition, seizures were common in MOG antibody-related encephalitis, and the type of seizures was age-related. Brain MRI results showed that the distribution of cerebral cortex lesions was closely related to the classification of cortical encephalitis. Based on the patient's response to the treatment, glucocorticoid therapy was effective against MOG antibody-associated cortical encephalitis, which is consistent with the treatment response and clinical prognosis of MOGAD. Therefore, our opinion was that MOG antibody might be the "responsible antibody" in MOG antibody-associated cortical encephalitis, although further studies are needed to confirm this hypothesis.

Clinico-Etiopathogenesis of Vitamin B12, Folic Acid and Iron Deficiency in Severe Acute Malnutrition Children: A Tertiary Care Hospital Experience from Central India.

In severe acute malnutrition, micronutrient deficiency as well as protein energy malnutrition is a major obstacle to growth & development. Iron deficiency dominates the spectrum of nutritional anemia. After taking informed consent, 211 SAM children and 211 age-and sex-matched healthy children with normal nutritional status were enrolled for the study. MUAC was used to diagnose SAM. A 5-part automated hematoanalyzer was used to measure the complete blood count and red cell indices, and the peripheral smear method to determine the red cell morphology. We measured serum ferritin, Vitamin B12, and folic acid using the ELISA method. Compared to controls, children with SAM had significantly lower red cell indices, platelet counts, and white cell counts. The most common clinical symptoms seen in SAM children were diarrhea, pneumonia, acute gastroenteritis, and acute respiratory infection. Children with SAM are more likely to suffer from iron deficiency and B12 deficiency. Severe vitamin B12 deficiency was more frequently associated with severe anemia. The severe anemia in SAM children constantly changes the body's defense mechanism, affecting the haematopoiesis. In this study, haematological indices are recommended for predicting severity of anemia, and hematopoietic changes are described, in order to improve anticipatory care and outcome in children with SAM.

A Novel Multi-Target Mu/Delta Opioid Receptor Agonist, HAGD, Produced Potent Peripheral Antinociception with Limited Side Effects in Mice and Minimal Impact on Human Sperm Motility In Vitro.

Pain is a common clinical symptom among patients. Although various opioid analgesics have been developed, their side effects hinder their application. This study aimed to develop a novel opioid analgesic, HAGD (H-Tyr-D-AIa-GIy-Phe-NH2), with limited side effects. In vivo studies on mouse models as well as in vitro studies on Chinese hamster ovary (CHO) cells expressing human mu, delta, or kappa opioid receptors (CHOhMOP, CHOhDOP, and CHOhKOP, respectively) and human sperm were conducted. Compared with subcutaneous morphine (10 mg/kg), subcutaneous HAGD (10 mg/kg) produced equipotent or even greater antinociception with a prolonged duration by activating mu/delta opioid receptors in preclinical mouse pain models. The analgesic tolerance, rewarding effects (i.e., conditioned place preference and acute hyperlocomotion), and gastrointestinal transit inhibition of HAGD were significantly reduced compared with those of morphine. Both HAGD and morphine exhibited a withdrawal response and had no impacts on motor coordination. In CHOhMOP and CHOhDOP, HAGD showed specific and efficient intracellular Ca2+ stimulation. HAGD had minimal impact on human sperm motility in vitro, whereas 1 × 10-7 and 1 × 10-8 mol/L of morphine significantly declined sperm motility at 3.5 h. Overall, HAGD may serve as a promising antinociceptive compound.

The Role of Immunosuppression in the Development of COVID-19 in Systemic Lupus Erythematosus Patients: A Brief Report.

Recently, due to the coronavirus disease 2019 (COVID-19) pandemic, much concern has been raised about patients with chronic diseases who may become more susceptible to the disease. The present cross-sectional study aimed to characterize the clinical course of COVID-19 in patients with systemic lupus erythematosus (SLE). In addition, a possible correlation between the immunosuppression state and the incidence of COVID-19 is investigated. In May 2020, 500 SLE patients registered in the database of Golestan Rheumatology Research Center (Golestan province, Iran) were selected for this cross-sectional study. Using a questionnaire, patients were contacted by telephone to collect data including demographic characteristics, disease status, drug use, and new clinical symptoms. Data were analyzed using SPSS software version 24.0. Of the 500 selected patients, 355 responded to the phone calls and subsequently enrolled in the study. Among the enrolled patients, 25 were classified as COVID-19 positive, including eight hospitalized patients, of which two required intensive care and subsequently died. COVID-19 incidence was significantly lower in the immunosuppressed patients (2.2% vs. 10%, P=0.01). There was no significant correlation between hydroxychloroquine consumption and the incidence of COVID-19 in SLE patients. Fever, fatigue, dyspnea, and dry cough were the most common clinical symptoms. Our results showed that COVID-19 incidence was lower in immunosuppressed than the non-immunosuppressed SLE patients. Further studies are required to substantiate the role of immunosuppression in the development of COVID-19. A preprint version of this study was published at https://www.researchsquare.com/article/rs-78704/v1 with doi: https://doi.org/10.21203/rs.3.rs-78704/v1.

Clinical presentation and fungal species distribution in otomycosis in a tertiary care hospital

Abstract Objective: Otomycosis is a common fungal ear infection in tropical and subtropical regions worldwide. This study aimed to perform mycological analysis on fungal debris from the external auditory canals of the patients to study the most common clinical presentation and fungal species distribution in otomycosis. Materials and Methods: Patients who met the inclusion criteria for this cross-sectional study were included and evaluated after providing written informed consent. After obtaining a thorough medical history, ear swabs for culture, sensitivity, and potassium hydroxide were provided. Patients with positive culture results were studied between September 2019 and March 2021. Results: Among 103 cases observed for 18 months in the Department of ENT, Rajarajeswari Medical College, and Hospital, Bengaluru, India, we found that males (56.31%) were more affected than females (43.68%). Itching (67.96%) was the most primary and common symptom that was observed, followed by pain (20.38%), and the most common predisposing factor was the usage of earbuds (26.21%) followed by water in the ear (23.3%) and oil in the ear (16.50%). Unilateral infection was most common (96%), and the left ear was most affected (64.07%). Aspergillus niger was the most common fungal isolate (60.19%), and otomycosis was very common in postmonsoon (October–December) (58.25%). Conclusion: The most frequent fungal isolates in otomycosis are from the Aspergillus and Candida species. The left ear was typically affected by otomycosis, which frequently had a unilateral predominance. The most common clinical symptoms were itching and pain.

Characteristics of Hospitalized COVID-19 Patients in a Major Referral Center in Shiraz, Iran.

Several countries, including Iran, have been affected by the novel Coronavirus Disease 2019 (COVID-19) pandemic since December 2019. The aim of this study was to provide a comprehensive report on COVID-19 patients in Shiraz, Southern Iran. This study was performed on 311 hospitalized patients with COVID-19. The data on demographic, clinical, and paraclinical features were analyzed. The median age of the patients was 58 years, with 42.1% of the patients being above 60 years of age. Upon admission, fever was detected in 28.2% of critically ill patients. At least one underlying disease or risk factor was also present in 75.6% of the patients. Shortness of breath was the most common clinical symptom (66.2%), dry cough (53.7%), and muscle pain (40.5%) was the second and third. Sneezing (0.3%), rhinorrhea (0.7%), and sore throat (3.09%) were observed only in non-critically ill patients. In addition, 26.9% of all patients had lymphocytopenia, 25.8% had raised C-reactive protein, and 79.9% had abnormal creatinine levels. Finally, death occurred in 39 patients (12.5%). Noncritically ill patients were younger than critically ill patients. The most common risk factors for getting critically ill were surgery, hypertension, diabetes mellitus, chronic heart disease, asthma, and chronic renal disease.

The Potential of Seizure to Predict Prognosis in Glioblastoma Patients: A retrospective Study

Objective Glioma, particularly glioblastoma (GBM), represents a prevalent and aggressive primary brain tumor with limited curative options. Epileptic seizures often manifest as a common clinical symptom in these patients, but their prognostic significance remains debated. This study aimed to retrospectively analyze the clinical presentations, tumor characteristics, and the impact of seizures on the prognosis of GBM patients. Materials and Methods A total of 113 adult patients with histologically confirmed GBM treated between April 2018 and January 2022 were included in this retrospective analysis. Data encompassed clinical symptoms, preoperative and postoperative seizures, tumor localization, overall survival (OS), and other relevant factors. Statistical analysis was performed to assess the relationships between seizures and various prognostic parameters. Results Seizures were present in 39.8% of GBM patients, with 20 patients experiencing both preoperative and postoperative seizures. Preoperative and postoperative seizures were not significantly associated with differences in prognosis (p&gt;0.05). Tumor localization, OS, Karnofsky performance score, and length of hospital stay showed significant differences between patients with and without seizures (p&lt;0.05). Complete resection was achieved in 90.3% of patients, leading to a relatively lower incidence of postoperative seizures. Conclusion Seizures in GBM patients are associated with OS, Karnofsky performance score, and hospitalization duration, independently of other factors. The presence of seizures serves as a valuable prognostic indicator for GBM, prompting further investigation into its influence on patient outcomes, quality of life, and socioeconomic aspects of survival. These findings emphasize the importance of early seizure management in GBM patients and the need for tailored treatment strategies.

CLINICAL AND HEMATO-BIOCHEMICAL STUDIES ON GOATS NATURALLY INFESTED WITH SUCKING AND BITING LICE

The current study was performed to assess the most common clinical symptoms and hemato-biochemical alterations in goats naturally infested with sucking and biting lice. A total of 4599 goats were included in the clinical investigation. The changes in concentrations of some hematological and biochemical parameters were evaluated using 20 naturally infested animals divided into 2 equal groups – group 1 (infested with Bovicola caprae) and group 2 (infested with Linognathus stenopsis). Blood samples were collected before the treatment with Eprinomectin and on the 30th and 60th-day post-treatment (DPT). After sampling, the blood was examined for changes in the complete blood cell count including RBC, HGB, HCT, RBC indices (MCV, MCH, MCHC, RDW), WBC, leukocyte differential count as well as some biochemical parameters (Ca, P, Fe, total protein, albumin, bilirubin, ASAT, ALAT, AP). Clinical demonstrations in infested goats were not specific, represented with rubbing, scratching, broken hairs, alopecia, skin secretion, inflamed lesions (papules), crusts, and keratinization. The changes found in the hematological and biochemical parameters were normocytic hypochromic anemia (p˂0.001) and hypoferremia (p˂0.01) in the goats infested with sucking lice (L. stenopsis) and leukocytosis (p˂0.001), hyperproteinemia (p˂0.001) and hyperalbumineamia (p˂0.05) in the animals infested with biting lice (B. caprae). All changed parameters have returned to the reference ranges on the 30th and 60th DPT.

Gram-negative Late Onset Neonatal Sepsis in a Tertiary Care Center From Central India: A Retrospective Analysis.

Neonatal sepsis has been a major cause of neonatal mortality and morbidity globally. Late onset sepsis is on the rise mostly due to better health care services and improved survival of premature neonates. Gram-negative sepsis has emerged as a major public health problem constituting significant morbidity and mortality. There is limited data on gram-negative late onset sepsis from the central part of India, therefore this study was conducted at a tertiary care center from rural part of India. To determine the clinical profile and outcome among neonates with gram-negative late onset sepsis. It is a retrospective analysis conducted among neonates with gram-negative late onset sepsis at a tertiary care center from central India. All neonates below 28 days of age suspected to have late onset sepsis were enrolled in the study. The data for the period of January 2019 to December 2021 was collected and analyzed using software SPSS version 29. The outcome variables studied were discharge (good outcome) and death (poor outcome). In the present study, overall prevalence of gram-negative late onset sepsis was 4.8%. Respiratory distress (52.2%), seizure (18.9%), jaundice (15.6%), and lethargy (15.6%) were common clinical symptoms among neonates with sepsis. The most common organism isolated was Klebsiella spp. (36.7%) followed by Acinetobacter spp. (31.1%) and E. coli (17.8%). Low gestational age (n = 20 vs n = 7, P = .002) and low birth weight (n = 33 vs n = 4, P = .02) were associated with poor outcomes in neonates with gram negative LOS. The overall mortality rate was found to be 30% among neonates with gram negative sepsis. The prevalence of gram-negative sepsis was found to be 4.8%. Factors associated with poor outcome in gram-negative sepsis were low birth weight, and prematurity. Klebsiella spp. was found to be a common cause of gram-negative LOS, therefore, the empiric antibiotic policy must provide coverage against these micro-organisms.