Morbidity Symptoms Research Articles

Small RNA sequencing of Scutellaria baicalensis reveals brassica yellows virus infection and the complementary development of a sensitive and reliable RT-qPCR assay

To identify the potential causal agent that has caused Scutellaria baicalensis to exhibit yellowing and other morbid symptoms, we sampled from this medicinal plant in Gansu Province, Northwest China, namely, that plant's main growing area. All 18 contings obtained from small RNA sequencing (sRNA-Seq) were homologous to brassica yellows virus (BrYV), with 93%–100% nucleotide similarity. A full-length genome (5693 bp) was obtained using segmentation amplification and Rapid Amplification of cDNA Ends (RACE), which was subsequently identified as BrYV-HQ. Genomic similarity between BrYV-HQ and other isolates ranged from 80.64% to 90.58%. Observed variation was mainly in the coding region of the ORF 3–5 fusion proteins. Evolutionary tree analysis indicated that the kinship of BrYV-HQ may be linked to BrYV-NtabQJ (MK057527.1), known to infect tobacco plants produced in China. Recombination analysis indicated that BrYV-HQ may have derived through recombination between BrYV-NtabQJ and a BrYV isolate (KY310572.1) that infects Brassica napus in China. Based on the coat protein (CP) gene design of the RT-qPCR primer set obtained, the linearity of the standard curve equation y = −2.987*Log(x) + 41.75, which we established for quantitative detection, was good (ranging from 4.43 × 1010 copies/μl∼4.43 × 103 copies/μl) for the quantitative detection of BrYV-HQ. This study marks the first time that BrYV has been confirmed to infect S. baicalensis and upon which a quantitative detection method was established, providing a molecular basis for the research and management of S. baicalensis viral disease in China.

Fighting and writing during Zimbabwe's interregna: Part I–A morbid murder

ABSTRACT: This article started out as a review essay reflecting on how three books (Kanyenze 2022; Mpofu 2021; and Fontein 2022) illustrate Zimbabwe's interregna influence on the scholarly pursuits of economics, political philosophy, and anthropology in that country. But a murder got in the way. Its interpretation by those representing Zimbabwe's two political poles as either an assassination or quotidian horror inspired further investigation within the ambit of the 'morbid symptoms' of the interregna only subtly suggested by the academic books ready for review. The brutal killing of a single mother in Zimbabwe's biggest township became indelibly imbued with political competition and thus provided what I had planned to be an illustrative introduction to the review article. However, Moreblessing Ali's death soon became more than that: my pursuit of the discursive conflict– and physical violence around it–became a micro-political example in itself of Zimbabwe's macabre interregna. That the case had not been officially resolved as the August 2023 election approached indicated its importance. The election took place as these words were heading to press. Yet another suspect victory, this time of 52.6% for ZANU-PF's Emmerson Mnangagwa as president and 44% for Nelson Chamisa of the Citizens Coalition for Change, was announced on August 26 (Zimbabwe Electoral Commission 2023). Thus, the Moreblessing Ali murder has become a good proportion of Part I of a two-part series. The start of this paper presents a thumbnail outline of Zimbabwe's current political and economic situation–a conjuncture of sorts. Theoretical arguments on 'interregna' follow. The last section pursues the ideologies and politics of Moreblessing Ali's political death. Part II will include the review article, further theoretical considerations of Zimbabwe's interregna, and how August's election fits in with these discussions.

Vertigo in pediatric age group

BACKGROUND: Vertigo is a morbid symptom among children. However, children rarely experience vertigo, a clinical condition that has received less research than the adult group. OBJECTIVE: This study aimed to evaluate vertigo among pediatric age group on the basis of the clinical and neurotological profiles. MATERIALS AND METHODS: There were 78 children manifesting with giddiness or vertigo, who attended vertigo clinic at a tertiary care teaching hospital between March 2019 and April 2022. RESULTS: Of 78 children, 30 (38.46%) were boys and 48 (61.53%) were girls. In this study, the average age of the participating children was 11.8 years. Of the 78 children, 10 (12.82%) children were of preschool age, 22 (28.20%) children were of elementary school age, and 46 (58.97%) children were in the adolescent age group. The most common cause of the vertigo was vestibular migraine in pediatric age (30.76%). The most common associated symptom with vertigo was nausea and vomiting. CONCLUSION: There are various etiologies for vertigo. The most common etiology for vertigo in children is vestibular migraine. Children may show same types of clinical presentations. The treatment of vertigo in children should be individualized as per the diagnosis.

Covid-19 Related Morbidity and Long Covid-19 Symptoms in Patients with Chronic Liver Disease

Covid-19 Related Morbidity and Long Covid-19 Symptoms in Patients with Chronic Liver Disease

Assessing the Prevalence of Mental Disorders and its Relationship with Resilience Among ISIS Prisoners in Iraq

Background and Aim: Despite the high prevalence of mental disorders in these people and the important role of resilience in mental health, resilience in prisoners has not received much attention. The present study was conducted with the aim of evaluating the prevalence of mental disorders and its relationship with resilience among ISIS prisoners of war in Iraq between 2014- 2021. Methods: This research was conducted using the SCL questionnaire and Connor and Davidson's resilience. The statistical population of this research is based on the official statistics of the Iraqi Ministry of Migrants and Displaced Persons Affairs and there are 465 thousand people, after making the necessary coordination with the officials of the POW camps among 383 people (based on the Cochran formula) questionnaires were distributed by random sampling method. became Pearson's correlation coefficient was used to analyze the data. Results: The findings of the present study showed that the participants in the study suffered from significant mental disorders on average, and all dimensions of the morbid symptoms index were reported at the level of significant mental disorders. Also, based on the results of people's resilience, it was also reported at an unfavorable level. Resilience dimensions include perception of individual competence, trust in individual differences, tolerance of negative emotions, positive acceptance of change and secure relationships, and spiritual influences at an unfavorable level and control at a relatively favorable level. Conclusion: The results of this research indicated that resilience can predict the index variable of morbid symptoms in an inverse way. In this study, it was observed that people who had less resilience are more prone to mental disorders.

Safety and Acceptance of Acupuncture and Acupressure in Children, Adolescents, and Young Adults Undergoing Hematopoietic Stem Cell Transplant.

Hematopoietic stem cell transplant (HSCT) is associated with significant morbidity and high symptom burden including mucositis pain, nausea, and vomiting. There is little documentation in the literature regarding acupuncture or acupressure for children undergoing HSCT. The purpose of this study was to determine the safety and acceptance of acupuncture and acupressure in children undergoing HSCT in a large tertiary care children's hospital. This is a descriptive retrospective study that evaluated 80 admissions to the HSCT unit over a 24-month period. Every child admitted for HSCT was offered acupuncture or acupressure as part of their care. Of 80 patients, 46 were male patients (ages range, 0-32 years; mean, 8 years). Diagnoses include leukemia/lymphoma, sickle cell disease, aplastic anemia, neuroblastoma, and other metabolic, other solid tumor, or other hematologic disorders. Both allogenic and autologous were represented. Sixty-six patients (82.5%) agreed to treatment with acupuncture, acupressure, or both. There were no adverse effects or safety concerns noted. Symptoms addressed by acupuncture or acupressure included pain from mucositis, nausea, constipation, diarrhea, anxiety, insomnia, and general wellness or healing. This study demonstrates that acupuncture and acupressure are well accepted by children and their families admitted for HSCT and are safe even when performed in the first 4 weeks following transplant when the patient is likely to have thrombocytopenia. These findings suggest that there may be more therapies for patients undergoing HSCT to help with symptom control.

A Short 5'triphosphate RNA nCoV-L Induces a Broad-Spectrum Antiviral Response by Activating RIG-I.

Small molecular nucleic acid drugs produce antiviral effects by activating pattern recognition receptors (PRRs). In this study, a small molecular nucleotide containing 5'triphosphoric acid (5'PPP) and possessing a double-stranded structure was designed and named nCoV-L. nCoV-L was found to specifically activate RIG-I, induce interferon responses, and inhibit duplication of four RNA viruses (Human enterovirus 71, Human poliovirus 1, Human coxsackievirus B5 and Influenza A virus) in cells. In vivo, nCoV-L quickly induced interferon responses and protected BALB/c suckling mice from a lethal dose of the enterovirus 71. Additionally, prophylactic administration of nCoV-L was found to reduce mouse death and relieve morbidity symptoms in a K18-hACE2 mouse lethal model of SARS-CoV-2. In summary, these findings indicate that nCoV-L activates RIG-I and quickly induces effective antiviral signals. Thus, it has potential as a broad-spectrum antiviral drug.

RF21 | PSUN08 Morphologic or Molecular Imaging - Diagnostic Capabilities in von Hippel-Lindau related pheochromocytoma

Abstract Background Within a spectrum of cancers implicated by VHL germline pathogenic variants, one rare cancer which may present in patients are pheochromocytomas (PHEOs). These tumors occur in the adrenal glands and predispose patients to a variety of morbid clinical symptoms due to the excess secretion of catecholamines. As a part of these patients’ management, imaging is important to localize the tumors of which there are both morphologic (CT and MRI) and molecular (PET/CT with 18F-FDG, 68Ga-DOTATATE, 18F-DOPA, and 18F-DA) imaging modalities. Purpose To determine which imaging modalities provided the optimal detection of VHL-related PHEO. Methods The study compared detection of 19 PHEOs (18 histologically proven and 1 is a contralateral tumor awaiting resection) in 12 patients. The CT and MRI were evaluated by a body radiologist and the PET/CT of18F-FDG, 68Ga-DOTATATE, 18F-DOPA, and 18F-DA were evaluated by a nuclear medicine physician in a blinded fashion. Both experts graded using a five-point Likert scale (1 – not PHEO and 5 – PHEO). For analysis, the Likert scale was dichotomized with 1-3 designating negative for PHEO and 4-5 positive for PHEO. The findings were reported as detection rates of positive PHEOs found on imaging to the gold standard of pathologically (aside from one contralateral PHEO awaiting surgery) proven PHEOs. The McNemar test was performed to compare the statistical relevance of detection rates between histology and the imaging modalities. Two-sided p values <0.05 were considered significant. Results The detection rates were CT 17/19 [89.5%, 95% CI = 66.9%-98.7%], MRI 17/17 [100%, 95% CI = 80.5%-100%], 18F-FDG PET/CT 16/17 [94.1%, 95% CI = 80.5%-100%], 68Ga-DOTATATE 5/9 [55.6%, 95% CI = 21.2%-86.3%], 18F-DOPA 12/14 [85.7%, 95% CI = 57.2%-98.2%], and 18F-DA 4/6 [66.7%, 95% CI = 22.3%–95.7%]. All McNemar tests showed p-values greater than 0.05, which were not statistically significant. Conclusion The study was performed in a small patient set with VHL-related PHEO showed MRI, with the highest detection percent followed by 18F-FDG PET/CT. More trials with a larger patient set are needed to support the statistical relevance as it was not seen in this study. Furthermore, performing a study on a patient cohort with additional VHL associated cancers could prove clinically beneficial for patients. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 1:18 p.m. - 1:23 p.m.

Korsakoff syndrome and altered pain perception: a search of underlying neural mechanisms.

Patients with Korsakoff syndrome (KS) may have a diminished pain perception. Information on KS and pain is scarce and limited to case descriptions. The present study is the first to investigate the underlying neural mechanisms of altered pain perception in patients with KS more systematically. We conducted a literature search on neural correlates of pain perception in other neurocognitive disorders in which extensive research was done. The brain areas that are affected in KS showed considerable overlap with the neural correlates of pain perception in other neurocognitive disorders. We discussed which different aspects of disturbed pain perception could play a role within KS, based on distinct neural damage and brain areas involved in pain perception. Combining current knowledge, we hypothesize that diminished pain perception in KS may be related to lesioned neural connections between cerebral cortical networks and relays of mainly the thalamus, the periaqueductal gray, and possibly lower brain stem regions projecting to the cerebellum. Based on these neural correlates of altered pain perception, we assume that increased pain thresholds, inhibition of pain signals, and disturbed input to cerebral and cerebellar cortical areas involved in pain processing, all are candidate mechanisms in cases of diminished pain perception in KS. We recommend that clinicians need to be alert for somatic morbidity in patients with KS. Due to altered neural processing of nociceptive input the clinical symptoms of somatic morbidity may present differently (i.e. limited pain responses) and therefore are at risk of being missed.

Duration of Exclusive Breastfeeding for Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis.

Cessation of exclusive breastfeeding (EBF) with early introduction of complementary food provides additional calories for catch-up growth but may also increase the risk of adverse outcomes. The objective of this study was to assess effects of exclusive breastfeeding for less than 6 months compared with 6 months in preterm and low birth weight infants. Data sources include Medline, Scopus, Web of Science, CINAHL, and Index Medicus through June 30, 2021. Study selection includes randomized trials and observational studies. Primary outcomes were mortality, morbidity, growth, and neurodevelopment. Data were extracted and pooled using random-effects models. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias of included studies. A total of 2 studies of 307 preterm or low birth weight infants were included. None of the study results could be pooled. Both studies compared EBF for 4 months to 6 months. Growth was similar between the 4-month and 6-month EBF groups for the following outcomes: weight-for-age z-score at corrected age 12 months (mean [standard deviation], 4-month group: -1.7 [1.1], 6-month group: -1.8 [1.2], 1 study, 188 participants, low certainty evidence), absolute weight gain (gram) from 16 to 26 weeks of age (4-month group: 1004 [366], 6-month group: 1017 [350], 1 study, 119 participants, very low certainty evidence), and linear growth gain (cm) from 16 to 26 weeks of age (4-month group: 4.3 [0.9], 6-month group: 4.5 [1.2], 1 study, 119 participants, very low certainty evidence). There were no apparent differences in reported morbidity symptoms. No difference in the timing to achieve motor development milestones between the 2 groups was found (1 study; 119 participants, very low certainty evidence). A limited number of studies prevented data pooling. The evidence is very uncertain about the effect of exclusive breastfeeding for less than 6 months for preterm and low birth weight infants. Further studies are warranted to better answer this question.

Benign Paroxysmal Positional Vertigo in Pregnancy

Background: Benign paroxysmal positional vertigo (BPPV) is a common clinical condition characterized by sudden, brief paroxysmal attacks of rotation vertigo occurred by changing the head position. BPPV is the most common peripheral vestibular pathology and is found frequently in females. There are very limited data on the association between BPPV and pregnancy. Objective: The objective of this study was to study the BPPV during pregnancy along with details of clinical manifestations and management. Patients and Methods: This is a cross-sectional study where pregnant women with BPPV were enrolled. The study was conducted between April 2020 and May 2022. Detailed neurological examinations were done at the vertigo clinic. Results: There were seven cases of BPPV associated with pregnancy in this study. The most common symptom was rotatory vertigo. All were diagnosed with the Dix–Hallpike test. All underwent Epley maneuver and symptoms resolved. Out of seven cases, two showed low 25-hydroxyvitamin D levels. Conclusion: Vertigo is a morbid symptom during pregnancy that affects both pregnant women and fetal status. To improve the quality of life during gestation, clinicians should consider this BPPV as an important clinical entity in their differential diagnosis of vertigo.

Pattern of psychiatric morbidity and somatic symptoms in a family medicine clinic of a University Teaching Hospital in Enugu, Southeast Nigeria

Introduction: Unexplained distressing bodily complaints like localised heaviness in the body, tingling, heat, pain and crawling sensations, unattributable to physical pathology and psychiatric morbidity, are common among patients that attend Family Medicine Clinic. Objectives: The study assessed patterns of psychiatric morbidity and somatisation symptoms Family Medicine Clinic of a University Teaching Hospital in Enugu, Southeast Nigeria. Methods: A cross-sectional survey of 81 somatising patients were part of a case-control study, selected by a consecutive sampling of 89 patients at the Family Medicine Clinic of the University of Nigeria Teaching Hospital, Enugu. Data was collected using the PHQ-15 and MINI plus English Version 6.0 and analysed with SPSS 21. Results: Seventy-six (93.3%) of the participants had psychiatric diagnoses. The most prevalent symptoms were heat sensations (75.3%), pain sensations (61.7%), crawling sensations (51.9%), heaviness (46.9%) and tingling/paresthesia (29.6%). The mean age at onset was 32.99 years. The mean duration was 6.07 years (±7.58). The study revealed that 76 (93.3%) participants had psychiatric diagnoses, and somatisation disorder was the most prevalent psychiatric disorder 71(87.7%). Conclusion: Knowledge of the patterns of somatisation symptoms and comorbid psychiatric conditions is vital for the effective management of these patients.

Postoperative Morbidity of Dental Paediatric Patients Treated under General Anaesthesia at a University Hospital: An Observational Study.

Aims To assess prevalence of postoperative morbidity signs and symptoms in children treated under GA, and to investigate the association between pre- and intra-operative factors with postoperative morbidity. Study design and Methods Prospective, observational study supported by pre-operative, intra-operative, and postoperative questionnaire conducted on paediatric patients treated for dental reasons under general anaesthesia at a university hospital. Results Hundred and fifty patients were included with average age 5.5 years. The majority (92%) experienced at least one postoperative morbidity sign and symptom on the day of treatment under GA and the majority of symptoms subside by the third day. Dental pain (81.3%), sleepiness (70%), and poor appetite (46.7%) were the most frequently reported. Logistic regression analysis showed that age, gender, type of treatment provided, use of LA, and duration of procedure were significantly associated with postoperative morbidity. Conclusions Most patients experienced one or more morbidity sign/s or symptom/s during first postoperative day and the majority subsides by the third day. Dental pain and poor appetite were the most and long lasting reported. Factors that would predict the occurrence of postoperative morbidity were gender, patient's age, and duration of procedure.

Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis

IntroductionSleep disturbances are common following traumatic brain injury (TBI) worsening morbidity and other neuropsychiatric symptoms. Post-TBI alterations in sleep architecture require further study.Objectives(1) To evaluate polysomnographic measures of sleep architecture in participants with history of TBI compared to controls and as meta-analyses of pooled means. (2) To evaluate effects of timing and severity of TBI on polysomnographic outcomes.MethodsPRISMA compliant systematic review was conducted of MEDLINE, PsycINFO, EMBASE and Scopus. Inclusion criteria: 1) reporting polysomnography in the context of TBI and 2) operationalizing TBI using clear/formalized criteria. Data were pooled in random-effects meta-analyses with outcomes expressed as mean differences (MD).ResultsIn participants with TBI, sleep was comprised of 19.39% REM sleep, 8.13% N1, 51.18% N2, and 17.53% N3, as determined by meta-analyses of single means. Total sleep time was reduced in chronic (>6 months) TBI compared to acute-intermediate TBI (<6 months) (p=0.01). Compared to controls, participants with TBI differed with increased N1 sleep (MD=0.64%; 95%CI=0.02,1.25; p=0.04), reduced sleep efficiency (MD=-1.65%; 95%CI=-3.18,-0.12; p=0.03), and reduced sleep latency on the multiple sleep latency test (MD=-5.90mins; 95%CI=-10.09,-1.72; p<0.01). On sub-group analyses, participants with mild TBI differed from controls with reduced total sleep time (MD=-29.22mins, 95%CI=-54.16,-4.27; p=0.02). Similarly, participants with acute-intermediate TBI exhibited increased sleep latency compared to controls (MD=8.96mins; 95%CI=4.07,13.85; p<0.01) and differed significantly from participants with chronic TBI (X2(1,N=608)=6.54; p=0.01).ConclusionsSleep architecture is altered following TBI with potential implications regarding functional outcomes and recovery. These alterations appear to differ based on severity of injury and time since injury.DisclosureNo significant relationships.

Vertigo in children - A review

Vertigo is a morbid symptom in the pediatric age group. It is not an uncommon clinical presentation in children. The etiopathology of vertigo in children is different from that of the adult age group. It is often not easy to evaluate this symptom in pediatric age group. In most cases, the children do not express their symptoms in detail and so clinicians cannot obtain adequate history and determine their exact etiology for vertigo. The benign paroxysmal vertigo is a common etiology in younger children, whereas the vestibular migraine is responsible for vertigo in majority of older children. Hence, pediatricians, otorhinolaryngologists, physicians, and neurologists often face difficulty in establishing the appropriate diagnosis of vertigo in children. The diagnosis of vertigo in children includes a detailed history, clinical examination, complete neurological examination, and audiological assessment. The treatment of vertigo in children includes the treatment of appropriate etiology. The prognosis of vestibular function recovery in children is often variable and unpredictable. Imaging such as computed tomography scans or magnetic resonance imaging is done in selected cases. The objective of this review article is to familiarize the readers with these complex disorders of children and with the current protocols in their management.

Laparoscopic Proximally Extended Colorectal Resection With Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Late Complications of Chronic Radiation Proctopathy.

BackgroundChronic radiation proctopathy (CRP) is a common complication after radiation therapy for pelvic malignancies. Compared with diversion surgery, resection surgery removes the damaged tissue completely to avoid the risks of recurrence and improve patients' outcome. Hence, resection surgery could be an optimal surgical approach when CRP is complicated by late complications. This study aimed to describe a modified surgical procedure of resection surgery and report its preliminary efficacy and safety in treating patients with CRP with late complications.MethodsWe retrospectively reviewed the patients who were diagnosed with CRP with late complications and underwent the modified surgical procedure of laparoscopic proximally extended colorectal resection with two-Stage Turnbull-Cutait pull-through coloanal anastomosis (PE-Bacon) between November 2019 and October 2020 in the Sixth Affiliated Hospital of Sun Yat-sen University.ResultsA total of 15 patients were performed the modified laparoscopic procedure of PE-Bacon, of which 1 patient underwent conversion from laparoscopic to open operation for intraoperative massive hemorrhage. Overall, the major (Clavien-Dindo III-V) postoperative complications occurred in 1 patient, anastomotic leakage was observed in 2 (13.3%) patients, and anastomotic stricture was observed in 4 (26.7%) patients. No patient had to be reoperated and died. Up to now, at the average follow-up of (524.40 ± 108.39) days, the preoperative symptoms of 93.3% (14/15) patients were relieved, with nine patients achieved complete remission, five patients only suffered minor symptoms. Because of the progression of radiation uropathy, one patient still had a vesicovaginal fistula as pre-operative complication. Colostomy reversal has been performed on 8 (53.3%) patients at an average postoperative duration of 299.5 ± 92.68 days, among whom only 2 patients suffered from major Low Anterior Resection Syndrome (LARS) until now.ConclusionsLaparoscopic PE-Bacon surgery is a safe and feasible surgical procedure for late complications of CRP with low morbidity and high symptom remission rate.

Impact of Psychotherapy and Cognitive restructuring on wellbeing of Geriatric Survivors of Covid-19 pandemic

The present study documents the impact of Psychotherapy on wellbeing of geriatric survivors of Covid -19, who were dealing with post covid complications both physiological and psychological. Some were referred by counsellors and some by family members and some were referred through their physicians as they refused to continue medication and were emotionally shattered. This document is about twenty such elderly people. Present psychological condition was comorbid with pre-existing medical condition of chronic Diabetes, hypertension and Arthritis. There routine medication as prescribed by their physicians continued and were not altered in any respect. They were only worked on the psychologically morbid symptoms that were affecting their wellbeing. A pre-test was done by administering WHO-5, a reliable and valid measure to screen wellbeing of individuals. The findings showed poor wellbeing. Psychotherapy and cognitive restructuring strategies were used in the intervention process. Psychotherapy helped in developing a deeper insight into the past events that were causing psychological turbulences in the present. Cognitive restructuring strategies were used to address the cognitive distortions. The findings indicated a significantly positive outcome and improvement in wellbeing when tested pre-post on WHO-5 scale. These techniques helped in alleviating symptoms of stress, depressive episodes, generalised anxiety and helped in regulating emotions, behaviour, and cognitions. They were also able to get to a functional state in dealing with loss of their loved ones. They moved on from helplessness to strength to self-acceptance. Conclusively, Psychotherapy and cognitive restructuring are effective in improving wellbeing of geriatric survivors dealing with psychological, affective and cognitive issues in post covid recovery period.

Deviated nasal septum in children: a review

Deviated nasal septum (DNS) is a common clinical entity in human beings. Deviated nasal septum (DNS) may also result in upper respiratory infection, sinusitis, headache, epistaxis, middle ear infection, and hyposmia which increase the morbidity of the child and hamper the quality of life. The common clinical symptoms associated with DNS among children are nasal obstruction and postnasal discharge. The chronic nasal block in DNS has an adverse effect on the development of the child. DNS has an important effect on the faciomaxillary growth and development, particularly in the first decade of life. The treatment of DNS in childhood has received challenges among otolaryngologists because of its concern about the role of the nasal septum in the overall growth of the midface. So, otolaryngologists are often cautious during the correction of the DNS in children. DNS and its impact on nasal breathing impairment in children are often underestimated by clinicians. Clinicians often have little knowledge on the impact of DNS, its clinical manifestations in children, and its appropriate management. Early intervention for DNS in children is helpful to prevent morbid symptoms and their complications. This review article discusses etiopathology, epidemiology, clinical presentations, diagnosis, and current treatment of the DNS in children.

Morbid Symptoms: What Did Gramsci Really Mean?

Abstract One of Gramsci’s most quoted phrases is his 1930 statement in the Prison Notebooks that ‘[t]he crisis consists precisely in the fact that the old is dying and the new cannot be born; in this interregnum a great variety of morbid symptoms appear’. This has traditionally been taken to refer to the emergence of fascism against a background of capitalist crisis and failure of anti-capitalist forces. However, a closer examination of the textual and historical context of that sentence indicates that Gramsci was more likely to have been referring to the pci’s ultraleft turn in conjunction with the Comintern’s Third Period.

Deviated nasal septum in children

Abstract Background: Nasal obstruction is a common symptom among children with numerous causes. Congenital or acquired nasal septal deviation may cause nasal obstruction in children. Deviated nasal septum (DNS) may also result in sinusitis, headache, epistaxis and hyposmia which increase the morbidity of the child and hamper the quality of life. The present study investigated the clinical details of the DNS among children at a tertiary care teaching hospital. Methods: This is a retrospective study was conducted at a tertiary care teaching hospital between November 2016 and December 2021. History of nasal obstruction, mouth breathing, nasal bleeding and sinusitis among children with DNS was noted. Anterior rhinoscopy, fiberoptic endoscopic examinations of both nostrils and imaging such as computed tomography were done in all participating children with DNS. Results: Out of 652 children who attended the outpatient department of otorhinolaryngology, 128 (19.6%) were diagnosed with DNS. Out of 128 children with DNS, 72 (56.3%) were male; male:female ratio was 1.28:1. Out of 128 children, 54 (42.2%) children showed C-shaped DNS, 27 (21.1%) showed anterior dislocation, 21 (16.4%) showed S-shaped DNS, 15 (11.8%) showed spur and 11 (8.6%) showed nasal septal thickening. Conclusions: DNS and its impact on nasal breathing impairment in children are often underestimated by clinicians. Clinicians often are unaware on the impact of DNS and its clinical manifestations in children and its appropriate management. Early intervention for DNS in children is helpful to prevent morbid symptoms and their complications.