scholarly journals Magnetic resonance imaging of temporomandibular joint in juvenile idiopathic arthritis

2020 ◽  
Vol 8 (5) ◽  
pp. 1848
Author(s):  
Namrita Sachdev ◽  
Yashvant Singh ◽  
Parikha Rampal ◽  
Sana .
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Joint Effusion ◽  
Facial Dysmorphism ◽  
Cross Sectional ◽  
Wide Range ◽  
Clinical Signs And Symptoms ◽  
Mri Changes ◽  
Sensitivity Specificity

Background: Juvenile Idiopathic Arthritis (JIA) is the most common autoimmune inflammatory synovial arthritis causing wide range of disability in children. The involvement of temporo-mandibular joint (TMJ) in JIA varies ranging from 17% to 87%. Unlike other synovial joints, the TM joint is particularly vulnerable to inflammatory damage as the mandibular growth plate is superficial. JIA is a clinical diagnosis and is characterized by synovial hyperplasia and inflammation leading to joint effusion. TMJ involvement is clinically difficult to assess and often goes untreated. Children with TMJ arthritis have mastication dysfunction and pain. Delayed detection and treatment leads to abnormalities like micrognathia, jaw deformity, facial dysmorphism and chewing problems. MRI is the most sensitive modality to diagnose synovitis and involvement of TMJ in children of JIA.Methods: A cross-sectional observational study was undertaken in 30 children diagnosed as JIA as per ILAE criteria. They were evaluated clinically followed by contrast enhanced MRI for evidence of TMJ arthritis.Results: Of the 60 joints evaluated, clinical involvement was found in 18 joints (10 patients). 12(66.7%) out of them had MRI changes. 3(7.1%) joints out of 42 asymptomatic joints had MRI changes. 13 joints had synovial hypertrophy, 8 joints showed bone erosions. Bone marrow edema was seen in 2 joints, with no evidence of cartilage involvement in any joint. The sensitivity, specificity, PPV and NPV of clinical examination to diagnose TMJ arthritis as compared to MRI was 80.0%, 86.7%, 66.7% and 92.7% respectively.Conclusions: With paucity of clinical signs and symptoms, early involvement of TMJ arthritis in children of JIA can be detected by MRI to prevent long term disability in patients.

scholarly journals The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

2021 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Luh Putu Listya Paramita ◽  
Robert Sinto ◽  
Fransiscus Nikodemus Hosea ◽  
Pringgodigdo Nugroho ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

STUDY OF ABSOLUTE, IMMATURE NEUTROPHIL COUNT AND CRP AS DIAGNOSTIC MARKERS FOR EARLY ONSET NEONATAL SEPSIS.

2021 ◽  
pp. 25-26
Author(s):  
Pooja Poswal ◽  
Manisha Rohilla ◽  
Sunil Arora ◽  
Irbinder Kour Bali
Keyword(s):  
Blood Culture ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Neonatal Sepsis is difcult to differentiate from other conditions due to non- specic clinical signs and symptoms. Inammation in neonates shows variations in hematological parameters. Our study is to evaluate the hematological parameters and C-reactive protein estimation in neonatal sepsis for early diagnosis. Material And Methods: It was a cross-sectional study including 80 neonates admitted in the neonatal care unit, 40 (proven sepsis) and 40 probable cases); blood culture being the gold standard. Hematological parameters, immature to total neutrophil ratio (I/T ratio), Absolute neutrophil count (ANC), CRP and Blood culture were done as per standard protocols. Results: ANC had highest sensitivity of 90% followed by I/T ratio (87.5%) and CRP (77.5%). The sensitivity and specicity for the combination of ANC and I/T ratio was 78.3% and 83.6% respectively. Conclusion: ANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in neonatal sepsis prediction and to start proper and timely antibiotic therapy.

An Update of Gorlin-Goltz Syndrome

2018 ◽  
Vol 7 (3) ◽  
pp. 38-41 ◽  
Author(s):  
Aliya Hasan ◽  
Dapo Akintola ◽  
Aliya Hasan ◽  
Dapo Akintola
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Oral Manifestations ◽  
Early Referral ◽  
Goltz Syndrome ◽  
Dental Practitioners ◽  
Wide Range ◽  
Risk Of Malignancy ◽  
Clinical Signs And Symptoms

Gorlin-Goltz syndrome encompasses a variety of clinical signs and symptoms including important oral manifestations which general dental practitioners should be aware of. In light of the risk of malignancy it is important to be aware of this syndrome and recognise the need for early referral for multidisciplinary management. This paper aims to discuss Gorlin-Goltz syndrome, the pathophysiology of the condition and address the wide range of clinical manifestations. The author will pay particular attention to the oral manifestations of the condition and the management of such anomalies.

scholarly journals Clinical symptoms, paraclinical tests and histopathological results in children with acute appendicitis in Zabol southeast of Iran: a cross-sectional study

2017 ◽  
Vol 5 (7) ◽  
pp. 2836
Author(s):  
Mehran Hesaraki
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Intestinal Loop ◽  
Negative Appendectomy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Histopathological Results

Background: This article aimed to assessment clinical signs and symptoms, paraclinical tests and histopathological results in children with acute appendicitis.Methods: A cross-sectional study conducted on 100 children with acute appendicitis in an urban hospital in southeast of Iran from January to December 2016. Participants were selected by simple random sampling method. Clinical signs and symptoms, paraclinical tests and histopathological results recorded in checklists. The data were analyzed using SPSS 22.Results: Mean age of the patients was 10.26±3.25, fourthly-eight of patients (58.5%) were males and 34 patients (41.5%) were females. The most frequent clinical signs and symptoms were acute suppurative appendicitis with peri appendicitis (45.83%) and acute suppurative appendicitis (39.58%). The most frequent results in ultrasound reports were Intestinal loop thickness greater than 6 mm without peristalsis (positive report) (46.34%) and Invisible appendix (nega Hesaraki tive report) (13.41%).Conclusions: The results of this study showed that abdominal pain and RLQ tenderness were the most common signs and symptoms and WBC left-shift was the most common laboratory finding. Since the rate of negative appendectomy in this study was consistent with surgical results and other articles, it is concluded that diagnostic accuracy of preoperative appendectomy was acceptable and most children with acute appendicitis underwent appendectomy.

scholarly journals Validity of selected clinical signs and symptoms in diagnosis of Schistosoma mansoni infection

1991 ◽  
Vol 33 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Maria Fernanda F. de Lima e Costa ◽  
Roberto S. Rocha ◽  
Daniel Colley ◽  
Giovanni Gazzenelli ◽  
Naftale Katz
Keyword(s):  
Schistosoma Mansoni ◽  
Endemic Area ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Predictive Values ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

Sensitivity, specificity and positive predictive values of selected clinical signs and symptoms in the diagnosis of Schistosoma mansoni infection were evaluated in 403 individuals (69% of inhabitants over 1 year of age) in an endemic area in Brazil (Divino). Highest sensitivity (13%) was found for blood in stools. Specificity over 90% was found for blood in stools, palpable liver with normal consistency and palpable hardened liver at middle clavicular (MCL) or middle sternal lines (MSL). Hardened liver at MSL (83%) or MCL (75%), and blood in stools (78%) presented higher positive predictive values for S. mansoni infection, while palpable liver with normal consistency at MCL (45%) or MSL (48%) presented smaller values. Enlarged liver without specification of its consistency has been traditionally used as an indicator of the infection in areas where malaria or Kalazar are not endemic. Our results demonstrate that the probability that a person with blood in stools or hardened palpable liver is infected is higher than among those with palpable liver with normal consistency.

scholarly journals Scorpion Venom and the Inflammatory Response

2010 ◽  
Vol 2010 ◽  
pp. 1-16 ◽  
Author(s):  
Vera L. Petricevich
Keyword(s):  
Inflammatory Response ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Biological Properties ◽  
Scorpion Venom ◽  
Multiple Organ ◽  
Chemical Compositions ◽  
Wide Range ◽  
Clinical Signs And Symptoms ◽  
High Doses

Scorpion venoms consist of a complex of several toxins that exhibit a wide range of biological properties and actions, as well as chemical compositions, toxicity, and pharmacokinetic and pharmacodynamic characteristics. These venoms are associated with high morbility and mortality, especially among children. Victims of envenoming by a scorpion suffer a variety of pathologies, involving mainly both sympathetic and parasympathetic stimulation as well as central manifestations such as irritability, hyperthermia, vomiting, profuse salivation, tremor, and convulsion. The clinical signs and symptoms observed in humans and experimental animals are related with an excessive systemic host inflammatory response to stings and stings, respectively. Although the pathophysiology of envenomation is complex and not yet fully understood, venom and immune responses are known to trigger the release of inflammatory mediators that are largely mediated by cytokines. In models of severe systemic inflammation produced by injection of high doses of venom or venoms products, the increase in production of proinflammatory cytokines significantly contributes to immunological imbalance, multiple organ dysfunction and death. The cytokines initiate a cascade of events that lead to illness behaviors such as fever, anorexia, and also physiological events in the host such as activation of vasodilatation, hypotension, and increased of vessel permeability.

scholarly journals Determinants of hypoxemia in children associated with pneumonia

2015 ◽  
Vol 7 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Pramila Ramawat ◽  
Balkishan Sharma
Keyword(s):  
Clinical Signs ◽  
Severe Pneumonia ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Specific Sign ◽  
Severe Manifestation ◽  
Clinical Signs And Symptoms ◽  
Very High

Background and Objectives: The most severe manifestation of pneumonia is hypoxemia has been shown to be a risk factor for morbidity and mortality. Authors investigated associating factors and determinants of hypoxemia in children with pneumonia.Materials and Methods: A cross-sectional study is designed among children of pediatric outpatient and emergency department that enrolled at Government Multi-Speciality Hospital, Chandigarh. One hundred fifty children recruited for study. The demographic and clinical parameters were recorded. Oxygen saturation measured by pulse oximeter.Results: The prevalence of hypoxemia was 48% and 61 (84.7%) infants aged 1 year found with hypoxemia. Age (p=0.006), respiratory rate (p=0.001) and severity of pneumonia (p=0.001) were strongly associated with hypoxemia. The prevalence of severe and very severe pneumonia among hypoxemic were 56.1% and 73.7% respectively. Central cyanosis (98.7%), peripheral (98.7%) cyanosis, head nodding (97.4%) grunting (96.15%) were highly specific but suprasternal (62.82%), subcostal (43.58%) and intercostal retractions (44.87%) were fairly specific sign. Sensitivity for subcostal (81.94%) and intercostal retractions (83.33%) was very high but was fair for intercostal (83.33%) retraction. Grunting (p=0.009), nasal flaring (p=0.008), subcostal (p=0.001) and intercostal (p=0.000) retractions were strongly but suprasternal retraction was significantly (p=0.024) associated with hypoxemia. Dyspnea (97.22%) was very sensitive while decrease feeding (84.61%) and irritability (83.33%) was highly but lethargy (58.97%) was fairly specific symptom.Conclusions: Study suggested that clinical signs and symptoms such as chest wall retraction, decrease feeding, dyspnea, grunting and nasal flaring in children with pneumonia may be utilized as markers for hypoxemia in conditions where pulse-oximeter isn’t available. This study supports the view of hypoxemia was disabling factor in better functional recovery in severity of pneumonia.Asian Journal of Medical Sciences Vol.7(2) 2015 64-70

scholarly journals Clinical Signs of Infection in Diabetic Foot Ulcers With High Microbial Load

2009 ◽  
Vol 11 (2) ◽  
pp. 119-128 ◽  
Author(s):  
Sue E. Gardner ◽  
Stephen L. Hillis ◽  
Rita A. Frantz
Keyword(s):  
Diabetic Foot ◽  
Medical Center ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Microbial Load ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Tissue Specimens

Aims. One proposed method to diagnose diabetic foot ulcers (DFUs) for infection is clinical examination. Twelve different signs of infection have been reported. The purpose of this study was to examine diagnostic validity of each individual clinical sign, a combination of signs recommended by the Infectious Disease Society of America (IDSA), and a composite predictor based on all signs of localized wound infection in identifying DFU infection, among a sample of DFUs. Methods. A cross-sectional research design was used. Sixty-four individuals with DFUs were recruited from a Department of Veterans Affairs Medical Center and an academic-affiliated hospital. Each DFU was independently assessed by 2 research team members using the clinical signs and symptoms checklist. Tissue specimens were then obtained via wound biopsy and quantitatively processed. Ulcers with more than 106 organisms per gram of tissue were defined as having high microbial load. Individual signs and the IDSA combination were assessed for validity by calculating sensitivity, specificity, and concordance probability. The composite predictor was analyzed using c-index and receiver operating curves. Results. Twenty-five (39%) of the DFUs had high microbial loads. No individual sign was a significant predictor of high microbial load. The IDSA combination was not a significant predictor either. The c-index of the composite predictor was .645 with a 95% confidence interval of .559-.732. Conclusions. Individual signs of infection do not perform well nor does the IDSA combination of signs. However, a composite predictor based on all signs provides a moderate level of discrimination, suggesting clinical use. Larger sample sizes and alternate reference standards are recommended.

scholarly journals How long before hospital admission do the symptoms of heart failure decompensation arise?

2019 ◽  
Vol 27 ◽  
Author(s):  
Maraísa Carine Born ◽  
Karina de Oliveira Azzolin ◽  
Emiliane Nogueira de Souza
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Clinical Signs ◽  
Emergency Admission ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Heart Failure Decompensation

ABSTRACT Objective: to identify the signs and symptoms of decompensation of heart failure (HF) and the duration of time to hospital admission. Method: this is a cross-sectional study with adult patients hospitalized for decompensated HF in a teaching hospital located in southern Brazil from July to October 2017. Data collection was performed through a structured questionnaire that included sociodemographic, clinical signs and symptoms of HF. In the data analysis, the following tests were applied: t-Student, Mann Whitney U-Test, Chi-Square Tests. Results: 94 patients, aged between 42 and 98 years old (mean of 71.2 years old) were included. The most prevalent signs and symptoms before emergency admission were dyspnea (79.8%), cough (29.8%), orthopnea (27.7%), edema (23.4%), and fatigue (22.3%). The median time from onset of signs and symptoms to arrival in the emergency room is fatigue and edema 7 days, orthopnea 5 days, cough 4 days and dyspnea 3 days. Conclusion: the set of classic signs and symptoms of decompensation of HF occurs around seven days before the emergency search and dyspnea is the worsening that leads the patient to a hospital emergency.

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