scholarly journals Mania and hypomania associated with COVID-19: a series of 15 cases seen by the consultation-liaison psychiatry service in Qatar

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Yousaf Iqbal ◽  
Majid Alabdulla ◽  
Javed Latoo ◽  
Rajeev Kumar ◽  
Sultan Albrahim ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Past History ◽  
Polymerase Chain Reaction Test ◽  
Upper Respiratory Tract ◽  
Liaison Psychiatry ◽  
Retrospective Case ◽  
Potential Risk Factors ◽  
History Of ◽  
Sporadic Cases ◽  
Chain Reaction Test

Background: A range of neuropsychiatric diagnoses have been reported in association with coronavirus disease 2019 (COVID-19). However, only sporadic cases of mania or hypomania have been reported in patients with COVID-19. This study aimed to report clinical characteristics of 15 consecutive cases of COVID-19-associated mania or hypomania seen in three general hospitals in Qatar in the early months of the pandemic in 2020. Methods: This study is a retrospective case-note review of 15 cases of COVID-19-associated mania or hypomania (confirmed by polymerase chain reaction test), seen as inpatient consultations out of the first 100 consecutive patients managed by consultation-liaison psychiatric teams in Qatar between 2 March 2020 and 7 July 2020. Results: The mean age of the 15 patients was 40 years. Twelve patients had mania, and three had hypomania. Regarding the physical severity of COVID-19, 10 patients were asymptomatic, two had upper respiratory tract symptoms alone and three had pneumonia. None of the patients were intubated. Potential risk factors for mania/hypomania included pandemic-related psychosocial stress before admission (n = 9), past history of mania/bipolar disorder (n = 6) or psychosis (n = 2), raised inflammatory markers (n = 7) and steroid use (n = 3). None had a history of recent substance misuse. Other than one patient with advanced cancer, none had comorbidity regarded as likely to have caused mania or hypomania. Three patients had mild white matter ischaemic changes on brain imaging. Standard pharmacological treatment for mania (i.e. antipsychotic medication supplemented by prn benzodiazepines) was effective. Ten patients were discharged home from the COVID-19 facility where they presented, but five required transfer to Qatar's psychiatric hospital for further treatment of mania. Conclusion: The association of mania or hypomania with COVID-19 may be spurious (e.g. representing an initial presentation of bipolar disorder) or causal. The reported cases illustrate a range of potential aetiological mechanisms by which COVID-19 could cause mania or hypomania. Cohort studies are necessary to determine the incidence, aetiology and prognosis of COVID-19-associated mania/hypomania.

scholarly journals Prolonged persistence of SARS-CoV-2 in the upper respiratory tract of asymptomatic infected individuals

QJM ◽  
2020 ◽  
Vol 113 (8) ◽  
pp. 556-560 ◽  
Author(s):  
S Saurabh ◽  
R Kumar ◽  
M K Gupta ◽  
P Bhardwaj ◽  
V L Nag ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Polymerase Chain Reaction Test ◽  
Considerable Proportion ◽  
Upper Respiratory Tract ◽  
Virus Persistence ◽  
Gamma Distributions ◽  
Upper Respiratory ◽  
Asymptomatic Individuals ◽  
Log Normal ◽  
Chain Reaction Test

Summary Background Duration of persistence of SARS-CoV-2 in the upper respiratory tract of infected individuals has important clinical and epidemiological implications. Aim We aimed to establish the duration and risk factors for persistence of SARS-CoV-2 in the upper respiratory tract of asymptomatic infected individuals. Methods Data of repeat rRT-PCR (real-time reverse transcription-polymerase chain reaction) test done for SARS-CoV-2 infected individuals at our institute at Jodhpur, India were analysed from 19 March to 21 May 2020. Duration of virus persistence was estimated with parametric regression models based on weibull, log-normal, log-logistic, gamma and generalized gamma distributions. Factors associated with prolonged viral persistence were analysed with the best-fitting model. Results Fifty-one SARS-CoV-2 infected individuals with repeat rRT-PCR test were identified with 44 asymptomatics. The asymptomatic individuals had median virus persistence duration of 8.87 days (95% CI: 7.65–10.27) and 95 percentile duration of 20.70 days (95% CI: 16.08–28.20). The overall median virus persistence including both symptomatic and asymptomatic individuals was found to be 9.18 days (95% CI: 8.04–10.48). Around one-fourth asymptomatics (10/44) demonstrated SARS-CoV-2 persistence beyond 2 weeks. Age <60 years and local transmission were found to be significantly associated with longer virus persistence among asymptomatic individuals on univariate regression but not in multivariate analysis. Conclusion Recommended home isolation duration for SARS-CoV-2 infected individuals in India should be extended from 17 days to at least 3 weeks. Prolonged persistence of SARS-CoV-2 in a considerable proportion of asymptomatic individuals merits attention with regard to ensuring universal infection prevention precautions irrespective of symptomatic status.

Risk factors for HIV infection in a gynaeco - obstetric population in Vietnam — a case-control study

Sexual Health ◽  
2005 ◽  
Vol 2 (2) ◽  
pp. 71 ◽  
Author(s):  
Thi Thu Ha Tran ◽  
Brian P. Mulhall ◽  
Petra Macaskill ◽  
Thanh Quang Nguyen
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Case Control Study ◽  
Past History ◽  
Hiv Infections ◽  
Case Control ◽  
Potential Risk Factors ◽  
History Of ◽  
Control Study ◽  
Current History

Background: Vietnam has an emerging HIV epidemic, particularly in male drug injectors. Data on HIV infections in women in the general population, and their risk factors, are scanty. Methods: A case-control study was performed in a large gynaeco–obstetric hospital in Haiphong city in 1998–2001. The sample was 22000 attendees. The medical records of 58 HIV-seropositive cases were compared with 422 randomly chosen HIV-seronegative controls for potential risk factors. Results: A multivariate analysis found that HIV infection was associated with young age, past/current history of sexually transmitted infections (STI) and being unemployed. Patients aged 21–30 years were 10-fold less likely to be infected than women aged <20 years (OR 0.11, 95%CI 0.04–0.33). Women with a past/current history of STI had over 20 times the risk of those who did not (95% CI 6.7–62.3). Unemployed women had at least twice the risk of infection of any other occupational group. Conclusions: We have identified risk factors in women that have not been highlighted previously in Vietnam. Our study suggests that all antenatal women, especially those who are young or unemployed (or, with a current/past history of STI), should be offered free HIV tests, counselling and management.

A Retrospective Case-Note Study of Bipolar Disorder in Old Age

1991 ◽  
Vol 158 (4) ◽  
pp. 485-490 ◽  
Author(s):  
John Snowdon
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Age Of Onset ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Case Note ◽  
Retrospective Case ◽  
History Of ◽  
Study Case ◽  
Reason For Admission

In a replication of an earlier published study, case notes of 75 elderly in-patients with bipolar affective disorder were examined. Few of the patients had experienced a manic episode before the age of 40. Mean age of onset of affective disorder was 46 years, and first manic episode at 60 years. Cerebral insults before the first manic attacks were recorded in a substantial number of cases, and a family history of mental illness was less common among this group. Bipolar affective disorder is relatively common as a reason for admission of elderly patients.

scholarly journals Septal rhinoscleroma

2010 ◽  
Vol 43 (02) ◽  
pp. 219-221
Author(s):  
Mohamed A. Shoeib
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Nasal Cavity ◽  
Past History ◽  
Inferior Turbinate ◽  
Upper Respiratory Tract ◽  
History Of ◽  
Upper Respiratory ◽  
The Right ◽  
Tip Rhinoplasty

ABSTRACTRhinoscleroma is a chronic granulomatous condition of the nose and other structures of the upper respiratory tract. Infection by the bacterium Klebsiella rhinoscleromatis is said to be the cause. A female patient aged 45 years, presented with a past history of trauma to the nose and swelling on her nose since last 1 year. There was nasal asymmetry and internal nasal examination showed a septal swelling protruding to the right nasal cavity with hypertrophied nasal mucosa and inferior turbinate. Open tip rhinoplasty approach was used to excise the mass, which examined pathologically revealing a rhinoscleroma, fibrotic infiltrative stage.

scholarly journals Acute respiratory infections in children from an ENT perspective

2015 ◽  
Vol 10 (2) ◽  
pp. 172-175
Author(s):  
A. ZAMFIR-CHIRU-ANTON ◽  
◽  
N. MANEA ◽  
D.C. GHEORGHE ◽  
◽  
...  
Keyword(s):  
Soft Palate ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Case Series ◽  
Pulmonary Complications ◽  
Upper Respiratory Tract ◽  
Retrospective Case ◽  
History Of ◽  
Upper Respiratory ◽  
Tract Infections

Background. Adenoidectomy remains a frequent surgical approach for recurrent upper respiratory tract infections (URTI) in children. We research if only age and collectivity are responsible for recurrences, or other anatomic conditions can account for the history of the patient. Design. Retrospective case series review. Material and method. Questionnaire about respiratory symptoms and correlations observed between the history of the patient and the presence or absence of short soft palate. Results. 102 children could provide enough data to be included in the study. Frequent URTI were observed in 30% of the affected children and only 16% of their normal peers. 41% of URTIs each persisted longer than 10 days in short soft palate children vs. 17% in normal patients. Broncho-pulmonary complications were encountered in 44% of children with short palate as opposed to 27% in others. Conclusions. Short velli palatini can disturb normal swallowing process and allow rhinopharyngeal chronic inflammation. That can lead to persistent recurrent URTIs, more probable chronic obstruction through the adenoids and other diseases in pediatric ENT practice.

scholarly journals Paediatric multisystem inflammatory syndrome in a ten-year old boy in a resource limited setting: a case for locally developed diagnostic criteria

2021 ◽  
Vol 3 (1) ◽  
pp. 01-03
Author(s):  
Animasahun Ba
Keyword(s):  
Complete Blood Count ◽  
Polymerase Chain Reaction Test ◽  
High Grade Fever ◽  
Resource Limited ◽  
History Of ◽  
Polymerase Chain ◽  
Chain Reaction Test ◽  
Control Criteria ◽  
Inflammatory Syndrome ◽  
Limited Setting

Paediatric multisystem inflammatory syndrome (PMIS) occurs two to four weeks following exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus 2019 (COVID-19). It is characterized by the presence of persistent fever, inflammation and organ dysfunction. We present AE a 10-year old Nigerian boy who presented to the children emergency room with a history of continuous and high grade fever with back and multiple joint pains. While on admission he developed cough, difficulty with breathing, bleeding from the gums and altered consciousness which progressed to loss of consciousness. Complete blood count showed neutrophilia of 82.9%, lymphopenia of 9.8%, thrombocytopenia of 142,000 cells/mm3, elevated erythrocyte sedimentation rate of 75mm/hr, chest radiograph findings of ground glass appearance and consolidation in all lung lobes bilaterally with a positive reverse transcriptase-polymerase chain reaction test for COVID-19 which met the Centre for Disease Control criteria for the diagnosis of pediatric multisystem inflammatory syndrome. The patient was treated with intranasal oxygen, transfused with fresh whole blood, analgesics and antifailure drugs. His condition however deteriorated while on admission and died on the seven days of admission.

scholarly journals Clinical difference between acute appendicitis and acute right-sided colonic diverticulitis

2020 ◽  
Author(s):  
Ji Ho Song ◽  
Sanghun Lee ◽  
Han Ho ◽  
Jun Seok Seo ◽  
Jeong Hun Lee ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Acute Appendicitis ◽  
Logistic Regression Analysis ◽  
Past History ◽  
Colonic Diverticulitis ◽  
Retrospective Case ◽  
Laboratory Findings ◽  
Clinical Difference ◽  
History Of

Abstract Background: The clinical presentations of acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are similar, but the usual treatment for each disease differs between surgical and conservative management. This study aimed to identify the clinical differences between AA and ARCD.Method: We performed a single-center retrospective case-control study on adult patients with AA and ARCD confirmed by computed tomography who had visited an emergency department between March 2018 and February 2019. The clinical variables, including past medical history, presented symptoms and signs, and laboratory findings were compared between the two groups. We subsequently performed a logistic regression analysis for differentiating ARCD from AA based on the results of univariate analyses.Results: A total of 222 (79%) and 59 (21%) patients were enrolled in the AA and ARSD groups, respectively. Logistic regression analysis revealed that factors associated with ARCD were a past history of diverticulitis [OR 141.691 (95% CI: 12.222 – 1642.601), p < 0.001], ketonuria [OR 0.268 (95% CI: 0.099 – 0.726), p = 0.010], anorexia [OR 0.037 (95% CI: 0.007 – 0.207), p < 0.001], and neutrophilia [OR 0.179 (95% CI: 0.062 – 0.519), p = 0.002].Conclusion: Anorexia, neutrophilia, and ketonuria were predictors of AA and a history of diverticulitis was a predictor of ARCD.

Varenicline-Induced Mixed Mood and Psychotic Episode in a Patient with a Past History of Depression

CNS Spectrums ◽  
2008 ◽  
Vol 13 (6) ◽  
pp. 511-514 ◽  
Author(s):  
Andres J. Pumariega ◽  
Robert Nelson ◽  
Larry Rotenberg
Keyword(s):  
Bipolar Disorder ◽  
Adverse Effects ◽  
Preventive Measures ◽  
Past History ◽  
Psychotic Episode ◽  
Promising Agent ◽  
History Of ◽  
Effective Use ◽  
Psychiatric Adverse Effects ◽  
History Of Depression

ABSTRACTVarenicline is a promising agent with demonstrated efficacy in the promotion of smoking cessation. However, from the time of initial trials, it has been associated with significant psychiatric adverse effects. We describe a case where mixed mood and psychotic disturbance developed in an individual with a history of depression and a family history of bipolar disorder. Based on this case, we hypothesize a possible mechanism of action for these adverse effects and preventive measures that could be undertaken in its effective use.

scholarly journals Gastrointestinal injurious insults in gynecological surgical procedures at El Sahel Hospital

2020 ◽  
Keyword(s):  
Risk Factors ◽  
Research Study ◽  
Past History ◽  
Significant Risk ◽  
Gynecologic Surgery ◽  
Retrospective Case ◽  
P Values ◽  
Control Research ◽  
Gynecological Surgical Procedures ◽  
History Of

Background: Gastrointestinal surgical insults during operative gynecologic procedures varies considerably according to the procedure. Prognostic tools and risk factors should be elucidated by further research efforts to enhance management levels of those cases category Aim of the work: To investigate the risk factors, impact and severity as regards gastrointestinal injuries during gynecological and obstetrical operations Methodology: A retrospective case-control research study performed on cases who have underwent gynecologic surgery in the period between 2014 and 2019. Results: Risk factors for gastrointestinal injuries in which past history of abdominal operation , pelvic adhesions, previous pelvic operation have shown to be statistically significant risk factors for GIT injuries (p values = 0.007, 0.019, consecutively) Conclusions and Recommendations: Innovation of a surgical prognosis algorithm based on statistical analysis is considered the cornerstone of enhancement of surgical management of gynecologically challenging cases aiding in reducing gastrointestinal surgical insults within gynecological surgical practice.

scholarly journals Unusual Chief Complaint of Patient with History of Vaccination Leading to Unrecognized Human Rabies with Extreme Risk of Saliva Exposure for Medical Personnel-A Case Report and Literature Review

2020 ◽  
Author(s):  
Kittisak Sripong
Keyword(s):  
Case Report ◽  
Medical Personnel ◽  
Chief Complaint ◽  
Polymerase Chain Reaction Test ◽  
Human Rabies ◽  
Extreme Risk ◽  
History Of ◽  
Polymerase Chain ◽  
Chain Reaction Test ◽  
The Brain

The aim of this case report is to present an unrecognized case of human rabies with an unusual chief complaint-chest pain-at presentation. The patient had been vaccinated for rabies, presented multiple times at the emergency room, was discharged each time, and was eventually found dead at his house with an unknown cause of death. A post-mortem examination along with a trans-orbital necropsy and real-time reverse transcription polymerase chain reaction test were performed. The results showed rabies virus in the brain tissue.

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