Unusual Anastomotic Failure in Patients with COVID-19: A Case Report of 2 Patients

Introduction: A newly appeared challenge for the healthcare system is the variety of clinical symptoms of COVID-19. In this research, we report 2 cases admitted to Modarres Hospital with unusual postoperative anastomotic failure. Case Presentation: In a 72-year-old man with a perforated peptic ulcer in D2 and signs of leakage after the first operation and during the second operation due to massive unexpected hemorrhage, we found fully disrupted anastomosis on the second part of the duodenum. Accordingly, the suture ligature of the bleeding ulcer with the closure of the duodenal stump and loop gastrojejunostomy and tube duodenostomy were performed. During the postoperative period, he developed dyspnea, and the diagnostic test of SARS-CoV-2 confirmed him as a case of COVID-19. Unfortunately, 1 week after the second surgery, evidence of anastomotic leakage appeared again by bile discharge from drains; although it was managed conservatively, he died because of respiratory failure. In another case, a 65-year-old woman was admitted to the emergency ward with closed-loop small bowel obstruction. After emergency laparotomy, resection of ischemic bowel with primary anastomosis was performed. The same as the previous case, she developed dyspnea, and the diagnostic test resulted positive for COVID-19. After 2 weeks, she was admitted to the hospital with signs of anastomotic leakage that was subsequently confirmed by abdominal computed tomography (CT); although it was managed conservatively, she died because of respiratory failure due to COVID-19. Conclusions: These cases were unique in that intestinal microangiopathies can cause very severe problems, weaken the body, and eventually death, as we have seen in these 2 cases.

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Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season

Scientific Reports ◽

10.1038/s41598-021-81558-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yuyun Li ◽

Dongming Wang ◽

Lili Zhi ◽

Yunmei Zhu ◽

Lan Qiao ◽

...

Keyword(s):

Respiratory Tract ◽

Allergic Asthma ◽

Respiratory Tract Infections ◽

Allergen Immunotherapy ◽

Clinical Symptoms ◽

Influenza Season ◽

The Body ◽

History Of ◽

Tract Infections ◽

Stage 1

AbstractTo describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.

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One-generation reproduction toxicity study of Dithane M-45 (mancozeb) and lead acetate

Acta Veterinaria Hungarica ◽

10.1556/avet.50.2002.3.12 ◽

2002 ◽

Vol 50 (3) ◽

pp. 365-371 ◽

Cited By ~ 1

Author(s):

L. Várnagy ◽

P. Budai ◽

E. Molnár ◽

Keyword(s):

Body Weight ◽

Lead Acetate ◽

Clinical Symptoms ◽

Reproductive Toxicity ◽

The Body ◽

High Dose ◽

Lactation Period ◽

Treatment Groups ◽

Body Weight Increase ◽

Dose Levels

The reproductive toxicity of lead acetate and of a fungicide formulation (Dithane M-45) containing 80% mancozeb was studied on rats. Lead acetate was applied in the feed in the following dose groups: control, 1,000, 5,000 and 10,000 mg/kg of diet. The three treatment groups received, in addition to the above doses of lead acetate, 4,500 mg/kg Dithane M-45 in the diet. The method was based on the OECD Guideline for Testing of Chemicals No. 415 (1981). Clinical symptoms and mortality were not found in the parent generation. The body weight of female animals decreased significantly before the pregnancy period. This tendency was also seen in males after the combination treatment. At the two high dose levels a remarkable body weight increase was seen in the female animals during the lactation period. As a result of treatment, decreased body weight of offspring was measured during the lactation period. No gross pathological changes were seen. Histological examination showed general tubulonephrosis in the experimental animals. It can be established that the administration of Dithane M-45 did not enhance the reproductive toxicity of lead acetate.

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A Case of Invasive Mole

Faridpur Medical College Journal ◽

10.3329/fmcj.v12i2.34236 ◽

2017 ◽

Vol 12 (2) ◽

pp. 86-87

Author(s):

Shahana Ahmed ◽

Dipti Rani Shaha

Keyword(s):

Hydatidiform Mole ◽

The Body ◽

Emergency Laparotomy ◽

Molar Pregnancy ◽

Complete Hydatidiform Mole ◽

Partial Hydatidiform Mole ◽

Normal Limits ◽

History Of ◽

Invasive Mole

Invasive mole is a condition where a molar pregnancy, such as a partial hydatidiform mole or complete hydatidiform mole, invades the wall of the uterus, potentially spreading and metastasizing to other parts of the body. Here is a case who presented with history of evacuation for molar pregnancy. She presented with irregular P/V bleeding on and off and after admission silent perforation with massive haemoperitoneum was detected for which emergency laparotomy was done. She recovered and was followed up till her b-hCG levels were within normal limits. As patient presented to us with haemoperitoneum and on laparotomy, there was invasion into whole of the uterus, it could not be saved and hysterectomy was done.Faridpur Med. Coll. J. Jul 2017;12(2): 86-87

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DIAGNOSIS OF ORAL MUCOSAL PATHOLOGY IN PATIENTS WITH VARIOUS MANIFESTATIONS OF GROUP B VITAMIN IMBALANCE

The actual problems in dentistry ◽

10.18481/2077-7566-20-16-4-77-83 ◽

2021 ◽

Vol 16 (4) ◽

pp. 77-83

Author(s):

Anna Yatsenko ◽

Lidiya Trankovskaya ◽

Olga Artyulova

Keyword(s):

Oral Cavity ◽

Oral Mucosa ◽

Human Body ◽

Clinical Symptoms ◽

Negative Impact ◽

Vitamin B12 Deficiency ◽

Vitamin Deficiency ◽

The Body ◽

B Vitamins ◽

Group B

Subject. The scientific works of recent years show an increase in the degree of negative impact of vitamin deficiency and vitamin-like substances on the state of health of the population. With the deficiency of most vitamins, synthetic processes and regeneration of oral tissues are reduced, so often the initial signs of hypovitaminosis are stomatitis, gingivitis, glossitis, and therefore, it is dentists who are the first to diagnose deviations in the body associated with vitamin deficiency. This justifies the relevance and practical value of studying and describing clinical cases of manifestations of deficient vitamin conditions in the oral cavity. The object – is to study the effect of B vitamins on the oral mucosa in order to increase the effectiveness of diagnosis of vitamin-deficient conditions of the human body. Methodology. These clinical examples illustrate the management experience of patients with manifestations of deficient vitamin conditions on the oral mucosa. Clinical and laboratory methods of diagnosing the analysed conditions of the organism were applied. Statistical processing of materials was carried out using the STATISTICA 10 software (StatSoft, Inc., USA). Results. The deficient condition of the organism in relation to vitamins B2, B6, B12 in patients 18-75 years old has been studied. Characteristic clinical changes on the oral mucosa of the examined patients were established. So, in most patients with vitamin B2 deficiency, the classic Sebrel triad was found: dermatitis, glossitis, cheilitis. In those examined with a lack of vitamin B6, language desquamations (smoothed, polished language) were determined in the 83.6%, often combined with glossodinia. Patients with vitamin B12 deficiency were characterized by a lesion in the form of Meller-Gunter glossitis in 74.9% of cases, moreover, 67.6% of patients showed paresthesia in the area of tongue and oral mucosa. Conclusions. The study found that the first clinical symptoms of deficient conditions of the presented vitamins of group B were found from the oral cavity. Thus, it is the dentist who is the first to diagnose the pathological states of lack of group B vitamins in the human body, which emphasizes the importance and relevance of continuing to study these states of the body.

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Diagnostic significance of clinical and para-clinical signs of community-acquired pneumonia in children

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(2)-08 ◽

2020 ◽

Vol 24 (2) ◽

pp. 244-249

Author(s):

V.Yu. Pasik

Keyword(s):

Young Children ◽

Sensitivity And Specificity ◽

Clinical Symptoms ◽

Clinical Signs ◽

The Body ◽

Diagnostic Methods ◽

Statistical Hypothesis ◽

Diagnostic Significance ◽

Operational Characteristics ◽

Gallbladder Dyskinesia

Annotation. Respiratory diseases are relevant in pediatric practice, which is associated with its widespread and frequent complications, especially in young children. The aim of the study was to assess the diagnostic value of clinical symptoms, laboratory and ultra-sonographic parameters in pneumonia in children of the first 3 years of life. A retrospective study of medical records of 218 children who were hospitalized in the department for young children diagnosed with pneumonia for the period from 2016 to 2018. The average age of children was 11.67±9.97 months and it was within the range from 1 month to 3 years. The ration of boys and girls was practically identical (51.8% and 48.2% accordingly). The first group included children aged under one year (the average age is 4.57±0.84 months; n=88). The second group included children aged from 1 to 3 years (the average age is 18.2±4.25 months; n=130). To characterize the information content of clinical and laboratory symptoms the study has used objective parameters defined as the operational characteristics of tests. The most important operational characteristics of diagnostic methods included: sensitivity (Se, sensitivity) and specificity (Sp, specificity). To check the statistical hypothesis on differences of absolute and relative frequencies, fractions, and ratios in two independent samples, the criteria of хі-square (χ2) was used. While detailing an anamnesis, the disease was more often related to untimely treatment and outpatient care. Various data were obtained on the absolute and relative risk, as well as the sensitivity and specificity of the localization of pneumonia depending on age. Therefore, the incidence of bilateral pneumonia was considered an indicator of risk. On admission to hospital, the body temperature of patients was 38.2±0.66°С. Most of the complaints were on the unproductive or productive cough. Besides, in some cases, shortness of breath and runny nose were mentioned. Thus, in young children with pneumonia, a diagnostically significant clinical symptom is a bilateral lung impression (82.6%), compared with right-handed (15.1%) and left-handed (2.3%), which is significantly more common in children under 1-th year of life compared with patients 1–3 years; laboratory features are probably higher levels of liver-specific enzymes – ALT and AST in children under 1 year; ultrasonographic indicators associated with the presence of pneumonia in young children include increased liver size, gallbladder deformity, the presence of sediment in the gallbladder, dyskinesia of the biliary tract, thickening of the gallbladder wall; children under 1 year of age have a risk of liver enlargement and biliary dyskinesia.

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Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

Annals of African Surgery ◽

10.4314/aas.v18i3.9 ◽

2021 ◽

Vol 18 (3) ◽

pp. 176-179

Author(s):

Ephraim Bitilinyu-Bangoh ◽

Fatsani Mwale ◽

Loveness Ulunji Chawinga ◽

Gift Mulima

Keyword(s):

Hospital Stay ◽

Anastomotic Leakage ◽

Primary Anastomosis ◽

Length Of Hospital Stay ◽

Operative Management ◽

Sigmoid Resection ◽

Sigmoid Volvulus ◽

Hartmann’S Procedure ◽

Hartmann's Procedure ◽

Kamuzu Central Hospital

Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to describe the surgical management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has significant oedema or is gangrenous.

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An Evaluation of Thrombotic Tendency by Whole-Body Enhanced CT Scan for Critical COVID-19 Pneumonia: A Case Series Study

10.21203/rs.3.rs-282409/v1 ◽

2021 ◽

Author(s):

Fumihiro Ogawa ◽

Yasufumi Oi ◽

Kento Nakajima ◽

Reo Matsumura ◽

Tomoki Nakagawa ◽

...

Keyword(s):

Respiratory Failure ◽

Ct Scan ◽

Clinical Symptoms ◽

Degradation Products ◽

Thrombus Formation ◽

Case Series ◽

Whole Body ◽

Pathological Feature ◽

Case Series Study ◽

Enhanced Ct

Abstract Background: Coronavirus disease (COVID-19) pneumonitis associated with severe respiratory failure has a high mortality rate. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently observed. Coagulopathy has emerged as a significant contributor to thrombotic complications. Although recommendations have been made for anticoagulant use for COVID-19, no guidelines have been specified.Case presentation: We describe four cases of critical COVID-19 with thrombosis detected by enhanced CT scan. The CT findings of all cases demonstrated typical findings of COVID-19 and pulmonary embolism or deep venous thrombus without critical exacerbation. Two patients died of respiratory failure due to COVID-19.Discussion: Previous reports have suggested coagulopathy with thrombotic signs as the main pathological feature of COVID-19, but no previous reports have focused on coagulopathy evaluated by whole-body enhanced CT scan. Changes in hemostatic biomarkers, represented by an increase in D-dimer and fibrin/fibrinogen degradation products, indicated that the essence of coagulopathy was massive fibrin formation. Although there were no clinical symptoms related to their prognosis, critical COVID-19-induced systemic thrombus formation was observed. Conclusions: Therapeutic dose anticoagulants should be considered for critical COVID-19 because of induced coagulopathy, and aggressive follow-up by whole body enhanced CT scan for systemic venous thromboembolism (VTE) is necessary.

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Streptococcus suis infection: Clinical manifestations

Medicinski pregled ◽

10.2298/mpns0506236d ◽

2005 ◽

Vol 58 (5-6) ◽

pp. 236-239 ◽

Cited By ~ 8

Author(s):

Julijana Dragojlovic ◽

Branko Milosevic ◽

Neda Sasic ◽

Miomir Pelemis ◽

Milan Sasic

Keyword(s):

Hearing Loss ◽

Bacterial Meningitis ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Sensorineural Deafness ◽

Streptococcus Suis ◽

The Body ◽

Effective Prevention ◽

Sporadic Disease ◽

Male Patients

Introduction Streptococcus suis is a bacterium causing a disease in pigs and rarely in humans. This zoonosis is mostly found as a sporadic disease in individuals that were in contact with the affected or infected pigs: farmers, veterinarians and workers engaged in fresh pork processing. It is assumed that the bacterium enters the body through a cut abrasion in the skin. Initially, the condition resembles a flu, followed by signs of bacteriemia and sepsis. The most frequent clinical manifestation of Streptococcus suis infection is meningitis, leading to hearing loss in over 75% of patients, and subsequent arthritis, endophtalmitis, endocarditis and pneumonia. Toxic shock syndrome with hemorhagic manifestations rarely develops. Material and methods This study included five male patients aged 22 to 63 years treated in the Intensive Care Unit of the Institute of Infectious and Tropical Diseases in Belgrade, due to Streptococcus suis infection. The aim of this study was to point to the existence of this bacteria in our environment, to describe clinical manifestations of the disease and to point out the importance of its prevention. Results All patients had epidemiological evidence of being in contact with pork meat. There were no data about diseased pigs. The estimated incubation period was 4 to 8 days. All patients had meningeal signs. Clinical symptoms included shivering, fever, vomiting, headache, malaise, vertigo and tinitus. Three patients presented with alerterd level of awareness. Four patients developed very severe bilateral hearing impairemnt, whereas one endophtalmtis and one developed endocarditis. The cerebrospinal fluid (CSF) was opalescent in four patients, and only one patient presented with clear CSF. CSF examination showed typical changes characeteristic for bacterial meningitis. Streptoccocus suis was isolated in CSF in all patients, and in one patient the bacteria was isolated in blood as well. All patients underwent treatment with II and III generation cephalosporins and one with one aminoglycosides. All patients were cured, but 4 of them developed sequelae like permanent sensorineural deafness and mild ataxia. Conclusions Streptococcus suis infection is present as a zoonosis in pigs, while humans are contracted occasionally, most frequently related to occupational risk. In cases with bacterial meningitis with sepsis and hearing loss, Streptococcus suis infections must be suspected. Effective prevention requires collaboration between epidemiologists, veterinarians and human medicine physicians. .

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Arduino Promini-based Helmet Temperature Measuring Helmet with MLX90614-DCI Sensor

Procedia of Engineering and Life Science ◽

10.21070/pels.v1i1.862 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Wahyu ja’far siddiq ◽

Indah sulistiyowati

Keyword(s):

Body Temperature ◽

Clinical Symptoms ◽

The Body ◽

Shortness Of Breath ◽

Turn On ◽

Measurement Results ◽

Accuracy Level ◽

Human Body Temperature ◽

Body Temperature Measurement ◽

The Government

The Covid-19 pandemic that is currently spreading in Indonesia has claimed thousands of lives. Coronavirus Disease is characterized by the main clinical symptoms of fever >38 °C, coughing, to shortness of breath. In preventing its spread, the government conducts early detection by examining the main symptoms in the form of a fever and enforcing health protocols on each line. Therefore, we need an appropriate innovation that can make it easier for officers/guards to check human body temperature, especially in crowded places such as at airports, malls, or on the highway. Currently, body temperature measurement equipment is widely used, which allegedly made many errors in detecting it. Therefore, an innovative helmet was created that can be used by guards, security and even the police to detect body temperature based on the Arduino Pro Mini with the MLX90614-DCI sensor and the output is the real body temperature displayed on the LED screen. When the body temperature reads more than 38 °C, the helmet will turn on a buzzer and an LED to show that the target measurement is in a fever condition, and it is recommended going to the health center for further examination. This tool has been tested, and the sensor readings have an accuracy at a distance of 100 cm with several participants and the sensor readings are compared with the reading values from the alpha one thermometer and the measurement results have an accuracy level of 95%.

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Diagnosis and treatment of sacroiliac joint region pain in horses

UK-Vet Equine ◽

10.12968/ukve.2021.5.4.150 ◽

2021 ◽

Vol 5 (4) ◽

pp. 150-157

Author(s):

John David Stack ◽

Jessica Harley

Keyword(s):

Diagnostic Imaging ◽

Diagnostic Test ◽

Sacroiliac Joint ◽

Joint Pain ◽

Surgical Techniques ◽

The Body ◽

Anecdotal Evidence ◽

Joint Region ◽

Disease Treatment ◽

Presumptive Diagnosis

The sacroiliac joint and pain deriving from this complex region remains poorly understood in horses, although our understanding grows as the body of literature grows. A deeper understanding can be derived from the richer body of literature in human sacroiliac joint pain as the disease processes and biomechanics appear similar in both species. A highly specific and sensitive diagnostic test for this condition does not exist, so equine clinicians have to make presumptive diagnosis based on presenting signs, findings of clinical examination, diagnostic imaging and the response to blocking of the sacroiliac joint region. Many horses with sacroiliac joint region pain have concurrent orthopaedic injury or disease. Treatment is largely based on fundamentals, anecdotal evidence and translation of non-surgical techniques used in humans. Treatment for other orthopaedic conditions can conflict with rehabilitation for sacroiliac joint region pain, necessitating compromise.

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