CHANGES IN THE FOREARM VESSELS OF PATIENTS WITH VIBRATION DISEASE AFTER CORONAVIRUS INFECTION

A lot of scientific literature has already been written on the study of the consequences of a new coronavirus infection. The real long-term effects of this disease on population health are yet to be studied in the coming years. Vibration disease is a leading occupational pathology in the Russian Federation, characterized by vegetative-vascular disorders of the extremities and is manifested by cold extremities, cyanosis, paresthesias, and a violation of regional blood circulation. It is necessary to take into account the concomitant chronic diseases in patients who are particularly dangerous in the post-ovoid period. The aim of the study was to study the features of hemodynamics in patients with vibration disease after a new coronavirus infection. In the clinic of occupational pathology, 28 patients were examined with a previously established diagnosis of vibration disease after a coronavirus infection. Ultrasound examination of the arteries and veins of the upper extremities was performed. In patients with ultrasound of the vessels of the upper extremities, moderate expansion of the radial and ulnar veins, insufficiency of the valvular apparatus during functional tests, and increased venous outflow were revealed. There was also an increase in peripheral vascular resistance, which indicates violations of the tonic properties of the vessels of the upper extremities and violations of vasodilation. Inference. In patients with vibration disease in the post-ovoid period, ultrasound examination reveals violations of the tonic properties of blood vessels, venous dyscirculation in the veins of the forearm.

“CLINICAL STUDY OF SCORPION STING ENVENAMATION - CLINICAL PROFILE, COMPLICATIONS, TREATMENT AND EFFECT OF EARLY TREATMENT WITH PRAZOCIN IN PREVENTING THE COMPLICATIONS”

BACKGROUND:The incidence and severity of scorpion sting are higher in the deferent parts of world , South India is not an exception. AIM :To study the clinical manifestations , complications and preventing the complications with early use of Prazosin in scorpion sting. RESULTS :Age of the study subjects were ranging from 21 -45 years, among them 70% were male and 30% were female. All the study subjects witness pain at the site of sting, other symptoms were paraesthesia (93%), profuse sweating all over the body (78%),cold extremities (76%), swelling at the sie of the sting (65%), nausea and vomiting (48%). CONCLUSIONS : Severity of the clinical features are mild as prazosin included in management of scorpion bite , no case fatility reported in the study. Prazosin is the effective pharmacological and physiological antidote to venom.

Complicated Pneumococcal Meningitis: A Diagnostic and Therapeutic Challenge

Meningitis is an uncommon complication of head trauma. Vasculitis in bacterial meningitis is seen in 9–25% of adults while neurological deficits in bacterial meningitis are seen in about one-third of children. We report a 5-year-old boy, previously healthy who was admitted in March 2019 to Latifa Women’s and Children’s Hospital, Dubai, UAE, with pneumococcal meningitis. One day before presentation, he had a history of fall with head trauma while running at school. Initial brain CT scan was normal. Few hours after admission, the child was noticed to be drowsy with cold extremities and mottled skin. He was shifted to PICU and, ultimately, he required intubation and mechanical ventilation. The child continued spiking high-grade fever with deterioration in the neurologic status. His GCS deteriorated to 4/15 with decerebrations posture. He underwent serial brain imaging which revealed multiple chronic infarcts with hydrocephalic changes due to ongoing cerebral vasculitis. The child was started on steroid therapy on 28 April 2019 after which his condition improved at an incredible pace.

Massive spontaneous hemoperitoneum: known cause from an unknown site

A 35 years old female presented to casualty with complaints of pain abdomen and vomiting since 3 days. The pain is non radiating type with associated abdominal distension. There is no blood or bike in the vomitus. She has undergone mitral valve replacement 1 month 15 days back and was on prophylactic warfarin medication. On examination vitals were unstable with pallor present and cold extremities. On physical examination. On physical examination: abdominal distension+ guarding+ diffuse tenderness over abdomen+. On USG Abdomen gross collection of blood in the peritoneal cavity. Patient immediately stabilised with 8 units of PRBC. On abdominal laparotomy, active bleeding from right ovarian cyst was observed. Right oophorectomy with peritoneal lavage was done. Hemostasis secured. Postoperative period was uneventful with good post op recovery.

Brain injury and SARS-CoV-2 infection: Bidirectional pathways

Coronavirus infection disease (COVID-19) is a recent pandemic infectious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). COVID-19 is associated with different neurological manifestations, as one-third of COVID-19 patients have some neurological disorders, including paraesthesia, headache, cold extremities and disturbances of consciousness, that are more evident in severely affected patients. The entry of SARS-CoV-2 into human host cells is mediated mainly by the cellular receptor angiotensin-converting enzyme 2 (ACE2), which is expressed at very low levels in the CNS under normal conditions. The dissemination of COVID-19 in the systemic circulation or across the cribriform plate of the ethmoid bone during an early or later phase of the infection can lead to cerebral involvement as has been reported in the past for SARS-CoV affected patients. COVID‐19‐related CNS dysfunction results from direct viral injury, indirect consequences of immune‐mediated disease, systemic effects of infection, or local effects of the virus is still a matter of debate and these hypotheses are not mutually exclusive.

Two cases of ectopic pregnancy, successfully operated in extremis with gastrointestinal surgery

The first case concerns a 24-year-old patient who was admitted to the Jewish Odessa hospital on June 8, 1893, in a state of severe acute anemia: cold extremities, cyanosis of the lips, intense deep breathing, deathly pallor, cold sweat on the forehead, barely noticeable, threadlike pulse, but at times completely disappearing, semi-unconscious, dilated pupils.

Lyme aortitis

A 72-year-old man was admitted with complaints of sudden-onset oppressive precordial pain radiating to the back for 1 hour. He had hypotension, peripheral cyanosis and cold extremities. An initial assessment was done and acute coronary syndrome was excluded. After the patient was admitted, he developed fever and increased levels of inflammatory markers. Data obtained from CT angiography and transoesophageal echocardiogram revealed diffuse parietal thickening of the arch and the descending thoracic aorta, as well as dilatation of the aortic root and the proximal ascending aorta. In addition, the test for Borrelia burgdorferi was positive, and the patient was diagnosed with Lyme vasculitis of the thoracic aorta. He was treated with doxycycline for 3 weeks. Two months later, the patient exhibited a Stanford type A aortic dissection (clinically stable), which was treated by prosthesis replacement. The patient has remained asymptomatic for 1 year after the episode, performing his routine daily activities.

Clinical study of scorpion sting envenomation

Background: Scorpion stings are common in India. Presentation of scorpion sting may vary from localised pain at the site of the sting to life threatening condition. Systemic envenomation will even result in death among one third of the subjects. The present study was conducted to determine the clinical presentation, course, complications and outcomes of scorpion sting envenomation among children as they are sensitive to scorpion envenomation.Methods: 50 cases of scorpion sting, admitted to 2 hospitals, under JJMMC, Davangere for 1 year were included. A detailed clinical history followed by examination was done. Relevant investigations were also done. All the cases were monitored for complications and managed accordingly.Results: Maximum number of cases were noted in the age group of 1-3 years and 10-12 years. 58% of them were boys, 54% of the cases had red scorpion sting. Pain at the sting site, diaphoresis and restlessness were the most common presenting symptoms. The common signs noted were restlessness, cold extremities and tachycardia. Commonest complications were peripheral circulatory failure, pulmonary oedema, myocarditis and congestive cardiac failure. Majority of cases recovered without any sequelae.Conclusions: Present study we conclude that majority of the cases were among boys belonged to 1-3year age group. Red scorpion sting was common, and commonest presentation was pain and recovered without any sequelae.