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The current coronavirus disease 2019 (COVID-19) pandemic is one of the most challenging healthcarecrisesfaced globally. Adequate information and understanding of the clinical presentation and impact of the disease on maternal and neonataloutcomesis the key to successfully manage a pregnancy with COVID-19.

The purpose of the present study wasto evaluate the clinical presentation of COVID-19 in pregnancy, its course during pregnancy and its effects on maternal and neonataloutcomes.

This studywasa retrospective observational study conducted at Tata Main Hospital, Jamshedpur, a tertiary care hospital in Eastern India. Population and study period All COVID-19-positive (by reverse transcription polymerase chain reaction or rapid antigen test) pregnant women admitted to the hospital from 15

May 2020 to 15

November 2020. Results A total of 132 COVID-19-positive pregnant women were included in the study. Eighty-six women(65.15%) were asymptomatic, 45 women(34.09%) had mild symptoms and one womanhad severe dissyndrome coronavirus 2 (SARS-CoV-2) within 24 hours of delivery. Conclusion COVID-19 in pregnancy commonly presents as an asymptomatic or mild disease. It is associated with high rates of preterm births and neonatal admissions to the intensive care unit. Intrauterine and neonatal death rates remain low. Vertical transmission is possible; however, the incidence is low, and the majority of these neonates are asymptomatic.West Nile virus disease (WNVD) is a mosquito-borne disease that affects the meninges and central nervous system, causing West Nile virus (WNV) encephalitis, a debilitating, life-threatening condition, especially in the elderly. While there is a lot of research discussing different aspects of the disease, the treatment is mainly unknown. We conducted a literature review to explore the wide variety of treatment options that consolidate the knowledge about the most recent management of WNV encephalitis. We did a combined advanced search and Medical Subject Headings (MeSH) search on PubMed. Inclusion criteria included papers written in the English language and human subjects research for the past 25 years. We initially gather 110 papers, and after applying the inclusion/exclusion criteria, we end up with 30 articles for the paper's discussion. This review aims to provide clinicians with an overview of the latest approach in treating and managing hospitalized WNVD patients. It discusses case reports and the outcome of different treatment regimens done in vitro and in vivo. The study discusses all the advancements in treatment and prophylaxis and compares their effectiveness. However, more research is warranted to gain further insight to develop a single guideline for the management of this disease. This review discusses the following treatment modalities ribavirin, interferon-alpha, intravenous immunoglobulin (IVIG), and other less-used drugs. More studies about ribavirin are needed to know if the drug is useful for WNV encephalitis. Interferon-alpha has been shown to have both protective and disease limiting properties. At the moment, there are no guidelines for the treatment of WNV encephalitis, nor is there a single Food and Drug Administration (FDA)-approved drug. For the time being, IVIG offers the best results in treating WNV encephalitis.Mesenchymal stem cells differentiate into a plethora of cell types. These differentiated cell types include osteoblasts, chondrocytes, myocytes, and adipocytes. Sarcomas occur secondary to malignant transformation of these mesenchymal, pluripotent stem cells. Involuntary smooth muscle is responsible for the make up of hollow organs and vasculature in our body and is regulated by our autonomic nervous system, hormones, as well as chemical and local mediators. Cancer involving smooth muscle cells is designated as leiomyosarcoma (LMS). LMS can arise from any location in the body where smooth muscle is present and is frequently reported in the abdomen and pelvis, as well as the trunk, extremities, and throughout the retroperitoneum.Human immunodeficiency virus (HIV) infection occurs due to the HIV virus. It results in an immunodeficient state and multi-organ system infections and malignancy known as AIDS. HIV-associated nephropathy (HIVAN) is the most common HIV kidney involvement and may present as acute kidney injury (AKI), as well as chronic kidney disease (CKD). HIVAN is a collapsing form of focal segmental glomerulosclerosis (FSGS). HIVAN treatment options include antiretroviral therapy (ART), steroids, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), and hemodialysis (HD). We herein describe the case of a 40-year-old patient with an established diagnosis of HIVAN who has had partial recovery of end-stage renal failure following the initiation of ART.Osteochondral fractures of the medial femoral condyle of the knee can be diagnostically and therapeutically challenging. Various techniques of osteochondral defect treatment include fixation, abrasion chondroplasty, drilling, microfracture, autografts, allografts and chondrocyte transplantation A 37-year-old man presented with persistent left knee pain of about six months duration. Concomitant symptoms included swelling, several episodes of locking and clicking, and a sense of instability especially in walking downstairs. MRI scan revealed an unstable osteochondral lesion about 2 cm in diameter involving the medial femoral condyle. The patient underwent arthroscopic removal of the fragment and microfracturing of the defect on the medial femoral condyle. Postoperatively, he was treated with non-weight bearing for six weeks along with quadriceps strengthening and range of motion (ROM) exercises. The final outcome was good as the patient has returned to his previous activities. Microfracture technique is quite effective with regard to the improvement of daily activities with a favorable impact on pain relief and overall satisfactory functional results.We report a case of a 48-year-old man with a history of episodes of severe headache, accompanied by motor aphasia and agraphia, with complete recovery between episodes. The neurological examination revealed no abnormality. A lumbar puncture was performed and showed lymphocytic pleocytosis. Cerebrospinal fluid analysis ruled out viral, bacterial, mycobacterial, fungal, treponemal, and NMDA receptor antibodies. Brain magnetic resonance imaging and electroencephalogram revealed no abnormalities. A focal frontotemporal area of hypoperfusion was detected in brain single-photon emission tomography. A diagnosis of syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) was made to the patient and then treated with ibuprofen 400 mg three times per day with excellent response. He remained asymptomatic and free of any relapse during six months of following. We presented a typical case of HaNDL that manifests with agraphia, a transient focal neurological deficit non previously reported. Showing that the clinical picture could probably be any sign and symptom related to focal cortical alteration due to cortical transient hypoperfusion.Modular femoral and acetabular components are frequently used in hip arthroplasty. Although the use of modular components offers many advantages, the increased number of components leads to a high risk of disassembly. Disassociation of the femoral head and neck is a rarely reported complication in the literature. This case report depicts a patient with non-traumatic early disassociation of the femoral head and neck components following total hip revision arthroplasty. Femoral head-neck disassembly in early postoperative period may occur due to manufacturing error or insufficient impaction. If sufficient impaction is thought to be achieved, manufacturing errors should be kept in mind as potential underlying reasons for femoral head-neck dissociation.Papaver somniferum contains many opioids and is frequently used in agriculture. Lonafarnib supplier Both the intoxication and the withdrawal of opioids have a wide range of symptoms such as coma, depressed respiration and agitation. Here, a fatal case of opioid intoxication will be presented. A four-year-old female patient was admitted to the pediatric intensive care unit after ingesting raw poppy plants. She had shallow respiration, tachycardia, hypertension and muscle cramps. A high plasma opioid level was measured and bolus intravenous naloxone was administered which resulted in a brief gain of consciousness. She was intubated after a sudden respiratory depression and loss of consciousness 10 hours later. Naloxone infusion was started and continued for two days. She developed disseminated intravascular coagulation and was lost on day twelve. Raw plant ingestion proves difficult to treat since there is less information about the ingredients. Having no consensus on naloxone dosage and intrinsic complications such as hypo- and hypertension, redistribution, rhabdomyolysis and dysmotility disrupts naloxone administration. Ingestion of opioids as plants brings out different complications for the treatment course while deciding on naloxone dosage proves opioid intoxication difficult to treat.Background and objective Hepatic cirrhosis is one of the leading causes of morbidity and mortality worldwide. Patients with cirrhosis frequently develop complications such as ascites, variceal bleeding, and hepatic encephalopathy (HE). The clinical manifestations of HE range from the mildly altered level of sensorium to severely altered consciousness levels, difficulty in judgment, the day-night reversal of sleep, flapping tremor of hands, and irrelevant talking or speech. Patients with hyponatremia are at a higher risk of developing HE and electroencephalographic abnormalities. The severity of hyponatremia is directly related to the deterioration in terms of grades of HE. Our study sought to determine the frequency of hyponatremia in cirrhotic patients and its correlation with the frequency and severity of HE. Methodology This study was carried out at the inpatient department of medicine in a tertiary care hospital in Pakistan. A total of 260 patients of both genders with hepatic cirrhosis were approached. A6.9%) patients. Among these, 51 (53.12%) were male and 45 (46.8%) were female; 24 (9.2%) patients had mild hyponatremia, 56 (21.5%) had moderate, and 16 (6.2%) had severe hyponatremia. HE was present in 176 (67.7%) patients. HE grade I was present in 54 (20.8%), grade II in 62 (23.8%), grade III in 32 (12.3%), and grade IV in 28 (10.8%) patients. In 96 patients with hyponatremia, 84 were found to have HE (p-value less then 0.001). Conclusion Based on our findings, cirrhotic patients with chronic hepatitis infections have a variable presence of low sodium levels. Sodium levels of less then 130 meq/L were associated with higher morbidity and mortality rate. Moreover, patients with lower levels of sodium had higher grades of HE.The gene PTRH2 encodes a protein with peptidyl-tRNA hydrolase activity and is involved in the translation process in protein synthesis. The kinesin family member 1-A (KIF1A) gene encodes a molecular motor involved in axonal transport along microtubules. Mutations in these genes lead to respective phenotypical conditions that have been reported in the literature. In this paper, we present a novel syndrome of concurrent occurrence of mutations in the PTRH2 and KIF1A genes in a 19-year-old girl of Dravidian-Tamil descent from the Southern part of India. The girl presented with global developmental delay, intellectual disability, weakness of upper and lower limbs, and diabetes. On workup, she was found to have severe peripheral axonopathy, outer hair cell (OHC) dysfunction, severe bilateral sensorineural hearing loss (SNHL), total pancreatic lipomatosis, exocrine pancreatic insufficiency, cerebellar atrophy, vertebral artery hypoplasia, and scoliosis. The patient had a deceased elder sibling who also had had a similar phenotype.

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