ABSTRACT
Loss of smell function (Anosmia) is reported to be associated with novel coronavirus disease 2019 (COVID-19) infection. The present study was designed to evaluate the effectiveness of an indigenously developed prototype smell test to identify/diagnose asymptomatic COVID-19 positive individuals. A panel of five different odorants belonging to Indian household with unique and mutually exclusive odor were used to develop prototype kit to test the hypothesis. The developed prototype kit was tested at 2 centers (N = 49 and 34) with slight modifications. Simultaneously, the kit was also tested on 55 (N = 35 and 20) healthy controls. Our results indicate that otherwise asymptomatic COVID-19 positive individuals were having quantifiable deficit in smell sensation. Interestingly, the variable sensitivity of different odorants was observed in different patients. None of the healthy controls reported difficulty in sensing any of the odorant, whereas, some of healthy controls did misidentify the odorants. Overall, the present study provides a preliminary data that loss in smell sensation for various odorants can be exploited as a quick and affordable screening test to identify infected cases among at risk individuals.
ABSTRACT
Urinothorax is an uncommon thoracic complication of genitourinary (GU) tract disease, which is most frequently caused by obstructive uropathy, but may also occur as a result of iatrogenic or traumatic GU injury. It is underrecognized because of a perceived notion as to the rarity of the diagnosis and the absence of established diagnostic criteria. Urinothorax is typically described as a paucicellular, transudative pleural effusion with a pleural fluid/serum creatinine ratio >1.0. It is the only transudate associated with pleural fluid acidosis (pH < 7.40). When the pleural fluid analysis demonstrates features of a transudate, pH <7.40 and a pleural fluid/serum creatinine ratio >1.0, a confident clinical diagnosis of urinothorax can be established. A technetium 99m renal scan can be considered a confirmatory test in patients who lack the typical pleural fluid analysis features or fail to demonstrate evidence of obstructive uropathy that can be identified via conventional radiographic modalities. Management of a urinothorax requires a multidisciplinary approach with an emphasis on the correction of the underlying GU tract pathology, and once corrected, this often leads to a rapid resolution of the pleural effusion.
Subject(s)
Hydronephrosis/complications , Pleural Effusion/complications , Urinoma , Aged , Aged, 80 and over , Exudates and Transudates/diagnostic imaging , Female , Humans , Hydronephrosis/surgery , Kidney/diagnostic imaging , Male , Middle Aged , New York , Pleural Effusion/surgery , South Carolina , Urinoma/diagnosis , Urinoma/etiology , Urinoma/surgeryABSTRACT
Dural arteriovenous fistula (DAVF) is classically defined as abnormal arteriovenous connections located within the dural leaflets. Though the exact etiology is still not clear, they are generally accepted as acquired lesions. However, some DAVFs formed as the congenital disorders are called dural arteriovenous malformations and these lesions with a marked cortical venous reflux are considered to be aggressive and warrant an early intervention. The authors describe a case of 35-year-old man presented with unique type of DAVF. The fistula was located adjacent to the confluence of venous sinuses with multiple feeders. The feeders drained into a large venous pouch just anterior to the confluence which had a bilateral venous drainage. This was associated with multiple cerebellar venous ectasia along the draining cortical vein. It was managed by staged endovascular procedures and complete cure could be achieved. The pathogenesis and technique of embolization of this complex fistula/malformation are also discussed.
Subject(s)
Arteriovenous Malformations , Central Nervous System Vascular Malformations , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Dilatation, Pathologic , Drainage , Early Intervention, Educational , Endovascular Procedures , Fistula , Varicose Veins , VeinsABSTRACT
The association of congenital pouch colon with rectal atresia is quite rare with only 2 cases previously reported in literature. We describe the third such case and the second instance to survive. Although the prior survivor was managed by a single-stage procedure, we successfully managed our case by staged procedures. In this case report, we discuss the etiology and surgical options available for this rare condition.
Subject(s)
Abnormalities, Multiple/diagnosis , Colon/abnormalities , Intestinal Atresia/diagnosis , Rectum/abnormalities , Abnormalities, Multiple/surgery , Anastomosis, Surgical/methods , Colectomy/methods , Female , Follow-Up Studies , Humans , Infant, Newborn , Intestinal Atresia/surgery , Rare Diseases , Risk Assessment , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
INTRODUCTION: Macroprolactin is a significant cause of misdiagnosis, unnecessary investigation, and inappropriate treatment in patients with hyperprolactinemia. Its frequency has not been clearly established due to technical difficulties in identifying it. Most laboratories and clinicians are unaware of macroprolactin interferences in prolactin assays. MATERIALS AND METHODS: A comprehensive literature search was conducted on the websites of the National Library of Medicine (http://www.ncbl.nlm.nih.gov) and PubMed Central, the US National Library of Medicine's digital archive of life sciences literature (http://www.pubmedcentral.nih.gov/). The data were also looked for in relevant books and journal. RESULTS: Macroprolactin is a non-bioactive prolactin isoform usually composed of a prolactin monomer and an IgG molecule having a prolonged clearance rate similar to that of immunoglobulins. This isoform is clinically non-reactive but it interferes with immunological assays used for the detection of prolactin. CONCLUSION: There is a need to understand and explore the recent progress in the diagnosis and pathophysiology of macroprolactinemia for improving patient care.
