RESUMO
Background During the COVID-19 pandemic, there was a dramatic upsurge in the prevalence of respiratory symptoms, which may have altered the usual pattern of bacterial infections and relevant decision-making. Objectives This study aimed to investigate the prevalence of rapid antigen detection test (RADT) positivity for group A Streptococcus (GAS) in patients with respiratory symptoms and signs during the COVID-19 pandemic. In addition, we evaluated the association between a positive test and the modified Centor criteria in a population of children and adults with upper respiratory tract infections (URTIs). Methods A prospective study was conducted in primary health care centres (PHCCs) and the paediatric emergency department (ED) of the Maternity and Children Hospital in Dammam City, Kingdom of Saudi Arabia (KSA). Trained physicians collected data from patients aged three years and older or their guardian(s) regarding URTI symptoms. The modified Centor score was calculated, and RADT was performed for all patients. Results Data were collected from 469 patients. The prevalence of positive RADT was 19 (4.1%), and the setting was associated with RADT positivity, as 14% of ED visitors tested positive compared with 0.6% of PHCC visitors. The RADT results had an area under the curve of 0.856 (95% confidence interval (CI)=0.774-0.939), with Centor scores of 2 and 3 having a sensitivity of 89.5%/78.9% and specificity of 70.6%/80.8%, respectively. Individuals with a score of 5 had the highest rate of positive RADT (33.3%, P<0.001); a score less than 0 excluded the possibility of GAS infection. Conclusion The Centor score can improve effective antibiotic prescribing; however, Centor scores ≥2 should be supplemented with an additional confirmatory test. The high specificity of RADT makes it a useful tool in preventing the prescription of unneeded antibiotics.
RESUMO
Background Upper respiratory tract infections (URTIs) represent the most common diagnosis in ambulatory care settings. Some of these infections are properly treated with antibiotics, but evidence points to an inappropriate overuse of antibiotics in URTI management. This overuse is linked to antibiotic resistance, drug-related adverse effects, and increased costs. Objective This study evaluated the prevalence and predictors of antibiotic prescription for patients with URTI symptoms at the primary healthcare centers (PHCCs) and pediatric emergency department (ED) of the Maternity and Children Hospital (MCH) in Dammam, Saudi Arabia. Methods A prospective study was conducted in the PHCCs and pediatric ED of MCH. Trained physicians collected data on patients with URTI symptoms aged three years and older. Scores based on modified Centor criteria were calculated, and rapid antigen detection tests (RADTs) were conducted for all study participants. Results Out of 469 patients with a URTI, 141 (30.1%) received a prescription for an antibiotic, with a smaller proportion in the PHCCs (n=85; 24.4%) than in the pediatric ED (n=56; 46.3%). The main significant predictors of antibiotic prescription in terms of odds ratio (OR) and 95% confidence interval (95%CI) were a positive RADT result (OR=41.75, 95%CI=4.76-366.28), the presence of tonsillar exudate (OR=5.066, 95%CI=3.08-8.33), tender and/or swollen anterior cervical lymph nodes (OR=4.537, 95%CI=1.96-10.54), and fever (OR=3.519, 95%CI=2.33-5.31). A higher Centor score was also a predictor (2 to 5 vs. -1 to 1) (OR=2.72, 95%CI=1.8-4.12). The absence of a cough was not a significant predictor (OR=1.13, 95%CI=0.74-1.72). Conclusions Although a positive RADT increased the likelihood that a patient would be prescribed an antibiotic at the time of assessment, most antibiotic prescriptions were not justified. To control expenses, prevent adverse effects, and limit the spread of antibiotic resistance, efforts should be made to reduce unnecessarily high antibiotic usage.
RESUMO
The trigeminal nerve is the fifth cranial nerve, which transmits facial sensations, and is divided into the ophthalmic, maxillary, and mandibular branches. Damage to this nerve can cause trigeminal neuralgia, a clinical condition that can also present in patients with coronavirus disease 2019 (COVID-19). This meta-analysis reviews the clinical cases of trigeminal neuralgia reported in patients with COVID-19 from 2019 to 2022, describes the anatomical mechanism of pain and its radiation and identifies other associated symptoms. We performed a literature search to identify reports of patients with COVID-19 who developed trigeminal neuralgia and examined these cases for prevalence and any identified source of associated ocular pain. Of the relevant studies identified, 638 patients with COVID-19 developed trigeminal neuralgia out of 7561 total COVID-19 cases (8.4 %). Of the 638 cases, 590 (7.8 %) had known causes of ocular pain, while the cause of ocular pain was unknown in 48 cases (0.6 %). Trigeminal neuralgia developed infrequently in patients with COVID-19, and cases with known causes of ocular pain were more common than cases with unknown causes. Understanding the link between COVID-19 and trigeminal neuralgia may lead to preventing further complications and mortality in these patients, as well as improving care for patients with these conditions in the future. Additionally, understanding these new clinical issues can prepare many types of physicians to protect themselves better in the event of a COVID-19 outbreak among medical staff in different departments of hospitals, such as clinics, wards, emergency rooms, and operating theatres.
El nervio trigémino es el quinto par craneal, que transmite las sensaciones faciales, y se divide en las ramas oftálmica, maxilar y mandibular. El daño a este nervio puede causar neuralgia del trigémino, una condición clínica que también puede presentarse en pacientes con enfermedad por coronavirus 2019 (COVID-19). Este metaanálisis revisa los casos clínicos de neuralgia del trigémino informados en pacientes con COVID-19 desde 2019 hasta 2022, describe el mecanismo anatómico del dolor y su radiación e identifica otros síntomas asociados. Realizamos una búsqueda bibliográfica para identificar informes de pacientes con COVID-19 que desarrollaron neuralgia del trigémino y examinamos estos casos en busca de prevalencia y cualquier fuente identificada de dolor ocular asociado. De los estudios relevantes identificados, 638 pacientes con COVID-19 desarrollaron neuralgia del trigémino de un total de 7561 casos de COVID-19 (8,4 %). De los 638 casos, 590 (7,8 %) tenían causas conocidas de dolor ocular, mientras que la causa del dolor ocular era desconocida en 48 casos (0,6 %). La neuralgia del trigémino se desarrolló con poca frecuencia en pacientes con COVID-19, y los casos con causas conocidas de dolor ocular fueron más comunes que los casos con causas desconocidas. Comprender el vínculo entre COVID-19 y la neuralgia del trigémino puede ayudar a prevenir más complicaciones y mortalidad en estos pacientes, así como a mejorar la atención de los pacientes con estas afecciones en el futuro. Además, comprender estos nuevos problemas clínicos puede preparar a muchos tipos de médicos para protegerse mejor en caso de un brote de COVID-19 entre el personal médico en diferentes departamentos de hospitales, como clínicas, salas de emergencia y quirófanos.
RESUMO
SUMMARY: Sever acute respiratory syndrome SARS-CoV-2 which is coronavirus disease-2019. It is transmitted by droplet transmission and other methods such aerosols transmission and faecal-oral transmission. The clinical features of Sever acute respiratory syndrome SARS-CoV-2 are fever, cough, dyspnea and gastrointestinal symptoms which present based on affected organ. The current study is anatomical study and provide interpretation of transmission and clinical features as well as the clinical investigation. Further, current study explains complication of coronavirus disease-2019. With explanation of COVID-19 which includes spread clinical features and investigations as well as the consequences by using anatomical clarification result in the intensification of understanding infection and provide high quality in teaching and medical services in future. Therefore, the new disease is a start to learn basic and clinical skills to encourage scientist and physician to improve medical education.
RESUMEN: El síndrome respiratorio agudo grave (SARS CoV-2) es una enfermedad por coronavirus-2019. Se transmite por transmisión de gotitas y otros métodos como la transmisión por aerosoles y la transmisión fecal-oral. Las características clínicas del síndrome respiratorio agudo severo SARS-CoV-2 son fiebre, tos, disnea y síntomas gastrointestinales y se presentan según el órgano afectado. El reporte actual es un estudio anatómico y proporciona una interpretación de la transmisión y las características clínicas, así como la investigación clínica. Además, el estudio explica la complicación de la enfermedad por COVID-19, que incluye las características clínicas y las investigaciones difundidas, así como las consecuencias. Mediante la aclaración anatómica, se profundiza la comprensión de la infección y se proporciona una alta calidad en la enseñanza y los servicios médicos en el futuro. Por lo tanto, la nueva enfermedad es un comienzo para aprender habilidades básicas y clínicas para alentar a los científicos y médicos a mejorar la educación médica.
Assuntos
Humanos , COVID-19/complicações , COVID-19/patologia , COVID-19/transmissão , Pandemias , SARS-CoV-2RESUMO
The iliolumbar artery (ILA) is a standard branch from the posterior trunk of the internal iliac artery. It is the only pelvic artery ascending from pelvic cavity. Current study comprises 171 cadavers dissection to assess the origin variability of ILA. The present study identified the incidence of the ILA origin variability in Caucasian population which also clarified the iliolumbar variability in males and females. The current study shows that the ILA arises from the common iliac artery in 2%, from the external iliac artery in 0.3% and from the internal iliac artery in 13.8% either from its dorsal or dorsomedial aspects in 1 and 12.8%, respectively. The common, external and internal iliac arteries are defined as a high (early) origin and occurred in 16.1%. The posterior trunk of the internal iliac artery is the most common origin of the ILA found to be in 77.9%. Occasionally, it also arose from the superior gluteal artery (0.7%) and the sciatic artery (0.3%). Furthermore, the ILA arises from the anterior trunk indirectly as from the inferior gluteal artery in 0.3%. The ILA arising from the superior or inferior gluteal artery or from the sciatic artery is defined as a low (delayed) origin and occurred in 1.3%. In contrast, the ILA was 4.7%. Consequently, variability of the ILA leads to vascular variability of the lumbosacral trunk of the sciatic nerve. Clinicians have to be aware of these variations to avoid unnecessary ligation to prevent sciatic neuropathy.
