In this article, we will discuss various Symptoms of the Novel Coronavirus infection. So, let’s get started.
Coronaviruses are enveloped non-segmented positive-sense RNA viruses belonging to the family Coronaviridae and the order Nidovirales. Although most human coronavirus infections are mild, the epidemics of the two beta coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) have caused more than 10000 cumulative cases in the past two decades, with mortality rates of 10% for SARS-CoV and 37% for MERS-CoV. In December 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubel, China, with clinical presentation greatly resembling pneumonia. Deep sequencing analysis from lower respiratory tract samples indicated a novel coronavirus, which was named 2019 novel coronavirus (2019-nCoV). The following are the symptoms of coronavirus infection (2019-nCoV). Majority cases are being reported from China, Thailand, Japan, South Korea, and the USA.
Symptoms
Common symptoms
Fever
Cough
Shortness of Breath
Myalgia
Fatigue
Less common symptoms include:
Sputum production
Headache
Hemoptysis
Diarrhea
Dyspnea
According to CDC symptoms of 2019-nCov may appear in 2 days or as long as 14 days after exposure.
In this article, we will discuss the Classification of Myocardial Infarction (MI). So, let’s get started.
Classification
Type 1 – Spontaneous MI – It is related to ischemia due to a primary coronary event such as plaque rupture, ulceration, fissuring, erosion or dissection resulting in coronary thrombosis
Type 2 – Supply/Demand mismatch – MI secondary to ischemia due to either increased oxygen demand or decreased oxygen supply e.g. coronary artery spasm, coronary embolism, anemia, arrhythmia, hypertension or hypotension.
Type 3 – Suspected MI-related death – Sudden unexpected cardiac death often with symptoms suggestive of myocardial infarction.
Type 4a – PCI related MI (percutaneous coronary intervention) – Rise in cardiac biomarkers accompanied by symptoms along with electrographic, angiographic or imaging evidence of ischemia after PCI (MI associated with PCI).
Type 4b – Stent thrombosis – Confirmed stent thrombosis in the context of ischemia and dynamic cardiac biomarkers changes (MI associated with stent thrombosis).
Type 5 – CABG related MI (coronary artery bypass graft) – Rise in cardiac biomarkers accompanied by electrographic, angiographic or imaging evidence of ischemia after CABG (MI associated with CABG).
In this article, we will discuss about Tension Pneumothorax. So, let’s gets started
Tension Pneumothorax
In tension pneumothorax, the mean pleural pressure is positive which means that air in the pleural cavity is under tension which causes compression collapse of the lung. It develops due to persistent air leak (air entry) inside the pleural cavity by the communication which opens during inspiration and closes during expiration preventing the air to escape. In this way, with each successive breath, the intrapleural pressure increases which eventually causes the mediastinum to shift to the opposite side and increased intrapleural pressure also puts pressure on the surrounding blood vessels.
There is decreased venous return to the heart and along with decreased cardiac output causing hypotension (cardiac tamponade) and cyanosis.
Clinical Features
Dyspnea, cough and acute exacerbation of pneumothorax symptoms
Trachea and mediastinum shifts to the opposite side
Decreased or absent breath sounds, there may be amphoric breathing present at a localized place.
Hyperinflated chest with decreased or absent chest wall movement of the involved side
Tachypnea, tachycardia, hypotension, cyanosis, and paradoxical pulse.
In this article, we will discuss about the Clinical features of Pneumothorax. So, let’s get started.
Clinical features
Chest pain ( Pain is sharp, pleuritic, and is localized to the same side of pneumothorax)
Dyspnea
Fullness of intercoastal spaces
Decreased chest wall movement
Hyper-resonant percussion note
Decreased breath sounds, vocal fremitus, and vocal resonance in closed and tension pneumothorax. s
Increased vocal fremitus, vocal resonance, presence of whispering pectoriloquy (on development of large bronchopleural fistula), and amphoric bronchial breathing.
Accumulation of fluid or pus in the pleural cavity in case ocharacterized by f an associated infection (open pneumothorax or pneumothorax due to tuberculosis) along with physical signs of horizontal shifting level of dullness and succussion splash, and additionally there is signs of toxemia
Recurrent spontaneous pneumothorax occurs with emphysema due to the rupture of bullae occurring on the same side.
It refers to the pain and weakness of rotator cuff musculature Rotator cuff comprises of four main muscles viz. Subscapularis, Supraspinatus, Infraspinatus, Teres Minor responsible for abduction and rotation movement of shoulder
EPIDEMIOLOGY
Commonly affects athletes involved in sporting activities like Cricket, Swimming, Throwers etc and it can be age related problem affecting old aged patients their is an incidence of 11.2 cases per 1000 patients per year
CLININCAL PRESENTATION AND PATHOPHYSIOLOGY
Their is a difference between tendinitis and tendinopathy. Tendinitis is an inflammation of tendons whereas tendinopathy is deterioration of tendons. Rotator Cuff tendinopathy is clinically presented with
Pain, Weakness, Loss of strength to bear load aur lift weight on shoulders along with tenderness around shoulder joint painfull overhead movement localised swelling may also be present
MECHANISM
PHYSICAL EXAMINATION AND DIAGNOSIS
For Physical examination two clinical tests are performed namely
Empty can test and Hawkins test
Other tests include Modified Belly press test, Palpation, ROM testing the latter two are not so significant In order to see how the tests are performed visit
Other diagnostic tools include ultrasound, radiographs, radionucleotide isotope scan, magnetic resonance imaging (MRI), computed axial tomography (CT), electromyography
Ultrasound reveal partial tear of tendon fibres partial thickened tears and thickened subacromial bursa MRI also reveals rotator cuff tears
DIFFERENTIALDIAGNOSIS
Osteoarthritis
Biceps tendinopathy
Frozen Shoulder
Cervical Disc Disease
Cervical Spondylosis
MEASUREMENT
For measuring extent of rotator cuff tendinopathy VAS score, SPADI (Shoulder pain and disability index) have be adopted extensively by physiotherapist
PHYSIOTHERAPY MANAGEMENT
Physiotherapy is the gold standard treatment for rotator cuff tendinopathy along with Medical Management in majority cases and rarely require surgical intervention if Conservative treatment doesn’t work Medical Management includes NSAIDS, Shoulder immobilisation etc Surgery involves Arthroscopic intervention Physiotherapy treatment includes step wise procedure firstly Stretching, ROM exercises and then Muscle Strengthening exercises for pain management Ultrasound, TENS etc Modalities can be applied Kinesiotaping have shown better result in patients with Rotator Cuff Tendinopathy. Other techniques include
In this article, we will discuss the Clinical Features of Respiratory Acidosis. So, let’s get started.
Clinical Features
The clinical features vary according to severity and duration of the respiratory acidosis, the underlying disease, and whether there is accompanying hypoxemia.
A rapid rise in PaCO2 (acute hypercapnia) may cause anxiety, dyspnea, confusion, psychosis and hallucinations and may progress to coma called acute hypercapnic encephalopathy.
Lesser and slowly rising PaCO2 (chronic hypercapnia) leads to sleep disturbances, loss of memory, daytime somnolence, personality changes, impairment of coordination and motor disturbances such as flapping tremors and myoclonic jerks. Headache and signs of raised intracranial pressure including papilledema may occur.
Cardiovascular effects of respiratory acidosis include increased cardiac output, normal or increased BP, warm skin, bounding pulse and diaphoresis.
In this article, we will discuss Common Causes and Clinical Features of Respiratory Alkalosis. So, let’s get started.
Causes
Hypoxia due to acute attack of bronchial asthma, pulmonary edema, pulmonary embolism, and acute circulatory failure. Chronic hypoxia occur in cyanotic heart disease, high altitude, and pulmonary fibrosis
They are due to hyperventilation and hypoxemia. Paraesthesias, circumoral numbness, chest wall tightness or pain, light-headedness, dizziness, inability to take an adequate breath and rarely tetany or convulsions may occur. In digitalised patients, cardiac arrhythmias and cardiac arrest may occur.
In this article, we will discuss the Signs and Symptoms of Hypocalcemia. So, let’s get started.
Signs and Symptoms
The clinical manifestations vary from asymptomatic state to life-threatening features like convulsions, tetany, laryngeal spasm, depending on the level of ionised calcium. The neuromuscular and neurological manifestations of hypocalcemia are due to enhanced neuromuscular excitability due to lowered threshold; and common features include tetany, perioral paraesthesias, numbness, muscle cramps and fasciculations. The signs and symptoms of hypocalcemia are given below:
In this article, we will discuss various Causes of Hypercalcemia. So, let’s get started.
Causes
Hypercalcemia results either from an increased entry of calcium into the extra-cellular fluid (from bone resorption or intestinal absorption) or a decreased renal calcium clearance. Following are the causes of hypercalcemia:
Increased intake or absorption
Milk alkali syndrome
Total parenteral nutrition
Excess amount of vitamin A or D.
Endocrinal disorders
Primary hyperparathyroidism (adenoma)
Secondary or tertiary hyperparathyroidism
Acromegaly
Adrenal insufficiency
Thyrotoxicosis
Pheochromocytomas
Neoplastic diseases
Tumor metastases (excessive production of PTH)
Solid tumor with secretion of PTH like protein
Hematological malignancies, i.e. multiple myeloma, leukemia, lymphoma (elaboration of osteoclast activating factor)
