Symptoms of Novel Coronavirus infection

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.

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Classification of Myocardial Infarction (MI)

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).

 

Tension Pneumothorax

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.

 

 

Clinical features of Pneumothorax

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.

 

 

Signs and Symptoms of Pleural Effusion

In this article, we will discuss about the various Signs and Symptoms of Pleural Effusion . So, let’s get started.

Sign and Symptoms

Chest pain often referred to the left shoulder or upper abdomen because of diaphragmatic irritation.

Dyspnea

Dry cough

Shortness of breath

Difficulty in inspiration

Orthopnea

Fever

Persistent hiccups

Lower extremity edema

Paroxysmal nocturnal dyspnea

Rotator Cuff Tendinopathy

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

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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

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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

https://www.physio-pedia.com/Rotator_Cuff_Tendinopathy

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

DIFFERENTIAL DIAGNOSIS

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

Isometric exercises

Kinetic Chain exercises

Correcting scapulohumeral rhythm

Corrective Posture

Pilates technique

for more info visit

https://www.physio-pedia.com/Rotator_Cuff_Tendinopathy

Clinical Features of Respiratory Acidosis

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.

Common Causes and Clinical Features of Respiratory Alkalosis

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
  • CNS disorders (e.g. CVA, brain tumor, encephalitis)
  • Pregnancy
  • Gram-negative septicemia or endotoxemia
  • Hepatic failure
  • Drugs, e.g. salicylate and xanthine poisoning
  • Anxiety induced hyperventilation
  • Pain
  • Excessive mechanical ventilation

Clinical Features

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.

Signs and Symptoms of Hypocalcemia

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:

Mental: Irritability, depression, psychosis, convulsions.

Neurological: Tetany, paraesthesias, seizures.

Cardiac: Precipitation of CHF by beta blockers, arrhythmias, prolonged QTc on ECG.

Eye: Cataracts, optic neuritis, papilledema.

Causes of Hypercalcemia

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)
  • Miscellaneous
  • Thiazide diuretics, lithium intake
  • Paget disease of bone
  • Hypophosphatasia
  • Immobilzation
  • Familial hypocalciuric hypercalcemia
  • Complication of kidney transplant
  • Aluminium intoxication

Signs and Symptoms of Hypercalcemia

In this article, we will discuss the Signs and Symptoms of Hypercalcemia. So, let’s get started.

Signs and Symptoms

CNS: Mental confusion, depression, lethargy, irritability, insomnia, inability to concentrate, fatigue, stupor, and coma

Neuromuscular: Paraesthesia, muscle cramps, weakness, diminished tendon reflexes

GIT: Nausea, vomiting, anorexia, constipation, peptic ulcer disease, pancreatitis

Renal: Polyuria, nocturia, polydipsia (increased thirst) due to tubular defects, dehydration, renal colic due to stones, nephrocalcinosis, hematuria

Cardiac: Bradycardia, AV blocks, arrhythmias, palpitations, hypertension, short QTc interval on ECG, sensitivity to digitalis

Eye: Band keratopathy, calcification of lens

Skin: Pruritus, skin necrosis (small vessel thrombosis)

Bone: Bone and joint pain