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.


Common symptoms



Shortness of Breath



Less common symptoms include:

Sputum production





According to CDC symptoms of 2019-nCov may appear in 2 days or as long as 14 days after exposure.


Classification of Myocardial Infarction (MI)

In this article, we will discuss the Classification of Myocardial Infarction (MI). So, let’s get started.


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)


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.


Dry cough

Shortness of breath

Difficulty in inspiration



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



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


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





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



Biceps tendinopathy

Frozen Shoulder

Cervical Disc Disease

Cervical Spondylosis


For measuring extent of rotator cuff tendinopathy VAS score, SPADI (Shoulder pain and disability index) have be adopted extensively by physiotherapist


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

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Definition and Causes of Atrial Flutter

In this article, we will discuss the Definition and Causes of Atrial Flutter. So, let’s get started.


It is a supraventricular arrhythmia characterised by rapid atrial rate (250-350/min) due to intra-atrial re-entry (circus movement), involves commonly the right atrium. The arrhythmia occurs commonly in patients with organic heart disease. Flutter may be paroxysmal induced by pericarditis, acute respiratory failure or it may be persistent. Atrial flutter if lasts for more than a week, it will eventually convert into atrial fibrillation.


The causes of atrial flutter are more or less same as that of atrial fibrillation with the exception that pericardial disease, severe pulmonary disease commonly lead to atrial flutter than atrial fibrillation.

Differentiation between Cardiac Dyspnea and Bronchial Asthma (Physical Signs)

In this article, we will discuss the Differentiation between Cardiac Dyspnea and Bronchial Asthma (Physical Signs). So, let’s get started.

Physical Signs

Cardiac Dyspnea (asthma)

  • Tachypnea, tachycardia, cyanosis (central, peripheral)
  • Trachea central, normal in length
  • No retraction of supraclavicular fossae or intercostal spaces
  • Percussion note is dull at the bases
  • Crackles at the bases
  • Apex beat is normal or displaced
  • Breath sounds are normal
  • 3rd heart sound (gallop rhythm) may be present

Bronchial Asthma (dyspnea)

  • They are less marked
  • Trachea is central but palpable part is decreased
  • Retraction of supraclavicular fossae and/or intercostal spaces is marked
  • Hyper-resonant note may be present
  • Both crackles and rales throughout the lungs
  • Apex beat may not be normal
  • Normal breath sounds with prolonged expiration
  • No 3rd heart sound

Classification of Guillain-Barré Syndrome

In this article, we will discuss the Classification of Guillain-Barré Syndrome. So, let’s get started.



1. Acute inflammatory demyelinating polyradiculopathy (AIDP)


  • Demyelinating
  • Adults affected more than children
  • Anti-GM antibodies present (>50%)
  • Recovery rapid


2. Acute motor axonal neuropathy (AMAN)


  • Axonal damageChildren and young adults affected
  • Prevalent in China and Mexico
  • Anti-GD1a antibodies present
  • Recovery rapid


3. Acute motor-sensory axonal neuropathy (AMSAN)


  • Axonal damage
  • Uncommon, adults affected
  • Closely related to AMAN
  • Recovery slow


4. Miller-Fisher Syndrome


  • Demyelinating, uncommon
  • Affects children and adults
  • Ophthalmoplegia, ataxia and areflexia occur
  • Anti GQ-1b antibodies present (>90%)

Clinical Features of Barbiturates Poisoning

In this article, we will discuss the Clinical Features of Barbiturates Poisoning. So, let’s get started.

Clinical Features

The clinical features are mainly due to CNS depression followed by features of respiratory depression and hypotension.

  • CNS depression: Confusion, lethargy, depressed mental activity, decreased responsiveness to external stimuli, dilated pupils, depressed tendon reflexes and extensor plantar response are seen.
  • Respiratory depression: It causes Cheyne-stoke’s respiration, apnea, aspiration pneumonia and respiratory acidosis
  • Other features include hypotension, shock, hypothermia, acute renal failure and a characteristic bullous rash seen on pressure points like elbow or malleolus after 2-3 days

10 MCQs on Biomechanics (Part-II)

In this article, we will solve 10 MCQs on Biomechanics (Part-II). So, let’s get started.

Questions and Answers (Correct answers in bold)

Q1. The specific gravity of the human body is:

  • 1.995
  • 0.095
  • 0.95
  • 9.05

Q2. Normally in the standing position the centre of gravity lies:

  • 5 cms anterior to second sacral vertebrae
  • 5 cms posterior to second sacral vertebrae
  • Around umblicus
  • 5 cms anterior to second sacral vertebrae

Q3. Vector is a physical force that has:

  • Magnitude
  • Direction
  • Both magnitude and direction
  • Fixed point of application of force

Q4. In second order level the arrangement is:

  • Weight in middle, fulcrum and effort point on either end
  • Fulcrum in middle, weight and effort point on either end
  • Effort point in middle, weight and fulcrum on either end
  • None of the above

Q5. The body’s center of gravity in an adult normally has up and down movements of:

  • 1.5 inch
  • 2.5 inch
  • 3.5 inch
  • 4.5 inch

Q6. A therapist examines joint play movement by placing the joint in resting position. The position is best described as:

  • Maximal congruency between the articular surfaces and joint capsule
  • Minimal congruency between the articular surfaces and the joint capsule
  • Passive separation of the joint surfaces is limited
  • Parallel to the joint treatment line

Q7. If a plumb line is positioned laterally to a patient so it runs along the line of gravity, where should the line fall with respect to the midline of the knee:

  • Anterior
  • Posterior
  • Directly through the knee joint
  • Posterior and medial

Q8. A physical therapist instructs a patient to move her lower teeth forward in relation to the upper teeth. This motion is termed as:

  • Protrusion
  • Retrusion
  • Lateral deviation
  • Occlusal position

Q9. Tests for the length of the hamstrings typically involve stabilisation of the uninvolved leg while raising the leg to be tested. It is important to stabilise the uninvolved leg because it:

  • Prevents excessive posterior pelvic tilt and excessive flexion of lumbar spine
  • Prevents excessive posterior pelvic tilt and excessive extension of lumbar spine
  • Prevents excessive anterior pelvic tilt and excessive flexion of lumbar spine
  • Prevents excessive anterior pelvic tilt and excessive extension of lumbar spine

Q10. A physical therapist consistently falls behind with his documentation due to an excessive patient load. The most appropriate action is:

  • Discuss the situation with other staff (physical therapists)
  • Ignore the situation and attempt to complete the documentation in a timely fashion
  • Discuss the situation with immediate supervisor
  • Discuss the situation with the Director of rehabilitation

(Note: Correct answer in bold)