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History Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Catarrh is a non-specific term used by patients for a number of different symptom patterns. These range from a productive cough to nasal obstruction. The wide variety of symptoms requires careful history taking, as the causative factors are wide ranging. Typically, catarrh is defined as inflammation of the mucous membranes of the upper airways causing an excess of mucus. Patients often describe a feeling of mucus ‘running down’ their throat. In some patients, catarrh persists due to underlying organic disease such as allergies or abnormalities like nasal polyps. However, it is common that no underlying abnormality can be detected; where this is the case, education and reassurance are the mainstay of treatment.
Routine maternal immunizations for all pregnant women
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The incubation period for pertussis is 7 to 10 days (range 5–21 days). Classic pertussis is characterized by three phases: Catarrhal, paroxysmal, and convalescent. The catarrhal phase lasts 1 to 2 weeks and consists of injection of the conjunctiva, frequent sneezing, a watery nasal discharge, and frequent cough. The cough suggests that tracheal irritation is short, hacking, isolated, and present equally day or night. Fever is uncommon during any phase.
History Stations
Published in Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox, ENT OSCEs: A Guide to Passing the DO-HNS and MRCS (ENT) OSCE, 2019
Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox
Catarrh is a non-specific term used by patients for a number of different symptom patterns. These range from a productive cough to nasal obstruction. The wide variety of symptoms requires careful history taking, as the causative factors are wide ranging. Typically, catarrh is defined as inflammation of the mucous membranes of the upper airways causing an excess of mucus. Patients often describe a feeling of mucus ‘running down’ their throat. In some patients, catarrh persists due to underlying organic disease such as allergies or abnormalities like nasal polyps. However, it is common that no underlying abnormality can be detected; where this is the case, education and reassurance are the mainstay of treatment.
Bilateral Marginal Corneal Infiltrates: A Novel Ocular Manifestation of DRESS Syndrome
Published in Ocular Immunology and Inflammation, 2022
José Ignacio Vela, Victoria Bulnes, Nuria Torrell, Marta Giró, Sandra Perich
To the best of our knowledge, only seven cases of intraocular inflammation have been previously reported (three cases of acute anterior uveitis, two cases of acute posterior multifocal placoid pigment epitheliopathy, a case of intermediate uveitis and a case of panuveitis).2–6 Cases of cicatrizing conjunctivitis and acute angle closure have been also described. Marginal corneal infiltrates have not been described yet as a manifestation of DRESS syndrome. These infiltrates have been described in association with staphylococcal hypersensitivity, herpes simplex virus keratitis, hypersensitivity to topical medications, collagen vascular diseases, peripheral rosacea keratitis, and as an immune reconstitution inflammatory syndrome.10 Corneal subepithelial infiltrates in our patient were bilateral, symmetrical, and located in the three hundred and sixty-degree periphery. Like catarrhal infiltrates were separated from the limbus by a distinct lucid interval of approximately 2 mm. On the other hand, the patient had no signs of blepharoconjunctivitis, herpes virus keratitis, or rheumatologic disorders. No follicular or papillary reaction was observed. In addition, infiltrates were associated with severe anterior uveitis. Moreover, catarrhal infiltrates are commonly found at the 10-, 8-, 4- and 2-o´clock positions and rarely in all the corneal periphery.11 Thus, it probably represents a hypersensitivity reaction to exogenous antigens.
Emerging therapeutics for the management of COVID 19
Published in Expert Opinion on Emerging Drugs, 2020
Sujit Kumar Debnath, Rohit Srivastava, Abdelwahab Omri
Zhejiang Hisun Pharmaceutical’s anti-viral drug favipiravir or favilavir has been approved by The National Medical Products Administration, China [109]. This medicine was designed to treat catarrhal or throat/nose inflammation. Favipiravir becomes the first approved medicine in China for the treatment of COVID-19 [110]. It works by inhibiting the RNA-dependent RNA polymerase or the RdRp [111]. A clinical trial was conducted on favipiravir at Shenzhen, in Guangdong province, China. Seventy patients were enrolled for this study which reported that the efficacy of this drug against coronavirus is significantly high with minimal side effects. Finally, Favipiravir was approved by the National Medical Products Administration of China [67]. Glenmark Pharmaceuticals is the first company in India that has commenced phase-3 clinical trial in India using favipiravir, a generic version of Avigan [112]. A multi-center, randomized, open comparative clinical trial was conducted by the Russian Direct Investment Fund (RDIF), Russia’s sovereign wealth fund, and the ChemRar Group jointly using favipiravir on hospitalized patients with COVID-19 [113]. Favipiravir has received a temporary registration certificate from the Ministry of Health of the Russian Federation [114].
The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review
Published in Expert Review of Vaccines, 2019
Walid Kandeil, Petar Atanasov, Diana Avramioti, Josephine Fu, Nadia Demarteau, Xiao Li
In unvaccinated individuals and non-immune patients, the classical disease has an incubation period of 7–10 days (range 4–28 days) and evolves in three phases (catarrhal, paroxysmal and convalescent). The catarrhal phase occurs with non-specific symptoms, such as rhinorrhoea, sneezing and coughing, and fever is typically absent. In the paroxysmal phase specific symptoms of pertussis are present, such as coughing spasms, inspiratory whooping and vomiting. The coughing attacks gradually decrease in frequency during the final convalescent phase. However, the great variety of pertussis symptoms, differing from one age group to another, make diagnosis based on clinical symptoms challenging. In neonates and unvaccinated infants, the symptoms in the early stages of pertussis are often non-specific coughs and apnoea, while for older, vaccinated children, adolescents and adults, the symptoms can vary greatly throughout disease progression. Adult pertussis may often be of long duration; the associated paroxysmal, persistent cough, which can last on average six weeks, can be accompanied by choking, vomiting, and whooping [10]. Various case definitions for pertussis are used; the World Health Organization (WHO) clinical definition requires more than two weeks of coughing with paroxysms, inspiratory whooping and posttussive vomiting [11].