<p>Pandemi global Coronavirus Disease 2019 (COVID-19) memiliki gejala utama batuk, demam, kelelahan, sesak napas, dan gejala respiratori lainnya. Didapatkan kasus pasien COVID-19 yang memiliki keluhan okular seperti konjungtivitis. Angiotensin-converting enzyme 2 (ACE2), yang merupakan reseptor SARS-CoV-2 juga didapatkan pada sel epitel konjungtiva dan kornea manusia, sehingga memungkinkan transmisi melalui okular. Tatalaksana gejala okular pada COVID-19 hingga saat ini masih terus dikembangkan serta diuji coba.</p><p>The Global Coronavirus Disease 2019 (COVID-19) pandemic has cough, fever, fatigue, shortness of breath, and other respiratory symptoms as the main symptoms. There were cases of COVID-19 patients with ocular complaints such as conjunctivitis. Angiotensin-converting enzyme 2 (ACE2) – SARS-CoV-2 receptor, is also found in human conjunctival and corneal epithelial cells, thus allowing ocular transmission. Treatment for ocular symptoms in COVID-19 are still being developed and tested.</p>
COVID-19 has become a pandemic concern with the clinical manifestations ranging for asymptomatic to severe organ failure. Early contact tracing and isolation are important keys to slow the infection spread within communities. Clinical triage and early recognition of warning signs on admission are needed to classify patients based on clinical severity. Due to the limited capacity of hospital settings for COVID-19 patients, a makeshift isolation center is needed for all confirmed and suspected cases with mild or no symptoms who will be provided with basic medical care, frequent monitoring, and rapid referrals. During observations, the physician needs to raise early alertness of the patient who is at risk to develop a worse outcome. This study reports five cases of patients who came with mild or no symptoms at initial presentation and developed into worsening disease progression after several days of observation. These patients developed shortness of breath, fatigue, abdominal disturbances, and chest pain. These findings were supported by the physical examinations that showed a decrease in blood oxygen saturation. Similarly, with the Centers for Disease Control and Prevention (CDC) criteria for the early warning signs, these patients were referred to the hospital-based isolation setting that could provide more advanced and optimal management. This study describes clinical manifestations of COVID-19 patients to decide the ideal time for referral.
Background: The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects. Material and Methods: A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA). Results: The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment). Conclusions: It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals.
Patient: Male, 44-year-old Final Diagnosis: Orbital celullitis with multiple abscesses and pneumoorbita of the right eye caused by orbital-compressed air and diesel explosion Symptoms: Worsening of the right upper eyelid swelling • accompanied by pain • fever • redness Medication: — Clinical Procedure: Ophthalmology examination • CT Scan • microorganism culture • laboratory test Specialty: Ophthalmology Objective: Unusual clinical course Background: In this observational case report, we describe a case of orbital cellulitis caused by blunt trauma from an orbital compressed air and diesel explosion injury. Case Report: A 44-year-old man presented to our emergency department with a marked clinical worsening of right upper eyelid swelling, accompanied by pain, fever, and redness. Four days prior, the patient’s right eye was struck by a pressurized diesel engine explosion. He sought treatment at another hospital, where an initial examination was conducted and a small laceration was found and immediately treated with irrigation and medication. The wound became progressively worse, and on examination at our hospital, we diagnosed orbital cellulitis, multiple abscesses, and pneumo-orbital formations. There was no indication of infection from the ears, nose, throat, and oral cavity, which usually causes orbital cellulitis. Drainage, debridement, incision, and necrotomy with orbital decompression (canthotomy and cantholysis procedure) was then performed on the patient. Conclusions: Diesel explosion injury can cause orbital cellulitis which can appear to be a simple case at first but has a poor prognosis. Therefore, evaluating the patient’s trauma history, computed tomography scan, and histopathological examination are essential in establishing the diagnosis. As early as possible, a diagnosis should be made to prevent tissue damage due to inflammation. Surgical debridement and the administration of a corticosteroid and antibiotic were key to managing the presented case.
Congenital dacryocystocele (CD) is a rare anomaly of the medial region of the orbit, caused by distal at the level of the valve of Hasner and proximal at the level of the valve of Rosenmuller obstruction of the lacrimal system. It may present as isolated abnormalities or maybe associated with syndromes. We described a neonate with a history of bilateral enlarged lacrimal sacs below medial canthal tendon with blue-grayish color and epiphora. Computed tomography (CT) scan resulted in congenital dacryocystocele. She was given topical antibiotics and Crigler massage as conservative treatment. In the first week, the right eye got a complete resolution. Otherwise, the left eye's lesion was worsening. The patient underwent endoscopic dacryocystorhinostomy (En-DCR) and silicone intubation on the left eye. Epiphora resolved with no recurrence at one month follow up. Conservative treatment and En-DCR have a success rate with no complication and widely used nowadays. In the case of CD associated with a syndrome, multidiscipline workups and treatment are essential.
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