COVID-19 patients have a higher risk of developing inflammatory responses associated with serious and even fatal respiratory diseases. The role of oxidative stress in exacerbating manifestations in COVID-19 pathogenesis is under-reported.This study aimed touseserum levels of superoxide dismutase (SOD3) and glutathione-S-transferase (GSTp1) by ELISA, zinc (ErbaChem5), ferritin and free iron (VitrosChemistry, Ortho Clinical Diagnosis, Raritan, NJ, USA) at the first encounter of randomly selected RT-PCR-positive COVID-19 patients, for assessing disease severity. The parameters which helped in identifying the severity, leading to poor prognosis, were neutrophil:lymphocyte higher than 4, high CRP, low SOD3 values and high GSTp1 values, and diabetes mellitus as a co-morbidity. Higher zinc levels correlated with high GSTp1 and low SOD3, indicating the protective effect of zinc on ROS. The increased high GSTp1 shows an anticipated protective biochemical response, to mitigate the low SOD3 values due to ROS consumption. Decreased SOD3 levels indicate a state of high oxidative stress at cellular levels, and an anticipated increase in GSTp1 levels points to the pathophysiological bases of increasing severity with age, sex, and co-morbidities, such asdiabetes. High levels of initial GSTp1 and zinc levels possibly offer protection to redox reactions at the cellular level in severe COVID-19 infection, preventing deterioration.
Background: Covid-19 curve can be flattened by adopting mass screening protocols with aggressive testing and isolating infected populations. The current approach largely depends on RT-PCR/rapid antigen tests that require expert personnel resulting in higher costs and reduced testing frequency. Loss of smell is reported as a major symptom of Covid-19, however, a precise olfactory testing tool to identify Covid-19 patient is still lacking. Methods: To quantitatively check for the loss of smell, we developed an odor strip, COVID-Anosmia checker, spotted with gradients of coffee and lemon grass oil. We validated its efficiency in healthy and COVID-19 positive subjects. A trial screening to identify SARS-CoV-2 infected persons was also carried out to check the sensitivity and specificity of our screening tool. Results: It was observed that COVID positive participants were hyposmic instead of being anosmic when they were subjected to smelling higher odor concentration. Our tool identified 97% of symptomatic and 94% of asymptomatic COVID-19 positive subjects after excluding most confounding factors like concurrent chronic sinusitis. Further, it was possible to reliably predict COVID-19 infection by calculating a loss of smell score with 100% specificity. We coupled this tool with a mobile application, which takes the input response from the user, and can readily categorize the user in the appropriate risk groups. Conclusion: Loss of smell can be used as a reliable marker for screening for Covid-19. Our tool can rapidly quantitate anosmia, hyposmia, parosmia, and can be used as a first-line screening tool to trace out Covid-19 infection effectively.
Osler-Weber- Rendu syndrome is a rare autosomal dominant vascular disorder, characterised by multiple telangiectases of the skin and mucous membranes with recurrent nasal and gastrointestinal bleedings and arteriovenous malformations of various organ systems. It is also called as hereditary hemorrhagic telangiectasia (HHT). The occurrence of telangiectases in the stomach and small bowel can result in chronic bleeding and anaemia. We report a rare case of 39 year old female with Osler Weber Rendu syndrome associated with portal hypertension. She had recurrent nasal and gastrointestinal bleeding, and presented with complaints of progressive dyspnea NYHA class III. On further evaluation she was found to have portal hypertension, which is a rare association.
We report a case of pituitary adenoma with normal hormone levels in a 34-year-old female. She presented to OP with headache, milky discharge from nipples and secondary amenorrhea with transient loss of vision. Patient had hyperprolactinemia with normal levels of all other pituitary hormones. MRI revealed space occupying lesion in sellar and suprasellar region. Neurological consultation suggested Rathke’s cyst/ craniopharyngioma/ macroadenoma. Excised lesion was diagnosed as pituitary adenoma during histopathological analysis.
COVID-19 derives from infection with Coronavirus [severe acute respiratory syndrome (SARS)-CoV-2] is associated with high morbidity and mortality. These hazardous impacts are due to the release of a storm of pro-inflammatory cytokines and thrombogenic agents. Increasing evidences about multi organ involvement in COVID infection have started pouring in, where patients who either recovered from or had mild symptoms after COVID-19, exhibit diffuse multi organ related symptoms. We describe a case of a 23-year-old male who presented to emergency room with intermittent high-grade fever, sudden onset of breathlessness, giddiness and weakness. His COVID RTPCR was negative. He was unvaccinated but his covid antibodies were increased multifold. Further examination revealed active multi organ involvement which suggestive for multisystem inflammatory syndrome (MIS). With appropriate diagnosis and treatment patient improved clinically over a course of 3 weeks and discharged and is under regular follow up.
Background: Aim of the study was to analyse the relation between elevated neutrophil lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) in Helicobacter pylori (H. pylori) positive chronic gastritis patients, as compared to the control group containing H. pylori negative chronic gastritis patients.Methods: Chronic gastritis patients were segregated in equal numbers based on H. pylori status. NLR was calculated, and ESR noted from the observations, comparison was done between the control and the study groups.Results: A total of 100 patients were included in the study. The 50 each from the control and study group. An observation of elevation in NLR and ESR in H. pylori positive chronic gastritis patients, as compared to the control group was seen. With an average NLR of 2.43 and 1.43, in the control and study group, respectively.Conclusions: Raise in NLR in H. pylori positive chronic gastritis patients with an associated raise in ESR suggests, the severity of the infection and the need for eradication and prevent complications.
Polycythemia rubra vera (PV) is a disease characterised by increased production of red blood cells due to genetic mutation which leads to increase in RBC mass and increased viscocity of blood. Myeloproliferative neoplasms have been implicated in the causation of cerebral venous thrombosis (CVT). Here we presented a 34 year old male who present with headache and diplopia. Fundus examination revealed bilateral papilledema. MRI brain with venogram was done which revealed right transverse and sigmoid sinus thrombosis. Blood investigations revealed polycythemia, elevated RBC counts and hematocrit levels. Peripheral smear showed increased RBC, WBC and platelets. Serum erythropoietin was low. Bone marrow aspiration study revealed hypercellular marrow. Patient tested positive for JAK2 V617F mutation. Patient was treated with anticoagulants, therapeutic phlebotomy and other supportive measures. Here we present a rare case of PV presenting with CVT.
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