IntroductionCoronavirus disease 2019 (COVID-19) primarily affects the pulmonary system and presents itself as shortness of breath, fever, and cough. However, it may affect other systems as well, ...including the nervous system. This study aimed to determine the frequency of neurological symptoms in COVID-19 patients and its association with the severity of the disease.MethodsThis cross-sectional study was conducted at a public sector tertiary care teaching hospital in Karachi, Pakistan, from April to July 2020. All patients with positive polymerase chain reaction (PCR) tests were included, except those with pre-existing neurological and psychiatric conditions.ResultsThe most common neurological symptom was dizziness (17.5%), followed by headache (15.7%). Three (2.6%) patients had a stroke. Nine (7.8%) participants had a taste impairment, and another nine (7.8%) had a smell impairment. There was no significant difference in the frequency of neurological symptoms when severe and non-severe disease was compared.ConclusionNeurological symptoms are frequent in COVID-19. Care should be taken to identify them early. COVID-19 should be suspected in patients presenting with neurological abnormalities and should be included in the differential diagnosis to prevent further virus transmission.
Abstract
All over the world Concrete is widely used as a sturdy and solid material for various uses. According to International usage, it comes in second place after water. River sand, considered ...expensive because of its scarce availability, is utilized as one of the raw materials for Concrete. Researchers started looking for potential alternatives for river sand and recent studies by them have shown promising results in using Quarry Dust as a possible alternative for sand and for producing high-quality/strength Concrete. The present study attempted to determine the properties of Quarry Dust and its use as an alternative for river sand in Rigid Pavement construction. Various specimens of M30 Grade Concrete were casted and the test results indicate that by replacing fine aggregate with Quarry Dust the Concrete meets the requirements for Rigid Pavement construction. The strength parameters of M30 Grade Concrete in the form of Cubes, Beams and Cylinders were tested at 7, 14 and 28 days. Compressive Strength Test, Flexural Test and Split Tensile Tests were performed on the test specimens and results show that in concrete up to 40% river sand can be replaced with Quarry Dust and it can be used as an alternative for river sand in Rigid Pavement Construction.
This article investigates the effects of Atwood numbers on the flow physics of shock-driven elliptical gas inhomogeneity based on numerical simulations. We examine five different gases—He, Ne, Ar, ...Kr, and SF6—that are filled inside an elliptical bubble and surrounded by N2 in order to study flow physics. A high-order modal discontinuous Galerkin finite element approach is used to solve compressible Euler equations for all numerical simulations. In terms of validation studies, the numerical outcomes match the existing experimental data quite well. The findings show that the Atwood number has a significant impact on the characteristics of flow, including wave patterns, the development of vortices, the generation of vorticity, and bubble deformation. When the value of At is greater than zero i.e. At > 0, there is a notable divergence between the incident wave outside the bubble and the transmitted shock wave inside the bubble. Complex wave patterns, including reflected and newly transmitted shock, are seen during the encounter. Interestingly, the transmitted shock and incident shock waves move with the same rates at At ≈ 0. While, compared to the incident shock wave, the transmitted shock wave moves more quickly for At < 0. The influence of Atwood number is then investigated in depth by looking at the vorticity production at the elliptical interface. Furthermore, in the analysis of vorticity production processes, the important spatial integrated domains of average vorticity, dilatational and baroclinic vorticity production terms, and evolution of enstrophy are extended. Finally, a quantitative research based on the interface qualities delves deeply into the influence of the Atwood number on the flow mechanics.
Sclerosing angiomatoid nodular transformation (SANT) is a benign vascular lesion of the spleen with uncertain etiology. It predominantly affects women between the ages of 30 and 60 years. Clinically, ...it is asymptomatic or can cause abdominal pain, but usually discovered incidentally on imaging, which can identify a mass but may not provide a definitive diagnosis. In uncertain vascular lesions, there is always a risk of spontaneous rupture of large vessels and the potential for spreading malignancy. Hence, the final diagnosis is rendered on microscopy after splenectomy. A middle-aged female came to the clinic complaining of abdominal pain. Radiology showed a solid splenic mass and the patient underwent splenectomy. Gross examination showed a 3 cm white firm mass with focal hemorrhage. Microscopy revealed multiple nodules of variable sizes surrounded by fibrosclerotic stroma. The nodules showed round to slit-like vascular spaces with numerous red blood cells. The internodular stroma consisted of dense fibrous tissue with scattered plump myofibroblasts and lymphoplasmacytic inflammatory cells. These distinctive features lead to the diagnosis of SANT. SANT possesses characteristic histologic features with distinctive immunohistochemistry (IHC). IHC reveals three different types of vessels within the nodules as follows: (1) small veins (CD34-, CD31+, CD8-), (2) sinusoids (CD34-, CD31+, CD8+), and (3) capillaries (CD34+, CD31+, CD8-). All three types of vessels are negative for CD21/CD35 and CD68. Hemangioma and littoral cell angioma are two frequent vascular tumors in the spleen that should be considered differential diagnoses. Both lesions lack the microscopic features of SANT and have only a single type of vessel. The vessels in hemangioma are (CD31+, CD34+, CD8-), while in littoral cell angioma they are (CD31+, CD34-, CD8-, CD21+, CD68+). There are no specific clinical or radiologic findings for SANT. It is important to recognize these characteristic features and to differentiate them from other benign and malignant lesions, such as angiosarcoma. A thorough histopathologic examination and IHC are helpful in making the correct diagnosis.
INTRODUCTIONDiabetic ketoacidosis (DKA) is a complication of hyperglycemia. Through this study we plan to study the clinical features of DKA and precipitating factors responsible for DKA in type 1 ...and type 2 diabetes. METHODSThis cross-sectional observational study was conducted in the emergency department of a tertiary care hospital in Sukkur, Pakistan from August 2019 to February 2020. Symptoms and precipitating factors were noted in a self-structured questionnaire. RESULTSOut of 71 patients, 19 (26.7%) patients had type 1 diabetes mellitus and 52 (73.3%) patients had type 2 diabetes mellitus. The most common clinical symptom was nausea and vomiting (57.7%), followed by pain in abdomen (42.2%) and dehydration (42.2%). We found that the most common precipitating factors were infections (69.0%) and non-compliance to treatment (53.5%). Among various infections, people commonly presented with pneumonia (38.7%) and urinary tract infection (30.6%). CONCLUSIONDiabetic ketoacidosis presents with vague symptoms such as nausea, vomiting, and pain in abdomen. Characteristic findings of DKA such as Kussmaul breathing was present in limited patients. Infections in diabetic patients should be carefully monitored as they are the most common precipitating factors for DKA.
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