Self-reported symptom study of COVID-19 chemosensory dysfunction in Malaysia

Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.

Palliative radiation therapy practice for advanced esophageal carcinoma in Africa

While numerous surveys of pattern of practices of palliative radiotherapy (RT) in advanced esophageal cancers have been published in developed countries, there is no such survey in African countries. During and after a regional training course by the International Atomic Energy Agency (IAEA) in palliative cancer care, a questionnaire was distributed to African RT centers to gather information about infrastructure and human resources available, and the pattern of practice of palliative RT for esophageal cancers. Twenty-four of the 35 centers (60%) completed the questionnaire. Twenty out of 23 (87%) centers treat patients with esophageal cancer presenting with dysphagia using external beam RT (16 centers external beam RT alone and 4 centers also use brachytherapy as a boost). Twelve (60%) centers prescribe RT doses of 30 Gy in 10 fractions and 2 centers 20 Gy in 5 fractions. Eighteen centers (78%) have low dose rate (LDR) brachytherapy, and 9 (39%) centers have high dose rate (HDR) brachytherapy. One center only used HDR brachytherapy alone to a dose of 16 Gy in 2 fractions over 8 days. RT remains a major component of treatment of patients with esophageal cancers in African countries. Still, there is a great variety among centers in both indications for RT and its characteristics for a treatment indication.

Influence of aqueous extract from Neurada procumbens L. on blood pressure of rats

Neurada procumbens is a desert plant in the Arabian Peninsula. It has been considered edible by Bedouin and has been used traditionally as a medicinal herb. During a screening test of Arabian plants, the aqueous extract of Neurada procumbens increased the blood pressure of anaesthetized normotensive rats when it was administered orally. Further studies proved it elevated the blood pressure of conscious SHR, and produced vasoconstriction on the aortic strips of rats in vitro, which was reduced partially by phentolamine. This study demonstrates that the aqueous extract of the plant has an effect of increasing blood pressure that might be mediated through alpha-adrenergic receptors. Though more investigations are needed to prove its effect in humans, the present study warns that Neurada procumbens might not be so safe as it has been considered, and people, especially those with cardiovascular diseases, should be careful when they use the plant.

Laser in situ keratomileusis to correct myopia, hypermetropia and astigmatism after penetrating keratoplasty for keratoconus: a series of 27 cases

BACKGROUND

Excimer laser treatment has been shown to be effective and safe in correcting anisometropia following penetrating keratoplasty (PKP). In this report we review our experience with excimer laser in situ keratomileusis (LASIK) to correct refractive myopia, hypermetropia and astigmatism in patients who had undergone PKP for keratoconus.

METHODS

We reviewed the records of 22 patients (27 eyes) who had undergone LASIK to correct myopia, hypermetropia or astigmatism, in simple or combined forms, following corneal transplantation for keratoconus. LASIK was performed at a hospital in Curitiba, Brazil, between September 1998 and February 2000. The eyes were classified into two groups: those with a negative spherical equivalent and those with a positive spherical equivalent. LASIK was performed using the Moria LSK microkeratome and the Nidek EC-5000 excimer laser.

RESULTS

The mean length of follow-up was 9.52 months for the 23 eyes with myopia and 5.75 months for the 4 eyes with hypermetropia. The mean refractive spherical equivalent in the myopic eyes was -5.27 (standard deviation [SD] 1.91) dioptres before LASIK and -0.45 D (SD 1.68 D) at the last follow-up visit. The corresponding values in the eyes with hypermetropia were +5.18 D (SD 1.46 D) and + 1.18 D (SD 0.94 D). The rate of regression of astigmatism in the myopic eyes was 76%. After surgery 18 (78%) of the myopic eyes and all the hypermetropic eyes had an uncorrected visual acuity of 20/40 or better. The best spectacle-corrected visual acuity was better than 20/25 in 22 (95.7%) of the myopic eyes and all the hypermetropic eyes. One eye lost 1 line of best spectacle-corrected Snellen visual acuity, and one eye lost 6 lines secondary to epithelial ingrowth. Wound dehiscence, intraoperative flap complications, graft rejection or other complications did not develop in this series.

INTERPRETATION

In this series, LASIK proved to be relatively safe and effective in correcting refractive errors after PKP for keratoconus.

A new flavone diglycoside from Carthamus tinctorius seeds

From the aqueous ethanol extract (AE) of Carthamus tinctorius seeds, a new acacetin diglycoside has been isolated and identified as acacetin 7-O-beta-D-apiofuranosyl-(1"'-->6" instead of 6')-O-beta-D-glucopyranoside together with previously isolated kaempferol 7-O-beta-D-glucopyranoside, acacetin 7-O-alpha-L-rhamnopyranoside and acacetin. The structures of these metabolites have been established on the basis of chemical, chromatographic and spectral methods.

Bioactivity of certain Egyptian Ficus species

The fruit extracts of Ficus sycomorus L., F. benjamina L., F. bengalensis L. and F. religiosa L. were screened for bioactivity. F. bengalensis and F. religiosa demonstrated activity in the brine shrimp test (Artemia salina) which indicates toxicity, whereas F. sycomorus and F. benjamina showed no activity. All the fruit extracts exhibited antitumor activity in the potato disc bioassay. None of the tested extracts showed any marked inhibition on the uptake of calcium into rat pituitary cells GH4C1. The extracts of the four tested Ficus species had significant antibacterial activity, but no antifungal activity. The results of this preliminary investigation support the traditional use of these plants in folk medicine for respiratory disorders and certain skin diseases.

Effect of some recent analgesics on labor pain and maternal and fetal blood gases and pH

This study attempts to determine the analgesic properties of nalbuphine, pentazocine and butorphanol during labor and their potential effects on maternal and fetal blood gases and pH. Butorphanol analgesia was superior to either nalbuphine or pentazocine in relieving labor pain. The studied analgesics caused significant maternal respiratory acidosis and fetal metabolic acidosis. These acidotic changes were most marked with pentazocine, moderate with nalbuphine and minimal with butorphanol.

Effect of Copper T intrauterine device on cervico-vaginal flora

The effect of the Copper T intrauterine device (IUD) insertion on vaginal and cervical flora was studied in thirty cases. The vaginal and cervical cultures showed a significant increase (P less than 0.01) in some of the anaerobic bacteria. Some of the aerobic organisms showed a statistically significant increase in the cervical cultures (P less than 0.01). Strict asepsis during insertion of the device is recommended.