On-the-spot Detection of COVID-19: A New Diagnostic Tool

Know a patient who is a COVID survivor. He was in the ICU for a month, requiring mechanical ventilation for almost four weeks. That’s much longer than a typical patient with bacterial pneumonia. This patient required a lengthy infusion of the neuromuscular blockade which, along with shock, contributed to the profound weakness. This complication is also called critical illness polyneuropathy. *What can we do during these 4 weeks when the patient is paralyzed to minimize the myopathy and neuropathy that may develop? *Are there treatments or therapies? *Are you familiar with the concept of Disease tolerance and Adaptogens? I’d love to hear others’ reflections on this and if you have any tips for preparation

Geriatric female with PMHx DM, HTN, A fib on Xarelto, chronic facial asymmetry present to ED following fall at home, change in mental status and febrile. Suggestions? Should I sent for COVID-19 test.

Patient in early 50s who has a history of SARS when it was going round. Presents with shortness of breath, oxygen saturation in high 80s despite no chronic pulmonary disease. The patient seems to be coping well, but when do you decide to proceed to intubation assuming this is COVID-19? Watch and observe until they begin to deteriorate, or intubate while still well?

#tsTime A 21 y/o/f came with h/o fever, anterior neck swelling, and weight loss of 3.5 kg for 3-4 months. The family history was significant for TB in one brother. On examination, she had marked swelling of anterior neck with no lymphadenopathy. Clinically, she was euthyroid. The systemic examination was unremarkable. Her CBC was normal with an ESR of 25 mm/1st hour. Mantoux test was positive. The routine biochemistry were all Wnl. What next should be done?

A 42-year-old male, working as a house builder came with 11-month history of persistent wheezing, heard not only during auscultation but also by the patient himself. This wheezing had no correlation with physical exertion. He had few episodes of haemoptysis within the last 7 months and dry cough for about a month. He had a 10 pack-years smoking history, until the age of 31 when he stopped smoking. He drank alcohol occasionally. His symptoms were unsuccessfully treated with inhaled β2-agonists and steroids for about 10 months. Apart from these medications, he took no other drugs. On auscultation, there were wheezes in the upper fields of both lungs. The chest radiograph showed a disproportion in dimensions. What else do you see?