Laryngeal Papillary Cystadenoma: A Case Report

Papillary cystadenoma is a rare, benign salivary gland neoplasm containing cystic cavities with intraluminal papillary projections. In the head and neck area, it occurs mainly in major and intraoral minor salivary glands, but rarely in the larynx. We report a case of a 67-year-old female with a chief complaint of hoarse voice diagnosed as laryngeal papillary cystadenoma. This paper emphasizes the need to consider papillary cystadenoma as one of differential diagnosis when benign looking lesions are observed in the larynx, where it uncommonly occurs.

The use of a mouthwash and a dentifrice containing antimicrobial phthalocyanine derivative on the reduction of clinical symptoms of COVID-19: A randomized triple-blinded clinical trial

PurposeThis clinical trial aimed to evaluate the use of a mouthwash and a dentifrice containing antimicrobial phthalocyanine derivative (APD) on the reduction of clinical symptoms in COVID-19 patients.MethodsThis randomized triple-blinded clinical trial enrolled 500 patients aged 18 years or older submitted to COVID-19 test by nasopharyngeal swab RT-qPCR in a reference center for the diagnosis of COVID-19, had no clinical contraindications to perform mouthwash and gargle, and had access to cell phone with communication application. Patients were randomly assigned (1:1) to use a mouthwash, and a dentifrice both containing antimicrobial phthalocyanine derivative (APD Group) or Non-APD (Control Group). All participants were instructed to floss twice a day, toothbrushing during 2 minutes/three times a day, and for gargling/rising (5ml) during 1 minute/three times a day for 7 days. An online questionnaire was sent to collect the clinical symptoms of COVID-19 in three times: T0 (baseline - before using the oral hygiene products); T3 (three days after); and T7 (seven days after). The investigators, patients, and outcomes assessor were blinded to group assignment. Mann-Whitney test, Chi-Square test, Exact Fisher test, and Cochran’s test were used according to the nature of the variables studied, with the level of significance set at P < 0.05.ResultsNo statistically significant difference was found in the prevalence of symptoms between the groups at baseline. A statistically significant reduction of clinical symptoms was found in the Control Group (fatigue, shortness of breath, hoarse voice, sore throat, nasal congestion, and chest pain) and in APD Group (cough, fatigue, shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, nasal congestion, chest pain, diarrhea and irritability/confusion) during the follow-up period. There were statistically significant differences with a higher symptoms’ prevalence for the Control Group at T3 and T7. Dysgeusia, sore throat, irritability/confusion was less prevalent at the APD Group at T3, and shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, diarrhea, and irritability/confusion were more prevalent in the Control Group at T7.ConclusionsBased on methodology, the results demonstrated that the regular use of mouthwash and dentifrice containing APD had a positive impact on the clinical symptoms reported by COVID-19 patients.

Croup as a manifestation of COVID-19 in infancy: a case series

The second wave of the COVID-19 pandemic in India brought with it an emerging clinical spectrum of the infection in children. Amongst these is the rarely reported presentation of croup, which otherwise remains a common clinical condition in infants caused by a variety of viruses and seen by pediatricians regularly. Airway manifestations of COVID-19 require reporting and unless their evaluation brings up any specific peculiarities, it is imperative to screen all such children presenting to the emergency department for SARS-CoV-2 infection. We hereby reported a series of three infants who were brought to us with typical features of croup including a mild fever, runny nose and indicators of subglottic inflammation including a hoarse voice, brassy cough and an inspiratory stridor. Each of them responded to conventional therapies for croup. However, the added conundrum of possible SARS-CoV-2 infection increases the relevance of rapid screening, assessment for complications and counselling in children presenting with croup.

Mild Botulism From Illicitly Brewed Alcohol in a Large Prison Outbreak in Mississippi

Botulism is typically described as a rapidly progressing, severe neuroparalytic disease. Foodborne botulism is transmitted through consuming food or drink that has been contaminated with botulinum toxin. During a botulism outbreak linked to illicitly brewed alcohol (also known as “hooch” or “pruno”) in a prison, 11 (35%) of 31 inmates that consumed contaminated hooch had mild illnesses. This includes 2 inmates with laboratory confirmed botulism. The most frequently reported signs and symptoms among the 11 patients with mild illness included dry mouth (91%), hoarse voice (91%), difficulty swallowing (82%), fatigue (82%), and abdominal pain (82%). Foodborne botulism is likely underdiagnosed and underreported in patients with mild illness. Botulism should be considered on the differential diagnosis for patients with cranial nerve palsies.

Wide Fontanels, Delayed Speech Development and Hoarse Voice as Useful Signs in the Diagnosis of KBG Syndrome: A Clinical Description of 23 Cases with Pathogenic Variants Involving the ANKRD11 Gene or Submicroscopic Chromosomal Rearrangements of 16q24.3

KBG syndrome is a neurodevelopmental autosomal dominant disorder characterized by short stature, macrodontia, developmental delay, behavioral problems, speech delay and delayed closing of fontanels. Most patients with KBG syndrome are found to have a mutation in the ANKRD11 gene or a chromosomal rearrangement involving this gene. We hereby present clinical evaluations of 23 patients aged 4 months to 26 years manifesting clinical features of KBG syndrome. Mutation analysis in the patients was performed using panel or exome sequencing and array CGH. Besides possessing dysmorphic features typical of the KBG syndrome, nearly all patients had psychomotor hyperactivity (86%), 81% had delayed speech, 61% had poor weight gain, 56% had delayed closure of fontanel and 56% had a hoarse voice. Macrodontia and a height range of −1 SDs to −2 SDs were noted in about half of the patients; only two patients presented with short stature below −3 SDs. The fact that wide, delayed closing fontanels were observed in more than half of our patients with KBG syndrome confirms the role of the ANKRD11 gene in skull formation and suture fusion. This clinical feature could be key to the diagnosis of KBG syndrome, especially in young children. Hoarse voice is a previously undescribed phenotype of KBG syndrome and could further reinforce clinical diagnosis.

Postpartum Thyroiditis: A Case Report

ABSTRACT: Background: Postpartum thyroiditis (PPT) is a thyroid dysfunctionn syndrome which is temporary or permanent that occurs 1 year after giving birth or abortion. The occurrence of postpartum thyroiditis is 5 – 10% of postpartum women in the world. It is caused by an inflammation of the thyroid gland which leads to a destruction of the thyroid follicle and proteolysis of thyroglobulin. Case presentation: A woman, 31 years old, was admitted to the hospital complaining an enlargement on her neck. The patient said her the enlargement keeps getting larger and she also complained a feeling of something stuck in the throat. The patient also complained a hoarse voice. The patient has just given birth of her second child 5 months ago. From a hematologic examination, radiologic, and blood culture, the patient was diagnosed with Postpartum Thyroiditis. The patient was given Euthyrox therapy and will undergo repeated evaluation after 1 months of the therapy. Conclusion: We reported a case of Postpartum Thyroiditis that was treated comprehensively, and showed a good prognosis.