MyMedR

Clinical manifestations of human Mpox infection: A systematic review and meta-analysis

Yon H, Shin H, Shin JI, Shin JU, Shin YH, Lee J, et al.

Rev Med Virol, 2023 Jul;33(4):e2446.

Little is known about the ongoing monkeypox (mpox) outbreak, and the clinical features of mpox in patients worldwide have not been rigorously analysed. Thus, we aimed to investigate the clinical features associated with mpox infection and understand the pathophysiology and characteristics of the disease. For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and the Cochrane Database of Systematic Reviews for articles published till 16 September 2022. We used a random effects model to calculate the pooled prevalence and 95% confidence interval (CI). We used the I2 statistic to assess heterogeneity, Egger's test to assess publication bias, 95% prediction interval to determine the level of uncertainty, and the Newcastle-Ottawa Scale and Joanna Briggs Institute quality assessment tool to assess the risk of bias. Twenty-six relevant articles from 19 countries across 5 continents were included, and data on 5472 mpox patients with 18 unique features were analysed. The pooled prevalence of clinical features of mpox were rash (85.7%, 95% CI: 68.3-94.3; k = 21), chills (77.8%, 95% CI: 70.5-83.7; k = 3), and fever (62.3%, 95% CI: 51.3-71.6; k = 25), lymphadenopathy (58.6%, 95% CI: 47.2-69.2; k = 21), lethargy or exhaustion (46.8%, 95% CI: 30.7-63.5; k = 14), pruritus (40.6%, 95% CI: 28.5-54.0; k = 5), myalgia (36.0%, 95% CI: 24.3-49.7; k = 16), headache (34.6%, 95% CI: 23.4-47.8; k = 17), skin ulcer (31.1%, 95% CI: 18.6-47.1; k = 7), abdomen symptom (24.2%, 95% CI: 17.9-31.9; k = 11), pharyngitis (23.0%, 95% CI: 12.7-37.9; k = 14), respiratory symptom (19.5%, 95% CI: 6.8-44.6; k = 6), nausea or vomiting (13.0%, 95% CI: 4.6-31.9; k = 3), scrotal or penile oedema (10.7%, 95% CI: 6.3-17.7; k = 4), conjunctivitis (7.1%, 95% CI: 2.4-18.9; k = 6), and death (0.9%, 95% CI: 0.4-2.0; k = 26). This is the first international and comprehensive study to examine all clinical presentations of human mpox infection. Our systematic review proposes a comprehensive understanding of the current mpox outbreak and may serve as key data for future studies on the pathological mechanisms and epidemiology of mpox infections.

Matched MeSH terms: Pharyngitis*

Post-thyroidectomy sore throat following endotracheal intubation

Hisham AN, Roshilla H, Amri N, Aina EN

ANZ J Surg, 2001 Nov;71(11):669-71.

PMID: 11736830 DOI: 10.1046/j.1445-1433.2001.02230.x

Background: Sore throat is not an uncommon complaint following general anaesthesia (GA) with endotracheal intubation. It has been a source of considerable discomfort particularly in those patients who had thyroid surgery. Driven by the increased number of patients with post-intubation sore throat following thyroid surgery, the aim of the present study was to evaluate the contributing factors of sore throat in patients who had thyroid surgery under general anaesthesia.
Methods: A total of 57 consecutive patients who had thyroid surgery from November 1998 to April 1999 was included in this prospective study. Factors such as intubation time, number of intubation attempts, size and type of endotracheal tube (ETT) used, gender and age were recorded. The nature and extent of the surgical procedures were also studied. Postoperative symptoms were assessed by questionnaire on the day after surgery and the different parameters were compared and analysed.
Results: The incidence of post-intubation sore throat following thyroid surgery was documented in 39 (68.4%) patients. Twenty-seven (47.4%) patients had a mild complaint of sore throat, which resolved after the third day. The data from the present study show that the size of ETT and extent of surgical procedure were significant contributing factors affecting the postoperative recovery.
Conclusion: The outcome of the present study demonstrated a substantial increased incidence of sore throat after thyroid surgery under GA. Postoperative sore throat following thyroid surgery under GA may be caused by multiple contributing factors. Nonetheless effort and care should be taken during endotracheal intubation and surgery to reduce this unpleasant complaint arising mainly from pharyngeal irritation or trauma.

Matched MeSH terms: Pharyngitis/etiology; Pharyngitis/epidemiology*

Comparison of the efficacy between oral rinse, oral gargle, and oral spray

Teh CSL, Raman R

J Prim Care Community Health, 2012 Apr 1;3(2):80-2.

PMID: 23803449 DOI: 10.1177/2150131911417185

INTRODUCTION AND AIMS: Patients with sore throats are often treated with oral gargles or oral sprays. Some may rinse instead of gargle, leading to unsatisfactory outcome. The authors studied the efficacy of oral rinses, gargles, and sprays and the effect of Friedman palate position on the outcome.
METHODS: Ten subjects used specially prepared solutions to rinse, gargle, and then spray their oral cavities at 2-hour intervals. The blue dye indicated the areas stained by the solution, which were scored.
RESULTS: Although there was no difference in reaching the oropharynx between the gargles and sprays, they were both better than were the oral rinses (P < .001). The difference in Friedman palate position did not have an effect on the efficacy of the different modalities.
CONCLUSION: Oral gargles and sprays have been shown to be significantly better than are oral rinses if the oropharynx is the targeted site, and the size of the oral airway does not impede their efficacy.
KEYWORDS: Friedman palate position; drug administration; oropharynx

Matched MeSH terms: Pharyngitis

Diagnosis of Group A streptococcal pharyngitis by enzyme immunoassay

Zooraidah Z, Farida J

Family Physician, 1990;2:27-29.

Matched MeSH terms: Pharyngitis

Postoperative sore throat in children: comparison between proseal LMA and classic LMA

Mokhtar AM, Choy CY

Middle East J Anaesthesiol, 2013 Feb;22(1):65-70.

PMID: 23833853

Postoperative sore throat after minor pediatric surgery although uncommon and the symptoms are mild, the incidence may be affected by several factors. This study was designed to compare the frequency and severity of post operative sore throat in children undergoing elective surgery following the use of proseal LMA (PLMA) compared to classic LMA (cLMA).

Matched MeSH terms: Pharyngitis/epidemiology*

Rheumatic fever

Chadha S, Inechen B

J Public Health Med, 1997 Sep;19(3):363-4.

PMID: 9347467

Matched MeSH terms: Pharyngitis/complications

Adult-onset nasopharyngeal diphtheria: an uncommon but rapidly progressive and potentially fatal infection

Ding CH, Wahab AA, Marina Z, Leong CL, Umur N, Wong PF

Trop Biomed, 2021 Jun 01;38(2):119-121.

PMID: 34172699 DOI: 10.47665/tb.38.2.045

Nasopharyngeal diphtheria is an acute infectious upper respiratory tract disease caused by toxigenic strains of Corynebacterium diphtheriae. We report a case of a young adult who presented to us with a short history of fever, sore throat, hoarseness of voice and neck swelling. He claimed to have received all his childhood vaccinations and had no known medical illnesses. During laryngoscopy, a white slough (or membrane) was seen at the base of his tongue. The epiglottis was also bulky and the arytenoids were swollen bilaterally. The membrane was sent to the microbiology laboratory for culture. A diagnosis of nasopharyngeal diphtheria was made clinically and the patient was treated with an antitoxin together with erythromycin, while awaiting the culture result. Nevertheless, the patient's condition deteriorated swiftly and although the laboratory eventually confirmed an infection by toxin-producing C. diphtheriae, the patient had already succumbed to the infection.

Matched MeSH terms: Pharyngitis/microbiology

Fulltext Keracunan sulfur dioksida di kalangan orang awam di kawasan perindustrian , Kemaman, Negeri Terengganu

Azmi, H., Mohd Kamil, H., Balkis, A.

Malaysian Journal of Public Health Medicine, 2002;2(1):31-35.

MyJurnal

In July 1997 at 7 pm , 49 members 0f the public complained of dizziness, sore throat, eyes irritation and tightness of chest after exposed to sulphur dioxide while traveling on the road about 100 meter 90m the sulphuric acid factory in Teluk Kalong Kemaman. The incident was caused by leaking sulfur dioxide from return pipe of scrubber circulation. tank in the factory. The problem had occurred due to carelessness of the operator to inspect the level of water in the scrubber circulation tank during the operation.

Matched MeSH terms: Pharyngitis

Effectiveness of amylmetacresol and 2,4-dichlorobenzyl alcohol throat lozenges in patients with acute sore throat due to upper respiratory tract infection: a systematic review protocol

Tan TW, Chen BC, Tan HL, Chang CM

JBI Database System Rev Implement Rep, 2017 Apr;15(4):862-872.

PMID: 28398972 DOI: 10.11124/JBISRIR-2016-003034

REVIEW QUESTION/OBJECTIVE: This review aims to determine the best available evidence related to the effectiveness of amylmetacresol and 2,4-dichlorobenzyl alcohol throat lozenges in patients with acute sore throat due to upper respiratory tract infection (URTI). The objective is to examine the analgesic properties of amylmetacresol and 2,4-dichlorobenzyl alcohol (AMC/DCBA) throat lozenge comparing with placebo for the relief of pain in patients with acute sore throat due to URTIs.The review question is:More specifically, the objectives are to.

Matched MeSH terms: Pharyngitis/drug therapy*; Pharyngitis/etiology

Fulltext Clinical performance of the LMA Protector™ airway in moderately obese patients

Shariffuddin II, Chaw SH, Ng LW, Lim CH, Zainal Abidin MF, Wan Zakaria WA, et al.

BMC Anesthesiol, 2020 07 31;20(1):184.

PMID: 32736516 DOI: 10.1186/s12871-020-01100-z

BACKGROUND: The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD, the Protector™ provides a functional separation of the respiratory and digestive tracts and its laryngeal cuff with two ports allowing additional suction in tandem with the insertion of a gastric tube. The laryngeal cuff of LMA Protector™ allows a large catchment reservoir in the event of gastric content aspiration.

METHODS: We evaluated the performance characteristics of the LMA Protector™ in 30 unparalysed, moderately obese patients. First attempt insertion rate, time for insertion, oropharyngeal leak pressure (OLP), and incidence of complications were recorded.

RESULTS: We found high first and second attempt insertion rates of 28(93%) and 1(33%) respectively, with one failed attempt where no capnography trace could be detected, presumably from a downfolded device tip. The LMA Protector™ was inserted rapidly in 21.0(4.0) seconds and demonstrated high OLP of 31.8(5.4) cmH2O. Fibreoptic assessment showed a clear view of vocal cords in 93%. The incidence of blood staining on removal of device was 48%, postoperative sore throat 27%, dysphagia 10% and dysphonia 20% (all self-limiting, resolving a few hours postoperatively).

CONCLUSIONS: We conclude that the LMA Protector™ was associated with easy, expedient first attempt insertion success, demonstrating high oropharyngeal pressures and good anatomical position in the moderately obese population, with relatively low postoperative airway morbidity.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12617001152314 . Registered 7 August 2017.

Matched MeSH terms: Pharyngitis/etiology; Pharyngitis/epidemiology

Fulltext Streptococcal pharyngitis in a primary care clinic

Foong HB, Yassim M, Chia YC, Kang BH

Singapore Med J, 1992 Dec;33(6):597-9.

PMID: 1488669

A study to determine the sensitivity and specificity of the Directogen Group A Streptococcal Test was carried out in a primary care clinic in University Hospital, Kuala Lumpur. The study also looked at the prevalence of streptococcal pharyngitis in the clinic. We found that the rapid test has a sensitivity of 90.9% and a specificity of 90.7%. Viral pharyngitis is the commonest form (63%) of pharyngitis followed by Group A Beta haemolytic streptococcal pharyngitis (14.2%). The presence of exudates, tonsillar enlargement and the presence of tender cervical lymph nodes have a significantly higher association with streptococcal pharyngitis.
Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Pharyngitis/diagnosis*; Pharyngitis/microbiology

Fulltext Adult acute epiglottitis

Arumainathan UD, Siow SC, Subha ST

Med J Malaysia, 2002 Jun;57(2):240-1.

PMID: 24326662

Acute epiglotiitis is a disease of rapid onset and progression of symptoms and has been well described in children. The importance of being aware of this diagnosis is to prevent an acute upper airway obstruction that can be potentially fatal. Here we describe two cases of adult acute epiglottitis where the patients had severe symptoms of sorethroat but a normal looking oropharynx.

Matched MeSH terms: Pharyngitis

Fulltext Sane and safe: Forced social distancing to prevent human-to-human transmission of COVID-19

Jahan F

Malays Fam Physician, 2021 Mar 25;16(1):15-17.

PMID: 33948138 DOI: 10.51866/rv0001

The current outbreak of COVID-19, originating from the city of Wuhan in China and ultimately involving over 200 countries, is now a global concern. Evidence indicates that COVID-19 spread to humans from wild animals, causing severe respiratory tract infections in humans; the typical symptoms of COVID include cough, high-grade fever, sore throat, and difficulty in breathing. The infection spreads from human to human via droplets. Therefore, social or physical distancing can reduce spread within communities. Asymptomatic spread can also occur during family gatherings or in the workplace; thus, we must enforce physical distancing as much as possible to reduce the spread of cases.

Matched MeSH terms: Pharyngitis

Fulltext Peritonsillar swelling is not always quinsy

Mohamad I, Yaroko A

Malays Fam Physician, 2013;8(2):53-5.

PMID: 25606284 MyJurnal

Quinsy is a common encounter in family physician practice. It is defined as a collection of purulent material in the peritonsillar space, giving appearance of unilateral palatal bulge. Presenting symptoms include trismus, muffled voice, odynophagia, and ipsilateral otalgia. When the diagnostic needle aspiration reveals no pus, the diagnosis is changed into peritonsillar cellulitis or also known as perintonsillitis. Peritonsillitis is sufficiently treated with antibiotics unlike a quinsy which warrants surgical incision and drainage.

Matched MeSH terms: Pharyngitis

Prevention of Group A streptococcal infection in Malaysia

Jamal F

Family Practitioner, 1988;11(1):73-74.

Group A streptococcus is an important cause of pharyngitis, skin infection and or its non-suppurative sequelae, i.e. rheumatic fever and post-streptococcal glomerulonephritis. The National Streptococcus Reference Laboratory was established in 1982 to collect data on various aspects of this infection.

Matched MeSH terms: Pharyngitis

Fulltext Comparison between LMA-Classic and AMBU AuraOnce laryngeal mask airway in patients undergoing elective general anaesthesia with positive pressure ventilation

Suzanna AB, Liu CY, Rozaidi SW, Ooi JS

Med J Malaysia, 2011 Oct;66(4):304-7.

PMID: 22299547

The LMA-Classic laryngeal mask airway (Classic LMA) is an autoclavable and reusable laryngeal mask airway with strong evidence supporting its efficacy and safety. Due to the concern of infection risk particularly of prion disease, various single-use laryngeal mask devices were developed. The Ambu AuraOnce LMA (Ambu LMA) is a single use disposable laryngeal mask airway with special design that conforms better to the anatomy of the airway.

Matched MeSH terms: Pharyngitis/prevention & control

Significance of enteric gram-negative bacilli in the throat

Philpot CR, McDonald PJ, Chai KH

J Hyg (Lond), 1980 Oct;85(2):205-10.

PMID: 7005325

Pharyngeal micro-organisms of 131 Australian and Malaysian children and adults were compared by analysis of aerobic culture of throat swab specimens. Enteric Gram-negative bacilli were commonly isolated in small numbers from Malaysian adults whether they had sore throats (28%) or not (36%), but were detected in only 9% of Australian adults without sore throats and in only 12% and 4% of Malaysian children with and without sore throats respectively. In other respects microbiological findings were similar in the different groups of subjects studied. It is concluded that the pharyngeal carriage rate of enteric Gram-negative bacilli may differ substantially between different groups of normal individuals. Our findings also suggest that these micro-organisms do not have a pathogenic role in pharyngitis.

Matched MeSH terms: Pharyngitis/microbiology

Health problems among international travellers: from a subtropical region to tropical and non-tropical regions

Pai HH, Lai JL

Travel Med Infect Dis, 2008 Jul;6(4):201-4.

PMID: 18571109 DOI: 10.1016/j.tmaid.2008.03.001

International travel may be associated with the risk of a wide range of infectious diseases. This study was designed to obtain information on the health problems among international travellers from a subtropical region to the neighbouring tropical, subtropical, and temperate regions. Health problems among international travellers from Taiwan to the Philippines, Malaysia, Indonesia, Singapore, Vietnam, Thailand (tropical group), Hong Kong, Macao, China and Japan (non-tropical group) were surveyed through the telephone. Of 649 travellers surveyed, 8.2% had one or more health problems and insect bite (3.4%) and coughing or sore throats (3.2%) were the most important symptoms. The rate of coughing or sore throats was significantly higher among those returned from the non-tropical regions. However, no associations were found between health problems and the demographic factors, travel style or travelling duration of travel.

Matched MeSH terms: Pharyngitis/epidemiology*

Ambu® AuraGain™ versus LMA Supreme™ Second Seal™: a randomised controlled trial comparing oropharyngeal leak pressures and gastric drain functionality in spontaneously breathing patients

Shariffuddin II, Teoh WH, Tang E, Hashim N, Loh PS

Anaesth Intensive Care, 2017 03;45(2):244-250.

PMID: 28267947 DOI: 10.1177/0310057X1704500215

Newer second generation supraglottic airway devices may perform differently in vivo due to material and design modifications. We compared performance characteristics of the Ambu® AuraGain™ and LMA Supreme™ Second Seal™ in 100 spontaneously breathing anaesthetised patients in this randomised controlled study. We studied oropharyngeal leak pressures (OLP) (primary outcome) and secondarily, ease of insertion, success rates, haemodynamic response, time to insertion, and complications of usage. We found no significant difference in OLP between the AuraGain versus the LMA Supreme, mean (standard deviation, SD) 24.1 (7.4) versus 23.6 (6.2) cmH2O, P=0.720. First-attempt placement rates of the AuraGain were comparable to the LMA Supreme, 43/50 (86%) versus 39/50 (78%), P=0.906, with an overall 98% insertion success rate for the AuraGain and 88% for the LMA Supreme after three attempts, P=0.112. However, the AuraGain was deemed subjectively harder to insert, with only 24/50 (48%) versus 37/50 (74%) of AuraGain insertions being scored 1 = easy (on a 5 point scale), P=0.013, and also took longer to insert, 33.4 (SD 10.9) versus 27.3 (SD 11.4) seconds, P=0.010. The AuraGain needed a smaller volume of air (16.4 [SD 6.8] versus 23.0 [SD 7.4] ml, P <0.001) to attain intracuff pressures of 60 cmH2O, facilitated more successful gastric tube insertion (100% versus 90.9%, P=0.046), and had significantly decreased sore throat incidence (10% versus 38%, P=0.020). One AuraGain and six LMA Supremes failed to be placed within the stipulated 120 seconds trial definition of 'success'; these patients had risk factors for failed supraglottic insertion. In conclusion, both devices had similar OLPs and performed satisfactorily. However, the AuraGain resulted in less postoperative sore throat despite being harder to and taking longer to, insert.

Matched MeSH terms: Pharyngitis/prevention & control

Pharyngeal exudates: mere mantle or menace?

Nathan PS, Jagathesan M

Med J Malaysia, 1976 Jun;30(4):264-5.

PMID: 790110

Matched MeSH terms: Pharyngitis/etiology*

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