Cardiac complications (arrhythmias and heart failure) in patients with ischemic stroke: A meta-analysis.

BACKGROUND: In patients with ischemic stroke (pwIS), cardiac complications have been observed in observational studies. We conducted a systematic review and meta-analysis to investigate the arrhythmias and heart failure in pwIS. METHODS: Up until September 2023, we searched for case-control, cross-sectional, or cohort studies in 4 databases. For case-control/cross-sectional studies, odds ratios (OR) were determined using a random-effects model meta-analysis, while hazard ratios (HR) were calculated for cohort studies, and 95% confidence intervals (CIs) were pooled in the meta-analysis. RESULTS: In the meta-analysis, we incorporated 5 studies: 2 cohort studies, 2 case-control studies, and 1 cross-sectional study. In all, 81,181 controls and 25,544 pwIS were included in this investigation. The combined OR for case-control studies of arrhythmias was estimated to be 1.86 (95% CI: 0.70-4.94, P = .21), HR for cohort studies of arrhythmias to be 4.2 (95% CI: 1.49-12.01, P < .05), and for cohort studies of heart failure to be 2.9 (95% CI: 2.65-3.18, P < .05), suggesting that pwIS may be more likely to experience cardiac complications. CONCLUSION: Our results revealed that there is a comparatively higher risk of cardiac complications in pwIS; however, more research is needed to evaluate the risk of cardiac complications in pwIS.

Renal vein thrombosis in a patient secondary to high-grade rhabdoid renal cell carcinoma: a case report and review of literature.

Introduction: Renal cell carcinoma, a common kidney tumour which is often incidentally discovered on imaging, can manifest with atypical symptoms. Renal cell carcinoma with rhabdoid features is a rare occurrence and even rarer in case of adults. Renal cell carcinoma has the tendency to form thrombus that can migrate to renal vein, inferior vena cava and even right atrium. Case presentation: The authors report a case of an 81-year-old male with rhabdoid renal cell carcinoma presenting with persistent cough for 6-7 months. with tumour thrombus extending into the renal vein and hepatic inferior vena cava. The patient was found feeble for the surgery and hence was treated on anticancer drugs pembrolizumab and axitinib. Conclusion: Renal cell carcinoma has the tendency to form tumour thrombus in renal vein and inferior vena cava. Prognosis without surgical intervention in these conditions is very poor.

Antibiotic Prophylaxis in Patients On Extracorporeal Membrane Oxygenation: A Systematic Review.

Despite the frequent use of prophylactic antibiotics in hospitals for extracorporeal membrane oxygenation (ECMO) patients, the Extracorporeal Life Support Organization (ELSO) Infectious Disease Task Force does not recommend routine antibiotic prophylaxis due to a lack of compelling evidence. We assessed the effectiveness of prophylactic antibiotics in ECMO patients. We conducted a comprehensive search of multiple databases from their inception up to September 6, 2023, on various databases using keywords like "antibiotics," "prophylaxis," "extracorporeal membrane oxygenation," and "ECMO." Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included research. We collected data using Microsoft Excel version 2016, mean and standard deviations were calculated for continuous data, while frequencies and percentages were calculated for binomial data. A total of three studies was included in the review with a total of 8,954 participants, of which 4,483 (50.06%) received antibiotic prophylaxis, and 1,131 (25.22%) were female. The administration of antibiotics prophylactically was associated with reduction in rate of mortality, the risk of infections, and complications like acute kidney injury and diarrhea. Although there have been some benefits on antibiotic prophylaxis, prospective research, and possibly the creation of tailored, ECMO-specific bundles will be needed to identify efficient ways to prevent ECMO infection.

A rare case of schwannomatosis with meningioma: a case report.

Introduction: Schwannomatosis is characterized by multiple schwannomas without vestibular schwannomas or any other stigmata of neurofibromatosis type 2 (NF2). Schwannomatosis is a rare disorder, with a reported incidence ranging from 1 in 40 000 to 1 in 1.7 million. Meningioma is also associated with schwannomatosis in around 5% of cases. Case presentation: We describe a case of a 20-year-old female presenting with progressive weakness of the right lower limb for 7 months with a tingling sensation and numbness of the same limb for 6 months and was found to have schwannomatosis with multiple spinal and right cerebellopontine angle (CPA) (9th/10th cranial nerve) schwannomas and left anterior cranial fossa meningioma. Discussion: Schwannomas in schwannomatosis are seen along the cranial, spinal, and peripheral nerves but not along the vestibular nerve, as is characteristically seen in NF2. The occurrence of meningiomas is about 5% in individuals with schwannomatosis, and the patient in our case also had an associated meningioma. The tumor was confirmed to be a schwannoma based on features on an MRI examination and histological examination. Conclusion: It is of great significance to identify the entire spectrum of the disease in a patient with schwannomatosis, and to differentiate it from related conditions in order to track and surgically manage the patient appropriately based on symptomatology and imaging findings.

Vasculitis, an Early Unusual Presentation of Rheumatoid Arthritis: A Case Report.

Rheumatoid arthritis (RA) is a chronic inflammatory disease, with rheumatoid vasculitis (RV) being its most threatening complication. We report a case of a 70-year-old female presenting with gangrene of the tips of fingers and toes early in the course of RA, which is a rare manifestation. The skin is the most commonly affected organ in RV, followed by the peripheral nerves. However, almost every organ system can get implicated. The management of RV is mostly empirical, with high-dose glucocorticoids and cyclophosphamide. Early diagnosis and optimum management are essential in preventing severe complications of the disease.

Dengue fever complicated with ST elevation myocardial infarction with atypical features: A case report.

Dengue fever is an arboviral infection whose presentation ranges from a mild febrile illness to a multisystem complicated syndrome. We report a case of 58-year-old female presenting with fever, myalgia, arthralgia, and vomiting who was found to be infected with dengue and had electrocardiography changes revealing ST-segment elevation myocardial infarction, a rare manifestation in dengue. Dengue fever can affect the cardiovascular system leading to conduction abnormalities, hypotension, arrhythmias, myocarditis, cardiomyopathy, and occasionally myocardial infarction, which has been reported in only a few case reports prior to this. The differentiation between myocarditis and myocardial infarction is essential for which echocardiography and coronary angiography can be helpful. It is essential to keep an eye on the cardiovascular complications in a dengue patient as the presentation can be quite subtle with devastating consequences.

Dengue fever presenting with acute pancreatitis: A case report.

Acute pancreatitis is an acute inflammation of the pancreas, with subsequent involvement of surrounding tissues and organ systems. Viral etiology of acute pancreatitis is uncommon; however, multiple viruses have been implicated. Dengue virus has also been found responsible for acute pancreatitis, with possible etiologies linked to direct viral invasion, autoimmune mechanism, or as a complication of dengue shock syndrome. We present a case of a 24-year-old female who presented with epigastric pain and vomiting in the background of a febrile illness and was later diagnosed with mild acute pancreatitis complicating dengue fever.

Pelvic and peritoneal hydatidosis: An uncommon presentation of the common entity.

Key Clinical Message: The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences. Abstract: We report a unique case of a 26-year-old male who presented with acute urinary retention and abdominal distention. Later, CT-urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically.

Persistent Vitello-Intestinal Duct Masquerading as Acute Appendicitis: A Case Report.

The vitello-intestinal duct normally regresses with the development. But, in certain cases, it could persist and present as Meckel's diverticulum. Here we report a case of an eight-year-old boy presenting with peri-umbilical abdominal pain, vomiting and loose stool. He was initially diagnosed and managed as acute appendicitis but did not improve, rather developed features of intestinal obstruction. Exploratory laparotomy was done which revealed persistent vitello-intestinal duct and was managed surgically. This case report highlights that in any case of suspected acute appendicitis, the complications of persistent vitello-intestinal duct should be considered as one of the differentials. Keywords: appendicitis; case reports; intestinal obstruction; laparotomy; omphalomesenteric duct.