A Young Adult With Multisystem Inflammatory Syndrome Following Weeks of Initial COVID-19 Respiratory Infection, With No Prior COVID-19 Vaccination: A Case Report.

Multisystem inflammatory syndrome (MIS) following COVID-19, a condition primarily diagnosed in children, has also been observed less frequently in adults. It usually presents with a multitude of symptoms, mimicking a shock-like state characterized by multiple organ failure. Diagnosis often involves ruling out other conditions and timely management to mitigate morbidity and mortality. In this case, a 39-year-old unvaccinated Caucasian male patient reported symptoms of fever, chills, night sweats, diarrhea, headache, nasal congestion, and facial pain. Despite treatment with antipyretics, the fever persisted. The patient had tested positive for COVID-19 via polymerase chain reaction (PCR) six weeks prior. Clinical findings included low oxygen saturation, sinus tachycardia, abnormal liver function, elevated inflammatory markers, a negative respiratory viral panel, a negative immunologic workup, and a positive Clostridium difficile (C. difficile) PCR. Following complaints of chest pain which quickly escalated to cardiac arrest, he was diagnosed with myopericarditis. These manifestations met the multisystem inflammatory syndrome in adults (MIS-A) diagnostic criteria as stipulated by the Centers for Disease Control and Prevention. The diagnosis of MIS-A was reached through exclusion. Notably, the patient responded well to symptomatic management. Given the infrequent occurrence of MIS-A cases, even in 2023, it remains a challenging diagnosis. Despite existing guidelines for management, the recovery of this patient solely through symptomatic treatment prior to the consideration of conventional treatment is striking. The patient had concurrent infections, including a C. difficile infection, but these did not account for the overall clinical presentation, particularly the myopericarditis and positive laboratory findings.

Association Between Trigeminal Neuralgia And Unnecessary Tooth Extraction.

BACKGROUND: Trigeminal neuralgia is a very painful condition which is presented as severe pain corresponding to spastic shock. This is caused by trigeminal nerve's vascular compression at root entry zone. The pain is induced due to ipsilateral neurovascular conflict. In spite of the condition being known since centuries, it still continues to frustrate the clinician and its pathogenesis remains as enigma to the medical profession. It is very common for these patients to undergo unnecessary dental extraction without any relief in pain. This study was conducted to assess the association between trigeminal neuralgia and unnecessary tooth extraction. METHODS: This was a cross-sectional study conducted between January 2017 and July 2019 in the Department of Dentistry of Ayub Teaching Hospital, Abbottabad. A total of fifty-three cases with Trigeminal neuralgia were included. All the patients were evaluated by history, clinical examination and local anaesthetic injection. RESULTS: Fifty-three Trigeminal neuralgia cases were enrolled in this study; out of which 22 cases (41.5%) were males and 31cases (58.5%) were females. Mean age of all the patients was 53.90 years. Twenty-nine patients (54.7%) had their right side involved, while the left side was involved in 23 patients (43.4%). In only one case (1.9%) there was bilateral involvement. Regarding tooth extraction unnecessary extraction were reported by 25 (47.1%) patients before they were diagnosed to have trigeminal neuralgia. The Maxillary first Premolar was the most common tooth extracted. CONCLUSIONS: Trigeminal neuralgia is one of the most severe painful condition of the maxillofacial region which can confuse the patient and the Dentist with toothache. Patient should be evaluated in detail to rule out trigeminal Neuralgia before tooth extraction.

Presentation of maxillofacial injuries in the 2005 earthquake victims.

BACKGROUND: Earthquakes cause a lot of damage to life and property. Maxillofacial injuries constitute an important proportion of injuries in earthquakes and some 13% of the trauma patients after the earthquakes suffer from maxillofacial injuries. The objective of this study was to assess the presentation of maxillofacial injuries in earthquake victims. METHODS: This descriptive study was conducted at the Department of Oral and Maxillofacial Surgery, Dental Section Ayub Teaching Hospital. Abbottabad from October 8th, 2005 to January 8th, 2006. Three hundred and seventy-eight patients were included in this study in the three months following the October 8th, 2005 earthquake on consecutive nonprobability sampling basis. RESULTS: Isolated facial bone fractures rather than the multiple bone fractures were the commonest type of fractures in earthquake victims. A significant number of patients presented with only soft tissue injuries and no bony fractures. CONCLUSION: Although considerable number of patients with fracture of multiple facial bones were present in the earthquake victims but isolated facial bone fractures and soft tissue injuries were the commonest type of injuries.