Dissection of coronary artery: A clinical overview.

Spontaneous coronary artery dissection (SCAD) is a rare but life-threatening disorder. SCAD is gaining importance as an emerging cause of acute coronary syndrome (ACS), especially in otherwise healthy young women. While SCAD and ACS show similarity in presentation, the management of SCAD differs to that of ACS. If not managed properly SCAD can lead to sudden death. This review examines the pathophysiology, clinical presentation, diagnostic algorithms, and the current and future management of SCAD.

Spontaneous coronary artery dissection: presentation and management options.

Coronary artery dissection is a serious, life-threatening heart condition. It can occur spontaneously or due to traumatic or iatrogenic causes. Spontaneous coronary artery dissection (SCAD) is often misdiagnosed as most patients present with symptoms resembling those of an acute coronary syndrome. Clinical sequelae of SCAD include debilitating morbidities such as myocardial infarction, myocardial ischaemia, sudden cardiac death, ventricular arrhythmias amongst many other myocardial ischaemia associated complications. There are two main methods of managing patients with SCAD; conservative management with medical therapy or revascularisation by percutaneous coronary intervention or coronary artery bypass grafting.

The effect of antivirals on COVID-19: a systematic review.

INTRODUCTION: Coronavirus Disease 2019 is a contagious infection that has infected millions worldwide. The objective of this systematic review is to identify studies pertaining to antivirals, both as sole and combined therapies, in COVID-19 patients and review the clinical outcomes of these treatment methods. AREAS COVERED: A systematic review was conducted using Preferred Reporting Items or Systematic Reviews and Meta-analysis (PRISMA) guidelines. A literature search was done on Medline, Global Health, and EMBASE using keywords and MeSH terms relevant to COVID- 19 and antivirals. Limits were put on date to obtain articles between December 2019 to May 2020 (the time at which the search was performed). 776 articles were identified and screened. After screening, 16 studies were included. The narrative synthesis revealed three key themes (1) Use of antivirals only (such as lopinavir, umifenovir, and remdesivir), (2) Use of lopinavir-ritonavir alongside other treatments, and (3) Use of other antivirals in combination with other treatments. EXPERT OPINION: Using antivirals in combination with other treatments has potential; however, further randomized controlled trials with larger sample sizes are required to identify the best candidate components that should comprise combined treatments for COVID-19. This should optimize treatment efficacy and improve patient outcomes.

The impact of COVID-19 on the provision of cardiac surgical services.

The global pandemic caused by COVID-19 has had a significant global impact on healthcare systems. One implication of this pandemic is the cancellation of elective cardiac surgeries and the centralization of services. As a result, hospitals in Europe, North America, and the United Kingdom have had to alter the services offered to patients to be able to cope with service provision for COVID infected patients. Data should be collected during this period to provide a good insight following the lockdown period to understand the implication of such service alteration. Future research should also focus on the effects on long-term mortality and morbidity as well as financial implications on hospitals as a result of these changes.

The Role of the Lung Ultrasound in Coronavirus Disease 2019: A Systematic Review.

The coronavirus disease 2019 (COVID-19) pandemic has now infected six million people and is responsible for nearly four hundred thousand deaths. We review the potential role of the lung ultrasound to evaluate its benefits and potential roles to compare it to the current gold standard of computed tomography. A literature search was carried out utilizing electronic search engines and databases with COVID-19. Keywords related to the lung ultrasound (LUS) were used to refine this search - only the relevant articles found are cited. This review showed that there exists a strong correlation between the CT and LUS scan in COVID-19. Prominent features include the vertical B-lines, thicker pleural lines, and subpleural consolidation. Potential roles include reducing transmission between health-care workers and monitoring the progress of the disease. However, the current research is scarce compared to well-established imaging modalities, and as such, there is a necessity for more research to confirm the findings of this review.

The Impact of COVID-19 on Medical Examinations.

Background and aim The coronavirus-19 (COVID-19) pandemic has had a profound impact on many aspects of our lives, including medical education. The suspension of clinical placements and cancellation of objective structured clinical examinations (OSCE) is likely to have an influence on students' performance.   Methods Using a questionnaire, a retrospective observational study was conducted. Our primary focus was 3rd year medical students following their examinations in May 2020.    Results Out of 46 responses obtained, the results demonstrated over 2/3 felt they perform better in clinical OSCE compared to written examinations and the majority performed worse this year during the pandemic. On a Likert scale, a mean result of 3/5 was obtained for confidence upon returning to placement and to address this, most stated they would benefit from extra optional teaching. Additionally, a further average of 3.82 was derived to represent how greatly students believed the absence of third year clinical OSCE would negatively impact their performance in the OSCE for the following academic year.  Conclusion The results of our study highlight that the cancellation of clinical placements and OSCE due to coronavirus has negatively impacted on medical education and if we are to be faced with future pandemics, we must be better prepared to train future doctors.