Presenting Clinicoradiological Features, Microbiological Spectrum and Outcomes Among Patients with Septic Pulmonary Embolism: A Three-Year Retrospective Observational Study.

Background: Septic pulmonary embolism (SPE) is an unusual condition characterized by the implantation of infected thrombi into the pulmonary vasculature from a variety of infectious sources. This study aimed to illustrate the clinicoradiological features, microbiological spectrum, and clinical course of patients with SPE, as well as to promote the early identification, diagnosis, and prognosis of this unusual disease. Methods: Nineteen patients with SPE collected from the electronic medical records of our hospital were retrospectively reviewed during three years. Results: The study included twelve men and seven women with a mean age of 49 (15-78). The most common presenting features were fever (79%) and shortness of breath (73.7%). Chronic kidney disease (68.4%) and diabetes (36.8%) were the most common comorbidities. The most common source of infection was venous catheters (58%). Staphylococcus aureus was the most predominant pathogen in about 52.6% of the cases. According to the CT findings, bilateral opacities were detected in all cases, flowing by nodular in 73.9% and cavitations in 57.9%. Central distributions were the most patterns regarding the location of the lesion seen in 47.4% of the patients. All patients received antimicrobial treatment, while 13 cases administered systemic anticoagulant. Most of the patients (73.7%) recovered from their illness, while 26.3% died. The median duration of hospitalization was 11.5 days. Oxygen saturation level and altered mental status were significantly associated with the mortality rate of SPE patients. Conclusion: The study's findings presented that altered mental status and low oxygen saturation are associated with a high mortality rate in SPE patients, especially those requiring critical care. Early diagnosis of an embolic phenomenon to other organ systems like the central nervous system can greatly influence the patient's outcome.

Incidental finding of mild COVID-19 pneumonia with multiple thromboembolic disease: A case report.

Corona virus disease is thought to be of zoonotic origin which has been named SARS-CoV-2 (COVID-19) and was first introduced in Wuhan, China, in December 2019. Although the corona virus-associated inflammatory state can additionally lead to significant thromboembolic complications despite prophylaxis, previous studies have reported the clinical manifestations of SARS-CoV-2 are varied, ranging from asymptomatic to severe. Here, we reported a 69-year-old female infected with COVID-19 pneumonia, presenting with shortness of breath, chest pain, and left leg swelling for 1 week. Although the patients who had no history of chronic disease, but she was diagnosed with pulmonary thromboembolism and deep vein thrombosis (DVT) from mild case of COVID-19 pneumonia.

Epidemiological characteristics, clinical relevance, and risk factors of thromboembolic complications among patients with COVID-19 pneumonia at A teaching hospital: Retrospective observational study.

Background: Thromboembolism is the third most common cardiovascular disorders and substantial worldwide health burden, with 1-2 instances per 1000 persons each year. This study aimed to describe the epidemiological characteristics, clinical relevance, risk factor and outcome of thromboembolic complications among COVID-19 infected patients. Method: This is a retrospective, single-center, observational study using a hospital information system (HIS). The study included 46-patients with a confirmed diagnosis of pneumonia by SARS-CoV-2 admitted to a tertiary hospital. Results: The incidence of cardiovascular thromboembolic events among COVID-19 infected patients was 41.3% (n = 19). Cerebrovascular accident was the most common thromboembolic events among COVID-19 infected patients about 15.2%, flowed by pulmonary embolism (13%), acute myocardial infract (8.7%), and deep venous thrombosis (4.4%). In generally, 63% (n = 29) were males, while 37% (n = 17) were females. The majority of those who suffered thromboembolic events were over 65 years old (p < 0.000**).Patients with thromboembolic event were also more likely to have IHD (13.0% vs 0%, p = 0.003), diabetes (24% vs 13.0%, p = 0.025) and CL (10.9% vs 2.2%, p = 0.03) as precipitating factors when compared those without thromboembolic events.According to the outcome, 19 examinees had thrombotic events: 11 (24%) patients had admitted to non ICU inpatient ward, 2 (43%) had admitted to ICU and remaining 6 (13%) patients had dead. There was significant statistical difference in the proportion of examinees with thrombotic and non-thrombotic events in relation to outcome (p = 0.000). Conclusion: The incidence of thromboembolic complications among COVID19 infected patients were associated with elder (>65years), IHD, diabetes and CLD.

Knowledge, attitude, and practice regarding lifestyle modification among type 2 diabetes patients with cardiovascular disease at a Tertiary Hospital in Somalia.

Background: Diabetic was the eighth leading cause of death among both sexes and the fifth leading cause of death in women in 2012{WHO, 2016}. The main objective of this study is to identify the knowledge, attitude, and practice regarding lifestyle modification among type 2 DM with CVD at Mogadishu Somali Turkish Training and research hospital in Mogadishu, Somalia. Method: This study was hospital-based cross-sectional study conducted from type 2 Diabetic Mellitus patients with cardiovascular disease attended to Mogadishu Somali Turkish Training and Research Hospital for medical check-ups and regular medical treatments between September 2020 to August 2,0221. Results: A total of 384 patients were enrolled in the study. Out of 384 participants 221(57.6%) were females, while 163(42.4%) were males. The majority of the repondents, 261 (68%) fell within the age group of 60 years and above. Most of the participants (29.4%, n = 113) had no formal education. Interestingly, more than half 228(59.4%) of participants were employed, while near one-third of the respondents (34.1%, n = 131) belonged to the low-income group (<2,000,000SH).Concerning knowledge of the patients towards LSM of diabetic; the majority of the participants 68% (n = 261) had poor knowledge regarding knowledge questions, while 32% (n = 123) had good knowledge. Regarding to the level of attitude, 71.9% of respondents had a negative attitude toward the lifestyle modification of diabetics and the remaining 28.1% (n = 108) had negative attitude. More than two-thirds of participants 61.2% (n = 235) had a poor practice, while 38.8%(n = 149) respondents had a good practice regarding lifestyle modification.Finally A significant relationship was evaluated between Knowledge and Attitude (0.007*) and between Knowledge and Practices (P = 0.000**) suggesting that most participants had good knowledge associated with good attitude and practices correspondingly. Conclusion: The result of this study revealed, majority of type2 DM patients with CVD had poor knowledge, negative attitude and poor practices towards LSM. So, we recommend to all stake holders (Ministry of health, Health institution, health professionals, and national and international NGO) to improve KAP of the patients towards LSM.

Simultaneous acute cardio-cerebral infarction associated with isolated left ventricle non-compaction cardiomyopathy.

Introduction and importance: The co-occurrence of acute ischemic stroke and acute myocardial ischemia; cardio-cerebral infarction (CCI) has been linked to increased morbidity and mortality. The incidence of these conditions to occur simultaneously has been reported to be less than 1% according to the published data. Left Ventricular Non-Compaction (LVNC), on the other hand, is characterized by large left ventricular (LV) trabeculae, a thin compacted layer, and deep intertrabecular recesses. In the inter-trabecular recesses, where blood flow is slow, cardiac mural thrombi may form, which can lead to systemic embolization. Case presentation: In this report, we describe a 51-year-old male patient with a history of hypertension and diabetes who developed a non-ST segment elevated myocardial infraction and an acute ischemic stroke that were thought to be related to left ventricular hypertrabeculation. Clinical discussion: Although it is rare, the simultaneous occurrence of myocardial infarction and an acute ischemic stroke can be fatal. There are numerous potential mechanisms for CCI, including cardiac thrombi-embolism, hypoperfusion during AMI. Both conditions have a narrow therapeutic window and management is very crucial. Conclusion: To the best of the author's knowledge, this is the first reported case of cardiocerebral infraction (CCI) in the setting of non-compaction left ventricle. Early and precise diagnosis is critical to the successful management of these conditions.

Spontaneous bilateral subdural hematoma in a patient with a prosthetic valve and association with plasmodium vivax malaria: A rare case report.

Introduction and importance: Bilateral subdural hematoma (SDH) is a very rare condition which can occur without any apparent etiology. It's characterized by a lower frequency of focal neurological impairments, which could delay the diagnosis and postpone treatment. The reported incidence of an acute spontaneous subdural hematoma (SSH) varies between 2% and 6.7% of all acute SDH. SDH following Plasmodium vivax (P. vivax) infection are uncommon to our knowledge, only two cases of SDH linked with P. vivax infection have been documented in the literature. Case presentation: We describe a case of a 31-year-old male with a history of mitral mechanical valve replacement on anti-coagulant presented with spontaneous bilateral subdural hematoma in the presence of malaria. The patient had a limited vague symptom, which delayed a prompt diagnosis of his disease. Clinical discussion: Spontaneous subdural hematoma has only a few documented cases. Hypertension, infections, vascular malformations, ruptured aneurysms, thrombocytopenia caused by hematological and oncological illnesses, acquired or inherited types of coagulopathies, and drug abuse are all risk factors. Also, SDH has been documented in the literature as a consequence of Plasmodium infection. In addition to that this patient was on anti-epileptic medicines which might potentiate vitamin K antagonists. Numerous factors were thought to have contributed to this significant bleeding. Conclusion: Patients on anticoagulants who exhibit nebulous symptoms, including a mild headache, should be subjected to a thorough history and examination. And any factor delaying an accurate diagnosis should be eliminated. This will complement the patient's plan and management.

49-years-old women with unusual presentation of severe hypokalemia mimicking Guillain-Barré Syndrome: A rare case report.

Acute neuromuscular weakness with associated subsequent developing respiratory failure is common neurological emergency in all emergency departments worldwide. Guillain-Barré Syndrome (GBS) remains the most common cause of acute ascending quadriplegia presents with ascending muscle weakness associated with paresthesia and loss of deep tendon reflexes and usually preceeded by diarrheal illness or upper airway infection. Here we report 49-year-old female presented with rapidly progressing, ascending quadraparesis for 48 hours duration with subsequently complicated by respiratory paralysis due to severe hypokalemia.

Public Health Surveillance for Adverse Events Following COVID-19 Vaccination in Africa.

Local, national, and international health agencies have advocated multi-pronged public health strategies to limit infections and prevent deaths. The availability of safe and effective vaccines is critical in the control of a pandemic. Several adverse events have been reported globally following reception of different vaccines, with limited or no data from Africa. This cross-sectional epidemiological study investigated adverse events following COVID-19 vaccination in Africans from April-June, 2021 using a structured online questionnaire. Out of 1200 participants recruited, a total of 80.8% (n = 969) respondents from 35 countries, including 22 African countries and 13 countries where Africans live in the diaspora, reported adverse events. Over half of the vaccinees were male (53.0%) and frontline healthcare workers (55.7%), respectively. A total of 15.6% (n = 151) reported previous exposure to SARS-CoV-2, while about one-fourth, 24.8% (n = 240), reported different underlying health conditions prior to vaccination. Fatal cases were 5.1% (n = 49), while other significant heterogenous events were reported in three categories: very common, common, and uncommon, with the latter including enlarged lymph nodes 2.4% (n = 23), menstrual disorder 0.5% (n = 5), and increased libido 0.2% (n = 2). The study provided useful data for concerned authorities and institutions to prepare plans that will address issues related to COVID-19 vaccines.

Extensive mediastinal thymolipoma mimicking pulmonary edema.

Thymolipoma is a rare benign slow-growing encapsulated tumor of anterior mediastinum that accounts for 2-9% of all thymic neoplasms. About 30-50% of them are asymptomatic and found incidentally. Less than 200 cases have been published in the world literature so far. Here we report a case of thymolipoma of an adult female presented with progressive dyspnea, chest tightness and non-productive chough for 2-month duration. All blood investigations were normal. Radiological examinations suggested the presence of fat and soft tissue within the tumor without invading the neighboring structures. We concluded that the only curative treatment of thymolipoma is surgical excision. Unfortunately, the patient did not give consent despite telling her the outcomes if we do not do the surgical procedure, and a week later she passed away due to respiratory distress secondary to the mass effect of the tumor.

An unusual combination of persistent silent truncus arteriosus Type-II with ascending aortic aneurysm.

Truncus arteriosus (TA) is a relatively uncommon cyanotic congenital cardiac anomaly accounting for 1.3% of all congenital cardiac malformations. TA associated with an ascending aortic aneurysm is an extremely rare congenital cardiovascular abnormality. A 15-year-old male presented with shortness of breath and cough for 2 weeks. Radiological examinations showed that the ascending aorta and main pulmonary arteries originate from a single truncus with ascending aortic aneurysm. TA has a poor prognosis if remain unrepaired and surgical intervention is necessary to avoid severe pulmonary vascular occlusive disease.