A Unique Case of Pericardial Effusion and Tamponade

Background We present a unique case of a female who developed a large pericardial effusion (PEff) from a rare cause. Case A 36-year-old female with recent COVID-19 infection presented with acute dyspnea. She had undergone liposuction, rectus plication and breast augmentation two months ago. Heart rate was 90/min and blood pressure 86/57mmHg. CT angiogram of the chest revealed a massive PEff with tamponade. She had large right-sided pleural effusion also. She underwent ultrasound-guided pericardiocentesis with the removal of 950 milliliters of serosanguineous fluid. Follow-up echocardiogram showed re-accumulation of fluid. Due to the rapid onset of PEff, she underwent a pericardial window and bilateral chest tube placement. Decision-making Pleural and pericardial fluid analysis showed silicone-gel particles (Figure. 1). Pericardial biopsy showed nonspecific chronic inflammation. Autoimmune workup was unremarkable. Elevated ESR and CRP in the presence of embolized gel particles indicated foreign body reaction from silicone embolism. Plastic surgery advised implant removal. Silicone embolism is known to cause silicone thorax, pleural effusions, and anaplastic large cell lymphoma. To our knowledge, this is the first reported case of PEff due to silicone embolism from breast implants. Conclusion Cardiologists should be aware of this rare but serious complication. Silicone embolism should be considered in the differential of PEff in patients with breast implants. [Formula presented]Copyright © 2023 American College of Cardiology Foundation

Pressure injuries in ventilated COVID-19 patients

Prolonged high-flow nasal oxygenation (HFNO), or non-invasive ventilation (NIV), or endotracheal intubation with prone ventilation in COVID-19 patients may result in pressure sores or ulcers at points on sustained pressure at patient-equipment interphase. Expert nursing care and following the relevant guidelines can prevent the development of such injuries. Copyright © 2022 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

Cutaneous Adverse Reactions after Administration of Covishield Vaccine in a Tertiary Care Hospital in Western Uttar Pradesh: A Series of Cases

COVID-19 is a recently discovered highly communicable disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) and its variants. The sudden emergence of the COVID 19 pandemic and its impact on global health meant that the development of effective and safe vaccines was crucial for this new lethal disease as vaccination always plays an essential role in the advancement of global health. So far, there are three main types of COVID-19 vaccines in use around the world: mRNA-based vaccines, adenoviral vector vaccines, and inactivated whole-virus vaccines. Since the introduction of vaccines for the COVID-19 disease, various reports of a spectrum of mucocutaneous side effects have surfaced. With the aid of this case series we would like to highlight the different types of cutaneous adverse effects that were observed post vaccination with the COVISHIELDTM vaccine by the department of Dermatology at our institution. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Image Encryption Using RSA Algorithm

In the current covid pandemic situation, secure online transmission of data has the highest precedence over other activities. For providing computational hardness that is for making tough to break the key for finding the unique message, there are various algorithms are present. For secure data transmission, many researchers have applied different cryptography algorithms and in order to improve the level of information security, different hybrid cryptography algorithms have been proposed. In cryptography algorithm implementation, key management plays a major role. For this reason, we have applied an image encryption technique in which a random image is considered as the key. Using the random image as a key, we have encrypted another image as information using the RSA algorithm. The comparison of the proposed method is done with the traditional approach and concluded that the cryptography algorithm implemented using an image as key provides more security in terms of encryption and decryption time. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

CARDIAC ADVERSE EVENTS AFTER VACCINATION-A SYSTEMATIC REVIEW

Background: Myocarditis and pericarditis can present as mild to life-threatening inflammatory symptoms involving the heart. This has been associated with several drugs and vaccines. We present adverse cardiac events reported after vaccination. Methods: A systematic review of the literature using Medline, Embase, Cochrane, and Scopus was performed to identify cases of adults who developed adverse cardiac events after vaccination from inception through July 2021. Data is reported using descriptive statistics. Results: There were 33 studies describing adverse cardiac events after vaccination with a total of 270 patients. The majority described adverse cardiac events following smallpox vaccine administration, followed by COVID-19 vaccination (12.96%), influenza vaccination (2.59%), tetanus vaccination (0.74%), and pneumococcal vaccination (0.74%). Approximately 85% of cases were male, and 96% of the patients were younger than 65 years old. From the cardiac events, 63.3% described were myocarditis, 13.33% were myopericarditis, 6.66% were acute coronary syndrome, 2.96% were pericarditis and 0.70% developed a pericardial effusion. Troponin levels were elevated in 68.2% of patients. Most developed cardiac events seven days post vaccination and 23.49% developed symptoms within seven days. Management was not described in the majority of the reports. In the cases where treatment was described anti-inflammatory medications were used in 56.09%, colchicine was used in 41.46% and steroids were used in 19.51% of patients. One patient required extra-corporeal membrane oxygenation. All patients recovered except one mortality with smallpox vaccine where biopsy showed eosinophilic epicardial inflammation on autopsy. Conclusion: Adverse cardiac events after vaccination have been reported with different vaccines. Management varies for these patients. These events are rare, and unlikely to be fatal.

Improper Disposal of Used Masks during COVID-19: A Health Hazard?

The Novel Corona Virus disease has taught us all to live the new normal way. As the virus transmission is mainly person-to-person through droplets, the outbreak has forced, even the general population to wear mask all the time when outdoors or meeting people. Everyone is educating the public about wearing the masks correctly by covering face and nose completely, however, correct methods of disposal of these used masks, which may be infected, is not being discussed. Proper biological waste management system is not followed while discarding the used masks and hence jeopardising the community health.

CARDIAC MUSCLE INJURY AND RIGHT VENTRICULAR ECHOCARDIOGRAPHIC CORRELATIONS IN PATIENTS WITH COVID-19

Background Cardiac muscle injury has been described as a known consequence of coronavirus-2019 (COVID-19) with poor clinical outcome. We aim to study the correlation between myocardial muscle injury and specific echocardiographic findings and, hence the association with mortality. Methods We conducted a retrospective cohort at the University Medical Center in Lubbock, Texas, under IRB of L20-172. We included COVID-19 patients from March 2020 until July 2020 who had transthoracic echocardiography (TTE) during their hospital admission. Myocardial muscle injury was defined by elevated troponin. Results A total of 101 patients were included. The mean age was 60 years, and 69.3 % were males. A total of 66 patients had a myocardial injury. Patients with myocardial injury had higher mortality than those without myocardial injury with a P-value of < 0.05, and this value remained significant after running a multiple regression analysis model. Only 4 patients had an ejection fraction of less than 40%. 11 patients had pericardial effusion. Only 4 patients had tricuspid annular plane systolic excursion (TAPSE)<1.5 cm. The mortality rate was 29.7%, and only 6 patients developed acute myocardial infarction. No difference was found between the two groups regarding the different echocardiographic findings. Conclusion Patients with COVID-19 and myocardial injury had higher mortality than those without myocardial injury with no difference regarding the different echocardiographic findings. [Formula presented]

Effective online teaching learning during COVID-19 pandemic

The COVID-19 pandemic has resulted in a dramatic change in our day to day life. It affected not only the normal working of many organizations but also the traditional classroom teaching and learning methodologies. Since everyone has to maintain social distancing to follow COVID-19 guidelines, work from home is being preferred as the best alternative as a preventive measure from spreading the pandemic. In its severe impact, schools, colleges, and universities were shut down, pushing nearly 1.2 billion students out of the classroom. As a result, the education system has to suddenly adapt to a distinctive online-based e-learning approach over digital platforms. Research tells that online learning motivated more towards the retention of online resources with less cost in terms of money and time. But, it has also brought many challenges along the way. In this research work, we focus on some of the major challenges such as information security and network bandwidth problem during online teaching. The related security measures being adopted in our research work to secure personal information during any online teaching and learning process. We also focus on some basic learning models for provisioning effective online-based teaching and learning. © 2021 Institute of Physics Publishing. All rights reserved.