Eptifibatide-Induced Severe Thrombocytopenia After ST-Elevation Myocardial Infarction (STEMI): A Case Report.

Eptifibatide is a platelet glycoprotein (GP) IIb/IIIa inhibitor that is used in certain cases of acute coronary syndrome, including those with high thrombus burden or with no-reflow. It can rarely be associated with severe thrombocytopenia, which brings up a dilemma in managing those patients who require antiplatelet therapy. We discuss a patient who had ST-elevation myocardial infarction (STEMI) and developed severe thrombocytopenia after eptifibatide infusion. He was managed with platelet transfusion, stopping eptifibatide, and interrupting dual antiplatelet therapy (DAPT).

Unusual Presentation of Thrombotic Thrombocytopenic Purpura With Non-ST-Elevation Myocardial Infarction.

Thrombotic thrombocytopenic purpura (TTP) is a multisystem disease characterized by disseminated thrombus formation in the arterioles and capillaries. Patients usually present with weakness, subtle mental changes, fever, and acute kidney injury. Cardiac symptoms, such as chest pain or arrhythmia, have been reported but were rarely the sole presenting symptom. We report the case of a 68-year-old woman with acute non-ST-elevation myocardial infarction who was found to have TTP. Prompt diagnosis of TTP is essential because traditional approaches to manage an acute coronary event, inclusive of dual antiplatelet therapy and percutaneous coronary intervention, might be contraindicated due to an increased risk of bleeding. Early administration of steroids and urgent initiation of plasmapheresis to improve platelet count would be crucial initial steps in the management of these patients.

Correction: Healthy lifestyle behaviors are major predictors of mental wellbeing during COVID-19 pandemic confinement: A study on adult Arabs in higher educational institutions.

[This corrects the article DOI: 10.1371/journal.pone.0243524.].

Assessment of final-year medical students' performance in diagnosing critical findings on chest X-ray.

PURPOSE: Due to the recently emerging shortage in medical staff during the novel corona virus pandemic, several countries have rushed their undergraduate medical students into the emergency department. The accuracy of diagnosing critical findings on X-rays by senior medical students is not well assessed. In this study, we aim to assess the knowledge and accuracy of undergraduate final-year medical students in diagnosing life-threatening emergency conditions on chest x-ray. METHOD: This is a cross-sectional nationwide survey across all medical schools in Jordan. Through an electronic questionnaire, participants were sequentially shown a total of six abnormal X-rays and one normal. For each X-ray, participants were asked to choose the most likely diagnosis, and to grade the degree of self-confidence regarding the accuracy of their answer in a score from 0 (not confident) to 10 (very confident). RESULTS: We included a total of 530 participants. All participants answered at least six out of seven questions correctly, out of them, 139 (26.2%) participants answered all questions correctly. Pneumoperitoneum was the highest correct answer (93.8%), whereas flail chest was the least correctly answered case with only 310 (58.5%) correct answers. Regarding self-confidence for each question, 338 participants (63.8%) reported very high overall self-confidence level. Answers related to tension pneumothorax had the highest confidence level. CONCLUSION: Senior Jordanian medical students showed good knowledge with high confidence levels in diagnosing life-threatening conditions on chest x-rays, supporting their incorporation in the emergency department during pandemics and confirming the reliability of information they can extract.

Healthy lifestyle behaviors are major predictors of mental wellbeing during COVID-19 pandemic confinement: A study on adult Arabs in higher educational institutions.

BACKGROUND: In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern. METHOD: An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was conducted to collect data from people attending or working at higher institutions from March 1, 2020 to April 24, 2020. A total of 1723 completed responses (917 males, 37.4 ±13.4 years old and 806 females 32.2 ± 11.5 years old) were collected. RESULTS: The female participants had significantly lower mental health scores than males (53.9% vs. 46.1%). The mental wellbeing scores were higher among participants with medium and high physical activity (PA) levels (p < 0.00). Additionally, the mental wellbeing scores were significantly improved by dietary quality and it's sleeping score (p < 0.001). However, PA was by far the major determinant of the mental health scores. CONCLUSION: Factors such as PA, diet, and sleeping patterns were associated with mental wellbeing during the COVID-19 confinement among Arab participants.