Unveiling cutting-edge developments: architectures and nanostructured materials for application in optoelectronic artificial synapses.

One possible result of low-level characteristics in the traditional von Neumann formulation system is brain-inspired photonics technology based on human brain idea. Optoelectronic neural devices, which are accustomed to imitating the sensory role of biological synapses by adjusting connection measures, can be used to fabricate highly reliable neurologically calculating devices. In this case, nanosized materials and device designs are attracting attention since they provide numerous potential benefits in terms of limited cool contact, rapid transfer fluidity, and the capture of photocarriers. In addition, the combination of classic nanosized photodetectors with recently generated digital synapses offers promising results in a variety of practical applications, such as data processing and computation. Herein, we present the progress in constructing improved optoelectronic synaptic devices that rely on nanomaterials, for example, 0-dimensional (quantum dots), 1-dimensional, and 2-dimensional composites, besides the continuously developing mixed heterostructures. Furthermore, the challenges and potential prospects linked with this field of study are discussed in this paper.

Evaluating the efficacy and safety of weekly Insulin Icodec vs. Daily Insulin Glargine in type 2 Diabetes Mellitus: a systematic review and meta-analysis.

Introduction: Various insulin therapies for Diabetes Mellitus offer different benefits while having potential risks. We aim to compare Insulin Icodec, a novel Insulin analogue with the ease of once-weekly administration, to the once-daily Insulin Glargine U100 regarding glycemic control and safety profile. Methods: We performed a systematic literature search of electronic databases for peer-reviewed articles from inception until September 1 2023. Results: A total of 2215 type 2 diabetic patients were included, of which 1209 received Insulin Icodec and1048 recieved Insulin Glargine U100. In terms of glycemic control, Insulin Icodec showed a significantly longer time in the target glucose range (MD: 0.304, CI: 0.069, P = 0.000) and a more significant reduction in HbA1c (MD: -0.154, CI: 0.003, P = 0.005) compared to Insulin Glargine U100. Fasting Plasma Glucose did not differ significantly. Insulin Icodec led to a more significant increase in body weight (MD: 0.161 kg, P = 0.029), while Insulin Glargine required a higher insulin dose (MD: 1.920 IU, P = 0.000). Regarding safety, the two groups had no significant differences in hypoglycemic events or adverse outcomes. Conclusion: Once-weekly Insulin Icodec demonstrates superior glycemic control with a reduced HbA1c compared to Once-Daily Insulin Glargine U100 while maintaining similar safety profiles. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01431-5.

Psychiatric implications of anti-seizure medications in epileptic population.

BACKGROUND AND OBJECTIVE: Epilepsy is a prevalent neurological disorder that affects a significant number of individuals globally. This condition is associated with a high occurrence of psychiatric comorbidities, which can significantly affect the quality of life of individuals affected. The aim of this study was to investigate the association between antiseizure therapies and the likelihood of psychiatric comorbidities in individuals with epilepsy. METHODOLOGY: Data for this study was gathered from the Neurology referral center in Islamabad, Pakistan. A standardized questionnaire was utilized to gather data from 120 individuals diagnosed with epilepsy. The survey consisted of inquiries regarding the management of seizures, the utilization of anti-seizure medications, and the presence of psychiatric comorbidities. The data was analyzed using the Statistical Package for the Social Sciences (SPSS). RESULTS: The findings indicated that individuals who were using multiple antiseizure medications had a notably higher likelihood of having psychiatric comorbidities in comparison to those who were on mono therapy (p = 0.010). suggests that patients with unsuccessful seizure control are more probable to have psychiatric comorbidities as compared to those with good seizure control (p = 0.029). CONCLUSION: To conclude poor seizure control and poly therapy are associated with increased risk of psychiatric comorbidities.

Comparing equiosmolar hypertonic saline and mannitol for achieving brain relaxation in elective craniotomy patients: A systematic review and meta-analysis.

Background: This study strives to provide a current and thorough assessment of the comparative efficacy and safety between equiosmolar quantities of hypertonic saline (HS) and mannitol in facilitating brain relaxation for patients undergoing elective craniotomies. Methods: This systematic review and meta-analysis, following preferred reporting items for systematic reviews and meta-analyses guidelines, compared the efficacy and safety of equiosmolar concentrations of mannitol and HS in elective craniotomies. PubMed, Scopus, Cochrane Library, ScienceDirect, and Proquest databases were searched using keywords related to mannitol, HS, and craniotomy. Results were analyzed through a random-effects model using Mantel-Haenszel risk ratio and standard mean difference. P < 0.05 was considered significant. Results: Thirteen randomized controlled trials encompassing 965 patients (516 in the HS group and 448 in the mannitol group) were analyzed. The quality of studies was moderate-to-high, and no significant publication bias was observed. The primary outcome, brain relaxation, favored HS over mannitol without significant heterogeneity. Mannitol was associated with increased urine output compared to HS, irrespective of dose, with high heterogeneity. HS was linked to significantly reduced fluid input, confirmed by subgroup analysis with lower heterogeneity. No significant difference was found in serum osmolality between the two agents. Serum sodium (Na+) levels favored HS, whereas arterial blood Na+ levels also favored HS despite considerable heterogeneity. Maximum mean arterial pressure was higher with HS, but it displayed significant heterogeneity. Maximum central venous pressure showed no significant difference between the two agents, with moderate heterogeneity. Conclusion: HS appears more effective than mannitol in achieving brain relaxation, and it may offer advantages in fluid management and Na+ balance. Clinicians should consider these findings when selecting hyperosmotic agents for neurosurgical procedures. Further research is needed to address heterogeneity in certain outcomes and guide clinical practice.

CRISPRi-based circuits to control gene expression in plants.

The construction of synthetic gene circuits in plants has been limited by a lack of orthogonal and modular parts. Here, we implement a CRISPR (clustered regularly interspaced short palindromic repeats) interference (CRISPRi)-based reversible gene circuit platform in plants. We create a toolkit of engineered repressible promoters of different strengths and construct NOT and NOR gates in Arabidopsis thaliana protoplasts. We determine the optimal processing system to express single guide RNAs from RNA Pol II promoters to introduce NOR gate programmability for interfacing with host regulatory sequences. The performance of a NOR gate in stably transformed Arabidopsis plants demonstrates the system's programmability and reversibility in a complex multicellular organism. Furthermore, cross-species activity of CRISPRi-based logic gates is shown in Physcomitrium patens, Triticum aestivum and Brassica napus protoplasts. Layering multiple NOR gates together creates OR, NIMPLY and AND logic functions, highlighting the modularity of our system. Our CRISPRi circuits are orthogonal, compact, reversible, programmable and modular and provide a platform for sophisticated spatiotemporal control of gene expression in plants.

Evaluation of Postoperative Pain after Using Dexamethasone Intracanal Rinse in Irreversible Pulpitis.

OBJECTIVE: To evaluate the efficacy of dexamethasone as a final intracanal rinse in relieving postoperative pain of teeth with symptomatic irreversible pulpitis. STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Department of Operative Dentistry, PIMS, Islamabad, Pakistan, from June 2019 to December 2020. METHODOLOGY: Sixty patients aged 18- 50 years diagnosed with symptomatic irreversible pulpitis were selected according to the inclusion criterion. After obtaining informed consent, root canal therapy (RCT) was initiated under rubber dam. Pulpectomy was done followed by canal preparation. The lottery method was utilised for the division of patients. Group A (experimental) received dexamethasone (4mg/ml in 5ml syringe) as a final rinse, while Group B (control group) recalled after 1 week and asked whether their pain had relieved or not as a yes/no question. After data collection teeth were obturated and permanent restoration was placed. Data were analysed using Chi-square test. RESULTS: The efficacy of dexamethasone as a final intracanal rinse was greater than saline 86.67% and 20.0%, respectively (p < 0.05) in relieving postoperative pain in teeth with symptomatic irreversible pulpitis. CONCLUSION: Dexamethasone was proved to be more efficacious than saline in alleviating postoperative pain when used as a final intracanal rinse after canal instrumentation. KEY WORDS: Irreversible pulpitis, Dexamethasone, Postoperative pain, Pulpectomy.

Cobalt-doped zinc oxide based memristors with nociceptor characteristics for bio-inspired technology.

Neuromorphic computing is a new field of information technology, which is inspired by the biomimetic properties of the memristor as an electronic synapse and neuron. If there are electronic receptors that can transmit exterior impulses to the internal nervous system, then the use of memristors can be expanded to artificial nerves. In this study, a layer type memristor is used to build an artificial nociceptor in a very feasible and straightforward manner. An artificial nociceptor is demonstrated here through the fabrication and characterization of a cobalt-doped zinc oxide (CZO)/Au based memristor. In order to increase threshold switching performance, the surface effects of the CZO layer are eliminated by adding cobalt cobalt-doped zinc oxide (CZO) layer between the P++-Si and Au electrodes. Allodynia, hyperalgesia, threshold, and relaxation are the four distinct nociceptive behaviours that the device displays based on the strength, rate of relapse, and duration of the external stimuli. The electrons that are trapped in or released from the CZO layer's traps are responsible for these nociceptive behaviours. A multipurpose nociceptor performance is produced by this type of CZO-based device, which is crucial for artificial intelligence system applications such as neural integrated devices with nanometer-sized characteristics.

Viability of Free and Alginate-Carrageenan Gum Coated Lactobacillus acidophilus and Lacticaseibacillus casei in Functional Cottage Cheese.

The survivability of encapsulated and nonencapsulated probiotics consisting of Lactobacillus acidophilus and Lacticaseibacillus casei and the nutritional, physicochemical, and sensorial features of cottage cheese were investigated under refrigeration storage at 4 °C for 28 days. Microbeads of L. acidophilus and L. casei were developed using 2% sodium alginate, 1.5% sodium alginate and 0.5% carrageenan, and 1% sodium alginate and 1% carrageenan using an encapsulation technique to assess the probiotic viability in cottage cheese under different gastrointestinal conditions (SGF (simulated gastric juice), SIF (simulated intestinal fluid)), and bile salt) and storage conditions. Scanning electron microscopy (SEM) elucidated the stable structure of microbeads, Fourier transform infrared spectroscopy (FTIR) confirmed the presence probiotics in the microcapsules, and X-ray diffraction (XRD) demonstrated the amorphous state of microbeads. Furthermore, the highest encapsulation efficiency was observed for alginate 1% and carrageenan 1% microbeads (T3), i.e., 95%. Likewise, viability was recorded in T3 against SGF, SIF, and bile salt solution, i.e., 8.5, 8.8, and 8.9 log CFU/g at 80 min of exposure, compared to the control. The results of pH showed a significant (p < 0.05) decline that ultimately increased the titratable acidity. Nutritional analysis of cottage cheese revealed the highest levels of ash, protein, and total solids in T3, exhibiting mean values of 3.2, 22, and 43.2 g/100 g, respectively, after 28 days of storage. The sensory evaluation of cottage cheese demonstrated better color, flavor, and textural attributes in T3. Conclusively, synergistic addition of L. acidophilus and L. casei encapsulated with alginate-carrageenan gums was found to be more effective in improving the viability of probiotics in cottage cheese than noncapsulated cells while carrying better magnitudes of ash and protein, lower acidity, and pleasant taste.

The Great Imitator: A Case of Lyme Carditis Mimicking ST Elevation Myocardial Infarction.

Lyme disease, caused by Borrelia burgdorferi and transmitted via Ixodes ticks, is a common vector-borne illness in the United States, with an estimated 476,000 annual cases. While primarily known for its neurological and rheumatological manifestations, Lyme disease can also involve the cardiac system, known as Lyme carditis, which occurs in about 4% to 10% of cases. This case report details a rare instance of Lyme carditis presenting as ST-segment elevation myocardial infarction (STEMI) in a 31-year-old female with no significant medical history. The patient exhibited symptoms of chest pressure and shortness of breath, with laboratory results showing significantly elevated troponin levels and other indicative markers. Notably, cardiac catheterization revealed no coronary occlusion, suggesting an alternative diagnosis to acute coronary syndrome (ACS). Further testing confirmed Lyme carditis through positive serological tests for Lyme-specific IgM antibodies. The case underscores the importance of considering Lyme myopericarditis in differential diagnoses for STEMI in Lyme-endemic areas and in patients without typical risk factors for coronary artery disease. This report aims to increase clinical awareness of this condition, highlighting the need for thorough investigation in atypical cardiac presentations.

Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum ß-lactamase- and carbapenemase-producing bacteria.

Hospital surfaces can harbour bacterial pathogens, which may disseminate and cause nosocomial infections, contributing towards mortality in low- and middle-income countries (LMICs). During the BARNARDS study, hospital surfaces from neonatal wards were sampled to assess the degree of environmental surface and patient care equipment colonisation by Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs). Here, we perform PCR screening for extended-spectrum ß-lactamases (blaCTX-M-15) and carbapenemases (blaNDM, blaOXA-48-like and blaKPC), MALDI-TOF MS identification of GNB carrying ARGs, and further analysis by whole genome sequencing of bacterial isolates. We determine presence of consistently dominant clones and their relatedness to strains causing neonatal sepsis. Higher prevalence of carbapenemases is observed in Pakistan, Bangladesh, and Ethiopia, compared to other countries, and are mostly found in surfaces near the sink drain. Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens and Leclercia adecarboxylata are dominant; ST15 K. pneumoniae is identified from the same ward on multiple occasions suggesting clonal persistence within the same environment, and is found to be identical to isolates causing neonatal sepsis in Pakistan over similar time periods. Our data suggests persistence of dominant clones across multiple time points, highlighting the need for assessment of Infection Prevention and Control guidelines.

Tranexamic Acid: Safeguarding Children with Craniosynostosis from Bleeding. A Review Article.

Craniosynostosis is a congenital condition characterized by the premature closure of one or more sutures in the skull after birth, often necessitating urgent surgical intervention. Nevertheless, cranial vault reconstruction surgery can cause rapid and massive blood loss. This procedure requires a blood transfusion, which entails potential hazards. In addition, the hemostatic system in children differs significantly from that in adults, resulting in increased bleeding during surgical procedures. We conducted a comprehensive literature review in the PubMed, Scopus, and Web of Science databases, referring to their inception for studies on the use of tranexamic acid in pediatric craniosynostosis surgery. Selection criteria were based on the relevance of tranexamic acid, its clinical efficacy, and its safety profile in pediatric populations. Authoritative reviews were considered to ensure a comprehensive synthesis of current knowledge and practice trends in the field. We determined that a low loading dose of 10 mg/kg followed by a maintenance dose of 5 mg/kg/h is as effective as a high dose of 50 mg/kg followed by a maintenance dose of 10 mg/kg/h of tranexamic acid when administered after induction of anesthesia through skin closure and can reduce blood loss by up to 72% and total packed red blood cell transfusion by up to 85%. No difference in safety profile is observed. We concluded that a low dose of tranexamic acid, administered as a loading dose followed by a maintenance dose, is beneficial and safe for reducing blood loss and transfusion following craniosynostosis surgery.

Systematic review and meta-analysis comparing Manta device and Perclose device for closure of large bore arterial access.

Data comparing MANTA device with Perclose device for large bore arterial access closure is limited. We performed meta-analysis to compare safety and efficacy of the two devices in large (⩾14 Fr sheath) arteriotomy closure post-TAVR. Relevant studies were identified via PubMed, Cochrane, and EMBASE databases until June, 2022. Data was analyzed using random effect model to calculate relative odds of VARC-2 defined access-site complications and short-term (in-hospital or 30-day) mortality. A total of 12 studies (2 RCT and 10 observational studies) comprising 2339 patients were included. The odds of major vascular complications (OR 0.99, 95% CI 0.51-1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI 0.45-1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI 0.63-2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57-1.56; p = 0.82); device failure (OR 0.74, 95% CI 0.49-1.11; p = 0.14); hematoma formation (OR 0.76, 95% CI 0.33-1.75; p = 0.52); dissection, stenosis, occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71-1.62; p = 0.73) and short-term mortality (OR 1.01, 95% CI 0.55-1.84; p = 0.98) between both devices were similar. MANTA device has a similar efficacy and safety profile compared to Perclose device.

The Clinical Characteristics and Outcomes of Infantile Seizures in the First Year of Life: A Single-Center Study.

BACKGROUND: Epilepsy has a high incidence among infants during their first year of life, yet the prognosis can vary significantly. Although considerable research has been conducted on infantile spasms, studies examining infantile-onset epilepsy, excluding infantile spasms, remain limited, particularly concerning the factors influencing outcomes. Therefore, our study aims to elucidate seizure control, developmental outcomes, and prognostic factors in infants with epilepsy during their first year of life, within a single-center study in Malaysia. METHODS: We retrieved data from patients who experienced seizures before age 12 months and were followed for over two years, using electronic patient records at Hospital Raja Perempuan Zainab II in Kelantan, a state in Malaysia's east coast. We retrospectively reviewed these records and assessed clinical outcomes based on the last follow-up. RESULTS: Of 75 patients, 61 (81.3%) achieved good seizure control or remission. At the last follow-up, 24 (32%) exhibited developmental delay, whereas 19 (25.3%) displayed abnormal neuroimaging. Patients with abnormal background electroencephalographic (EEG) activity, as well as abnormal radiological findings, were more likely to experience poor seizure control and unfavorable developmental outcomes (P < 0.05). CONCLUSIONS: Our study underscores that most infants with epilepsy can achieve seizure remission. However, poor seizure control and developmental delay are associated with abnormal EEG background and characteristics, as well as neuroimaging abnormalities. The management of infantile-onset epilepsies may necessitate substantial resources and precise interventions to enhance overall outcomes.

Optimization of physical and dielectric properties of Co-doped ZnO nanoparticles for low-frequency devices.

In this study, zinc-oxide (ZnO) nanoparticles (NPs) doped with cobalt (Co) were synthesized using a simple coprecipitation technique. The concentration of Co was varied to investigate its effect on the structural, morphological, optical, and dielectric properties of the NPs. X-ray diffraction (XRD) analysis confirmed the hexagonal wurtzite structure of both undoped and Co-doped ZnO-NPs. Scanning electron microscopy (SEM) was used to examine the morphology of the synthesized NPs, while energy-dispersive X-ray spectroscopy (EDX) was used to verify their purity. The band gap of the NPs was evaluated using UV-visible spectroscopy, which revealed a decrease in the energy gap as the concentration of Co2+ increased in the ZnO matrix. The dielectric constants and AC conductivity of the NPs were measured using an LCR meter. The dielectric constant of the Co-doped ZnO-NPs continuously increased from 4.0 × 10-9 to 2.25 × 10-8, while the dielectric loss decreased from 4.0 × 10-8 to 1.7 × 10-7 as the Co content increased from 0.01 to 0.07%. The a.c. conductivity also increased with increasing applied frequency. The findings suggest that the synthesized Co-doped ZnO-NPs possess enhanced dielectric properties and reduced energy gap, making them promising candidates for low-frequency devices such as UV photodetectors, optoelectronics, and spintronics applications. The use of a cost-effective and scalable synthesis method, coupled with detailed material characterization, makes this work significant in the field of nanomaterials and device engineering.

Cannabis Hyperemesis Syndrome in a Young Patient: A Case Report and Literature Review.

Cannabis hyperemesis syndrome (CHS) is a condition characterized by recurrent episodes of severe vomiting, abdominal pain, and intractable nausea in chronic cannabis users. With the legalization of recreational marijuana in many states, awareness of CHS is crucial to prevent delayed diagnosis or misdiagnosis. This case report presents a 25-year-old male with a history of type 1 diabetes mellitus and chronic cannabis use who presented to the emergency department with vomiting and epigastric pain. Our literature review sheds light on existing treatment options for this syndrome and gives future direction for research.

Advancements in Nanoenabled Membrane Distillation for a Sustainable Water-Energy-Environment Nexus.

The emergence of nano innovations in membrane distillation (MD) has garnered increasing scientific interest. This enables the exploration of state-of-the-art nano-enabled MD membranes with desirable properties, which significantly improve the efficiency and reliability of the MD process and open up opportunities for achieving a sustainable water-energy-environment (WEE) nexus. This comprehensive review provides broad coverage and in-depth analysis of recent innovations in nano-enabled MD membranes, focusing on their role in achieving desirable properties, such as strong liquid-repellence, high resistance to scaling, fouling, and wetting, as well as efficient self-heating and self-cleaning functionalities. The recent developments in nano-enhanced photothermal-catalytic applications for water-energy co-generation within a single MD system are also discussed. Furthermore, the bottlenecks are identified that impede the scale-up of nanoenhanced MD membranes and a future roadmap is proposed for their sustainable commercialiation. This holistic overview is expected to inspire future research and development efforts to fully harness the potential of nano-enabled MD membranes to achieve sustainable integration of water, energy, and the environment.

A Challenging Case of Managing Septic Arthritis of the Sternoclavicular Joint in a Patient With a History of Intravenous Opioid Use Disorder: A Case Report and Literature Review.

Septic arthritis of the sternoclavicular joint (SCJ) is a rare condition with limited literature available. We present a case of a 31-year-old female patient with a history of opioid drug use who presented with septic arthritis of the left SCJ. The patient exhibited chest wall pain; imaging revealed septic arthritis with an associated retrosternal abscess. Treatment with antibiotics alone resulted in the resolution of the abscess, highlighting the potential for medical management without surgical intervention. This case report and literature review emphasizes the importance of considering septic arthritis in patients with vague chest pain, particularly those with a history of intravenous drug use, and raise awareness about the complications associated with opioid use.

When a Tooth Pulls the Heart Strings: Takotsubo Cardiomyopathy Post-dental Extraction.

Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is a temporary left ventricular dysfunction caused by a catecholamine surge under severe stress. It's characterized by chest pain, non-specific ECG changes, and left ventricular apical ballooning observed during catheterization. We present a case of a 59-year-old postmenopausal female with a past medical history of asthma who arrived at the ED complaining of chest pain following dental extraction. The patient's abnormal ECG findings and elevated cardiac enzymes required cardiac catheterization, which revealed normal coronary vasculature but demonstrated left ventricular apical ballooning. Transthoracic echocardiogram (TTE) showed septal left ventricular hypertrophy, decreased ejection fraction (EF), and akinetic segments consistent with takotsubo cardiomyopathy. Secondary takotsubo cardiomyopathy induced by stress in the setting of dental procedures like a tooth extraction for a periapical dental abscess is rarely described in the literature. Our case serves as a reminder of the potential for stress-induced cardiomyopathy in postmenopausal women, especially those with undiagnosed underlying anxiety disorders, even following minimally invasive procedures.

Hydroxyzine-Induced Torsade De Pointes: A Case Report and a Literature Review.

Hydroxyzine is an H1-receptor antagonist used for managing allergies, anxiety, opioid withdrawal, and insomnia. An adverse effect of hydroxyzine, QT prolongation, may lead to torsade de pointes (TdP). Our case report and literature review highlight the risk of TdP with hydroxyzine use. Our patient, a 58-year-old male with an implantable cardioverter defibrillator (ICD) and a history of polysubstance abuse presented with chest pain and shortness of breath. During the admission, the patient started experiencing symptoms of opioid withdrawal, which were refractory to buprenorphine. Hydroxyzine 50 mg was administered as recommended for symptomatic anxiety relief. Overnight the patient developed TdP, which was managed by MgSO4, amiodarone, and lidocaine, but did not resolve the arrhythmia. The patient was sedated and intubated, which led to the episode's resolution. This case report and literature review underscore the importance of cautious prescribing practices for hydroxyzine and other QT-prolonging drugs to prevent TdP. Healthcare providers should conduct personalized risk assessments, monitor electrolyte levels, and perform regular electrocardiograms. Administering the lowest effective dose, avoiding drug interactions, and exercising caution in patients with underlying repolarization abnormalities or a history of TdP are crucial. These measures help minimize the risk of TdP associated with low-dose hydroxyzine therapy.

A Case of Immune Checkpoint Inhibitor-Induced Probable Myocarditis and Treatment Response.

Immune checkpoint inhibitors (ICI) are a new class of pharmaceuticals that facilitate the immune system in identifying and targeting cancerous cells. However, suppressing immune regulation can often cause immune-mediated adverse events. One such downstream effect recently recognized is ICI-associated myocarditis. This case involves a 67-year-old female patient with a medical history of metastatic small-cell lung carcinoma undergoing chemotherapy with atezolizumab (third cycle) and the carboplatin-etoposide regimen (fourth cycle). The patient presented to the medical service with chest discomfort and fatigue. Elevated cardiac markers were observed, despite the absence of ischemic changes on electrocardiography and patent coronary arteries on cardiac catheterization. Cardiac magnetic resonance imaging (MRI) did not reveal any significant fibrosis in the cardiac muscle; however, an endomyocardial biopsy noted mild fibrosis. Corticosteroid treatment resulted in the normalization of cardiac enzyme levels and subsequent symptom resolution. ICI-associated myocarditis typically manifests within two months of initiating therapy. However, this case report spotlights the occurrence of a milder form of myocarditis after three months of ICI treatment.