A Rare Case of Coronavirus Disease 2019 Vaccine-Associated Cerebral Venous Sinus Thrombosis Treated with Mechanical Thrombectomy.

BACKGROUND Vaccine-related thrombosis and thrombocytopenia syndrome (TTS) is a rare life-threatening syndrome reported after vaccination against COVID-19. CASE REPORT We describe a case of 56-year-old postmenopausal, obese woman with hypothyroidism and hyperlipidemia, who presented to the Emergency Department (ED) with fluctuating mental status and left-side weakness for 5 days. She received her first and second dose of mRNA-1273 vaccine (Moderna) at 12 and 8 weeks, respectively, prior to presentation. She was found to have multiple hemorrhages and infarcts on a computed tomography (CT) scan of the head. She was intubated in the ED for airway protection and mechanically ventilated. Magnetic resonance angiogram and venogram showed multiple infarcts in right frontal, parietal, and left parietal lobes, along with occlusion of left-side transverse sinus, sagittal sinuses, and left internal jugular vein, suggesting cerebral venous sinus thrombosis (CVST). Despite anticoagulation, her clinical condition continued to worsen, and she was referred for emergent endovascular thrombectomy. Her clinical condition improved after thrombectomy, and she was discharged on warfarin. At 4-month follow-up, she was able to walk with an assistive device and able to carry out activities of daily living with assistance. She is planned for further work-up for hypercoagulable state at follow-up. CONCLUSIONS This case highlights the occurrence of vaccine-related thrombosis 3 months after vaccine administration. Only 2 cases of TTS have been reported so far after mRNA-1273 vaccination (Moderna). To the best of our knowledge, this is the first reported case of CVST presenting 3 months after the first dose of COVID-19 mRNA-1273 vaccine (Moderna).

KNOWLEDGE AWARENESS AND BEHAVIOUR OF NON-MEDICAL STUDENTS ABOUT CARDIOVASCULAR DISEASES.

BACKGROUND: Cardiovascular diseases is the leading cause of death worldwide, yet very little data is available assessing the awareness of the younger population of Pakistan. The purpose of this study was to evaluate the awareness, knowledge and the preventive measures taken to avoid the health issues related to cardiovascular diseases. METHODS: It was a community based cross sectional descriptive study to assess the awareness and behavior in young non medical students. A questionnaire was developed and survey was conducted on 300 non medical students enrolled in different universities of Pakistan. Data analysis was performed using SPSS-16. RESULTS: The sample consisted of 300 students aged between 16 and 32 years. 6.7% of the participants had history of blood pressure, 0.7% had diabetes, and 68.3% had a family history of cardiovascular diseases. 17.4% students were smokers. In the knowledge section, only 22% respondent scored above 20 out of 28 showing lack of knowledge. 42.7% participants were concerned about developing coronary artery diseases. 43.3% and 6.7% knew their blood pressure and cholesterol level respectively.33.3% and 41.7% regulate their dietary fat and salt intake respectively. CONCLUSION: Our study elucidates that cardiovascular diseases are not perceived as major risk by Non Medical Students. Lack of knowledge, physical inactivity, and high positive family history render the target population prone to cardiovascular diseases. The findings of study indicates the need for heart disease awareness campaigns for young population, to escalate the preventive actions and adoption of healthy lifestyles so as to lower the incidence of cardiovascular diseases in Pakistan.