Efficacy of subcutaneous interferon-beta in COVID-19: a meta-analysis and systematic review.

Type 1 interferons, especially interferon-beta, has been reported to be effective in COVID-19 patients in multiple randomized controlled trials. The aim of our meta-analysis and systematic review is to assess efficacy of subcutaneous IFN-beta in regards to mortality and discharge rate. Prospective, retrospective and randomized controlled trials were included. Primary outcomes measured were 28-day mortality and discharge rate. Secondary outcomes measured were mean hospital stay and post-intervention intubation rate. A thorough literature search was conducted in Medline, PubMed, Ovid journals, Google Scholar, and Cochrane Central Register of Controlled Trials & Database of Systematic Reviews from 1 April 2020 to 28 February 2021. Relative risk was calculated using both the Mantel-Haenszel method (fixed-effects model) and DerSimonian Laird method (random effects model). The heterogeneity among studies was tested using Cochran's Q test, based upon inverse variance weights. 7 studies were included in the meta-analysis and systematic review. The IFN-beta group did not improve the 28-day mortality (RR = 1.276; 95% CI: 1.106-1.472, p = 0.001) or the discharge rate (RR = 0.906; 95% CI = 0.85-0.95, p = < 0.001). The mean hospital stay was 11.95± 2.5 days in the interferon-beta group and 11.43 ± 3.74 days in the traditional treatment group. Likewise, interferon-beta did not add any advantage to post-intervention intubation rate (RR = 0.92; 95% CI = 0.7841-1.0816, p = 0.3154). Our findings revealed that use of subcutaneous interferon-beta is futile in COVID-19.

Anomalous Coronary Origin and Malignant Course in a Young Patient With Palpitation and Demand Ischemia: A Serendipity or a Syndrome Without a Name?

Anomalous coronary artery remains the second most common cause for sudden cardiac death (SCD) in young athletes. The anomaly most commonly associated with SCD is the one that courses between the aorta and pulmonary artery, the malignant course. We present a case of a young gentleman who presented with symptomatic palpitations and was found to have anomalous right coronary artery from ostial left main coronary artery coursing between the aorta and pulmonary artery.

Successful Transfemoral Transcatheter Aortic Valve Replacement in a Patient with Double Aortic Arch: An Interesting Imaging Case.

Transcatheter aortic valve replacement (TAVR) has become a mainstay of treatment in the management of severe aortic stenosis. It is a challenging procedure that requires expertise in obtaining proper access, delivery of catheters to and beyond the aortic valve, and finally accurate deployment of the aortic bioprosthesis. Patients with aortic anomalies portend an added challenge in performing TAVR procedures. We present the case of a patient incidentally found to have a right dominant double aortic arch who underwent successful TAVR for severe aortic stenosis.

Abdominal pain - a common presentation with unusual diagnosis: a case report.

Acute abdominal pain is a frequent cause for evaluation in the clinic and emergency room. A number of causes of abdominal pain are diagnosed easily based on the history, physical exam, and some laboratory findings. However, unusual conditions may pose a challenge and require invasive procedures for diagnosis. Rare anomalies such as mobile caecum may present as either typical or atypical acute appendicitis. Endometriosis and pinworm infections can also present as acute appendicitis but are uncommon presentations. To increase the awareness of these uncommon causes of appendicitis, we present a 32 year old female who was previously diagnosed with irritable bowel syndrome later found to have all of the above mentioned rare conditions contributing to abdominal pain. She presented to the emergency room with a one day history of acute right lower quadrant abdominal pain along with nausea and non-bilious vomiting. Physical exam revealed right lower quadrant tenderness to palpation. A computerised tomography of the abdomen and pelvis demonstrated a mobile cecum in the left abdomen. She subsequently underwent a diagnostic laparotomy with cecopexy and appendectomy. Pathology of the appendix showed findings suggestive of endometriosis and intraluminal enterobius vermicularis. She was treated with two doses of pyrantel pamoate for the parasitic infection, and subsequently had resolution of her symptoms.

Physician Variability in Diastology Reporting in Patients With Preserved Ejection Fraction: A Single Center Experience.

To help standardize the assessment of diastolic dysfunction in the United States, the American Society of Echocardiography (ASE) released criteria for the assessment of diastology in patients with normal and abnormal ejection fraction. As heart failure with preserved ejection fraction (HFpEF) is a leading cause of morbidity and mortality in cardiac patients, it is imperative to assess diastology appropriately. Echocardiography is the mainstay in the assessment of diastolic function; with the new ASE guidelines, diagnosis is simplified especially in patients that have preserved baseline ejection fraction. Our study aimed to determine the extent of physician variability in diastology reporting at our medical center after the release of the new ASE criteria.