Post-COVID Multisystem Inflammatory Syndrome-Adult Leading to Cardiomyopathy and Autoimmune Thyroiditis: A Case Report.

The Coronavirus disease pandemic is an evolving disease with myriad presentations and sequelae. Multisystem inflammatory syndrome in adults (MIS-A) can affect various organ systems, including cardiovascular, gastrointestinal, and neurologic systems, with fever and abnormally increased inflammatory markers without significant respiratory affection. This is a well-known complication in children (MIS-C). Validated clinical criteria are used to diagnose this condition. Long-term sequelae of MIS-A are unclear and underreported. Here, we describe a case of Post-COVID-19 MIS-A who presented with cardiac dysfunction, hepatitis, and acute kidney injury and recovered well with steroids. He was left with persistent cardiomyopathy and thyroiditis with hypothyroidism which to date has not fully recovered. This case emphasizes that the sequelae of COVID-19 and its pathophysiology are not fully understood, and more research is needed to predict and prevent the same.

A study of clinical, radiological features and HLA-B27 serology of axial spondyloarthropathy with comparison of radiographic and non-radiographic disease.

Background: Axial spondyloarthropathy is a type of disease which affects the axial skeleton affecting productive years. Methods: This was a cross-sectional, observational study in which 28 consecutive patients more than 16 years of age, fulfilling the Assessment of SpondyloArthritis International Society (ASAS) criteria for axial spondyloarthropathy were included. They were further sub-grouped into radiographic and non-radiographic axial spondyloarthropathy. Clinical features, joint involvement, measurements, HLA-B27 serology, and disease activity were evaluated. Data was entered into Microsoft Excel, and SPSS (Statistical Package for Social Sciences) software 2.0 was used for analyzing the data. Results: Mean age was 28.5 ± 6.3 years. 85.7% were males. Inflammatory low back pain was the most common clinical feature at presentation (89.2%). Enthesitis was the most common extra-articular feature seen in 35.7% of patients. 42.8% were non-radiographic axial spondyloarthritis. 85.7% of patients were HLA-B27 positive. 50% of patients had bone marrow edema on MRI, and only one patient had ankylosis indicating predominantly early disease. 50%-70% of our patients had high disease activity and 89.3% were responding well to non-steroidal anti-inflammatory drugs (NSAIDs). There was no significant difference between the radiographic axial spondyloarthritis group and the non-radiographic group except for elevated C-reactive protein (CRP). Conclusion: Ankylosing spondylitis in western India occurs mostly in the age group of 20-30 years, suggesting affection of productive age group. There was a delay of diagnosis for approximately three years from the onset of symptoms. There was a positive association with HLA-B27 in majority of the patients. Most of our patients had early disease based on radiological findings, suggesting that there was room for therapeutic intervention before irreversible ankylosis had set in.

Use of a single 2.0-mm locking AO reconstruction titanium plate in linear, non-comminuted, mandible fractures.

PURPOSE: The aim of the following study is to prospectively evaluate the use of a single Arbeitsgemeinschaft für Osteosynthesefragen (AO) 2.0-mm locking reconstruction plate for linear non-comminuted mandibular fractures without the use of a second plate. MATERIALS AND METHODS: This study consisted of a sample of 10 patients who reported to the department with fractures of the mandible and were treated over a period of 24 months from November 2010 to November 2012. Out of these, there were 8 male patients and 2 female patients. There were four cases of isolated parasymphysis fractures, 1 of the case had a parasymphysis fracture associated with subcondylar fracture, 4 had a body fracture and 2 had a symphysis fracture. RESULTS: All patients had satisfactory fracture reduction and a successful treatment outcome without major complications. Only one patient (10%) developed minor complications. CONCLUSION: The study has demonstrated that treating linear non-comminuted mandibular fractures with a single AO 2.0-mm locking reconstruction plate provides excellent stability at the fracture site which in turn leads to sound bone healing and early functional rehabilitation.