scholarly journals Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 607
Author(s):  
Bibhuti B. Das ◽  
William B. Moskowitz ◽  
Mary B. Taylor ◽  
April Palmer

This is a cross-sectional study of 29 published cases of acute myopericarditis following COVID-19 mRNA vaccination. The most common presentation was chest pain within 1–5 days after the second dose of mRNA COVID-19 vaccination. All patients had an elevated troponin. Cardiac magnetic resonance imaging revealed late gadolinium enhancement consistent with myocarditis in 69% of cases. All patients recovered clinically rapidly within 1–3 weeks. Most patients were treated with non-steroidal anti-inflammatory drugs for symptomatic relief, and 4 received intravenous immune globulin and corticosteroids. We speculate a possible causal relationship between vaccine administration and myocarditis. The data from our analysis confirms that all myocarditis and pericarditis cases are mild and resolve within a few days to few weeks. The bottom line is that the risk of cardiac complications among children and adults due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection far exceeds the minimal and rare risks of vaccination-related transient myocardial or pericardial inflammation.

2021 ◽  
Vol 8 (26) ◽  
pp. 2253-2259
Author(s):  
Mohit B. Gor ◽  
Kuldeepsinh D. Mori ◽  
Mehul N. Bavishi ◽  
Nirmala C. Chudasama ◽  
Jaypalsinh D. Barad ◽  
...  

BACKGROUND Brain tumours represents 1.7 % of all cancers and contributes 1.8 % of all cancer deaths. Of all the brain tumours, 80 % are supratentorial.1 Magnetic resonance imaging (MRI) is an important modality, having higher sensitivity for detecting intracranial pathology. Multiplanar imaging is possible with MRI which helps in detection, localization and characterization of the lesion. MRI examination has helped in early diagnosis, accurate localization of the tumour, with prompt initiation of appropriate medical or surgical therapy. Recent advances like magnetic resonance (MR) spectroscopy, MR fluoroscopy with stereotactic guided biopsy have revolutionized the role of MRI in study of intracranial tumours. METHODS A cross sectional study of 75 patients was done by Siemens Essenza 1.5T MRI from June 2018 to June 2020 using dedicated head coil. RESULTS In our study, most of the patients were between 31 - 60 years of age (39 % of all patients) with the largest group between 31 - 40 years (20 % of all patients). Out of 75 cases of supratentorial neoplasms, 47 (72 %) were intra-axial lesions, 15 (23 %) were extra-axial lesions and 3 (5 %) were intra ventricular lesions. In this study, 69 % of the lesions were solitary and 31 % were multiple. Most of patients (89 %) showed some enhancement, most common being heterogeneous/inhomogeneous enhancement. Commonest type of supratentorial neoplasms were metastases comprising 29 % of this study. CONCLUSIONS Magnetic resonance imaging is an important modality, having higher sensitivity for detecting intracranial pathology. Multiplanar imaging is possible with MRI which helps in early detection, localization and characterization of the lesion. Metastasis is the most common supratentorial tumour in this study followed by meningioma. Intra-axial tumours are more common than extra-axial tumours in this study. KEYWORDS MRI, Metastasis, Glioma, Meningioma


2021 ◽  
Vol 8 (19) ◽  
pp. 1391-1396
Author(s):  
Kushal Singh ◽  
Anshita Singh ◽  
Piyush Piyush

BACKGROUND Echocardiography is considered as a traditional approach to clinically study dilated cardiomyopathy. Because of poor apical visibility, however, volumetric calculations are difficult to ascertain. In calculating left ventricle volumes and ejection fractions, magnetic resonance (MR) imaging has shown to be more accurate than echocardiography. Due to conflicting literature, the present study was conducted to diagnose dilated cardiomyopathy using 2 D - echocardiography and correlate these echocardiographic findings with magnetic resonance imaging (MRI). METHODS This observational cross-sectional study was conducted in the Department of Radio-diagnosis and Imaging, Sri Sathya Sai Institute of Higher Medical sciences, Puttaparthi, Andhra Pradesh, Pin 515134. The study group consisted of consecutive patients who had clinical suspicion of dilated cardiomyopathy. A total of 40 patients underwent both 2 D - echo and cardiac MRI on the same day. All patients underwent 2 - D echo which was performed at the frame rate of 40 - 80 frames per second in the left lateral decubitus position to obtain standard 2, 3, and 4 chambers as well as short axis views (GE Vingmed Vivid 7 Dimensions, Horton, Norway: 2.5 MHz transducer). MRI was performed on a 1.5 T scanner (Mangnetom Aera, Siemens, Erlangen, Germany). For patient monitoring and cardiac synchronization, 3 - lead electrocardiography was used. RESULTS In the present study, in comparison to reference standard (cardiac MRI), 2 D - echocardiography showed significant and systematic underestimation of enddiastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV). Good correlation between 2 D - echo and cardiac MRI was noted for end-diastolic volume (r = 0.89), stroke volume (r = 0.60) and ejection fraction (r = 0.75). CONCLUSIONS In summary, magnetic resonance imaging is an accurate, non-invasive, safe and advanced modality for evaluation of global left ventricular function and myocardial scarring. 2 D - echocardiography can be used for screening of the patients with clinically suspected dilated cardiac myopathy (DCM) and their follow up. KEYWORDS Echocardiography, MRI, Cardiomyopathy


Author(s):  
Jaybrata Ray ◽  
Jaharlal Baidya ◽  
Tanusri Debbarma ◽  
Jobin Joy

Introduction: Ultrasound screening for foetus congenital malformations is the mainstay in diagnosis and is commonly performed at 19-22 weeks gestation. Magnetic Resonance Imaging (MRI) is known as a problem solving tool which is used for answering a specific question. Both ultrasound and foetus MRI are highly sensitive and specific in diagnosis of congenital anomalies of the foetus with high agreement between both modalities. Aim: To determine the accuracy of Ultrasound Sonography (USG) and High Field 3 tesla MRI in diagnosis of different types of foetal Central Nervous System (CNS) and non CNS congenital abnormalities. Materials and Methods: A cross-sectional study was conducted in the Department of Radiodiagnosis at Agartala Government Medical College and GB Pant Hospital from June 2017 to May 2019. A total of 65 cases with ultrasound diagnosis of foetus abnormalities were examined by 3 Tesla MRI. MRI were performed within 15 days after USG detected anomalies. Statistical analysis was done using Chi-square test. Results: In cases with foetus anomalies high field MRI provided detailed findings leading to a more refined diagnosis. CNS anomalies were more as compared to other anomalies. Some of the antenatal findings were confirmed in some cases following termination of pregnancy and some were by postnatal examination. Among them chest anomalies was least common i.e., 1.5%. sensitivity of MRI was 88.13%, specificity was 66.66%, Positive Pressure Ventilation (PPV) was 96.29%, Negative Predictive Value (NPV) was 36.36% and USG sensitivity was 82.43%, specificity and 77.77%, PPV was 95.83%and NPV was 41.17%. Conclusion: High field MRI should be used as a second line of investigation in patients with foetus abnormalities diagnosed by ultrasound for confirmation of diagnosis and selecting the treatment protocol. In cases of fatal abnormalities, a confirmed diagnosis made before 20 weeks of pregnancy may help by terminating the pregnancy.


2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.


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