An Atypical Presentation of Acute Ischemic Stroke in COVID 19 Patient | Chapter 12 | Recent Developments in Medicine and Medical Research Vol. 13

 Novel coronavirus 2019, also known as SARS COV2, is an enveloped non segmented ribonucleic acid (RNA) virus. During the covid19 epidemic, acute ischemic stroke is still a major concern [1]. Thrombectomy is also important in the treatment of acute stroke victims. A woman with COVID 19 presented with symptoms of altered state of consciousness (ASOC), cough, fever, dysarthria, right-sided bodily weakness, and large bilateral middle cerebral artery (MCA)/ anterior. In the presence of coronavirus infection, our case was exceptional in that it revealed severe central nervous system (CNS) impairment. There have been a few examples of patients developing a stroke after contracting COVID 19.

Aims: Clinicians should be aware of various causes of unconsciousness in patients with coronavirus disease (COVID 19), especially since delirium appears to be a prevalent consequence. They should also look at the link between stroke and COVID 19 and how it affects mortality.

Presentation of a Case: A 70-year-old woman reported to us with stroke symptoms such as ASOC, right-sided bodily weakness, dysarthria, and pneumonia symptoms such as slight cough and fever, which subsequently turned out to be COVID 19. Clinicians should be aware of various causes of unconsciousness in patients with coronavirus illness (COVID 19), especially as delirium appears to be a prevalent consequence, in order to learn more about the link between stroke and COVID 19 and how it affects mortality.

Discussion: Bilateral ischemic stroke is a rare occurrence in the general population, and it is usually caused by a cardiac embolic condition such as atrial fibrillation or a recent myocardial infarction. Despite the fact that this patient had pre-existing stroke risk factors such as type 2 diabetes, hypertension, and advanced age, her electrocardiography revealed sinus rhythm.

Conclusion: COVID-19 could be a stroke risk factor or exacerbating factor.

Author(S) Details

Mahpara Nawazish
Shalamar Hospital, Lahore, Pakistan.

Sana Iqbal
Shalamar Hospital, Lahore, Pakistan.

Mujeeb Ur Rehman Abid Butt
Shalamar Hospital, Lahore, Pakistan.

View Book:- https://stm.bookpi.org/RDMMR-V13/article/view/5033

A Retrospective Study on Mesenteric Venous Thrombosis in a Referral Hospital in East Africa | Chapter 8 | New Frontiers in Medicine and Medical Research Vol. 15

Introduction: The superior mesenteric vein is the most prevalent location of thrombosis development in acute mesenteric venous thrombosis, which is a rare disorder. The Virchow trinity of endothelial damage, stasis, and hypercoagulability is usually disrupted in patients who are prone to this illness. The acute variant is characterised by intestinal ischaemia, making it difficult to diagnose before intestine gangrene occurs. A delayed diagnosis due to poor investigative ability results in patients suffering from acute renal failure and a high mortality rate, according to the limited experience with this ailment in the East African region. As a result, the goal of this research was to describe the presentation and treatment of four patients with mesenteric venous thrombosis in an East African referral hospital, followed by a review of the aetiology, clinical characteristics, and management of this illness.

Methods: Over the course of 18 months, a descriptive retrospective review of four patients was performed. From the patients' clinical files, demographic and clinical data were collected, and manual analysis was performed using a spreadsheet.

Four cases were identified over the course of 18 months. Acute symptoms persisted for 5 to 21 days in all patients, indicating a delay in diagnosis. Short bowel syndrome and severe renal failure killed two patients within 30 days of surgery. Two patients survived short bowel syndrome complications and one patient survived severe renal injury that necessitated dialysis.

This brief case series is characterised by a delay in the diagnosis of acute MVT. As a result, all of the cases had gangrenous bowel, which contributed to the high fatality rate. Anticoagulation prevents the spread of a clot in the veins, which is linked to a lower risk of death and recurrence. To avoid bowel with dubious viability, thrombolysis and thrombectomy might be considered in some cases. The mortality rate from MVT has reduced over the last four decades, and it now stands at 10-20%, however there isn't enough data in East Africa to make this determination.

Author (S) Details

Richard Wismayer

Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

View Book :- https://stm.bookpi.org/NFMMR-V15/article/view/3868