SARS COV-2 infection has become a global threat, cardiovascular manifestations associated with Covid-19 has been noted in several publications, and bradycardia related to Covid-19 is a complication which is commonly reported. We reported six serial cases of bradycardia attributable to Covid-19. Four among them developed a complete atrioventricular block. These patients experienced clinical symptoms related to bradycardia initially required a permanent pacemaker implantation. One patient later however did not require permanent pacing due to spontaneous conversion to sinus rhythm. In comparison, the other two patients who developed transient sinus bradycardia experienced a self-limiting condition during their hospitalization period without requiring any cardiac pacing device nor medication to increase heart rate. Complete atrioventricular block and transient sinus bradycardia in these patients despite not having any history of bradycardia might be due to complex processes in the systemic inflammatory response in covid-19. Cardiac monitoring, hemodynamic evaluation, and strategy for permanent pacemaker in these patients should be treated as a case-by-case basis.

Background The incidence of Brugada syndrome has been reported to occur mostly in Asian countries. However, key countries such as Indonesia, the largest-populated Southeast Asian country, have yet to report any existing data regarding the incidence of Brugada syndrome among its population. Detecting these patients has been challenging, especially in primary healthcare settings, which generally have limited resources. Telemedicine may represent an ideal solution for initial diagnosis to determine if a patient may have this condition. Methods We collected and analyzed numerous 12-lead electrocardiograms (ECG) of patients who visited various healthcare centers in Makassar for routine medical check-up between June 2017–April 2018. Electrocardiograms from these centers were sent to the Cardiac Center at Dr. Wahidin Sudirohusodo Hospital in Makassar via telemedicine. Results During the period, we successfully obtained 9558 ECGs. While none of the patients were initially suspected of Brugada Syndrome, we found 102 (1.07%) among them to have a Brugada ECG pattern (BrEP). BrEP was more commonly found in males compared to females (67.6% vs. 32.4% of the cases found). There were significant differences in the number of confirmed cases among the types of BrEP for male and female patients. The number of confirmed cases of BrEP in male and female patients were significantly different (p < 0.05), where the number of cases for male vs. female was 8 vs. 4 for type 1, 17 vs. 1 for type 2, and 44 vs. 28 for type 3. Conclusion Brugada syndrome is a disease that is at grave risk of being frequently underdiagnosed. Our study indicates that telemedicine can become an appropriate tool that can assist physicians in detecting suspected patients. Future efforts should also be directed at studying the possible use of telemedicine for detecting other similarly rare conditions.

Introduction: Tuberculous lymphadenitis (TBLN) is a form of extra-pulmonary TB with clinical features ranging from lumps to abscesses. Human Immunodeficiency Virus (HIV) co-infection and diabetes mellitus alongside TBLN made the diagnosis and management exceptionally challenging. We reported 3 cases of TBLN, 2 among them had an existing HIV co-infection, and 1 had preexisting diabetes mellitus.Case: The first case, a 28-year-old man, previously diagnosed with HIV, complained of a lump in the neck; biopsy results suggested TBLN. The second case was a 36-year-old man with a neck abscess and HIV co-infection. Acid Fast Bacilli (AFB) pus was positive & Human Immunodeficiency Virus Enzyme-Linked Immunosorbent Assay (HIV ELISA) was reactive. The third case was a patient with a neck abscess with preexisting diabetes mellitus (DM) underwent wound debridement and was given anti-tuberculosis drugs.Conclusion: TBLN with HIV co-infection or diabetes had clinical features ranging from a painful lump to an abscess. The definitive diagnosis was taken by examining AFB from pus. If the abscess was more extensive than or equal to 3 cm, wound debridement was necessary. The primary treatment for TBLN was anti-tuberculosis drugs and required even greater attention if a patient had any preexisting comorbidities such as HIV and diabetes.