Introduction
The novel Coronavirus Disease 2019 (COVID-19) is an infection caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which has been spreading rapidly amongst humans and causing a global pandemic. The notorious infection has shown to cause a wide spectrum of neurological syndrome, including autoimmune encephalitis.
Objective
Here, we systematically review the literature on autoimmune encephalitis that developed in the background of SARS-CoV-2 infections and also the possible pathophysiological mechanisms of auto-immune mediated damage to the nervous system.
Methodology
An exhaustive search was made in Medline/PubMed, Embase, Scopus and other medical databases, and 28 relevant published articles were selected according to the strict inclusion criteria.
Results
Autoimmune encephalitis can occur via three possible proposed pathophysiological mechanism and can manifest during or after the acute infection period. It is more common in adult but can also occur in the paediatric patients. There were various spectra of autoantibody panels reported including antineuronal antibody, anti-gangliosides antibody and onconeural antibody. Majority of the patients responded well to the immunomodulating therapy and achieved good recovery.
Conclusion
In conclusion, SARSCoV-2 infection can induce various spectrum of autoimmune encephalitis. It is a major concern since there is very limited long-term study on the topic. Hence, this review aims to elucidate on the potential long-term complication of SARS-CoV-2 infection and hopefully to improve the management and prognosis of COVID-19.
Coagulation predominant-type coagulopathy such as microthrombosis and macrothrombosis is a well-known recognised complication found in COVID-19 infected critically ill patients. In the context of high incidence of thrombotic events in patients with COVID-19, supplementation with anticoagulant therapy has been routinely recommended and shown to reduce mortality. However, the recommended type, dose, duration and timing of anticoagulant has not been determined yet. Spontaneous retroperitoneal haematoma secondary to anticoagulant therapy is one of the well-known but self-limiting conditions. We report a 51-year-old COVID-19 positive woman, who was taking intermediate-intensity heparin therapy for venous thromboembolism prophylaxis and died from complication of retroperitoneal bleeding. Further studies are needed to verify the risk–benefit ratio of anticoagulant therapy in patients with COVID-19. Although anticoagulant deems appropriate to use in patients with COVID-19, clinicians should be cautious about major bleeding complication such as retroperitoneal haemorrhage even when full therapeutic dosage is not used.
In today’s world of technology, gamification has become increasingly popular in education. Previous studies have reported that gamified learning enables 21st century students to motivate and engage in academic fields. However, there is a paucity of information on empirical studies on effectiveness of gamified learning in various fields of medicine. This lack of empirical evidence is evident in the varying recommendations for the implementation of gamification in medical education. This research aimed to investigate the effectiveness of gamified learning among undergraduate medical students. This was an quasi-experimental study comparing digital online gamified learning with conventional electronic learning (e-learning) at undergraduate level in medicine. Modified Kirkpatrick evaluation was used to appraise the outcome of educational intervention. The change in pre and post-test score was used to measure cognitive gain. There were twenty-one knowledge and skill assessment questions (twenty multiple choice questions and one objective structured clinical examination question respectively) to assess the knowledge and skill acquisition. The findings from this study revealed that gamified learning is more effective than conventional e-learning in improving ECG diagnostic accuracy while gamified learning is as effective as conventional e-learning for improving ECG interpretation skill.
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