It has been two years since vaccination for COVID-19 was launched worldwide. In Pakistan, the vaccination started in the beginning of 2020. Since then several side effects were reported after vaccination, including soreness of the arm, fever, chills, malaise and diarrhoea. Axillary lymphadenopathy has been found to be associated with several conditions that include autoimmune disorders, infections, malignancy and some idiopathic causes. We present a rare case of a 30 y old female with recent recovery from COVID-19, who developed ipsilateral axillary lymphadenopathy after 15 days of Sinovac vaccination. Ultrasonography was done to confirm the diagnosis and its spread towards breast and cervical region. This case report discusses some key points and recommendations regarding unilateral axillary lymphadenopathy after COVID-19 vaccination. Key words: COVID-19; Lymphadenopathy; vaccination; Pakistan Citation: Butt MN, Perveen W, Malik S, Raja SK, Feroz R, Asif R. Ipsilateral axillary lymphadenopathy after COVID-19 vaccination in a young female; a case report and literature review. Anaesth. pain intensive care 2022;26(6):815−818. DOI: 10.35975/apic.v26i6.2066
Background: To analyze the change in behavioral patterns, its impact, and peer pressure caused by COVID-19 lockdown among the adolescent population. Methods: It was an observational study with sample size of 443 participants. The study was conducted after ethical approval. Data were collected from different academic institutions in Sialkot, Pakistan using Burnout rating scale. The target population was adolescents of age 13-19 years. Regression analysis was done to find predictor factors mobile use and lockdown on the dependent variable Burnout score. The correlation was applied among mobile phone use, lockdown, and burnout score. IBM software SPSS version 21 was used to analyze data. Results: Among 443 participants, 305 were female and 138 were male making 68.8% and 31.2% respectively. 57.1% of participants were doing well, 24.8% became candidates for burnout. In 13.3% of candidates, the burnout made changes, and for only 4.7% action should be taken for their health. The correlation coefficient among burnout and using mobile was 0.194 that is highly significant showing a direct positive association between these two variables. The correlation coefficient (R) has a value of -0.222 between burnout and lockdown also showing significance. Conclusion: Behavioral changes in adolescents concerning burnout due to COVID-19 lockdown was more exaggerated than the actual burnout rate. Behavioral outcome due to COVID-19 lockdown was not that much destructive for adolescent mental health, but only if combined with the other negative traits of the individual. The protocol of the study was registered on ClinicalTrials.gov wide Identifier: NCT04697030
Background:COVID-19 pandemic had an unprecedented impact on the delivery of patient care. Rheumatology services had to rapidly adapt to virtual consultations at the onset of the pandemic. However, providing a high quality and effective service in a virtual setting can be challenging and therefore its prudent to do a formal review and gain patient feedback to ensure that these clinics are fit for purpose.Objectives:To evaluate the impact of first wave of COVID-19 pandemic on patients with autoimmune rheumatic conditions, assess delivery of rheumatology outpatient care and record patient feedback.Methods:This study included patients on the Rheumatology clinic lists between 3rd and 31st August 2020. An electronic survey questionnaire was developed and the survey link was sent to patients via a text message using secure IT platform. Data was collected on patient demographics, diagnosis, comorbidities, treatments, clinical/ laboratory confirmed COVID-19 diagnosis, treatment interruption, impact on work, personal protective measures taken and views on virtual consultations.Results:307 patients responded with 287 complete responses. 73.1%(223) were female and 32.4% (99) were >65 years of age. Rheumatoid arthritis was the most common diagnosis 41.6%(127). Hypertension was the commonest comorbidity 21.4%(64) followed by Chronic lung disease 17.3%(52). 28.8%(85) were on Hydroxychloroquine, 26.7%(79) Methotrexate, 14.2%(42) Sulfasalazine and 13.2%(39) on Prednisolone. 22.3%(66) were on Biologics: Anti TNF 12.8%(38), Tocilizumab 3.7%(11) and Rituximab 3%(9). 52.6%(161) shielded, 16.9%(55) self-isolated and 30.3%(93) only maintained social distance. 197 patients self reported as being vulnerable but based on their treatment,only 167 patiemts met the clinically extremely vulnerable (CEV) criteria and all of those received government shielding letter.3.6%(11) had lab confirmed COVID-19, 3.2%(10) had clinically suspected COVID-19 infection. 14.3% (43) had their treatment interrupted. 4.6%(14) were unable to work from home or maintain social distancing at work. 59.8%(182) had face-to-face consultation changed to virtual. 63.2%(189) were satisfied, 28%(84) neutral and 8.7%(26) reported dissatisfaction with their consultation. 50.5%(153) were happy to continue with virtual consultation but with an option of face to face only if necessary.For consultations post COVID-19, 59.4%(182) preferred a mixture of face to face and virtual appointments.Conclusion:Majority of our patients seem happy with virtual consultations as long as they are assured of a face-to-face consultation if needed. A minority(8.7%) however, were dissatisfied. Some of the suggestions were, use of video consultations and improvement in communication before the virtual appointments. Our survey also shows that our patients have adapted well to virtual consultations and many are keen to have virtual consultation in the longer term. In our survey, only 6.8%(21) patients reported definite or clinically suspected COVID-19. Possible explanations for this include strict compliance with government advice on social distancing/shielding and limited testing at the onset of the pandemic. More patients assumed themselves to be clinically CEV than those who were actually CEV based on their treatment which is not surprising because of high level of anxiety among patients due to rapidly spreading pandemic and multiple sources of information.This feedback provides useful data which will help us to plan the delivery of rheumatology services post COVID-19 pandemic. While face-to-face patient contact is needed for comprehensive disease assessment, teaching and training, a model for the future is likely to include a combination of face-to-face and virtual consultations. This could allow a greater capacity to see new patients and reduce waiting lists. Patients with uncomplicated and stable disease could be followed up in virtual clinics. There is also a need to formally incorportate the virtual consultations into the curriculum for Rheumatology trainees.Disclosure of Interests:None declared.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.