One of the most prevalent causes of pericarditis has been identified as virus infection. However, very little is known regarding cardiac involvement as a consequence of monkeypox infection. We describe a rare case of pericarditis with mild pericardial effusion in an immunocompetent adult with a one-week history of monkeypox. To the best of our knowledge, not many case reports are available in the existing literature. This might be the among the first few cases of monkeypox associated pericarditis during the current pandemic. The use of nonsteroidal anti-inflammatory medications, and colchicine to manage pericarditis has been the cornerstone of the therapy. Within two weeks, the patient reported improvement in his symptoms and the resolution of the pericardial effusion.
The aim of this study is to compare the efficacy and safety of low-dose and high-dose dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients. The current meta-analysis was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was carried out using PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Embase. Outcomes assessed in the current meta-analysis included 28-day mortality, intensive care unit (ICU) admission, mechanical ventilation, length of ICU admission (days), and length of hospital stay (days). For safety, we compared hypoglycemia and the incidence of infection between the high-dose dexamethasone group and the low-dose dexamethasone group. A total of four studies fulfilled the inclusion criteria and were included in this meta-analysis. No significant difference was found between the two groups in terms of ICU admission (risk ratio (RR): 0.72, 95% confidence interval (CI): 0.41-1.28, pvalue: 0.27), length of stay in ICU in days (mean difference (MD)
Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery are the options for revascularization in coronary artery disease (CAD). This meta-analysis aims to compare the efficacy of CABG and PCI for the management of patients with CAD. The meta-analysis was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane Library, and EMBASE were searched for relevant articles. The reference list of included articles was also searched manually for additional publications. Primary endpoints were cardiovascular mortality and all-cause mortality. Secondary endpoints included myocardial infarction, stroke, and revascularization. In total, 12 randomized control trials (RCTs) were included in this meta-analysis encompassing 9,941 patients (4,954 treated with CABG and 4,987 with PCI). The analysis showed that PCI was associated with a higher risk of all-cause mortality (risk ratio (RR) = 1.26, 95% confidence interval (CI) = 1.10-1.45) and revascularization (RR = 2.42, 95% CI = 1.82-3.21). However, no significant differences were reported between two arms regarding cardiovascular mortality (RR = 1.15, 95% CI = 0.96-1.39), myocardial infarction (RR = 1.17, 95% CI = 0.82-1.67), and stroke (RR = 0.64, 95% CI = 0.35-1.16). CABG was associated with a significant reduction in all-cause mortality and revascularization compared to PCI. However, no significant difference was reported in the risk of cardiovascular mortality, myocardial infarction, and stroke between the two groups.
The presentation of vitamin B12 deficiency varies from being asymptomatic to affecting multiple organ systems. In addition, several systemic diseases can be associated with generalized weakness and hyperpigmentation. However, vitamin B12 deficiency rarely presents with hyperpigmentation as an initial symptom. We present a rare case of a 22-year-old college student who presented with hyperpigmentation as the only physical manifestation of early vitamin B12 deficiency. This case underlines the need to rule out vitamin B12 deficiency when clinicians encounter hyperpigmentation as a solo presentation and also emphasizes the significance of early treatment in preventing the irreversible neurological manifestations of vitamin B12 deficiency.
The current meta-analysis aims to assess the efficacy and safety of sodium glucose cotransporter 2 (SGLT2) inhibitors in individuals with diabetes and chronic kidney disease (CKD). The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted to identify all relevant studies related to the efficacy and safety of SGLT2 inhibitors in individuals with diabetes and CKD. The search was undertaken in PubMed, EMBASE, and Cochrane Library from January 2000 to September 2022. The primary efficacy outcome assessed in the current meta-analysis included major adverse cardiovascular events (MACE). Other efficacy outcomes included all-cause mortality and change in hemoglobin A1c (HbA1c) (%). Safety outcomes included serious adverse events, acute kidney injury, hypoglycemia, and hyperkalemia. In total 11 articles met the inclusion criteria and were included in the final analysis enrolling 27520 patients (14491 in the SGLT2 inhibitors and 13029 in the placebo group). The findings of this meta-analysis have shown that the risk of MACE and all-cause mortality was significantly lower in patients receiving SGLT2 inhibitors. Additionally, Hb1AC change was also significantly greater in SGLT2 inhibitors group. In relation to safety outcomes, serious adverse events, risk of acute kidney injury, and hyperkalemia were significantly lower in the SGLT2 inhibitors group. The SGLT2 inhibitors significantly decreased the risk of major cardiovascular events and all-cause mortality in patients with CKD and diabetes. Furthermore, SGLT2 inhibitor is also effective in reducing Hb1Ac levels in patients.
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