Natl Med J India
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The Covid-19 pandemic affected undergraduate medical education worldwide. By March 2020, colleges in India had to close following a national lockdown. Most of the colleges including ours started using e-platforms. ⋯ Various challenges were faced due to online medical education. There was a dilemma over choosing the type of training that would produce adequate numbers with low quality or a delayed training but of assured quality. Various solutions including suspending the ongoing course and converting it to short-term skill training sessions to deal with pandemic care and strategies to improve online teaching were considered.
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Bell's palsy is described as an acute, unilateral mononeuropathy of the facial nerve resulting in partial or complete paralysis of the face with no identifiable cause. Although facial palsy is often idiopathic, its development soon after the BB-152 Covid vaccine is exceedingly rare. We report a patient with transient acute-onset unilateral infranuclear facial palsy following vaccination, after an exhaustive work-up for other common causes was negative. With no detectable aetiology the likelihood of an association of the Covid-19 vaccine and Bell's palsy remains.
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Patients with left-sided pneumothorax presenting with electrocardiogram (ECG) changes resembling acute coronary syndrome (ACS) have been reported in the literature. Takotsubo cardiomyopathy (TCM) occurs predominantly in post-menopausal women with underlying intense emotional or physical stress. However, as this case report shows, it can complicate any acute illness leading to intense stress. We report a rare combination of ECG changes mimicking ACS in a man with a large right-sided pneumothorax and TCM.
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Case Reports
Isolated pulmonary valve endocarditis with pulmonary annular abscess in a patient of Noonan syndrome.
Right-sided endocarditis is a rare entity, with various series reporting an incidence of 5%-10%. Pulmonary valve (PV) is not only the least commonly involved valve in infective endocarditis (IE), with an incidence of 1.5%-2%, but 'isolated' pulmonic valve endocarditis (PVE) without tricuspid valve involvement is even rarer with limited published data. ⋯ Initially, he was managed conservatively, but due to persistent fever, pulmonary regurgitation and evidence of pulmonary annular abscess extending into the right ventricular outflow tract, he required surgical intervention. Considering the low incidence of isolated PVE, it poses a challenge for physicians in prompt diagnosis and timely management of the infection.