Medicine and Health Sciences Commons^™

Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

The management of multifocal glioblastomas is a point of constant discussion amongst neuro-oncologists. Best outcomes in glioblastoma management come from gross total resection (GTR) followed by concomitant radiation and chemotherapy (CCRT). Multifocal disease is resistant to GTR. Conventional management of these lesion is usually biopsy only followed by CCRT. Recent evidence has shown that there may be some benefit to attempting GTR of the largest lesion whenever safe to do so.

Inflammatory Bowel Disease And Atherosclerotic Cardiovascular Disease In U.S. Adults-A Population-Level Analysis In The National Health Interview Survey, Khurram Nasir, Isaac Acquah, Amit K. Dey, Tanushree Agrawal, Syed Zawahir Hassan, Kerri Glassner, Bincy Abraham, Eamonn M M. Quigley, Ron Blankstein, Salim S. Virani

Office of the Provost

Objectives: To evaluate the association between inflammatory bowel disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) and whether this association is modified by age or sex.
Methods: We conducted a cross-sectional analysis using data from the 2015-2016 National Health Interview Survey (NHIS). The exposure of interest was self-reported IBD. The outcome of interest was prevalent ASCVD, which included a history of angina, myocardial infarction or stroke. We used survey-specific descriptive statistics to obtain weighted national estimates for IBD and ASCVD prevalence. Logistic regression models were used to assess the association between IBD and ASCVD, progressively adjusting for demographics and traditional risk …

Misperception About Epilepsy Among Common Public In Balochistan, Muhammad Essa, Gulandam ., Saleem Barech, Amanullah Kakar, Ihsan-Ul-Haq Zarkon, Suhail Mari, Muhammad Dawood, Tahir Shah

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT Background and Objective: Epilepsy is a treatable chronic neurological illness that is frequently associated with supernatural activity. The objectives of this study were to determine common myths and misperception about epilepsy by analysing a comprehensive panel of variables in our local population. Methods: We conducted a face-to-face questionnaire interview survey in three different shopping malls. One thousand people were randomly enrolled in this cross-sectional study at Quetta, Baluchistan, during the period of 21 august 2021 to 30 august 2021.

Results: A total of 1000 people were interviewed; among them 220(22%) were male and 780(78%) were female. Individuals between the …

Screening For Depression And Anxiety Among Medical And Dental Students Who Are Forced Into Their Field Of Study, Sohail Ahmed Khan, Asvad Ahmad Khan, Asiyah Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT Background and Objective: The study hypothesized that the students who are forced to enter the medical field by their parents may have a higher incidence of depression and anxiety.

Methods: A total of 210 medical and dental students were asked to fill out a form indicating their desire to enter medical college versus their parents’ wishes on an analogue scale. They were also asked to fill out screening forms for depression and anxiety.

Results: The students who selected the medical field by their parent’s wishes were found to have 1.2 times more anxiety & 1.96 times more depression. Conclusions: …

Prolonged Psychosis Before Onset Of Neurological Symptoms: An Atypical Clinical Manifestation Of Huntington’S Disease, Marium Mansoor, Nida Rahman Khan, Alviya Shaique

Pakistan Journal of Neurological Sciences (PJNS)

Huntington's disease (HD) is a rare, autosomal dominant, progressive neurodegenerative disorder. HD manifests with a triad of progressive motor, cognitive, and psychiatric symptoms. Our patient was a 39-years-old married female with over a nine-year history of psychotic symptoms. The patient was diagnosed and treated for schizophrenia. Over the last 2-3 years, the patient had a progressive decline in her Activities of Daily Living, instrumental activities of daily living, and psychotic symptoms. She developed slurred speech, gait disturbances, frequent falls, involuntary movements of the trunk and distal extremities, bowel and bladder incontinence, and severe weight loss. Her genetic test for Huntington’s …

A Case Of Ulcerative Colitis Presenting With Cerebral Venous Thrombosis, Zaid Waqar

Pakistan Journal of Neurological Sciences (PJNS)

Ulcerative Colitis is an autoimmune inflammatory bowel disease causing abdominal pain, bloody diarrhea and malnutrition and is associated with intestinal and extra intestinal complications. The clinical course has remissions and flare ups. Thromboembolism is a known risk associated with ulcerative colitis. Here we present a case of a young man who presented with a flare up of ulcerative colitis and developed neurological deficits that were diagnosed as due to cerebral venous thrombosis. Cerebral venous thrombosis is a rare complication of ulcerative colitis and can be missed without proper work up and consideration of diagnosis.

Options In The Treatment Of Subacute Sclerosing Panencephalitis: Implications For Low Resource Areas, Pauline Samia, Katherine Oyieke, Dorcas Tunje, Anaita Udwadia-Hegde, Kristen Feemster, Ibrahim Oncel, Banu Anlar

Paediatrics and Child Health, East Africa

Purpose of the review Subacute sclerosing panencephalitis (SSPE) is a rare, slowly progressive, and frequently fatal neurodegenerative disorder caused by measles virus. The risk of SSPE remains signifcant globally, with fuctuating incidence noted in in tandem with measles vaccine uptake. This review aims to explore the current global status of SSPE, its treatment, and preventive measures.

Recent findings An increase in measles cases have been reported in various parts of the world for different reasons related to the regional context of the outbreak. With reduction in measles vaccine doses since the onset of the COVID-19 pandemic, the future risk of …

A Case Report Of Minimally Invasive Percutaneous Ultrasound Guided Tuberculous Iliopsoas Abscess Drainage In An Immunocompromised Patient, Allyzain Ismail, Neelam Ismail, Authar Ali, Shabbir Adamjee, Ahmed Jusabani, Zainab Fidaali

Faculty of Health Sciences, East Africa

Introduction and importance

Iliopsoas abscess is a collection of pus that presents with nonspecific features with often delays in diagnosis however cause significant morbidity and mortality with Mycobacterium tuberculosis to be considered as causative agent in at risk individuals in tuberculous endemic regions. Management involves drainage and initiation of adequate antibiotics with radiological guided percutaneous approach considered the appropriate initial approach.

Case presentation

50-year-old immunosuppressed presenting with left iliopsoas abscess who underwent ultrasound guided drainage and placement of pigtail catheter successfully without the need for open surgical drainage. Our experience of interventional radiology for diagnosis of causative agent and treatment …

Tirofiban And Rivaroxaban Use In The Management Of Right Coronary Artery Thrombus As A Primary Manifestation Of Essential Thrombocythemia, Muhummad Nasir Rahman, Maleeha Javed

Section of Cardiology

A 45 year old male with hypertension was presented to our centre with a recent inferior wall myocardial infarction (IWMI) and post infarction angina. Invasive coronary angiography revealed an occluded proximal right coronary artery (RCA) with high thrombus burden, in the absence of obstructive disease in the remaining coronary vasculature. Based on raised platelet counts of 923,000/microliter and positive Janus kinase (JAK 2- V617) mutations tested by polymerase chain reaction (PCR), a diagnosis of essential thrombocythemia (ET) was made. A therapeutic strategy of aspiration thrombectomy along with I/V Tirofiban was used for three days, followed by reassessed angiogram and percutaneous …

The Nine-Item Internet Gaming Disorder Scale (Igds9-Sf): Its Psychometric Properties Among Sri Lankan Students And Measurement Invariance Across Sri Lanka, Turkey, Australia, And The Usa, Amira Mohammed Ali, Rasmieh Al-Amer, Maha Atout, Tazeen Saeed Ali, Ayman M Hamdan Mansour, Haitham Khatatbeh, Abdulmajeed A. Alkhamees, Amin Omar Hendawy

School of Nursing & Midwifery

The prevalence of internet gaming disorders (IGD) is considerably high among youth, especially with the social isolation imposed by the ongoing COVID-19 pandemic. IGD adversely affects mental health, quality of life, and academic performance. The Internet Gaming Disorder Scale (IGDS9-SF) is designed to detect IGD according to DSM-IV diagnostic criteria. However, inconsistent results are reported on its capacity to diagnose IGD evenly across different cultures. To ensure the suitability of the IGDS9-SF as a global measure of IGD, this study examined the psychometric properties of the IGDS9-SF in a sample of Sri Lankan university students (N = 322, mean age …

Effectiveness Of Implementation Of Standard Clinical Pathway Through Healthcare Professionals Among Acute Myocardial Infarction Patients Undergoing Angiography / Angioplasty In A Public Tertiary Care Hospital, Karachi, Shahzad Bashir, Sarfraz Masih, Rubina Barolia, Muhammad Nawaz Lashari, Iram Amin

School of Nursing & Midwifery

Objective: To assess the effect of acute myocardial infarction standard clinical pathway among acute myocardial infarction patients on length of stay in public tertiary care setting.
Methods: The quasi-experimental non-randomised study was conducted at the Department of Cardiology, Dr Ruth Pfau Civil Hospital, Karachi, from September to December 2018, and comprised acute myocardial infarction patients. Those admitted before the implementation of acute myocardial infarction standard clinical pathway formed the control group, while those admitted after the implementation were in the intervention group. Acute myocardial infarction standard clinical pathway was implemented and the interventional clinical practices of healthcare professionals, including cardiologists, …

Residual Symptoms And The Quality Of Life In Individuals Recovered From Covid-19 Infection: A Survey From Pakistan, Mohammad Aadil Qamar, Russell Seth Martins, Rubaid Azhar Dhillon, Areeba Tharwani, Omar Irfan, Qosain Fatima Suriya, Wajiha Rizwan, Javaid Ahmed Khan, Ali Bin Sarwar Zubairi

Medical College Documents

Background: There remains scarcity of literature regarding the patient's health status post-COVID-19 infection. This study analyzes the prevalence of residual symptoms and quality of life (QoL) after COVID-19.
Methods: An anonymous online survey was administrated in Pakistan from November 2020 to April 2021 in COVID-19 survivors. The questionnaire used the 12-Item Short Form Health Survey (SF-12) to assess mental and physical QoL. Multivariate linear regression was used to explore factors associated with mental and physical QoL scores.
Results: A total of 331 COVID-19 survivors participated in our survey. Around 42.0% of the cohort reported within 1-3 months of diagnosis of …

What Stops Us From Eating: A Qualitative Investigation Of Dietary Barriers During Pregnancy In Punjab, Pakistan, Muhammad Asim, Zarak Hussain Ahmed, Amy R. Nichols, Rachel Rickman, Elena Neiterman, Anita Mahmood, Elizabeth M. Widen

Community Health Sciences

Objective: Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab.
Design: In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis.
Setting: Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan.
Participants: Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n …

Inspire : Vol 5, Issue 3, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Medicine at National and International Forums
• World Congress - International Society of Nephrology (ISN)
• In-depth: featuring Manager Data Science – Mushyada Ali
• Featured Faculty – Dr Sonia Yaqub – Assistant Professor & Section Head- Nephrology section
• Poem section
• What are Academics Around the World Reading This Month?
• Publications
• Upcoming Events

Pharmacy Newsletter: March 2022, Pharmacy Department

Department of Pharmacy Archives

Content:

• Inhalers & Global emissions:
• Impact of Anticoagulation Management Clinics (AMC) at AKUH
• TOX TOK! A Poisonous Candy for the children: Mothballs (Phenyl ki Goli)
• Warfarin – A High Alert Drug

Assessment Of Neonatal Respiratory Rate Variability, Jesse Coleman, Amy Sarah Ginsburg, William Macharia, Roseline Ochieng, Dorothy Chomba, Guohai Zhou, Dustin Dunsmuir, Walter Karlen, J. Mark Ansermino

Paediatrics and Child Health, East Africa

Accurate measurement of respiratory rate (RR) in neonates is challenging due to high neonatal RR variability (RRV). There is growing evidence that RRV measurement could inform and guide neonatal care. We sought to quantify neonatal RRV during a clinical study in which we compared multiparameter continuous physiological monitoring (MCPM) devices. Measurements of capnography-recorded exhaled carbon dioxide across 60-s epochs were collected from neonates admitted to the neonatal unit at Aga Khan University-Nairobi hospital. Breaths were manually counted from capnograms and using an automated signal detection algorithm which also calculated mean and median RR for each epoch. Outcome measures were between- …

Modifying Group Interpersonal Psychotherapy For Peripartum Adolescents In Sub-Saharan African Context: Reviewing Differential Contextual And Implementation Considerations, Manasi Kumar, Helen Verdeli, Shekhar Saxena, Inge Petersen, Keng Yen Huang, Caleb Othieno, Nancy Grote, Roslyn Law, Jurgen Unutzer, Mary Mckay

Brain and Mind Institute

Background: This study describes adaptation and modification of World Health Organization (WHO) recommended group interpersonal psychotherapy (IPT-G) for depressed peripartum adolescents. The adaptation process includes accommodating contextual factors and strategies to address intervention implementation barriers, such as engagement problems with adolescents, caregivers, and providers, and stigma and dearth of mental health specialists. The modifications include and adolescent relevant iterations to the therapy format and content.

Methods: A multi-stakeholder led two-stage intervention adaptation and modification process integrating mixed qualitative methods were used with pregnant and parenting adolescents, their partners, and health care workers. In-depth interviews focusing on personal, relationship, social, and …

Post Covid Anti-Nmdar Encephalitis In An Adolescent Girl, Javeria Raza Alvi, Muhammad Haider Sultan, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Anti-N-Methyl D-aspartate receptor (NMDAR) encephalitis is a neuro-inflammatory disorder caused by antibodies targeting neurons in the central nervous system. Certain viruses break immune tolerance of neuronal proteins and increase the permeability of blood brain barrier (BBB) to antibodies resulting in post infectious autoimmunity. We report a case about a 13 years old girl diagnosed as a case of anti-NMDAR encephalitis, who presented with psychiatric symptoms followed by abnormal movements and encephalopathy, with later development of autonomic instability with tachycardia and blood pressure at 98th centile. Her thyroid profile initially showed hyperthyroidism with negative anti-thyroid antibodies with subsequent normalization without anti-thyroid …

Stroke: Are Women Worse Off?, Maria Khan

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a leading cause of death and disability worldwide. Although the age standardized rates of stroke have fallen, the absolute number of strokes continue to rise, particularly in the low and middle income countries. It was long recognized that women have a lower age-standardized incidence of stroke. This understanding has been challenged by the Global burden of Disease Study 2019 which highlights that although the total number of Disability Adjusted Life Years (DALYs) from stroke were higher in males compared to females, the number of incident and prevalent strokes were higher in females. In addition, the study did not …

World Brain Day- Brain Health For All, Safa Younis

Pakistan Journal of Neurological Sciences (PJNS)

World Brain Day is celebrated annually on July 22nd, and this year’s theme was “Brain Health for All”. In honor of World Brain Day, Aga Khan University, in collaboration with the World Federation of Neurology, hosted an international webinar moderated by Dr. Shafaq Saleem. Dr. Mohammad Wasay commenced the session by discussing the importance of WHO’s adoption of the Intersectoral Global Action Plan on epilepsy and other neurological disorders. He discussed how significantly this 10-year action plan will improve neurological training, awareness, and advocacy. He explained how this webinar would unpack problems related to neurological care in different parts of …

Multiple Sclerosis Care In Pakistan; Analysis Of Data Presented At First Paktrims Conference, Zara Shah, Haris Majid, Sadia Nishat, Sumera Rafat Umer, Sundus Mehtab Shafee, Ahmed Wali, Naila Shahbaz

Pakistan Journal of Neurological Sciences (PJNS)

Novel data on Multiple Sclerosis (MS) in Pakistan from leading institutes in the country was presented at the first Pakistan Treatment in Multiple Sclerosis (PAKTRIMS) Conference, organized by the section of Neurology, department of Medicine, Aga Khan University, Karachi on Saturday, December 18, 2021. Pakistan has been considered to have a low prevalence of MS; however, recent research reveals that it is not as uncommon as previously believed to be in the country. The true prevalence and incidence of MS in the country is unknown because of dearth of research. Data of MS patients enrolled in various private and public …

Use Of Steroids In Covid-19 Patients: What Is Known?, Syed Muhammad Mustahsan, Marzia Tahir, Emaduddin Siddiqui

Department of Emergency Medicine

COVID-19 pandemic has exaggerated the role of steroids in the standard of care despite minimum direct evidence of their efficacy in COVID-19 patients and their well-known adverse effects. The literature abounds on the side effects of steroids affecting different organ systems of the body. COVID-19 patients, who are on long-term steroids, are more susceptible to their adverse effects. We, herein, briefly review the potential uses and the adverse effects of steroids on different organ systems of the body. Key Words: Steroids, COVID-19, Adverse effects.

Knowledge And Awareness Regarding Uses Of Extracted Natural Tooth In Clinical Practice, Momina Anis Motiwala, Shizrah Jamal, Karshma Devi, Rabia Ghafoor

Section of Dental-Oral Maxillofacial Surgery

Restoration of aesthetics is one the major patients’ concern in dentistry which may be disrupted due to tooth-loss secondary to trauma, or as part of orthodontic treatment or periodontal problem. A number of treatment options are available for the replacement of teeth, but they may be expensive, and time-consuming, involving artificial teeth. For immediate tooth replacement, patient’s own intentionally extracted or unintentionally avulsed tooth maybe used. The current narrative review was planned to discuss various techniques for the use of natural tooth pontic, which preserves the original contours, size and colour of the replaced tooth. Before using these teeth in …

Perspective On Newborn Screening (Nbs): Evidence Sharing On Conditions To Be Included In Nbs In Pakistan, Hafsa Majid, Lena Jafri, Sibtain Ahmed, Khadija Humayun, Salman Kirmani, Natasha Bahadur Ali, Bushra Moiz, Aysha Habib, Bushra Afroze

Department of Pathology and Laboratory Medicine

Newborn screening aims at detecting treatable disorders early so that the treatment can be initiated to prevent mortality and morbidity. Such programmes are well established in most developed countries, and all newborns are screened for selected metabolic, endocrine and other disorders based on disease epidemiology, testing and treatment availability, efficiency and cost-effectiveness. Even in developing countries, such screening programmes are initiated using heel prick capillary blood collected on filter paper. The current narrative review was planned to provide a perspective with evidence in favour of starting newborn screening for different disorders. The programme project should be initiated nationwide, taking one …

Clinical Validation Of A Multiplex Pcr-Based Detection Assay Using Saliva Or Nasopharyngeal Samples For Sars-Cov-2, Influenza A And B, Nikhil S. Sahajpal, Ashis K. Mondal, Sudha Ananth, Allan Njau, Kimya Jones, Pankaj Ahluwalia, Eesha Oza, Ted M. Ross, Vamsi Kota, Arvind Kothandaraman

Pathology, East Africa

The COVID-19 pandemic has resulted in significant diversion of human and material resources to COVID-19 diagnostics, to the extent that influenza viruses and co-infection in COVID-19 patients remains undocumented and pose serious public-health consequences. We optimized and validated a highly sensitive RT-PCR based multiplex-assay for the detection of SARS-CoV-2, influenza A and B viruses in a single-test. This study evaluated clinical specimens (n = 1411), 1019 saliva and 392 nasopharyngeal swab (NPS), tested using two-assays: FDA-EUA approved SARS-CoV-2 assay that targets N and ORF1ab gene, and the PKamp-RT-PCR based assay that targets SARS-CoV-2, influenza viruses A and B. Of the …

The Status And Future Of Emergency Care In The Republic Of Kenya, J. Austin Lee, Grace Wanjiku, Naomi Nduku, Adam R. Aluisio, Ramu Kharel, John Tabu Simiyu, Benjamin Wachira

Emergency Medicine, East Africa

Kenya is a rapidly developing country with a growing economy and evolving health care system. In the decade since the last publication on the state of emergency care in Kenya, significant developments have occurred in the country's approach to emergency care. Importantly, the country decentralized most health care functions to county governments in 2013. Despite the triple burden of traumatic, communicable, and non-communicable diseases, the structure of the health care system in the Republic of Kenya is evolving to adapt to the important role for the care of emergent medical conditions. This report provides a ten-year interval update on the …

A Case Report Of Minimally Invasive Percutaneous Ultrasound Guided Tuberculous Iliopsoas Abscess Drainage In An Immunocompromised Patient, Allyzain Ismail, Neelam Ismail, Athar Ali, Shabbir Adamjee, Ahmed Jusabani, Zainab Fidaali

General Surgery, East Africa

Introduction and importance: Iliopsoas abscess is a collection of pus that presents with nonspecific features with often delays in diagnosis however cause significant morbidity and mortality with Mycobacterium tuberculosis to be considered as causative agent in at risk individuals in tuberculous endemic regions. Management involves drainage and initiation of adequate antibiotics with radiological guided percutaneous approach considered the appropriate initial approach.

Case presentation: 50-year-old immunosuppressed presenting with left iliopsoas abscess who underwent ultrasound guided drainage and placement of pigtail catheter successfully without the need for open surgical drainage. Our experience of interventional radiology for diagnosis of causative agent and treatment …

Scaling Up Locally Adapted Clinical Practice Guidelines For Improving Childbirth Care In Tanzania: A Protocol For Programme Theory And Qualitative Methods Of The Partoma Scale-Up Study, Jane Brandt Sørensen, Natasha Housseine, Nanna Maaløe, Ib Christian Bygbjerg, Britt Pinkowski Tersbøl, Flemming Konradsen, Brenda Sequeira Dmello, Thomas Van Den Akker, Columba Mbekenga, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and lower-middle-income countries are often developed and implemented top-down, needs and circumstances vary greatly across locations. Our pilot study in Zanzibar improved care through locally co-created intrapartum clinical practice guidelines (CPGs) and associated training (the PartoMa intervention). This intervention was context-tailored with health-care providers in Zanzibar and now scaled up within five maternity units in Dar es Salaam, Tanzania. This PartoMa Scale-up Study thereby provides an opportunity to explore the co-creation process …

Molecular Epidemiology Of Mycobacterium Tuberculosis Complex Strains In Urban And Slum Settings Of Nairobi, Kenya, Glennah Kerubo, Perpetua Ndungu, Yassir Adam Shuaib, Evans Amukoye, Gunturu Revathi, Susanne Homolka, Samuel Kariuki, Matthias Merker, Stefan Niemann

Pathology, East Africa

Kenya is a country with a high tuberculosis (TB) burden. However, knowledge on the genetic diversity of Mycobacterium tuberculosis complex (MTBC) strains and their transmission dynamics is sparsely available. Hence, we used whole-genome sequencing (WGS) to depict the genetic diversity, molecular markers of drug resistance, and possible transmission clusters among MTBC strains in urban and slum settings of Nairobi. We analyzed 385 clinical MTBC isolates collected between 2010 and 2015 in combination with patients’ demographics. We showed that the MTBC population mainly comprises strains of four lineages (L1–L4). The two dominating lineages were L4 with 55.8% (n = 215) and …

Intracardiac Thrombus In Coronavirus Disease-2019, Suganya Karikalan, Munish Sharma, Megha Chandna, Manju Sachdev, Ajay Gaalla, Farah Yasmin, Reena Shah, Iqbal Ratnani

Internal Medicine, East Africa

Intracardiac thrombus is often seen as a complication of ischemic heart disease (IHD) and non-ischemia cardiomyopathies (NICM). The advancements in imaging modalities and therapeutic options have helped reduce the complications arising from ventricular thrombi, such as systemic embolization. Here we present two cases of intracardiac thrombus associated with coronavirus disease (COVID) 19, one with an apical thrombus in the left ventricle and the other with a thrombus in the right ventricle adjacent to chordae tendinae. The effects of covid-19 on the cardiovascular system are yet to be thoroughly evaluated. Venous and arterial thrombosis is commonly associated with COVID-19 but in …