From Muscles to Wires: Report of Two Cases and Literature Review on COVID-19 Vaccination and Cardiac Conduction Disturbance

Since the end of 2020, several vaccines have become available as part of the global efforts to contain the adverse health outcomes of the coronavirus disease 2019 (COVID-19) pandemic. Although research has confirmed their safety on large scales, several post-marketing reports have revealed some rare cardiovascular side effects. Towards the end of the first half of 2021, multiple reports indicate possible links between COVID-19 vaccines (both mRNA-based vaccine and vector-based vaccines) and myopericarditis. Nevertheless, cardiac conduction disease in this context has only rarely been reported. In this report, we present two cases of probable vaccination-induced cardiac conduction disturbances along with a thorough literature review. In addition, we discuss probable pathophysiological mechanisms and insights into the suggested areas for future research. To our knowledge, these are the first published cases to result in permanent pacemaker implantation.

Breaking bad news from the doctors' perspective in a paternalistic society: the case of Sudan

Breaking bad news is a global challenge for all types of health providers. Our study assessed the attitude and practice from the doctors' perspective in a patriarchal society. A descriptive cross-sectional hospital-based study was conducted, involving doctors from both medical and surgical departments. Almost half of the respondents believed that Sudanese patients do not like to know their diagnosis, and a slightly higher proportion had no previous training on how to break bad news. Some 20% indicated that they would conceal the diagnosis from a patient if his or her relatives so requested. Less than one-quarter of respondents followed a standard protocol. Although most of the doctors subscribed to the notion that patients have the right to know everything about their illnesses, not all of them held this attitude towards their local patient population.

Antichlamydial activity of lacrimal fluid in patients with trachoma

The effect of lacrimal fluid on the growth of Chlamydia trachomatis in cycloheximide-treated McCoy cells was studied in 172 persons with active trachoma (Group A), in 54 with scarring trachoma (Group B) and in 40 healthy subjects (Group C). The patients in groups A and B were treated with tetracycline eye ointment for 4-6 weeks after which tears were collected for retesting. Pooled lacrimal fluid from patients with active trachoma, collected before treatment, had a higher antichlamydial activity compared with healthy individuals. No reduction of the chlamydial inclusion count was seen with such fluid from patients with scarring trachoma. After tetracycline treatment, patients with active trachoma had a slight decrease in their inhibitory activity. In patients with scarring trachoma, the treatment did not significantly reduce the inclusion count. Antichlamydial antibodies were detected more often in patients with active trachoma than in patients with scarring trachoma, while the healthy individuals had no such antibodies. Ultrafiltered and nonfiltered lacrimal fluids were equally effective in inhibiting C. trachomatis inclusion-formation. The inhibitory principle had a molecular weight of less than 10,000 Da.