Publications by authors named "Zarwa Idrees"

6 Publications

  • Page 1 of 1

Brown Tumor With Spine Involvement at Multiple Levels in a Hemodialysis Patient.

Cureus 2021 Aug 8;13(8):e17000. Epub 2021 Aug 8.

Medicine, Icahn School of Medicine at Mount Sinai/NYC Health+Hospitals Queens, New York, USA.

Brown tumor of the bone or osteitis fibrosa cystica is a rare manifestation of hyperparathyroidism, most seen nowadays in association with secondary and tertiary hyperparathyroidism. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are the major culprits of secondary hyperparathyroidism (sHPTH). CKD is known to cause phosphate retention and a decrease in 1,25-dihydroxyvitamin D and ionized calcium levels, which in turn trigger the PTH secretion. Brown tumor can affect the jawbones, femur, sternum, ribs, and rarely the spine. We present the case of a 60-year-old male with ESRD on hemodialysis who was found to have lytic bone lesions in the thoracic and lumbar spine. Initially, malignancy was suspected. Blood work revealed markedly elevated PTH at 3,563 pg/mL, hypocalcemia, and hyperphosphatemia. Biopsy of the L5-S1 lesion was consistent with reactive changes due to sHPTH. Once a diagnosis of the brown tumor was confirmed, the patient was started on cinacalcet and was referred for parathyroidectomy.
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http://dx.doi.org/10.7759/cureus.17000DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423116PMC
August 2021

New-Onset Diabetes in the Setting of Beta-Cell Dysfunction in a Young Patient With COVID-19 Infection.

Cureus 2021 Jul 19;13(7):e16497. Epub 2021 Jul 19.

Internal Medicine, Ichan School of Medicine at Mount Sinai, New York City (NYC) Health + Hospitals, Jamaica, USA.

Reciprocal relationships between viral illness and chronic diseases have been established. Such relationships augment one another and increase the potential harm. The coronavirus 2019 pandemic proved that the most vulnerable populations are the ones with underlying chronic diseases, especially diabetes mellitus. As new data are evolving, viral illnesses, like COVID-19, have been speculated to potentially induce diabetes mellitus. Here we report a 20-year-old male with no past medical history who presented with polyuria, polydipsia, and dry mouth. He was found to have significant hyperglycemia. He had COVID-19-like symptoms a few weeks prior to admission and was tested positive for COVID-19, but the symptoms had resolved prior to his presentation. He was managed with intravenous fluids (IVFs), electrolytes replacement, and insulin. He was diagnosed with new-onset diabetes mellitus likely secondary to a recent COVID-19 infection and was discharged home on insulin, oral antidiabetic medications, and outpatient follow-up with primary care clinic and endocrinology clinic.
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http://dx.doi.org/10.7759/cureus.16497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373597PMC
July 2021

An Unusual Case of Prostate Carcinoma With Metastasis to the Iliopsoas Muscle and Nerve Root Impingement.

Cureus 2021 Jul 9;13(7):e16286. Epub 2021 Jul 9.

Internal Medicine, Icahn School of Medicine at Mount Sinai / New York City (NYC) Health + Hospitals / Queens, Jamaica, USA.

The majority of prostate cancer cases carry a favorable prognosis due to various screening protocols and the progression of surgical/medical techniques. Prostate cancers that metastasize to the skeletal system bear worse five-year survival rates as they are indicative of widespread dissemination. There are very few cases of prostate cancer invading the iliopsoas muscle described in the medical literature. Here, we present the case of a 61-year-old male who was diagnosed with prostate cancer with metastasis to the bones and iliopsoas muscle. Given the advanced presentation of his disease, the patient underwent a prostate biopsy. He was initiated on bicalutamide and transitioned to leuprolide and docetaxel with eventual radiation therapy.
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http://dx.doi.org/10.7759/cureus.16286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349693PMC
July 2021

Current systematic reviews and meta-analyses of COVID-19.

World J Virol 2021 Jul;10(4):182-208

Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC H&H Queens, New York, NY 11432, United States.

Background: Coronavirus disease 2019 (COVID-19) has left a significant impact on the world's health, economic and political systems; as of November 20, 2020, more than 57 million people have been infected worldwide, with over 1.3 million deaths. While the global spotlight is currently focused on combating this pandemic through means ranging from finding a treatment among existing therapeutic agents to inventing a vaccine that can aid in halting the further loss of life.

Aim: To collect all systematic reviews and meta-analyses published related to COVID-19 to better identify available evidence, highlight gaps in knowledge, and elucidate further meta-analyses and umbrella reviews that are yet to be performed.

Methods: We explored studies based on systematic reviews and meta-analyses with the key-terms, including severe acute respiratory syndrome (SARS), SARS virus, coronavirus disease, COVID-19, and SARS coronavirus-2. The included studies were extracted from Embase, Medline, and Cochrane databases. The publication timeframe of included studies ranged between January 01, 2020, to October 30, 2020. Studies that were published in languages other than English were not considered for this systematic review. The finalized full-text articles are freely accessible in the public domain.

Results: Searching Embase, Medline, and Cochrane databases resulted in 1906, 669, and 19 results, respectively, that comprised 2594 studies. 515 duplicates were subsequently removed, leaving 2079 studies. The inclusion criteria were systematic reviews or meta-analyses. 860 results were excluded for being a review article, scope review, rapid review, panel review, or guideline that produced a total of 1219 studies. After screening articles were categorized, the included articles were put into main groups of clinical presentation, epidemiology, screening and diagnosis, severity assessment, special populations, and treatment. Subsequently, there was a second subclassification into the following groups: gastrointestinal, cardiovascular, neurological, stroke, thrombosis, anosmia and dysgeusia, ocular manifestations, nephrology, cutaneous manifestations, D-dimer, lymphocyte, anticoagulation, antivirals, convalescent plasma, immunosuppressants, corticosteroids, hydroxychloroquine, renin-angiotensin-aldosterone system, technology, diabetes mellitus, obesity, pregnancy, children, mental health smoking, cancer, and transplant.

Conclusion: Among the included articles, it is clear that further research is needed regarding treatment options and vaccines. With more studies, data will be less heterogeneous, and statistical analysis can be better applied to provide more robust clinical evidence. This study was not designed to give recommendations regarding the management of COVID-19.
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http://dx.doi.org/10.5501/wjv.v10.i4.182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316876PMC
July 2021

Coronavirus Disease 2019 (COVID-19)-Induced Takotsubo Cardiomyopathy Prognosis in Geriatric Setting.

Cureus 2021 Jul 6;13(7):e16211. Epub 2021 Jul 6.

Cardiology, Icahn School of Medicine at Mount Sinai/New York City (NYC) Health+Hospitals Queens, Jamaica, USA.

An 86-year-old female with a past medical history of hypertension, vertebral fractures with chronic lumbar pain, hip fracture, osteoporosis, deafness, and microcytic anemia underwent hospital admission for emergency medical management of her respiratory distress. The (overall) diagnostic workup confirmed COVID-19, the patient presented with 50% SPO2 (oxygen saturation), sinus tachycardia, diffuse bilateral pulmonary crackles, mild jugular venous distention (JVD), minimal bilateral pitting edema, elevated cardiac enzymes, bilateral pulmonary opacities, and ST-segment elevation. The cardiovascular assessment indicated stress-induced cardiomyopathy/Takotsubo cardiomyopathy (TCM) determined by 35%-40% LVEF (left ventricular ejection fraction), mid to apical left ventricular (LV) akinesia with preserved function in the proximal segment, aortic valve sclerosis, reduced excursion of Trileaflet valve (without stenosis), and mild-to-moderate tricuspid regurgitation with moderate pulmonary artery systolic pressure (PASP). The treatment protocol relied on 81 mg aspirin, 75 mg plavix, 20 mg lipitor, remdesivir, dexamethasone, ceftriaxone, azithromycin, red blood cells transfusion (pRBCs), endotracheal intubation for respiratory support, and systemic hemodynamic support. The patient's condition did not improve despite all treatment, and she passed away after seven days following her hospital admission.
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http://dx.doi.org/10.7759/cureus.16211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341288PMC
July 2021

Bullous drug eruption after second dose of mRNA-1273 (Moderna) COVID-19 vaccine: Case report.

J Infect Public Health 2021 Jul 8. Epub 2021 Jul 8.

Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, NY, USA. Electronic address:

Background: In December 2020, Moderna released the mRNA-1273 vaccine. The most common side effects are headache, muscle pain, redness, swelling, and tenderness at the injection site. In addition, there have been dermatological adverse events, such as hypersensitivity reactions. Although rare, various bullous eruptions have been described following vaccination. Bullous pemphigoid has been reported to occur most often after receipt of influenza and the diphtheria-tetanus-pertussis vaccine. To the best of our knowledge, there have been no reports of bullous drug eruptions resulting from mRNA vaccines.

Case Summary: A 66-years-old obese Guyanese male presented with a bullous rash following receipt of a commercial COVID-19 mRNA vaccine. He received the first dose uneventfully. However, within 24 h of receiving the second dose, he developed fever, myalgias, and malaise accompanied by a painful blistering rash of his torso, arms, and legs. His fever and myalgias improved after 24 h, but his painful rash did not, and five days after the initial symptoms, he presented to the hospital. There were many violaceous, poorly demarcated patches on his trunk, arms, and thighs on examination, many of which had large flaccid bullae within, and a few areas on his buttocks, posterior shoulder, and scrotum were eroded. The exam was also significant for lower extremity muscle tenderness, stiffness with preserved strength. A skin biopsy showed epidermal necrosis and sparse perivascular dermatitis concerning Stevens-Johnson syndrome or erythema multiforme. However, in the absence of mucous membrane involvement or targetoid lesions, the diagnosis of an extensive bullous fixed drug eruption was made.

Conclusion: This case illustrates that the bullae eruption occurred as a result of receiving the Moderna vaccination.
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http://dx.doi.org/10.1016/j.jiph.2021.06.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264280PMC
July 2021
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