There are rising concerns among the medical community and the public regarding the side effects of different vaccines developed throughout the world and their short and long-term effects, particularly COVID19 vaccines. Most notably, post-vaccination demyelinating diseases such as acute disseminated encephalomyelitis, transverse myelitis, and multiple sclerosis relapses have been reported. We present a case of a 32-year-old male who presented with a 2 weeks history of acute confusional state and imbalance 1 week after receiving the second dose of COVID19 vaccination. MRI findings showed typical distribution of neuromyelitis optica spectrum disorder and the patient was positive for AQP4 IgG. The pathogenesis behind developing neuromyelitis optica and vaccines is still unknown. Few case reports have been reported of post-vaccination neuromyelitis optica spectrum disorder but to our knowledge, this would be the first case published of neuromyelitis optica following exposure to COVID19 vaccine.

COVID-19 infection is associated with high risk of venous thromboembolic events mainly pulmonary embolism or deep venous thrombosis of the lower limbs. Ovarian vein thrombosis is a rare and serious condition usually seen in the immediate postpartum period and other conditions including pelvic inflammatory diseases, gynecological malignancies, hypercoaguable states and few cases to date have reported ovarian vein thrombosis as a complication of COVID-19 infection. Patient with ovarian vein thrombosis usually presents with fever and lower abdominal pain that can mimic acute surgical abdomen and high index of suspicion is required for diagnosis. We report a case of a 41-year-old Asian female presented to our hospital with fever and acute lower abdominal pain. Laboratory findings shows positive COVID-19 test and high D-dimer. Patient underwent computed tomography (CT) of the abdomen and pelvis and a confirmed diagnosis of right ovarian vein thrombosis was made. Patient was treated with anticoagulation and empirical antibiotics and her symptoms has significantly improved.

Intra-gastric balloon (IGB) insertion is a safe, well-tolerated and an effective weight loss procedure. It is commonly used as a step prior to bariatric surgery in obese patients with co-morbidities and failed conservative weight-loss methods. The main side effects post-IGB placement include nausea, vomiting and abdominal pain. The reported complications of IGB include balloon over-inflation, balloon migration, esophagitis, ulceration, gastric perforation and bowel obstruction. We report a case of acute pancreatitis attributed to IGB placement, which is a rare complication of this procedure. The diagnosis of acute pancreatitis due to IGB was made after excluding other causes of acute pancreatitis by radiological imaging. The patient underwent endoscopic IGB removal with rapid post-surgical improvement of her clinical course.

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