A case report on digoxin toxicity

Digoxin is an inotropic drug that is commonly prescribed in patient with heart related diseases. The effective dose of digoxin is 0.8-2.0 ng/ml beyond which digoxin causes toxic effects like visual dysfunction, irregular heartbeat, and cardiovascular collapse. Digoxin toxicity is caused due to increased automaticity and inotropy due to intracellular calcium and decreased dromotropy due to poisoning of sodium potassium transporter and AV nodal blockade. Digoxin toxicity should be assessed by continuous hemodynamic and cardiac monitoring including 12-lead electrocardiogram. There should be timely and immediate evaluation of electrolyte levels like potassium, calcium, serum creatinine and digoxin levels and prompt intensive care unit admission, if necessary. In this case study we studied a 43 old female patient prescribed with digoxin 0.25 mg, who had a medical history of congestive cardiac failure presented with symptoms of digoxin toxicity. The patient was assessed with electrocardiography (ECG) and managed by keeping digoxin on hold and effective patient counselling

A CASE REPORT ON SYSTEMIC-ONSET JUVENILE IDIOPATHIC ARTHRITIS (SOJIA) WITHOUT MULTIORGAN INVOLVEMENT

Systemic-onset juvenile idiopathic arthritis (SoJIA) is a rare form of juvenile idiopathic arthritis (JIA) which manifests as quotidian fevers and arthritis in one or more joints. Features include characteristic salmon pink-colored rash associated with lymphadenopathy, hepatosplenomegaly, and serositis. To the best of our knowledge, this is a rare form of JIA in India and very few cases without multiorgan involvement have been published in literature. The following case reports a 12-year-old male child who presented to the hospital with a history of spiking fevers and arthritis in the knees, ankle, and hip joints. Diagnosis of SoJIA was confirmed after subsequent laboratory investigations; treatment included long-term nonsteroidal anti-inflammatory drugs, and methotrexate. However, due to increased cost of medicines and no guaranteed “cure” for the disease, the present patient switched from allopathic to homeopathic medicines. He still experiences frequent flare-ups associated with the disease, during which aceclofenac is taken for symptom relief. This case also highlights the importance of a “cure” for diseases rather than “symptom-oriented” treatment measures. When a cure is not guaranteed, patients may transition to inexpensive alternate therapies portraying limited efficacy. Further research in the field of rheumatology, specifically for rare diseases, is warranted