Eisenmenger syndrome in a patient with ventricular septal defect: a case report

Eisenmenger Syndrome (ES) represents Pulmonary Arterial Hypertension (PAH) associated with Congenital Heart Defects (CHD). Although patients survive until their third or fourth decades of life, the symptoms include dyspnea, cyanosis, fatigue, dizziness, and syncope. In addition, cardiac arrhythmias, a late complication are causing sudden death in patients with ES. Treatment options have been limited; however, recent successes have been achieved with the use of therapies targeted against the pathophysiological pathways that underlie PAH. The dual endothelin receptor antagonist and prostacyclins demonstrated to improve hemodynamics of the patients. This is the case of a 16 year old young female with ventricular septal defect that was admitted with increasing shortness of breath and cyanosis with clubbing which are clinical features of Eisenmenger syndrome. She was medicated with Furosemide, Sildenafil which improved her functional status

Ofloxacin induced hypersensitivity reaction

Ofloxacin is a commonly used antimicrobial agent to combat various infections. The adverse profile of quinolones includes gastrointestinal symptoms, which are the most frequent, neuropsychiatric symptoms, hematologic abnormalities are less common. We report a rare case of ofloxacin induced hypersensitivity reaction in a 57 year old female patient with complaints of rashes over the axilla, upper limb and back, abdomen, thorax associated with exfoliation of skin all over the axilla associated with severe itching. Based on history and clinical examination patient was diagnosed as ofloxacin induced hypersensitivity reaction and was successfully treated with antihistamines and corticosteroids. Pharmacovigilance should be a part of patient care in order to reduce occurrence of adverse drug reaction and also encourage practitioners in reporting so as to gather more and more data regarding adverse drug reactions

Bilateral thalamic infarcts presenting oculomotor nerve palsy: case report

Bilateral thalamic infarctions are rare; oculomotor nerve palsy can be the result of direct or indirect damage to the oculomotor nerve. We report a case of oculomotor nerve palsy associated with changes in visual pattern and speech disturbances. There is no loss of consciousness. A computed tomography scan of brain showed acute bilateral thalamic infarct. Oculomotor nerve palsies with pupillary involvement warrant thorough investigation and there is no treatment to re-establish function of the weak nerve other than the body’s own healing process

Penicillin induced toxic epidermal necrolysis with secondary impetiginization: a rare case

Drug induced allergic reactions can be categorized into IgE-mediated and non-IgE mediated hypersensitivity reactions. Symptoms of IgE-mediated reactions are angioedema, bronchospasm, anaphylaxis, and urticaria that appears within 72 hours and those which are Non-IgE mediated hypersensitivity reactions include morbilliform eruptions, interstitial nephritis, hemolytic anemia, serum sickness, thrombocytopenia, and erythema multiforme, after 72 hours. TEN is defined as an extensive detachment of full-thickness epidermis most often related to an adverse drug reaction. We report a rare case of penicillin induced toxic epidermal necrolysis with Secondary Impetigination in a 38-year-old male patient with complaints of rashes all over the body, chest pain and dry tongue since seven days. Based on history and clinical examination patient was diagnosed as of penicillin induced toxic epidermal necrolysis with secondary impetigination and was successfully treated with antihistamines, parenteral antibiotics and corticosteroids.

Pemphigus vulgaris: a rare case report

Pemphigus Vulgaris (PV) is an organ-specific autoimmune disorder affecting skin and mucous membranes with a characteristic of intraepithelial blistering. The first common sign of this disease is involvement of oral mucosa followed by skin involvement. We here in report a rare case one such recently seen by us, where oral lesions and skin lesions in a 24 year old female patient presenting with a five months history of multiple fluid filled lesions all over the body, who is known case of psychosis finally diagnosed as having pemphigus vulgaris

Mayer-Rokitansky-Kuster-Hauser syndrome with gonadohypoplasia:a rare case report

MRKH (Mayer Rokitansky Kuster Hauser) syndrome is a congenital abnormality seen in one out of 5,000 women characterized by the agenesis of the vagina, cervix, and uterus. It is also associated with kidney, bone and hearing difficulties. The ovaries are present with a normal function similar to that of a healthy reproductive woman’s by producing eggs and female hormones. Chromosomes are the normal 46xx female karyotype. We report this rare syndrome in a 26–year-old female where she had presented with complaints of absence of uterus with the absence of left kidney. She didn’t attain menarchy, secondary sexual characters are well developed. Small right ovarian follicular cyst with a rim of ovarian tissue was observed. She had undergone vaginoplasty

Phenobarbital induced Stevens-Johnson syndrome: a case report

Stevens-Johnson Syndrome (SJS) is a life-threatening acute hypersensitive reaction affecting the skin and mucous membranes. We report a case with SJS likely induced by phenobarbitone during the switch of sodium valproate and phenobarbitone regimen. The patient reported fever with fluid-filled lesions all over the body and redness and burning sensation of both the eyes. Peeling of the skin due to rupture of the fluid-filled lesions and pigmentation on the skin for 10 days. Based on a physical examination and laboratory findings, he was diagnosed with Phenobarbital induced Stevens-Johnson syndrome. The patient was administered systemic steroid therapy and treated symptomatically and finally replaced with phenobarbitone and sodium valproate. During the hospital stay, the patient appeared normal and the skin lesions disappeared, after two weeks of treatment

Chlordiazepoxide induced Stevens-Johnson syndrome in acute pancreatitis

Stevens-Johnson Syndrome (SJS) is an acute hypersensitive reaction and a life-threatening condition affecting both skin and mucous membranes. We report a case with SJS likely induced by Chlordiazepoxide. The patient undergoing treatment for acute pancreatits is prescribed with Chlordiazepoxide after administering the patient reported mild pyexia with lesions all over the body with redness. Mild peeling of the skin due to rupture of the lesions and pigmentation on the skin was observed for 3 days. Based on these finding he was diagnosed with Chlordiazepoxide induced Stevens-Johnson syndrome. The patient was administered systemic steroid therapy and treated symptomatically. Here we describe a case of Chlordiazepoxide induced SJS in acute pancreatitis patient

Adverse drug reaction risk assessment with prescribed renal risk drugs among hospitalized patients attending a teaching hospital in South India

Background: Renal impairment is the primary cause of mortality and morbid conditions in patients. Inappropriate drug use in patients who are with risk of renal damage causes harmful and deleterious effects. Adjusting doses based on renal function is necessary for renal risk drugs, primarily to avoid adverse reactions of medications. Aim of the present study was to assess the risk of incidence on ADRs with drugs lowering the renal function.Methods: This is a cross-sectional observational study conducted in General Medicine department. 230 Patients constituted the sample in the study. The study was conducted for a period of one year and prescriptions with renal risk drugs were evaluated. Changes in the renal functional tests were compared to the normal range and adverse drug responses were monitored.Results: A total of 230 patients who fulfilled the inclusion criteria were included in the study. The meanage of the study subjects were 50.9±15.2 respectively. 56.39% patients were men and 43.6% were women. Renal risk drugs included in the study are anti-hypertensive, antibiotics, and analgesics. Paracetamol (24.77%) followed by telmisartan (20.85%) are the predominantly prescribed renal risk drugs with high incidence of adverse drug reactions. Causality assessment by Naranjo ADR probability scale showed out of 211 ADRs, 51.6% were possible, 25.59% were doubtful, 21.8% were probable and 0.94% was definite.Conclusions: The current study signifies that patients under high risk of renal damage require continuous monitoring and optimized therapy for better disease management

Effectiveness and use of prophylactic antibiotics in elective and emergency caesarean section at tertiary care hospital

Background: Post-operative infections in obstetrics and gynecological settings have been higher compared to other specialties. Women undergoing caesarean section have 5 to 20-fold greater risk for infection compared with vaginal delivery. Many studies reported antimicrobial prophylaxis prevent post-operative infections. Hence this study concentrates the evaluation of the prescribing antimicrobial use and to assess the frequency of post-operative morbidity related to infection in subjects undergoing caesarean section. The aim of the study was to analysis the effectiveness, prophylactic antibiotics (amoxicillin versus ceftriaxone) and to evaluate the post-operative (caesarean) infections in patients undergoing lower segment caesarean section (elective and emergency).Methods: This is a prospective observational study which assessed the effectiveness and use of prophylactic antibiotics in patients undergoing cesarean section at department of obstetrics and gynecology. The study was conducted over a period of one year.Results: The corresponding mean age of all the study population in amoxicillin group (n=113) was 56.5±28.5 and in ceftriaxone group (n=97) was 48.5±26.5 respectively. The participant who underwent previous cesarean section in amoxicillin group is 65.48% similarly in ceftriaxone group is 47.42%. The patients with fetal distress in ceftriaxone group are 14.77% and in amoxicillin group is 8.92%. Failed induction in amoxicillin group is 9.82% and in ceftriaxone group is 6.81%. The number of days in hospital stay in amoxicillin group is 42.42% and in ceftriaxone group is 45.94%. The post-operative complications in amoxicillin group reported, with Febrile Illness are 40% and wound Infection is 60%.Conclusions: Administration of pre-operative antibiotics significantly reduce post-operative infections. Use of ceftriaxone as a prophylactic antibiotic in patients undergoing lower segment caesarean section (elective and emergency) is more effective than Amoxicillin in preventing post-operative infections