ABSTRACT
Background: Calcium channel blockers (CCBs) are popular medicines used to treat hypertension, tachyarrhythmias or angina during pregnancy. Lack of adequate safety data has however created an uncertainty in the use of CCBs in pregnancy. Nifedipine has been reportedly associated with a variety of embryotoxic and fetotoxic effects in animals. Therefore, this study was undertaken to establish whether or not the commonly used CCBs (nifedipine and amlodipine) would produce teratogenic effects in rats.Methods: Twenty pregnant rats were randomly assigned to each of the treatment and control groups. Nifedipine and amlodipine were used in three dose levels of 5, 10, 20 mg/kg and 0.5, 1, 2 mg/kg body weight respectively to test its teratogenic effects. The maximum dose of the test drugs used in our study was ten times the maximum recommended human dose. The drugs were administered to the pregnant rats using nasogastric tubes from day 6 through day 15 of pregnancy. The number of live births, stillbirths, litter sizes, crown-rump lengths, birth weights and gross abnormalities of the pups delivered were observed and recorded. Skeletal changes and soft tissue changes were also observed in the pups delivered to treated pregnant rats.Results: It was found that nifedipine and amlodipine did not produce any teratogenic effects in rats at doses 2.5 to 10 times the recommended human dose. None of the pups showed any gross morphological, skeletal or visceral defects.Conclusions: Nifedipine and amlodipine appear to be safe during pregnancy in therapeutic doses.
ABSTRACT
Carbon monoxide (CO) is a non-irritating, colorless and odorless gas produced by the incomplete burning of carbon-containing fossil fuels. CO poisoning remains a leading cause of unintentional poisoning worldwide. During winters, accidental CO poisoning has been reported mostly due to incomplete burning of coal. Here, we report the case of a young female patient who presented with hypoxic brain injury due to CO poisoning while using gas geyser in bathroom. The diagnosis of CO poisoning was made on the basis of history, vital signs, blood gas, and MRI scan. The patient recovered well after high-flow normobaric oxygen therapy and showed significant resolution on follow up MRI. A high index of suspicion, early recognition of symptoms by emergency physicians followed by careful history taking can help in making a clinical diagnosis of CO toxicity.
ABSTRACT
Anorectal foreign bodies are rare but have shown a rising trend in recent times. Various kinds of a foreign object may be observed in the rectum, including sharp instruments which may pierce rectum, colon, or create visceral organ injuries. Most common presenting symptoms include abdominal, rectal pains and bleeding per rectum. Without proper history and examination, these foreign objects can easily be missed in the emergency department as these are still a matter of taboo especially in countries like India. We report a case of an elderly gentleman who presented to the emergency with bleeding per rectum and did not initially give a history of foreign body insertion
ABSTRACT
Diabetes Mellitus is a disorder of global proportion. Despite various treatment modalities presently being available, yet the desired glycaemic control and patient outcomes have not been achieved completely. Sodium glucose co-transporter type 2 inhibitors (SGLT2 inhibitors) are one such promising group of emerging drugs in diabetes treatment. Ertugliflozin prevents the reabsorption of glucose by inhibiting sodium-glucose cotransporter-2 (SGLT2) at proximal convoluted tubules. Ertugliflozin is available as 5mg and 15mg tablets. Ertugliflozin has been related to genital mycotic infections and urinary tract infections. Benefits of Ertugliflozin include better control on blood glucose, body weight and blood pressure.
ABSTRACT
Long QT syndrome (LQTS) is a cardiac electrical disorder. One of the rare symptoms of long QT caused by ventricular arrhythmia is seizure. Patients with LQTS may develop seizures due to an acute hypoxic-ischemic event associated with a ventricular arrhythmia. We present a case of a 47-year-old male who came to the Emergency Department (ED) with seizures and was diagnosed as LQTS. The cardiac cause of seizures was suspected because the patient was pulseless during the episode of seizures. The patient developed refractory ventricular tachycardia in the ED and was cardioverted (synchronized) multiple times. He was also put on amiodarone infusions. The patient was then urgently shifted to the Coronary Cath Lab for temporary pacemaker insertion with overdrive pacing. He was advised for an automated implantable cardioverter-defibrillator. This case illustrates that prolonged QT syndrome can masquerade as seizure. Therefore, a careful examination should be done in the patient presenting with the same and a cardiac cause should be excluded. Delays in recognition and treatment may expose the patient to a high risk of sudden cardiac death
ABSTRACT
Smiling is not a simple option in those patients who have a severe aesthetic deformity. Many definitions of aesthetics were introduced in dentistry but according to Young, beauty, harmony, naturalness and individuality are the major qualities of aesthetics. The dentist must visualize aesthetics in relation to the patient and then translate that visualization into an acceptable aesthetic result. The success of his efforts depends upon his artistic ability, his powers of observation and experience. Many treatment options are available to achieve aesthetics in compromised anterior teeth but in recent era with the introduction of advanced material (new ceramic and composite materials) has increased the demand of conservative treatment options. Porcelain laminate Veneers (PLVs) were introduced in the 1980s as an alternative to full-coverage crowns. The present case report describes the treatment of fracture & diastema in the anterior dentition with thin ceramic veneers, to restore esthetics and function.
ABSTRACT
@#BACKGROUND: Bottle gourd (Lagenaria siceraria) is popularly known as lauki, ghia or dudhi in India. Its consumption is advocated by traditional medicine healers for controlling diabetes mellitus, hypertension, liver diseases, weight loss and other diseases. However, in last few years there have been reports of suspected toxicity due to consumption of its juice leading to severe vomiting and upper gastrointestinal bleeding. As emergency physicians we need to be aware of this very rare poisoning specially in India. METHODS: We present a case of a 52-year-old woman who presented with multiple episodes of hematemesis and shock to the emergency department (ED) after consuming bottle gourd juice. The patient was resuscitated and stabilized with fluids, proton pump inhibitors and antiemetics and shifted to the intensive care unit (ICU) under the care of a gastroenterology team for urgent endoscopy and further management. RESULTS: The patient received intravenous fluids, antibiotics, antiemetics, and antacids and underwent upper gastroenterologic endoscopy during the hospitalization. She was discharged in a stable condition 4 days later. CONCLUSIONS: As a member of the Cucurbitaceae family, bottle gourd contains toxic tetracyclic triterpenoid compounds called cucurbitacins which are responsible for the bitter taste and toxicity. There is no known antidote for this toxicity, and clinicians treat such patients symptomatically only. It is important to educate the public about the harmful effects of this potentially life-threatening toxicity.