ABSTRACT
Heart failure is clinically defined as a syndrome caused by cardiac dysfunction generally resulting from myocardial muscle dysfunction or loss. Heart failure is a leading cause of hospitalization in people older than 65. Extensive evidence indicates that the cardiovascular system responds to the minimal but persistent changes in circulating thyroid hormone levels, which are typical of individuals with subclinical thyroid dysfunction. Subclinical hypothyroidism is associated with impaired LV diastolic function and subtle systolic dysfunction and an enhanced risk for atherosclerosis and myocardial infarction. Methods: A total of 200 patients between age group of 45 to 75 yrs, presenting in medical emergency and medical outdoor of Guru Nanak Dev Hospital, Government Medical College Amritsar with heart failure were studied.Comparison of Thyroid Profile and LVEF was done at Baseline, 3 months and 6 months. Results: The change in TSH, FT3, FT4, LVEF was significant at 3 months and 6 months as compared to baseline. Changes in FT4, LVEF, were significant at 3 months and 6 months, thus signifying progression of disease and worsening of cardiac functions. Conclusion: In treatment group in subclinical hyporthyroidism patients, after comparing the thyroid profile and 2D Echocardiography after 6 months; TSH, LVEF both have shown improvement (p <0.05).
ABSTRACT
Adverse drug reactions (ADRs) are one of the leading causes of death among hospitalized patients and occur in 0.3 to 7 per cent of all hospital admissions. These may vary from mild rashes to severe reactions such as Stevens-Johnson syndrome (SJS). Antiepileptic drugs-induced SJS is a life-threatening severe cutaneous adverse reaction. We report here a case of phenytoin induced SJS in a 38 year old male patient presenting at emergency room. The patient responded to the treatment and was prescribed tab. Levetrecitam and remained symptom free since then.