Thrombolytic therapy in acute pulmonary embolism due to heparin-induced thrombocytopenia type II

Hospitalized patients are in danger of deep venous thrombosis either due to a genetic tendency, immobilization or the underlying medical condition. Paradoxically heparin, the substance used to prevent this complication, can lead to thrombo-embolic phenomena, which can be life threatening. We report a case of heparin-induced thrombocytopenia, which caused a massive pulmonary embolism, and its management by administering a thrombolytic agent in a situation where bleeding seems inevitable

Traumatic fat embolism syndrome

Traumatic fat embolism syndrome occurs most often following fractures of long bones sustained in road traffic accidents and is a common cause of medical consultation from the orthopedic surgery department. The sub-clinical presentation is subtle and expresses itself by the presence of hypoxemia, while the full clinical syndrome compromises respiratory insufficiency, an altered consciousness and a characteristic petechial rash. Recognition is simple once the patient is viewed in the context of his or her clinical setting. Diagnosis is aided further by the presence of hematological and biochemical abnormalities including anemia, thrombocytopenia, an elevated erythrocyte sedimentation rate and fat macroglobulinemia. Imaging by chest radiograph, computed tomography or magnetic resonance of the brain is used to confirm the extent of the respective organ involvement and to exclude alternative pathologies. The release of free fatty acids into the circulation and their subsequent effects is the key pathological event. Treatment is based on supportive care and high-dose corticosteroid therapy. We report a patient with traumatic fat embolism syndrome who developed the syndromes classical symptoms and signs following fracture of the long bones of his left lower leg. Admission to an intensive care unit, mechanical ventilatory support with positive end-expiratory pressure and corticosteroid therapy lead to his improvement and allowed eventual open reduction and internal fixation and discharge of our patient. Modern therapy offers a relatively good prognosis for patients with traumatic fat embolism syndrome; the optimal dose and timing of corticosteroid therapy in prophylaxis and treatment however, remain the subject of intense debate

Evaluation of methanolic extract of Ficus platyphylla on gastrointestinal activity.

Methanolic extract of Ficus platyphylla was tested on isolated rabbit jejunum, rat duodenum and gastrointestinal motility in mice. The extract showed a biphasic effect on isolated smooth muscle. Lower concentration of extract caused contraction, while higher concentrations produced relaxation. The contractile phase was attenuated by atropine, while relaxant phase attenuated histamine induced contraction of guinea pig ileum. The extract also exhibited a dose-dependent inhibition of gastrointestinal motility. Acute toxicity test in mice established LD50 value (i.p.) of the extract to be 2000 mg/kg. Preliminary phytochemical screening of the extract gave positive test for flavonoids, tannins and saponins.