Liver Cirrhosis First Time Presented With Delirium Unveiled As Accidental Secondary Hypothermia

Liver cirrhosis is a condition which is defined histopathologically but cannot be diagnosed clinically without any non-invasive tests. There are various etiologies of cirrhosis such as alcoholic liver disease, chronic viral hepatitis B, C, and non-alcoholic fatty liver diseases. Liver, not only function as an organ for detoxification, conjugation, and synthesis but also it regulates body heat. Cirrhosis patients thus are prone to body heat loss and hyperthermia. We present a case with undiagnosed liver cirrhosis patient, 1st time presenting with altered sensorium, revealed as accidental secondary hypothermia with ECG changes of hypothermia. The patient treated for hypothermia only after which she recovered.

Snakebite Presenting As Acute Coronary Syndrome: An Interesting Diagnosis And Management

Snakebite is a common presentation in India, especially in the Sub-Himalayan region. The most common presentation of snakebite is neurotoxic and hematologic complications. Acute coronary syndrome after a snakebite is rare. This case report explicitly explains a patient presenting as acute coronary syndrome after a snakebite with dynamic electrocardiogram changes. Later on, the anti-snake venom therapy was given to the patient and her condition improved. It should be kept in mind that, since the pathology of snakebite-induced myocardial infarction is different, its management will also be different.

An unusual case of trifluoperazine induced hypoglycemia.

Hypoglycemia is a serious condition which if not diagnosed and treated urgently may cause irreversible damage to the brain and may be life threatening. There are various causes attributed to hypoglycemia, but drugs are one of the most important one of them. Various drugs are documented to cause hypoglycemia but we present a rare case report of a 52-year-old male patient with schizoaffective disorder on trifluoperazine who presented in emergency department with documented hypoglycemia and this hypoglycemic episode improved when the drug was withdrawn. When WHO causality assessment scale was applied, trifluoperazine was found as the probable cause of the episodes of hypoglycemia. Therefore, this possibility of hypoglycemia should always be kept in mind while prescribing trifluoperazine.

Pharmacovigilance Programme of India.

Adverse drug reactions from medicinal products are one of the important public health issues. The Pharmacovigilance system is used to monitor the safety of authorized medicinal products and detect any change to their risk-benefit balance. It is characterized by its structures, processes and outcomes. To run an effective Pharmacovigilance system a protocol is required for reporting adverse reactions associated with drug use.