RESUMO
Background: Ischemic heart disease is one of the leading causes of global disease burden. Despite treatment with standard therapy, many patients with chronic stable angina pectoris remain symptomatic making it an urgent necessity to introduce new strategies. Hence this study was planned to compare the efficacy and tolerability of Ivabradine and Ranolazine; the two novel antianginal drugs. Methods: This was a single blind, randomised, controlled trial. Thirty patients each taking IVA 5 mg twice daily or RAN 500 mg twice daily were randomised into two groups. Patients filled a pretested questionnaire on frequency of angina attacks and adverse reactions experienced at baseline and 2, 4 and 8 weeks. The haemodynamic parameters, routine laboratory investigations were evaluated at the baseline and after intervention. Results: There was no significant difference in the frequency of angina attacks per week between the IVA and RAN study groups. There was a statistically significant difference (P < 0.01) in the number of patients reporting ADR from the IVA group as compared to RAN group. In the IVA group, the most common ADR was dizziness (36.6%); whereas nausea (30%) and dizziness (23.3%) was most common in RAN group. The routine haematological and biochemical evaluations did not show any significant difference between the baseline and post intervention. However, IVA significantly decreased the resting heart rate after eight weeks of intervention.. Conclusion: Both IVA and RAN are comparable and efficacious antianginal agents. However, RAN had a better safety and tolerability profile than IVA.
RESUMO
Serum sickness-like reaction (SSLR) is an abnormal self-limited reaction that can cause fever, myalgia, fatigue, lymphadenopathy, arthralgia, and skin rashes. Its etiology is yet unknown; however, SSLR often develops in patients with hepatitis B and after drug and vaccination administration. SSLR's typical cutaneous manifestations include polycyclic, erythematous wheal-like or plaque-like lesions. A 47-year-old male hepatitis B carrier visited our emergency department with high fever and multiple annular erythematous plaques with clear centers on his trunk and upper and lower extremities. The patient's hematologic laboratory results indicated an acute exacerbation of hepatitis B, and his symptoms correlated with those of SSLR. Here, we report a case of SSLR in a patient with an acute exacerbation of hepatitis B with clinical, hematological, and histopathological evidence.