ABSTRACT
Eating patterns, food intake and type of alimentation vary greatly during the month of ramadan. Furthermore, fasting, which practiced during the month of ramadan, can have an impact on drug's metabolism. These two factors, fasting and eating habits changes during the month of ramadan, may impact acenocoumarol anticoagulant effect, translated by variations of INR values. The aim of our study was to see ramadan fasting effects on INR variations in patients treated by acenocoumarol. A prospective monocentric study was conducted during the ramadan month on fasting outpatients that were treated by acenocoumarol. Baseline INR values (e.i. most recent available value before the month of ramadan) were compared to INR values obtained during the month of ramadan. All patients were monitored for signs of secondary haemorrhagic complications linked to treatment by anti-vitamin K (AVK). Thirty patients were included in the study with a sex ratio 1. Patients mean age was 65 years. Around two thirds of the patients were treated by AVK for atrial fibrillation. The majority of patients (94%) have been treated by AVK for more than a year. Mean INR was significantly higher during the month of ramadan than baseline (3.51 vs 2.52; p< 0.0001). There were also more overdoses during the month of ramadan than baseline (9 vs. 0; p=0.014). The increased INR values highlights the need of a close monitoring of INR values during the month of ramadan, particularly in patients with a high haemorrhagic risk.
Subject(s)
Acenocoumarol/therapeutic use , Anticoagulants/therapeutic use , Fasting/physiology , Islam , 4-Hydroxycoumarins/pharmacokinetics , 4-Hydroxycoumarins/therapeutic use , Acenocoumarol/pharmacokinetics , Aged , Anticoagulants/pharmacokinetics , Atrial Fibrillation/drug therapy , Atrial Fibrillation/metabolism , Female , Hemorrhage/chemically induced , Humans , Indenes/pharmacokinetics , Indenes/therapeutic use , Male , Middle Aged , Tunisia , Vitamin K/antagonists & inhibitors , Vitamin K/pharmacokinetics , Vitamin K/therapeutic useABSTRACT
Here we report a case of a right atrial mass that morphology mimicking myxoma, in a young patient with no past medical history. The mass was pathologically confirmed to be symptomatic and surgical removal was successfully done.
Subject(s)
Heart Atria/pathology , Heart Neoplasms/diagnosis , Hypertension, Pulmonary/etiology , Myxoma/diagnosis , Adult , Female , Heart Neoplasms/pathology , Heart Neoplasms/surgery , Humans , Myxoma/pathology , Myxoma/surgeryABSTRACT
Here we report a case of central retinal artery occlusion revealing an ischemic cardiomyopathy. A 54-year old smoker man presented at the hospital because of sudden visual loss in his left eye. There was cherry-red spot in the macula in his left eye. We performed a fluorescein angiogram and cervical color Doppler. Later investigations revealed an ischemic cardiomyopathy undiagnosed until then.
