ABSTRACT
Beta-blockers are a class of medications that act on beta-adrenergic receptors and are categorized as cardio-selective and non-selective. They are principally used to treat cardiovascular conditions such as hypertension and arrhythmias. Beta-blockers have also been used to treat non-cardiogenic indications in non-pregnant individuals and the pediatric population. In pregnancy, labetalol is the mainstay treatment for hypertension and other cardiovascular indications. However, contraindications to certain sub-types of beta-blockers include bradycardia, heart failure, obstructive lung diseases, and hemodynamic instability. There is conflicting evidence of the adverse effects on fetal and neonatal health due to a scarce safety and efficacy profile, and further studies are necessary to understand the pharmacokinetics of the different classes of beta-blockers in pregnancy and fetal health. Understanding the hemodynamic changes during the stages of pregnancy is important to target a more beneficial therapy for both mother and fetus as well as better neonatal outcomes. Beta-blocker use in the pediatric population is less documented in studies but does have the potential to treat various cardiogenic and non-cardiogenic conditions. Future comprehensive studies would further benefit the direction of beta-blocker treatment during pregnancy in neonates and pediatrics.
ABSTRACT
Despite the lack of scientific evidence supporting its effectiveness, homeopathic treatment is increasingly being used as a form of alternative medicine, with many people taking homeopathic remedies instead of drug therapies. It is based on the principle of 'like cures like', meaning that a remedy similar to the illness can be used to treat it. However, there have been several reports suggesting the risks of homeopathic remedies, among which homeopathy-induced liver injury is widely discussed. Here, we report a case of a 35-year-old well-oriented male patient with a typical clinical presentation of liver injury as presented by yellowish discoloration of sclera and skin along with generalized body itching following the use of homeopathic medicine for musculoskeletal pain. Laboratory reports of increased liver markers along with bilirubin were also suggestive. Excluding other differentials like viral hepatitis, alcoholic hepatitis, hemochromatosis, Wilson disease, and standard drug and toxin-induced hepatitis, the recent use of homeopathic remedies was a contributing factor in leading to the diagnosis of homeopathy-induced liver injury. He was then treated with the discontinuation of homeopathic medicine and supportive care. This case highlights the need for public awareness of the possible complications such as headache, tiredness, skin eruption, dizziness, bowel dysfunction, allergic reactions to acute pancreatitis, renal failure, neurological dysfunction, possible liver injury, and even mortality in those patients who pursue homeopathic treatments and health care professionals should take this into account when making a differential diagnosis in patients with liver injury.
