The pharmacovigilance is essential to evaluate the effectiveness and safety of drugs and their adverse drug reactions (ADRs). Thiazide diuretics have been considered to use to prevent postmenopausal bone loss. We presented a case of a 54 year-old woman who developed hematuria and oliguria during treatment with hydrochlorthiazide (HCTZ) to reduce calcium loss. One month later, the patient presented similars symptoms when she took nimesulide to treat sore throat, raising the hypothesis that a cross-reaction occurred between a sulfonamide functional group common to HCTZ and nimesulide. Treatment plans should be considered for any possible adverse drug reactions and potential preventive measures should be improved with better communication, more studies and effective transfer of medical information. This case report will improve signal detection system by availability of adverse drug reaction data that may have international relevance.
We present the case of an 80-year-old Japanese female suffering from a genotype 1b HCV infection, with a previous history of post-treatment relapse of PEG-IFN (interferon)/ribavirin (RBV). The patient was retreated with telaprevir-based triple therapy, she achieved rapid virological response (RVR). Despite dose reduction of treatment because of adverse effect (AE), she obtained a sustained virological response (SVR). Furthermore, hepatic functional reserve improved.
This case suggests that in selected genotype 1 HCV-infected patients, a successful treatment can be obtained even with a very low dose of these therapy because of AE or reduced compliance for elderly patient with fibrosis.
Sore throat is often underestimated by emergency physicians if the patient has a healthy appearance; however, sore throat can be the initial presentation of some rare life-threatening conditions such as Lemierre syndrome, which is caused by the gram-negative anaerobic bacilli Fusobacterium necrophorum. A 4-year-old boy with a fever was brought to the pediatric emergency department (ED). The patient was already taking oral Amoxicillin with antipyretics for the past 2 days. He was discharged home with the diagnosis of pharyngitis. Two days later, he returned to the ED with additional complaints: neck and abdominal pain, shortness of breath, and a dry cough. According to his presentation, a diagnosis of compensated septic shock secondary to pneumonia, to rule out meningitis, was made, and he was started on intravenous vancomycin and ceftriaxone. The patient was admitted to the pediatric intensive care unit (PICU). A diagnostic work-up that included neck computed tomography (CT) showed that the patient had Lemierre syndrome. In cases of sore throat in children, a high index of clinical suspicion must be raised by emergency physicians to the possibility of Lemierre syndrome so that the appropriate treatment can be initiated.
We report a patient with a small unilateral midbrain lesion who showed both vertical gaze and convergence palsies. We speculate that the small lesion located near the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal (INC) is responsible for these ocular palsies. Our observations suggest that convergence neurons are located in the vicinity of the riMLF/INC.
Migration of central venous catheters into the heart is a rare complication, we present a case of Port-A-cath migration and looping in the right sided chambers where both ends were trapped in the hepatic vein, the catheter was looped in the pulmonary artery, the dislodgment of the catheter was confirmed by chest X ray then it was percutanously retrieved using pig tail catheter and goose neck snare.
