BMJ case reports
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The case of a 26-year-old woman who was 23 weeks pregnant is described; the patient presented, on a weekend, to the emergency department (ED) with left groin pain. There were few clinical signs of deep venous thrombosis (DVT) but ED ultrasound (US) showed a left external iliac vein thrombus. ⋯ The patient was admitted to the hospital and started on low-molecular-weight heparin. A formal radiology department US performed the next week confirmed the diagnosis of DVT.
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Wernicke's encephalopathy (WE) is a reversible neurological emergency caused by thiamine deficiency. Prolonged vomiting in pregnancy results in thiamine depletion. ⋯ Prompt administration of thiamine is important for preventing the occurrence of sequelae in the mother and for improving the fetal prognostic. We report a case of WE induced by hyperemesis gravidarum with a good maternal and fetal outcome.
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Case Reports
Massive calcium channel blocker overdose: intravenous insulin and glucose as a therapy.
We describe a case of massive overdosage with cardiac medications that proved resistant to conventional support, including fluid replacement, inotropes, mechanical ventilation, cardiac pacing and haemofiltration. The use of a high-dose insulin and glucose infusion proved to be beneficial in the acute management although the patient has been left with significant impairment of cardiac function.