The Journal of the Association of Physicians of India
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J Assoc Physicians India · Jan 2007
Case Reports Clinical TrialUtility of scorpion antivenin vs prazosin in the management of severe Mesobuthus tamulus (Indian red scorpion) envenoming at rural setting.
Scorpion antivenom (SAV) is specific antidote to scorpion venom..SAV did not prevent the cardiovascular morbidity and mortality (autonomic storm), hence its utility in the management for severe scorpion envenomingmay be limited. Since 1983 the advent of prazosin revolutionized the management of severe scorpion sting. Since 2002 SAV against Indian red scorpion (IRS) for the treatment of scorpion sting cases is available at primary health centers. We compared the effects of SAV Vs Prazosin (PRA) in the management of severe scorpion stung cases at rural setting in a non-randomised open label manner. ⋯ We found that SAV is no more effective to alleviate or reverse the cardiovascular effects of scorpion venom actions in severe case as against prazosin prevents and cures the cardiovascular manifestations in a severe scorpion envenomation. Therefore role of SAV in severe scorpoin venomation needs to be relooked and prazosin needs to be a standard of care in such cases to overcome the autonomic storm.
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J Assoc Physicians India · Dec 2006
ReviewCaspofungin: a major breakthrough in treatment of systemic fungal infections.
Invasive fungal infections are difficult to eradicate especially in immuno-compromised host. Amphotericin B and voriconazole have been the mainstay of treatment but both have significant toxicity. Caspofungin belongs to a new class of antifungal agents, the echinocandins. ⋯ Recently, it's use in paediatric patients, including after bone marrow transplantation, has also been shown to be safe. With compare to other antifungal agents known to be effective in systemic fungal infections, Caspofungin has the best safety profile, tolerability with very low potential for drug interactions. This makes Caspofungin an interesting and extremely valuable new antifungal agent that broadens the available therapeutic armamentarium for the treatment of systemic fungal infections.
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J Assoc Physicians India · Dec 2006
Case ReportsPrimary Sjö-gren's syndrome presenting with distal, renal tubular acidosis and rhabdomyolysis.
Primary Sjögren's syndrome (PSS) is rare in India. Clinically manifest renal disease in PSS is uncommon and is usually an autoimmune tubulointerstitial nephritis presenting with distal renal tubular acidosis (dRTA) or a urinary concentrating defect. ⋯ Rhabdomyolysis as a consequence of hypokalemia in PSS is exceptional. We report a case of PSS with dRTA and rhabdomyolysis causing prolonged respiratory failure and quadriparesis.
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Acute renal failure (ARF) in the intensive care unit (ICU) is associated with high mortality. A thorough understanding of the clinical spectrum of the disease is needed in order to devise methods to improve the final outcome due to this problem. ⋯ ARF was seen in 3.79% of cases in our ICU and associated with poor prognosis. Presence of sepsis, MOSF, higher APACHE--III scores and ventilation need were correlated with higher mortality in ARF patients in the intensive care unit.