Seizure and Coma due to hyponatremia induced by Vincristine

Patient with stage 1 Wilms tumour, on Vincristine had hyponatremia, presented as generalized tonic clonic seizures and coma. Investigations suggested no localizing neurological signs located to differentiate other causes of seizure. Treatment- Patient intubated and mechanically ventilated. Patient treated with fluid restriction, hypertonic saline (3%) and other supportive care. Patient improved clinically over three days and extubated on the third day and shifted to the ward on the fifth day. Complete report is available in Indian J of Crical Care Medicie, Year : 2009 Volume : 13 Issue : 3 Page : 167—168. Hope it is interesting for you and read more on this. Click below link to view complete report.
http://www.ijccm.org/downloadpdf.asp?issn=0972-5229;year=2009;volume=13;issue=3;spage=167;epage=168;aulast=Nagappa;type=2
Dr. Shivamurthy Nanjundappa, MD (Pharmacology)

Rituximab a chimeric monoclonal antibody targets the CD20

Rituximab a chimeric monoclonal antibody targets the CD20 molecule, leading to depletion of B-lymphocytes through antibody-dependent and complement-mediated cytotoxicity as well as by promotion of apoptotic mechanisms. Rituximab has been used in non-Hodgkin type B-cell lymphoma for over a decade,but is now being studied in a number of autoimmune conditions.It is proposed to be useful for Multiple sclerosis also.

Tamsulosin and alfuzosin are comparable in acute urinary retention

Comparison of alfuzosin and tamsulosin in patients suffering from acute urinary retention caused by benign prostatic hyperplasia (BPH) showed that Both groups had similar results which were significantly superior than placebo. Three months, followup suggested that alfuzosin- or tamsulosin-treated patients showed a significant decrease in AUA score and PVRV; and a significant increase in PFR as compared to placebo. Tamsulosin is considred to have comparable therapeutic benifits as that of alfuzosin in all respects, except a small but significant side effect of retrograde ejaculation. Detailed report available in Indian Journal of Urology (Indian J Urol)
2009 October-December Volume 25 Issue 4.

Dr. Shivamurthy Nanjundappa, MD (Pharmacology)

Mobile No: +919677632414
Alternate Email ID: shivuindia@yahoo.com

Ciprofloxacine - Toxic epidermal necrolysis agranulocytosis

Ciprofloxacin rarely produces Serious adverse reactions (<0.6%). Two rare adverse effects of ciprofloxacin, viz. toxic epidermal necrolysis and agranulocytosis reported recently. One case of granulocytopenia, four of pancytopenia and fifteen of leucopenia worldwide have been reported.

If you want to know more, please read from below link.

http://www.indianjmedsci.org/article.asp?issn=0019-5359;year=2009;volume=63;issue=10;spage=461;epage=463;aulast=Upadya;type=0

Thanks and kind regards,

Dr. Shiva Murthy N

Treat with Toxin - Botulinum toxin for acquired motor fusion deficiency - an eye problem

Acquired motor fusion deficiency is associated with diplopia in all positions of gaze and strabismus.These are extreemely difficult cases to treat. But fortunately they are rare cases.

A case with successful management has been reported and I am happy to share the same to all my friends. I am thrilled to see that opthalmoligists are using a toxin to treat a dificult condition.

Repeated 2.5 units of botulinum toxin injected to each lateral rectus muscle at one month gap. Patient recovered completely. Complete case report available in the below link:

http://www.ijo.in/downloadpdf.asp?issn=0301-4738;year=2009;volume=57;issue=6;spage=463;epage=464;aulast=Murthy;type=2

The article is published in ind j ophthalmology, vol 57, no 6, page 463. Enjoy reading the article.

Kind regards,

Dr. Shiva Murthy N

Ivabradine – Produce bradycardia without affecting force of heart muscle contraction –New hope for preventing Angina

Beta blockers reduce heart rate with reduction of strength of contraction also. If channel blocker Ivabradine is a novel drug. Coronary blood flow maintained. Myocardial oxygen demand reduced. Sensation of brightness in the fully illuminated field is the adverse event.
A brief review of the drug Is available in the below link.
http://www.jyoungpharm.in/downloadpdf.asp?issn=0975-1483;year=2009;volume=1;issue=3;spage=284;epage=284;aulast=Ameya;type=2
Hope this information is useful.

Dr. Shiva Murthy N

Phenytoin can induce chronic pulmonary disease

Patient may present with features of chronic interestial lung disease, peripheral eosinophilia, chronic interstitial pneumonitis.

Case study published in recent edition of Lung India, vol 26, iss 4, oct - dec 2009.

if you want to learn more please click below http://www.lungindia.com/downloadpdf.asp?issn=0970-2113;year=2009;volume=26;issue=4;spage=155;epage=158;aulast=Dixit;type=2

Kind regards,
Dr. Shiva Murthy N

Prenatal Supraventricular Tachycardia with hydrops - Manged with Digoxin and Sotalol

An interesting case which I am reading for first time. I am thrilled to know that Digoxine and Sotalol can be used to treat a fetus living inside the uterus. The baby is safely deliverd and leading normal life with completed first birth day. I am sure all of you are interested to read this interesting story. Dr. Vanith and her friends from PGI, Chandigargh, India have published their case report in Ind J Med Sci, Vol 63, No 9, Sept 2009. page 411 to 413. Link for this article is as follows. http://www.indianjmedsci.org/downloadpdf.asp?issn=0019-5359;year=2009;volume=63;issue=9;spage=411;epage=414;aulast=Suri;type=2 With best wishes, Dr. Shiva Murthy N

Intravenous Calcium Gluconate can reverse Azithromycine induced agrevation of Myesthenic Crisis

A rare case and clinical experience reported by the physicians. Many antibiotics like Aminoglycosides, tetracyclines, sulfonamides, pencillins, aminoacid antibiotics, fluroquinolones have tendency to increase weakness of myasthenia gravis. Azithromycine has joined this group now. Want to know more?? read the article from the below link. (published in Neurology India, May-July 2009, Vol 57, Issu 3, page 352) http://www.neurologyindia.com/temp/ni573352-3484153_094041.pdf Want to add more comments or share your experience? please comment on this discussion. All comments are welcome. Dr. Shiva Murthy N

Doxycycline has promising results in Idiopathic Pulmonary Fibrosis(IPF)

As of now no definite drug treatment available for this condition. Open lable trials gives promise to treat this condition with significant results. Doxycycline has non specific matrix metalloproteinase (MMP) activity. IPF has been proposed due to dysregulated activity of MMP. Long term use of Doxycycline has shown significant improvement as per the investigators opinion. For more details please read full article in the below link. (if you are not able to see the article please read the journal Lung India, Vol 26, issue 3, Jul-sept 2009, page 81) http://www.lungindia.com/temp/LungIndia26381-3485386_094053.pdf If anyone has views to share, comments are welcome. Kind regards, Dr. Shiva Murthy N

Surgeons suggest medical treatment - Hydatid cyst with Albendazole

In a below suggested link you can read about success story about treatment of Hydatid Cyst (11 cmx 9 cm size) getting shrinked completely to insignificant level and Immune test (IgG - anti echhinococcal antibody titre)) returning to normal level. Patient took Albendazole 15 mg/kg in two divided dose for 4 month. Follow up of 6 months revealed no symproms or signs of continuation of problem. This can be an alternative if patient refuses to undergo surgery. Previous literature suggest success variying from 30-60%. Read the article and choose the treatment carefully. Link (hard copy available in J of Ind Ass of Ped Sur iss 1, vol 14, Jan - Mar 2009, page 40) http://www.linkedin.com/redirect?url=http%3A%2F%2Fwww%2Ejiaps%2Ecom%2Fdownloadpdf%2Easp%3Fissn%3D0971-9261%3Byear%3D2009%3Bvolume%3D14%3Bissue%3D1%3Bspage%3D40%3Bepage%3D40%3Baulast%3DGangopadhyay%3Btype%3D2&urlhash=oyzR&_t=disc_detail_link Hope this information is useful for your practice and patient management. Kind regards, Dr. Shiva Murthy N