A Seizure Attributed to Ofloxacine in a Woman Undergoing Detoxification for Alcohol Dependence

Objective. To report one case of seizure following administration of ofloxacin.Case Summary. A 38-year-old woman with alcohol dependence but no prior history of seizure disorder admitted in our inpatient alcohol detoxification program was prescribed ofloxacin four days after admission for a lower urinary tract infection. She was currently prescribed diazepam 30 mg per day. This treatment was continued without modification following admission. Forty eight hours after starting ofloxacin and after receiving five doses of oral ofloxacin, the patient experienced a seizure. Ofloxacin treatment was stopped and no further seizures occurred. Neurological examination of the patient, laboratory tests, computerized tomography with contrast enhancement and electroencephalography did not detect any abnormalities. Up to the last consultation, six months after admission, the patient has reported no recurrence of the seizure.Discussion. Quinolone antibiotics vary in their ability to induce seizures, with ofloxacin having one of the least potentials. In the present case, the seizure could be attributed in all probability to taking ofloxacin; since she had no previous history of seizures, she did not present an alcohol withdrawal syndrome, benzodiazepine treatment was not modified, the seizure occurred 48 h after taking ofloxacin, but seven days after stopping drinking, no alternative aetiologies for the seizure could be identified and no seizure recurrence was reported over the following seven months. Of reported cases of seizures in patients treated with fluoroquinolones, none concerned patients with alcohol dependence or patients treated with benzodiazepines.Conclusions. The present case alerts us to the possibility that seizures may occur in alcohol dependent patients treated with benzodiazepines who concomitantly prescribed a fluoroquinolone. These widely-used antibiotics should thus be prescribed with caution to patients undergoing detoxification for alcohol dependence, particularly if they are also taking benzodiazepines, irrespective of whether they have a previous history of seizures or not.

Download Full-text

Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195941 ◽

2019 ◽

Vol 8 (1) ◽

pp. 344

Author(s):

Bushra . ◽

Ambreen Ghori ◽

Azra Ahmed ◽

Najma Dalwani ◽

Mushtaque Ali Shah ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Previous History ◽

Cross Sectional Study ◽

University Hospital ◽

Prior History ◽

Singleton Pregnancy ◽

Cross Sectional ◽

History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

Download Full-text

Pleomorphic lobular carcinoma in situ: A distinct entity of controversial significance.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.177 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 177-177

Author(s):

Marina De Brot ◽

Shirin Muhsen ◽

Victor P. Andrade ◽

Starr Koslow Mautner ◽

Melissa Murray ◽

...

Keyword(s):

Breast Cancer ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Previous History ◽

Prior History ◽

Lobular Carcinoma In Situ ◽

Pleomorphic Lobular Carcinoma ◽

History Of

177 Background: Pleomorphic lobular carcinoma in situ (PLCIS) is an increasingly diagnosed variant of lobular carcinoma in situ. Histologically, it resembles ductal carcinoma in situ (DCIS), leading to controversy over proper management. Yet, the natural history of PLCIS is unknown. Here we describe our experience with PLCIS. Methods: Review of pathology reports (1995–2012) identified 233 cases of LCIS variants. Patients with synchronous ipsilateral DCIS or invasive cancer (IC) were excluded leaving 25 cases for review. Consensus review by 3 pathologists further excluded 7; leaving 18 cases, 12 of which were classified as PLCIS and 6 as LCIS with pleomorphic features (LCIS-PF). (Table) PLCIS was defined by cellular dyshesion, nuclear pleomorphism with a 2-3 fold size variation, conspicuous nucleoli, mitoses and abundant cytoplasm; lesions not meeting all parameters were classified as LCIS-PF. Loss of e-cadherin was confirmed; clinical data were obtained from medical records. Results: Mean patient age at diagnosis of PLCIS/LCIS-PF was 57 yrs (42-67 yrs). All cases presented with imaging abnormalities. A previous history of breast cancer was present in 7/18 (39%) pts (3/7, ipsilateral; 4/7, contralateral). Following PLCIS/LCIS-PF diagnosis, 6/18 (33%) pts underwent mastectomy and 12/18 had excision alone, with (n=3) or without chemoprevention (n=9). Margin status was negative in 4/12 pts; close in 3/12 pts and positive in 5/12 pts undergoing excision. At a median follow-up of 27 mos (2-148 mos), 2/12 pts treated with excision developed ipsilateral breast cancer (1 DCIS; 1 IC). Both had close margins at initial excision; median time to cancer, 54 mos. Conclusions: Pure PLCIS is an uncommon lesion. Synchronous malignancy or prior history of breast cancer are often present in patients with PLCIS, contributing to the difficulty in determining the actual risk conferred by this lesion and appropriate management. Efforts to systematically characterize LCIS variants and prospective documentation of outcomes are needed to clarify the significance of these lesions. [Table: see text]

Download Full-text

Correlation of abnormal upper tract cytology and tumor histology in patients who have undergone a nephroureterectomy for urothelial carcinoma with disease recurrence in the bladder.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.288 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 288-288

Author(s):

Einar Freyr Sverrisson ◽

Timothy Kim ◽

Patrick Espiritu ◽

Wade Jeffers Sexton ◽

Julio Pow-Sang ◽

...

Keyword(s):

Bladder Cancer ◽

Previous History ◽

Tumor Grade ◽

Disease Recurrence ◽

Intravesical Therapy ◽

Prior History ◽

Upper Tract ◽

History Of ◽

One Year ◽

Bladder Recurrence

288 Background: 15-50% of patients with upper tract urothelial carcinomas (UTUC) will have a bladder recurrence. Abnormal upper tract cytology (UTC) is an indicator of higher grade tumors but has not been associated with bladder recurrence. We were interested in investigating the role of UTC as a predictor of bladder cancer recurrences in patients with no prior history of bladder cancer presenting with UTUC. Methods: Of 67 patients who had an UTC collected prior to their nephroureterectomy (NU) in 2004-2012, we identified 17 patients with a recurrent disease in the bladder who met the criteria of having no previous history of bladder cancer at the time of their NU. UTC and histology were reviewed and analyzed with the bladder pathology data. Positive or suspicious cytology was defined as abnormal and atypical or reactive as benign. Results: 15 (88%) of 17 patients (11 men and 6 women) who met our criteria were diagnosed with bladder cancer within one year after their NU (average 7.5 months (range 2-26)). 10 (59%) of 17 patients had abnormal UTC with a calculated sensitivity and specificity of 59% and 22%, respectively. 7 (70%) of 10 patients with abnormal UTC compared to 5 (71%) of 7 patients with benign cytology had high grade (HG) bladder cancer (p=1.0). Muscle invasive tumors were found in 5 (29%) of 17 patients and 3 (60%) of those had abnormal UTC. All six women had HG bladder cancer compared to 6 of 10 men (p=0.23). HG tumors were slightly more common in the bladder compared to the upper tract (75% vs 65%, p=0.70) and 14 (87.5%) of 16 bladder tumors had the same tumor grade in the upper tract. Conclusions: Abnormal UTC is a poor predictor of bladder recurrence in patients with a history of UTUC. The majority of patients who developed bladder recurrence presented within one year from NU with HG disease which underscores the importance of aggressive surveillance and the consideration of prophylactic intravesical therapy at the time of NU in this patient cohort.

Download Full-text

D2 dopamine receptor (DRD2) polymorphism is associated with severity of alcohol dependence

European Psychiatry ◽

10.1016/s0924-9338(02)00625-9 ◽

2002 ◽

Vol 17 (1) ◽

pp. 17-23 ◽

Cited By ~ 58

Author(s):

J.P. Connor ◽

R.McD. Young ◽

B.R. Lawford ◽

T.L. Ritchie ◽

E.P. Noble

Keyword(s):

Alcohol Dependence ◽

Dopamine Receptor ◽

Problem Drinking ◽

Drinking Behavior ◽

D2 Dopamine Receptor ◽

Drd2 Gene ◽

Allele Status ◽

Alcohol Detoxification ◽

Dependence Scale ◽

Alcohol Dependent

SummaryThe A1 allele of the D2 dopamine receptor (DRD2) gene has been associated with alcohol dependence. However, the expression of this allele risk on the severity of drinking behavior in patients with alcohol dependence has not been systematically explored. The present study examines the association between DRD2 A1+(A1/A1 and A1/A2 genotypes) and A1– (A2/A2 genotype) allele status and key drinking parameters in alcohol-dependent patients. A sample of Caucasian adults was recruited from an alcohol detoxification unit. A clinical interview and the Alcohol Dependence Scale (ADS) questionnaire provided data on consumption, dependence, chronology of drinking and prior detoxification. A1+ allele compared to A1– allele patients consumed higher quantities of alcohol, commenced problem drinking at an earlier age, experienced a shorter latency between first introduction to alcohol to the onset of problem drinking and had higher ADS scores. Moreover, A1+ allele patients had more detoxification attempts than their A1– allele counterparts. In sum, alcohol-dependent patients with the DRD2 A1 allele compared to patients without this allele are characterized by greater severity of their disorder across a range of problem drinking indices. The implications of these findings are discussed.

Download Full-text

Family Burden in Alcohol Dependence

European Psychiatry ◽

10.1016/s0924-9338(09)70682-0 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 2

Author(s):

T. Paparrigopoulos ◽

E. Tzavellas ◽

D. Karaiskos ◽

N. Stefanis ◽

I. Mourikis ◽

...

Keyword(s):

Alcohol Dependence ◽

Interpersonal Relations ◽

General Health Questionnaire ◽

Family Burden ◽

Published Data ◽

Paired Samples ◽

Alcohol Detoxification ◽

Considerable Impact ◽

Supportive Intervention ◽

Alcohol Dependent

Objective:There are no published data on how family burden changes over time in alcoholism. We present 6-month follow-up data on the burden of families of alcohol dependent individuals.Methods:The sample comprised 87 caregivers (63 females, 24 males) of alcohol dependent individuals who completed a 4-6 week inpatient alcohol detoxification in the Specialized Drug and Alcohol Addiction Clinic at the Eginition Hospital, Athens University Medical School. During hospitalization, a brief supportive intervention for the relatives took place. After detoxification all participants were followed-up as outpatients for a 6-month period in an affiliated service. Burden and psychopathology of caregivers were assessed with the Burden of Care Scale, and the General Health Questionnaire (GHQ-28). T-tests for paired samples were used for comparisons between different time points (admission-discharge-six months). A logistic regression model was used to identify factors which influence relatives’ relief.Results:Caregivers exhibited high scores of burden in terms of financial, household, interpersonal relations and parental roles at admission; mild psychopathological symptoms were also recorded. By the end of detoxification scores significantly decreased in most relatives (admission vs. discharge, p< .000); this improvement was determined by the patients’ soberness.Conclusions:Alcohol dependence may have a considerable impact on family interaction as shown by the high scores of burden and mild psychopathology recorded in the caregivers. Our findings suggest that the relatives’ relief was dependent on the achievement of abstinence and the number of relapses. Therefore, a brief supportive intervention is recommended.

Download Full-text

A retrospective assessment of parental attitudes in alcohol dependent and non-dependent groups

Psychiatria i Psychologia Kliniczna ◽

10.15557/pipk.2020.0031 ◽

2020 ◽

Vol 20 (4) ◽

pp. 241-258

Author(s):

Ewa Wojtynkiewicz ◽

Keyword(s):

Family History ◽

Alcohol Dependence ◽

Alcohol Use Disorder ◽

Parental Attitudes ◽

Alcohol Addiction ◽

Retrospective Assessment ◽

Identification Test ◽

History Of ◽

Disorder Identification ◽

Alcohol Dependent

Aim: The aim of the studies was to verify whether an alcohol-dependent group differs in terms of retrospectively assessed parental attitudes from a non-dependent group (study 1) as well as whether there are differences between individuals with alcohol dependence having or not having an addicted parent in terms of the retrospectively assessed parental attitudes (study 2). Materials and methods: 121 individuals with alcohol dependence and 121 people with no dependence took part in study 1 (in both groups there were 37 women and 84 men). 221 individuals with alcohol dependence (55 women and 166 men) participated in study 2. Mieczysław Plopa’s Questionnaire of Retrospective Assessment of Parental Attitudes (KPR-Roc) and Alcohol Use Disorder Identification Test (AUDIT) were used in the studies. Results: The outcome of study 1 proved that the individuals with alcohol dependence score higher in comparison with those non-dependent in terms of variables Mother Protectiveness, Father Demanding and Father Inconsequence and score lower for variables Father Acceptance/Rejection and Father Autonomy. The results of study 2 show that alcohol-dependent women with a family history of alcohol addiction tended to score lower for variables Mother Acceptance/Rejection, Father Acceptance/Rejection, Father Autonomy and Father Protectiveness in comparison with the non-dependent women with no family history of alcohol addiction. Whereas men addicted to alcohol with a family history of alcohol addiction score higher for the variable Father Acceptance/Rejection and higher concerning variables Father Demanding and Father Inconsequence in comparison with the addicted male group with no family history of alcohol addiction. Conclusion: Alcohol-dependent individuals have a tendency to assess more adversely the father’s attitude in comparison with the non-dependent group. Having an alcohol-dependent parent among individuals with alcohol dependence differentiates mainly the retrospective assessment of the father.

Download Full-text

SARS-CoV-2 Vaccine-Induced Antibody Response and Reinfection in Persons with Past Natural Infection

10.1101/2021.05.18.21257259 ◽

2021 ◽

Author(s):

Nitu Chauhan ◽

Ajeet Singh Chahar ◽

Prem Singh ◽

Neel Sarovar Bhavesh ◽

Ravi Tandon ◽

...

Keyword(s):

Viral Vector ◽

Natural Infection ◽

Previous History ◽

Adenovirus Vector ◽

Prior History ◽

Igg Antibody ◽

Vector Vaccine ◽

Women Subjects ◽

History Of ◽

Antibody Titers

Several studies have shown that subjects with a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection had significantly higher antibody titers than previously uninfected vaccinees after vaccination with mRNA vaccine. Yet no information is available for other vaccines. In the current observational cohort study, 105 health care workers who had received Covishield an Adeno associated viral vector-based DNA vaccine were enrolled at Sarojini Nadu Medical College Agra, India. The study included 40 (23 men and 17 women) subjects with a previous history of SARS-CoV-2 infection and 65 participants (39 men and 26 women) who were not infected previously. Both the groups received the adenovirus vector vaccine ChAdOx1-S recombinant vaccines (Covishield, Astra Zeneca). The levels of SARS-CoV-2-anti-spike-IgG-antibodies titer were measured using Electrochemiluminescence immunoassay on Roche platform as arbitrary units per milliliter (AU/ml). After 28 days of the second dose, subjects with no previous SARSCoV-2 infection showed a significantly lower level of circulating anti-spike-IgG-antibody titers compared to previously infected participants. After the second dose, we also observed a significant increase in SARS-CoV-2 infection in subjects with no prior history of SARS-CoV-2 infection compared to subjects with a previous history of natural infection. The most important observation of the study is a low percentage of infection in previously infected subjects. The finding of the study also indicates the presence of robust humoral memory response in previously infected patients.

Download Full-text

Pemetrexed and carboplatin plus bevacizumab for advanced non-squamous non-small cell lung cancer (NSCLC): Preliminary results

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.7601 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 7601-7601 ◽

Cited By ~ 7

Author(s):

J. D. Patel ◽

T. A. Hensing ◽

V. Villafor ◽

E. Hart ◽

P. Bonomi

Keyword(s):

Bowel Perforation ◽

Previous History ◽

Median Number ◽

Hematological Toxicity ◽

Prior History ◽

Toxicity Profile ◽

Common Grade ◽

History Of ◽

Grade 3 ◽

Number Of Cycles

7601 Background: Pemetrexed in combination with carboplatin has been shown to have promising activity and favorable toxicity profile in NSCLC. Bevacizumab has been shown to improve response rates and survival in pts with advanced non-squamous NSCLC when combined with carboplatin and paclitaxel. This study of pemetrexed and carboplatin plus bevacizumab was designed to evaluate the toxicity profile and to estimate the activity of the regimen in this pt population. Methods: Eligibility required that pts were chemotherapy-naive, had stage IIIB (effusion)/IV non-squamous NSCLC, PS 0–1, with no evidence of CNS metastases. Pts received pemetrexed 500 mg/m2 over 10 minutes, carboplatin AUC 6 over 30 minutes, and bevacizumab 15 mg/kg over 30–90 minutes on a 21-day cycle for 6 cycles. Pts with SD or PR received pemetrexed 500 mg/m2 and bevacizumab 15 mg/kg every 21 days until disease progression or toxicity. All pts received folic acid, vitamin B12 and steroid prophylaxis. Results: From 8/05 to 9/06, 39 pts (of planned 50) were enrolled: 20 M/19 F; median age 64 (range 41 - 80). One pt enrolled and subsequently refused treatment. Median number of cycles was 6 (range 1–22), and 25/38 (66%) completed at least 6 cycles of therapy. There was no grade 4 hematological toxicity. Grade 3 hematological toxicities were anemia (5%, N=2) and thrombocytopenia (3%, N=1). The most common grade 3/4 non-hematological toxicities included proteinuria (3%, N=1, gr 3), venous thrombosis (3%, N=1, gr 3), infection (3%, N=1, gr 4), and diverticulitis (11%: 8%, N=3, gr 3/3%, N=1, gr 4). 1 pt with diverticulitis experienced bowel perforation that required surgical intervention. The trial was temporally suspended and the group of pts with diverticulitis was analyzed separately. The only risk factor identified was previous history of diverticulitis. One CR, 20 PRs were observed for an overall response rate of 55% (95%, CI 43–75%). Conclusions: Treatment with pemetrexed and carboplatin plus bevacizumab in pts with advanced non-squamous NSCLC is feasible with an acceptable toxicity profile. The encouraging activity justifies further development of this regimen. However, pts with a prior history of diverticulitis should be excluded until this observation can be investigated further. No significant financial relationships to disclose.

Download Full-text

Prevalence of Hepatitis ‘B’ and ‘C’ in Orthopaedics Patients Admitted In Khyber Pakhtunkhwa Hospitals

10.53350/pjmhs211551208 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1208-1210

Author(s):

A. Khan ◽

M. S. Zardad ◽

Abdussaboor awan ◽

M. Tahir ◽

M. A. E. Bhattani ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C ◽

Blood Transfusion ◽

Hepatitis B ◽

Venous Blood ◽

Previous History ◽

Prior History ◽

History Of Surgery ◽

History Of ◽

Orthopedic Patients

Background and Aim: Hepatitis B and C are widespread global health issues that are rapidly spreading in developing countries due to ineffective preventive measures.Undiagnosed hepatitis B (HBV) and hepatitis C (HCV) viral infections in hospitalized patients and outdoor attendees must be addressed in order to obtain a more accurate picture of HBV and HCV prevalence.The purpose of this study was to determine the prevalence of HBV and HCV in patients admitted to the orthopedic department. Materials and Methods: This is a descriptive cross-sectional study of 1080 patients admitted to the department of orthopedics at Ayub Medical Teaching Institute Abbottabad and Orthopaedics department of DHQ Hospital Thimergara Dir lower for duration of six months fromSeptember 2019 to February 2020.The study included patients of both sex and all ages who were undergoing surgery. Venous blood was drawn from 1080 people and tested for infection using ELISA.All patients were screened for Hepatitis B and C, and positive patients were confirmed using the Elisa method. Results:Out of 1080 patients, 756 (70%) were male and 324 (30%) were female. Hepatitis B and C were found in 86 (8%) of the patients. Out of 86 infected patients, 49 (4.53 %t) had hepatitis C and 37 (3.42 %) had hepatitis B. The prevalence of both hepatitis B and C infections were 4 (0.37 %) of the patients. Of the 49 hepatitis C patients, 32 (65.3%) were male and 17 (34.7%) were female. Thirty-one (83.8 %) of the 37 hepatitis B patients were male, while six (16.21 %) were female.The prevalence of risk factors were history of blood transfusion 14 (16.27 %) patients, Previous history of surgery 17 (19.8 %), dental procedure 6 (7.00 %), and abroad visit in 5 (5.81 %) patients. Conclusion:Hepatitis B and C are common in orthopedic patients, with the following risk factors: prior history of surgery or blood transfusion. To prevent the transmission of HBV and HCV to others, a routinely screened procedure should be followed on a regular basis. Keywords:Prevalence, Hepatitis B, Hepatitis C, Orthopedic patients.

Download Full-text