scholarly journals TOXIC EPIDERMAL NECROLYSIS INDUCED BY CARBAMAZEPINE: A CASE STUDY

2017 ◽  
Vol 10 (7) ◽  
pp. 78 ◽  
Author(s):  
Jahirul Islam Laskar ◽  
Pinaki Chakravarty ◽  
Babul Dewan
Keyword(s):  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Causality Assessment ◽  
Treatment Guidelines ◽  
Drug Reactions ◽  
Medical College ◽  
Life Threatening ◽  
Ward Rounds

 Objectives: The objective of this case study is to evaluate the importance of detection, assessment, and reporting of an adverse drug reaction and to improve the medication perseverance. Methods: This is an observational type of case report which was observed and analyzed in Silchar Medical College and Hospital on regular ward rounds. Results: A case report of toxic epidermal necrolysis due to carbamazepine (CBZ) administration by a 47-year-old male patient who presented as a follow-up case of ischemic stroke. Causality assessment of the event done with Naranjo’ causality assessment scale suggests to be “Probable.” Conclusion: Daily, CBZ is being increasingly prescribed for control of pain in neuralgias and diabetic neuropathy, apart from control of seizures. Awareness about the drugs implicated in life-threatening drug reactions will help physicians in preventing them by cautious use of the drugs. Moreover, proper counseling to the patient regarding the use of medications is of utmost importance, in such life-threatening conditions where treatment guidelines remain indistinct. 

scholarly journals Stevens-Johnson syndrome induced by phenytoin: a case report

2016 ◽  
Vol 6 (1) ◽  
pp. 208
Author(s):  
Lalkota Prakash Bhanu ◽  
Kumara Swamy M. ◽  
Mohammed Nasiruddin ◽  
Naveen H. D. ◽  
Rajesh Venkataraman
Keyword(s):  
Adverse Reaction ◽  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Antiepileptic Drugs ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Adverse Reaction ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Grade 3

Stevens-Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN) are rare (one to two per 10,00,00 population per year) but life threatening adverse drug reactions. Antiepileptic drugs-induced Stevens-Johnson syndrome (SJS) is a life-threatening severe cutaneous adverse reaction, amongst anti-epileptics; carbamazepine and phenytoin are the major culprits. We report here a case of SJS due to phenytoin (CTC vs 2 Grade 3).

scholarly journals Phenytoin induced Stevens-Johnson syndrome: a case report

2018 ◽  
Vol 7 (3) ◽  
pp. 573
Author(s):  
Shambhavi Kulkarni ◽  
A. N. Dattatri
Keyword(s):  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare but potentially life threatening cutaneous adverse drug reactions. Drugs commonly implicated are anti-microbials, anti-epileptics and non-steroidal anti-inflammatory drugs (NSAIDs). Amongst anti-epileptics, carbamazepine and phenytoin are the most common offending drugs. We report here a case of SJS due to phenytoin.

Intensive Stuttering Therapy With Telepractice Follow-up: A Case Study

2011 ◽  
Vol 21 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Farzan Irani ◽  
Rodney Gabel
Keyword(s):  
Case Report ◽  
Therapeutic Intervention ◽  
Intensive Therapy ◽  
Positive Outcome ◽  
Eclectic Approach

This case report describes the positive outcome of a therapeutic intervention that integrated an intensive, residential component with follow-up telepractice for a 21 year old male who stutters. This therapy utilized an eclectic approach to intensive therapy in conjunction with a 12-month follow-up via video telepractice. The results indicated that the client benefited from the program as demonstrated by a reduction in percent stuttered syllables, a reduction in stuttering severity, and a change in attitudes and feelings related to stuttering and speaking.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

scholarly journals Fatal case of toxic epidermal necrolysis induced by ciproflfl oxacin in a child

2021 ◽  
Vol 12 (Supp 1) ◽  
pp. 26-29
Author(s):  
Thomas Schiestel
Keyword(s):  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Reactions ◽  
Pediatric Population ◽  
Fatal Case ◽  
Stevens Johnson Syndrome ◽  
Delayed Treatment ◽  
Drug Eruptions ◽  
Johnson Syndrome ◽  
Life Threatening

Bullous drug eruptions such as Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare but known adverse reactions of fluoroquinolones. Although uncommon, TEN can be life-threatening for the patient, especially in the context of delayed treatment and in fragile patients such as the pediatric population. In the present case, TEN occurred in a 13-year-old girl with no medical history following initiation of ciprofloxacin treatment for an inguinal cyst. We hope that the case report will make interrogate the practices concerning the use of antibiotics, in particular fluoroquinolones in the context of an use not prescribed by the Marketing Authorization of the drug in children.

The EMDR DeTUR protocol for the treatment of self-injury in a patient with severe personality disorder: a case report

2019 ◽  
Vol 5 (1) ◽  
pp. 27-38
Author(s):  
Phyllis Annesley ◽  
Adedayo Alabi ◽  
Laura Longdon
Keyword(s):  
Case Report ◽  
Factitious Disorder ◽  
Content Type ◽  
Self Injury ◽  
Life Threatening ◽  
History Of ◽  
Mental Health Difficulties ◽  
Healthcare Interventions ◽  
Therapy Sessions

Purpose The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT). Design/methodology/approach Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation. Findings The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks. Practical implications This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure. Originality/value The case report offers an important contribution to an area that requires much further research.

Identification of Persistent Aortocaval Fistula Using Ultrasonography in the Outpatient Setting: A Case Report

2020 ◽  
Vol 44 (3) ◽  
pp. 150-153
Author(s):  
Richard A. Meena ◽  
Melissa N. Warren ◽  
Thomas E. Reeve ◽  
Olamide Alabi
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Surgical Repair ◽  
Outpatient Setting ◽  
Aortocaval Fistula ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Aortocaval fistula (ACF) is a rare and life-threatening complication associated with rupture of an abdominal aortic aneurysm (rAAA). Early detection and management of ACF’s during surgical repair of rAAAs is recommended to reduce the risk of future aneurysm-related complications, including mortality. There is a paucity of current literature on the natural history of ACFs postendovascular exclusion. We present a case study describing the detection of a persistent ACF by duplex ultrasonography (DU) postendovascular aortic repair (EVAR).

scholarly journals Pattern of adverse drug reactions reported to the regional Pharmacovigilance center at Nepal Medical College and Teaching Hospital, Kathmandu

2012 ◽  
Vol 26 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Durga Bista ◽  
Bal Ram Shrestha ◽  
Prakash Rai ◽  
Akhilesh Chandra Jauhari ◽  
Vishnu Kant Kulshrestha
Keyword(s):  
Adverse Drug Reactions ◽  
Teaching Hospital ◽  
Causality Assessment ◽  
Age Group ◽  
Drug Reactions ◽  
Preliminary Stage ◽  
Medical College ◽  
Probable Relationship ◽  
Pharmacovigilance Center ◽  
Inflammatory Drugs

The Pharmacovigilance program in Nepal is at very preliminary stage. Present study analyzed the pattern, causality, severity and preventability of the reported adverse drug reactions (ADRs) to the Pharmacovigilance center at Nepal Medical College and Teaching Hospital (NMCTH), from June 2007 to July 2011. A total of 40 ADR cases were reported, among which 23 (57.5%) were in males and 17 (42.5%) in females. Nineteen (47.5%) ADRs were reported in the age group between 21-40 years. Department of Medicine reported 12(30%) ADRs. Among the total ADRs, antibiotics [n=17, (42.5%)] were responsible for most of the reactions followed by non steroidal anti-inflammatory drugs [n=5, (12.5%)]. Most of the drugs were found to affect dermatological system [n=14, (35%)]. Carbamazepine accounted for 5 (12.5%) ADRs. The causality assessment showed 34 (85%) of the ADRs to have a ‘probable’ relationship with the suspected reaction.DOI: http://dx.doi.org/10.3126/jnpa.v26i1.6633JNPA. XXVI(1) 2012 54-61

scholarly journals Physician experiences of patient-centered and team- based ward rounding – an interview based case-study

2014 ◽  
Vol 3 (6) ◽  
pp. 127 ◽  
Author(s):  
Fredrik Baathe ◽  
Gunnar Ahlborg Jr ◽  
Annica Lagström ◽  
Lars Edgren ◽  
Kerstin Nilsson
Keyword(s):  
Ward Round ◽  
Structured Interviews ◽  
Patient Centered ◽  
Essential Change ◽  
Positive Experiences ◽  
Ward Rounds ◽  
The Right ◽  
Relationship Of

Background: Rounding has long traditions within hospital-based healthcare, as a way to organize the ward-based part of the care and cure process. Despite an increased emphasis on patient participation, there has been limited research exploring physician experiences of actually applying these principles to the ward round. Aim: To explore physician experiences after changing to a patient-centered and team-based ward round, in an internal medicine department at a Swedish mid-size hospital. Methods: Qualitative exploratory case-study. Semi-structured interviews with 13 physicians (six consultants, three residents, four interns) have been carried out. All interviews have been transcribed and analyzed by qualitative method. Results: The traditional relationship of superiority and subordination, embodied by the patient lying down in bed and the physician standing over the bed, was one essential change in the new ward round. Physicians experienced that less hierarchical relationships with patients, combined with working in a multi-professional team, contributed to better-informed clinical decisions, fewer follow-up questions from patients, and increased professional fulfilment. However, physicians also experienced that their autonomy was being reduced, and there was uneasiness about exposing potential knowledge gaps in front of others. Conclusions: This qualitative study of physician experiences finds that patient-centered and team-based ward rounds is a fertile development journey forward. Also important to notice are the seemingly new and paradoxical findings that despite the introduction of the “right” ward round structure, negative experiences emerged as unwanted side effects to the positive experiences reported. It could be beneficial for leaders in healthcare (both managers and physicians) to consider these results to facilitate future ward round initiatives. 

scholarly journals Use of anterolateral thigh flap for reconstruction of traumatic bilateral hemipelvectomy after major pelvic trauma: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Saleh Al-wageeh ◽  
Faisal Ahmed ◽  
Khalil Al-naggar ◽  
Mohammad Reza Askarpour ◽  
Ebrahim Al-shami
Keyword(s):  
Case Report ◽  
Cause Of Death ◽  
Axial Skeleton ◽  
High Energy ◽  
Pelvic Trauma ◽  
Anterolateral Thigh Flap ◽  
Trauma Patients ◽  
Anterolateral Thigh ◽  
Life Threatening

Abstract Background Major pelvic trauma (MPT) with traumatic hemipelvectomy (THP) is rare, but it is a catastrophic health problem caused by high-energy injury leading to separation of the lower extremity from the axial skeleton, which is associated with a high incidence of intra-abdominal and multi-systemic injuries. THP is generally performed as a lifesaving protocol to return the patient to an active life. Case report A 12-year male patient exposed to major pelvic trauma with bilateral THP survived the trauma and multiple lifesaving operations. The anterolateral thigh flap is the method used for wound reconstruction. The follow-up was ended with colostomy and cystostomy with wheelchair mobilization. To the best of our knowledge, there have been a few bilateral THP reports, and our case is the second one to be successfully treated with an anterolateral thigh flap. Conclusion MPT with THP is the primary cause of death among trauma patients. Life-threatening hemorrhage is the usual cause of death, which is a strong indication for THP to save life.

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