A Avinash

A Rare Case of Tamoxifen-Induced Thrombocytopenia

Breast cancer is a commonly encountered cancer in women. Tamoxifen is a frequently used drug in breast cancer. It is a selective estrogen receptor modulator (SERM). It is used for both chemoprevention and for palliative care in these patients. Drug-induced thrombocytopenia is a common diagnosis these days. Moreover, this condition can be life threatening or even fatal. It can either be due to increased platelet destruction or reduced formation. Either way, early diagnosis followed by discontinuation of the offending agent is the key to successful management. Here, we present a rare case of tamoxifen-induced thrombocytopenia.

A rare instance of levofloxacin induced myoclonus

Levofloxacin is a widely used fluoroquinolone, mainly as a respiratory antimicrobial agent. It is employed as a second line therapeutic modality in pulmonary tuberculosis as well. The drug has been in use for ages, and is known to be both efficacious and safe. However, it is not free of adverse effects. The most dangerous ones are those involving the Central Nervous System (CNS). Although rare, levofloxacin can cause involuntary movements like chorea and myoclonus. Here by, we present a case of an elderly male patient who developed reversible myoclonus/chorea after a course of levofloxacin (which was initiated as part of his anti-tubercular therapy) following the development of peripheral neuropathy secondary to isoniazid.

A Case of Accidental Formic Acid Poisoning

Formic acid is a commonly available compound, available commercially for the purpose of coagulating rubber. It is a highly corrosive agent. Consumption of this pungent liquid has resulted in dire consequences, based on the available literature. There have been a few reports of accidental/suicidal consumption of formic acid in the past. This is one such case report of an accidental poisoning with formic acid, with successful management and recovery.

Cefoperazone: A Rare Cause of Thrombocytopenia

Beta lactam antibiotics are one of the most commonly prescribed antibiotic drug classes in medical practice. Cephalosporins differ from other beta lactam antibiotics in both their structure and spectrum of action. Beta lactam antibiotics, in general, may cause platelet deficiency owing to their interference with normal platelet function. Cefoperazone, belonging to the group of 3rd generation cephalosporins, has been reported to cause hypoprothrombinemia and hence, bleeding manifestations. However, it is not known to alter platelet function and count at the routinely used therapeutic doses. This case report highlights a rare case of cefoperazone-induced thrombocytopenia.

Echocardiographic abnormalities in cirrhosis & their correlation with severity of cirrhosis using Child-Pugh score among patients in a tertiary care hospital

Background & objectives: Child-Pugh score (CPS) is a widely used prognostic marker in cases of cirrhosis and pulmonary arterial hypertension (PAH). However, the role of this score in the quantification of severity of PAH is not well studied. In mild cases, echocardiography is more sensitive. This study was done to assess the association between echocardiography and severity of cirrhosis using CPS. Methods: A cross-sectional study was done from April to June 2014 in 42 patients with cirrhosis using a pre-tested semi-structured interview schedule. Results: There was no significant association between echocardiographic changes and CPS in patients with liver cirrhosis. Interpretation & conclusions: Advising an echocardiographic evaluation may prove beneficial in patients of Child-Pugh Grades B and C. However, more extensive studies are required to confirm the same.