Cerebral venous sinus thrombosis [CVST] is often an infrequent cause of neurological dysfunction resulting in admissions in Intensive care units [ICU]. Because of its myriad presentation it may be under diagnosed. Unfractionated Heparin [UFH] has been advocated in treatment but needs frequent monitoring. We studied the clinical profile of patients of cerebral venous sinus thrombosis, use of low molecular weight heparin [LMWH] with emphasis on safety in 64 patients of CVST.
Objective: To describe phenytoin-induced rare hypersensitivity and dose related reactions, emphasizing the importance of early omission of drug to achieve clinical improvement. Design: Case series and review of literature. Setting: Tertiary level medical intensive care unit. Patients: Three cases, two of whom had hypersensitivity reactions and the third had drug-induced dyskinesia. Intervention: Omission of phenytoin and corticosteroid therapy in two cases. Results: Improvement and discharge. Conclusion: A high index of suspicion of drug-induced complications is necessary especially when multiple drugs are being administered to critically ill patients.
Objective: We present a rare case of survival following inhalation of nitric acid fumes and its decomposi tion products, which resulted in severe pulmonary edema and Acute Respiratory Distress Syndrome (ARDS). Successful outcome followed ventilatory support and use of steroids. Design: Case report. Setting: Terti ary-level medical intensive care unit. Patient: A single case of inhalation of nitric oxide fumes. Interven tion: Ventilatory support and addition of steroids. Measurement and main results: Improvement and discharge. Conclusion: Inhalation of nitric acid fumes and its decomposition gases such as nitrogen diox ide results in delayed onset of severe pulmonary edema deteriorating into ARDS. Intensive respiratory management, ventilatory support, and steroids can help in survival.
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