Acetazolamide-responsive myotonia
A sulfonamide derivative with diuretic, antiglaucoma, and anticonvulsant properties. Acetazolamide is a non-competitive inhibitor of carbonic anhydrase, an enzyme found in cells in the proximal tube of the kidney, the eye, and glial cells. Inhibition of this enzyme in the kidney prevents excretion of hydrogen, leading to increased bicarbonate and cation excretion and increased urinary volume, which results in an alkaline diuresis. Acetazolamide reduces the concentration of bicarbonate, resulting in a decreased synthesis of aqueous humor in the eye, thereby lowering intraocular pressure. Although its mechanism of action is unknown, acetazolamide has anti-convulsant properties resulting from indirect effects secondary to metabolic acidosis or direct effects on neuronal transmission. Acetazolamide also produces respiratory stimulant effects in response to changes to both carbon dioxide and oxygen tension levels within the lungs.
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Pharma standards body Indian Pharmacopoeia Commission (IPC) has issued an alert over some commonly used medicines as they trigger adverse reactions. Commonly-used painkiller "Nimesulide" & antibiotic "Cefuroxime" can lead to serious skin disorders. In your practice and observation, have you noticed any such adverse reactions in patients in recent times?
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Epididymal cysts are fluid filled sacs that develop in the Epididymis. They occur for a number of reasons but are always benign and generally cause mild discomfort only. Dr. Vivek Jha is sharing a clinical case of "Epididymal cyst" managed with surgical expertise by him. Share your views on the case & learn new things.
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Dear doctor friends, Kindly suggest Rx. Female /55 years Diabetic Suffering from GANGRENE RIGHT FOOT *Chief Complaints* Swelling over right foot Bleeding from wound No pus Wound Not getting good *History* Diabetic type 2 *Vitals* PPS 180 BP 120/84 *Physical Examination* Deep bleeding wound but no pus *Investigations* The sonography report is attached *Diagnosis* Gangrene right feet, skin so thickened *Management* Regular dressing, controlled blood sugar, strictly following diet control
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Pneumothorax is air around or outside the lung. It may result from chest trauma, excess pressure on the lungs or a lung disease, such as COPD, cystic fibrosis, TB, Asthma etc. Correct interpretation of chest X-ray in this clinical setting & knowledge of when to request more complex imaging techniques are essential. In this learning series, we discuss the role of the chest X-Ray in the assessment of pneumothorax along with the value of CT scan. Learn & update your basic radiological approach for “Pneumothorax” & interpretation knowledge & patient care approach with this post.
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Secondary hypertension often affects younger patients & those with resistant or refractory hypertension. Identifying the underlying cause of secondary hypertension may lead to successful intervention with the potential to improve quality of life & reduce cardiovascular morbidity and mortality. Dr. Sanjay Jain is sharing a clinical case of “Secondary Hypertension - Pheochromocytoma management”. Share your views on the case.
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