This case emphasizes the value of meticulous observation and regular follow-up of patients receiving rifampicin therapy. The prognosis for complete improvement in renal function in such cases was excellent, with prompt recognition and discontinuation of rifampicin. Teaching patients about these possible adverse effects and encouraging immediate reporting of signs and symptoms are likely to be beneficial because acute kidney injury can manifest itself very quickly after rifampicin is started. Even if renal failure can happen with any dose of rifampicin, primary physicians must have awareness about patients on intermittent or irregular therapy and those who have previously used this medication. It is challenging to determine the prevalence of adverse reactions to common antibiotics where a state- or country-wide reporting system is absent. Along with withdrawal of the causative agent patients were treated with corticosteroids (0.5–1 mg/kg/day) for an average period of 4–12 weeks showing significant recovery of renal function.
Introduction: Very low-dose prophylaxis of antihemophilic factor (AHF) in hemophilia involves administration of minimal amounts of clotting factor concentrates, typically below standard doses, to maintain baseline levels and reduce bleeding episodes. This method uses smaller, more frequent doses to balance bleeding prevention and cost-effectiveness. Close monitoring ensures adequate protection while avoiding overtreatment, offering a tailored, cost-effective approach to improve the quality of life (QoL) of the hemophiliacs.
Aim: The study aims to study the bleeding risks in patients with severe hemophilia who are on very low-dose AHF prophylaxis. It also seeks to assess the annual consumption of AHF in the hemophiliacs. In addition, the research will determine the QoL in both groups using the social functioning (SF)-36 questionnaire,evaluate patient compliance with the prophylactic regimen, and check functional disability using the Functional Independence Score in Hemophilia (FISH).
Materials and methods: The patients selected for the study were diagnosed with cases of hemophilia and were planned for any surgical procedure. The study was a cross-sectional study lasting 12 months. Patients over 13 years were included and patients with any other bleeding tendencies were excluded from the study.
Results: The differences found in the study, were significant in terms of annual bleed rate (ABR), amount of AHF consumed, SF-36, and FISH scores.
Conclusion: Our study found that very low-dose prophylaxis significantly reduced the ABR in hemophilia patients. Functional independence worsened in the control group but remained stable in the test group, which showed significant improvements in SF-36 domains. The test group had no inhibitor development and showed a decline in severe bleeds, proving the efficacy and superiority of low-dose prophylaxis over on-demand therapy.
Abstract: Metformin, an insulin-sensitizer, is used in the treatment of polycystic ovarian syndrome (PCOS) in obese women as it helps in weight loss and regularizes the menstrual cycle. However, impaired absorption of Vitamin B12 due to metformin has also been hypothesized. Here, we report the case of a 39-year-old woman prescribed metformin for PCOS, presenting with an unusual symptom of eyelid myokymia. She developed distressing unilateral eyelid twitching, not responsive to conservative management or oral methylcobalamin. She was a nonsmoker, nonalcoholic, and nor caffeine-abuser. Other confounding factors such as stress, sleep deprivation, or eye strain were not evident. The only significant finding was borderline low Vitamin B12 levels. The symptoms subsided on discontinuation of metformin and reappeared when metformin was reintroduced. Although eyelid myokymia is a self-limiting benign condition, it can also be triggered by drugs and affect the quality of life. Practitioners should monitor Vitamin B12 levels during metformin therapy to prevent adverse effects.
Background: Long-term metabolic disease type 2 diabetes mellitus (T2DM) is distinguished by elevated blood glucose, insulin resistance, and drought of insulin with dyslipidemia. Oral hypoglycemic agents lower blood glucose levels as well as prevent both short-term and long-term complications such as micro/macrovascular atherosclerosis, chronic kidney diseases, and chronic heart disease. This study aims to compare the effect of glimepiride versus teneligliptin in combination with metformin in T2DM patients attending a tertiary care hospital.
Materials and methods: This prospective, randomized, open-label study was initiated in a tertiary care hospital after obtaining IEC approval. Written informed consent was obtained. The sample size was calculated using "Statistics and sample size software." Ninety-seven patients satisfying the inclusion criteria were assigned to two groups using simple randomization with allocation 1:1. Group A received metformin + glimepiride while Group B received metformin + teneligliptin for 12 weeks. Fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1c), and lipid profile were recorded at the baseline and at the end of 12 weeks. This study was conducted for 1 year. Data were analyzed using SPSS version 23.0 software.
Results: Out of 97 participants (Group A: 48 and Group B: 49), Group A showed a higher reduction in FBS (48.18 ± 9.64) whereas Group B showed 72.53 ± 5.01, 1.74 ± 0.42 of change in PPBS and HbA1c after 12 weeks.
Conclusion: The study found that combining metformin with teneligliptin was better tolerated and improved glycemic control and lipid profile compared to metformin plus glimepiride.