Takotsubo cardiomyopathy: a rare complication of acute viral gastroenteritis.

Takotsubo Cardiomyopathy (TCM) is characterized by a transient but reversible ventricular dysfunction in post-menopausal females following, but not always, a recent emotional or physical stress. Typically, chest pain is reported as a presenting symptom in the majority of patients. The severe diarrheal illness secondary to acute viral gastroenteritis is not commonly reported as the stressor event prior to TCM.

Helicobacter pylori: An Underrated Cause of Immune Thrombocytopenic Purpura. A Comprehensive Review.

Idiopathic thrombocytopenic purpura (ITP) is the autoimmune-mediated destruction of platelets. ITP is a diagnosis of exclusion after other identifiable etiologies have been ruled out. After the first report by Gasbarrini et al.

Hydrocortisone Reduces 28-day Mortality in Septic Patients: A Systemic Review and Meta-analysis.

The goal of this study was to determine the utility of hydrocortisone in septic shock and its effect on mortality. We performed a systematic search from inception until March 01, 2018, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines comparing hydrocortisone to placebo in septic shock patients and selected studies according to our pre-defined inclusion and exclusion criteria. Four reviewers extracted data into the predefined tables in the Microsoft Excel (Microsoft Corp.

Methotrexate and doxycycline interaction: a rare cause of pancytopenia.

Methotrexate (MTX) was originally formulated as one of the first antitumour drugs due to its ability to alter folate metabolism, which renders it to be an antiproliferative agent. Classically, the higher dosage is administered via parenteral route, in a cyclical fashion, to achieve antitumour effects. Patients on high doses of MTX are prone to develop rare complications of myelosuppression and pancytopenia, in a dose-dependent fashion, secondary to altered folate metabolism.

A Late Presentation of Substance-related Rhabdomyolysis with Normal Serum Creatine Kinase Levels and Complicated with Acute Tubular Necrosis.

Substance abusers are at increased risk of acute kidney injury (AKI) compared to the general population due to nontraumatic rhabdomyolysis. The primary target of these nephrotoxic agents is the tubulointerstitial compartment and the most frequent findings on biopsy are consistent with acute tubular necrosis (ATN) and acute interstitial nephritis. We present a rare case of an intravenous cocaine and heroin abuser who presented with recent onset oliguria, hematuria, and reduced peroral intake.

"Takotsubo cardiomyopathy presenting with QT prolongation: an atypical presentation.".

Takotasubo Cardiomyopathy (TCM), also known as broken heart syndrome, is a syndrome of transient and reversible cardiac dysfunction in the absence of obstructive coronary artery disease following an unpleasant emotional event. TCM commonly presents as chest pain mimicking acute coronary syndrome (ACS) in character. The most common electrocardiogram (EKG) findings associated with TCM are ST-segment elevation or T wave inversion.

Is ivabradine a wonder drug for atypical POTS?

Syncope is a sudden loss and gain of consciousness. Traditionally, it is caused by the abnormalities of neurological, cardiac or vasovagal systems. We present a case of a 19-year-old woman presenting with recurrent syncopal episodes with no apparent cause.

Transient Systolic Anterior Motion of the Anterior Mitral Valve Leaflet in a Critical Care Patient with a Structurally Normal Heart.

Systolic anterior motion (SAM) is defined as the displacement of the anterior mitral leaflet towards the left ventricular outflow tract, which results in left ventricular outflow tract obstruction (LVOTO). The SAM of the anterior mitral leaflet is a well-established phenomenon in hypertrophic obstructive cardiomyopathy (HOCM), but its occurrence in a structurally healthy heart is uncommon. We present a critical care patient with presumed septic shock whose blood pressure was previously controlled by fluid resuscitation and vasopressors.

Clot Mayhem: A Case of May-Thurner Syndrome.

May-Thurner syndrome (MTS), also known as the iliac vein compression syndrome, is an anatomic anomaly in which the compression of the left common iliac vein by an overlying right common iliac artery leads to blood stasis, which predisposes to deep venous thrombosis (DVT) in the iliofemoral venous system. We present a case of a female with a history of DVT and currently on warfarin with a therapeutic international normalized ratio (INR), admitted with left leg swelling, redness, and intractable pain. Venous Doppler scan confirmed a massive DVT from the level of the left common femoral vein to the popliteal vein.

Garbled speech: a rare presentation of metronidazole-induced neurotoxicity.

Neurotoxicity is a rare but significant side effect of metronidazole. We present, here, a case of a 34-year-old man, presenting with garbled speech and word finding difficulty. He was taking metronidazole for the last 3 months for stage 4 decubitus ulcers.

Thyroxine-induced periodic paralysis: a rare complication of nutritional supplements.

The consumption of daily nutritional supplements has risen dramatically all over the world. Many people believe that dietary supplements, if not useful, are at least safe to fulfil small dietary gaps. Many nutritional supplements have not been approved by Federal Drug Administration due to their unregulated active ingredients, but they are available as over the counter.

Double Trouble - Severe Hypernatremia Secondary to Central Diabetes Insipidus Complicated by Hypercalcemic Nephrogenic Diabetes Insipidus: A Case Report.

BACKGROUND Patients with malignancies often have electrolyte abnormalities. We present a case of a patient with central diabetes insipidus secondary to metastatic pituitary invasion complicated by hypercalcemic nephrogenic diabetes insipidus. CASE REPORT We present a case of 40-year-old female with a history of stage IV breast cancer with skeletal and leptomeningeal metastasis, who was admitted with polyuria, polydipsia, and recent onset of confusion.