1.Cardiac arrhythmia triggered by diureticinduced hyponatremia
Hou Tee Lu ; Hou Chan Loo ; Kian Seng Ng ; Yin Onn Wong ; Rusli Bin Nordin
Malaysian Family Physician 2019;14(2):39-43
Diuretics have a long and distinguished history in the treatment of hypertension and heart failure.
Clinical practice guidelines recommend that diuretics should be considered to be as suitable as
other antihypertensive agents for the initiation and maintenance of antihypertensive treatment.
However, diuretics may potentially cause electrolyte disturbances and metabolic side effects.
Diuretic-induced hyponatremia is probably more prevalent than generally acknowledged. We
present an unusual case of indapamide-induced hyponatremia and hypokalemia complicated by
cardiac arrhythmia. The adverse drug reaction was reversible and non-life-threatening, but this case
serves as a reminder that careful evaluation and constant monitoring are necessary when prescribing
diuretics.
3.Association between lung compliance phenotypes and mortality in COVID-19 patients with acute respiratory distress syndrome.
Ser Hon PUAH ; Matthew Edward COVE ; Jason PHUA ; Amit KANSAL ; Jonathen VENKATACHALAM ; Vui Kian HO ; Duu Wen SEWA ; Roshni Sadashiv GOKHALE ; Mei Fong LIEW ; Benjamin Choon Heng HO ; Jensen Jiansheng NG ; John A ABISHEGANADEN ; Yee Sin LEO ; Barnaby Edward YOUNG ; David Chien LYE ; Tsin Wen YEO
Annals of the Academy of Medicine, Singapore 2021;50(9):686-694
INTRODUCTION:
Acute respiratory distress syndrome (ARDS) in COVID-19 is associated with a high mortality rate, though outcomes of the different lung compliance phenotypes are unclear. We aimed to measure lung compliance and examine other factors associated with mortality in COVID-19 patients with ARDS.
METHODS:
Adult patients with COVID-19 ARDS who required invasive mechanical ventilation at 8 hospitals in Singapore were prospectively enrolled. Factors associated with both mortality and differences between high (<40mL/cm H
RESULTS:
A total of 102 patients with COVID-19 who required invasive mechanical ventilation were analysed; 15 (14.7%) did not survive. Non-survivors were older (median 70 years, interquartile range [IQR] 67-75 versus median 61 years, IQR 52-66;
CONCLUSION
COVID-19 ARDS patients with higher compliance on the day of intubation and a longitudinal decrease over time had a higher risk of death.
COVID-19
;
Humans
;
Lung Compliance
;
Phenotype
;
Respiratory Distress Syndrome/therapy*
;
SARS-CoV-2
4.Fatal subarachnoid haemorrhage in a patient with severe dengue
Seng Wee Cheo ; Qin Jian Low ; Eng Kian Ng ; Yuen Kang Chia ; Giri Shan Rajahram
The Medical Journal of Malaysia 2021;76(1):107-109
Dengue fever is one of the commonest tropical disease in
the tropics. It can present with mild acute febrile illness to
severe organ failure. Reported neurological complications
of dengue include dengue encephalopathy, encephalitis,
transverse myelitis and intracranial haemorrhage.
Intracranial haemorrhage in dengue can present as subdural
haematoma, extradural haematoma, intracerebral
haemorrhage and subarachnoid haemorrhage. We report
here a case of subarachnoid haemorrhage in a patient with
severe dengue. Our patient was a 30-year-old man who
presented with acute febrile illness. He subsequently
developed plasma leakage and upper gastrointestinal
bleeding. He then had reduced conscious level. Computed
tomography of his brain showed subarachnoid
haemorrhage. He eventually succumbed to his illness.