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Showing posts from October, 2017

Azithromycin with Statins causes severe rhabdomyolysis leading to acute renal failure

Azithromycin a widely used broad-spectrum antibiotic used to treat community-acquired pneumonia or respiratory tract infections. It is observed that azithromycin if given with statins, may cause severe rhabdomyolysis which may lead to an acute renal shutdown. A case reported by Dr Gaurav Alreja shows a possible interaction of azithromycin with simvastatin, A 73 years old male who was given azithromycin for bronchitis, he was taking simvastatin. He presented in emergency with the acute weakness of all extremities, he was found to have abnormal renal function tests with elevated creatinine. Simvastatin was stopped, and he was started on supportive management, bicarbonate was replaced, his renal function improved, and two months later he was again started on simvastatin without recurrence of symptoms. This gives us an indication that probably the azithromycin was responsible for the acute severe rhabdomyolysis and resultant acute renal failure when was given along with the statin. So

Testosterone replacement in Elderly, Benefits

Testosterone is an androgen, responsible for the masculinity in males. It is responsible for the development of secondary sexual characteristics in males, it increases libido, promote the growth of muscles and bones and improves mood and behaviour. The testosterone level in the blood reaches its peak at the age of 20 and with the passage of time it gradually decreases and by the age of 80, its level reaches 10 - 20 % of testosterone level at age 20. Studies showed that testosterone replacement in elderly, not only improves sexual function, but also prevents osteoporosis, improves cognitive function and overall health of the elderly individual. In a study published in New England Journal of Medicine on Feb 24th, 2016, 790 men with serum testosterone level less than 275ng/dl were given testosterone and their testosterone level was maintained at a mid-normal range for age 20-40. By the end of 12 months, it was observed that libido and erectile function was improved, as well as patie

Difference Between Direct and Indirect Coomb's test - Dr. Adil Ramzan

Coomb's test is very helpful in making a diagnosis of hemolytic anemia. Once a patient is found to have anemia, with raised bilirubin and raised retic count, hemolysis becomes the most likely possibility. Coomb's test is of two types. 1. Direct Coomb's test 2. Indirect Coomb's test. Direct Coomb's test: In case of direct Coomb's test, patient's RBC's are washed clear of plasma and are mixed with Coomb's serum (antihuman globulins), if agglutination occurs, it means the Direct Coomb's test is positive. If the direct Coomb's test is positive it means the patient has autoimmune hemolytic anemia. Indirect Coomb's test.  In indirect Coomb's test, the patient's serum is taken instead of RBCs and this serum is then mixed and incubated with RBCs with a known antigen if the patient's serum contains antibodies against the RBCs antigens then antibody-antigens complexes are formed, then coombs serum is added to the sample, if