Valproic acid is commonly used in the treatment of both focal and generalized epilepsies and is often tolerated well. Valproic acid is usually tolerated well, but serious complications, including hepatotoxicity and hyperammonemic encephalopathy, may occur. Here, we report a case of valproic acidinduced hyperammonemic encephalopathy on concomitant use with lacosamide.
Hydroxyurea is an anti cancer chemotherapeutic drug .For high risk patients of essential thromocytosis (ET) , interferon and hydroxyurea are available agents in India to reduce their platelet count .Interferon is not an attractive agent due to its parentral mode of delivery and systemic side effects. Here, we aim to evaluate the efficacy of hydroxyurea in these subset of patients to normalize their platelet counts.This Retrospective study was conducted in the department of medical oncology and hematology at Amrita institute of medical science. We collected the data by reviewing the electronic medical records of the patients with ET in which 23 patients were seen to be at high risk for thrombotic events ,Out of these 23 high risk patients 17 were females and 6 were males and belonged to the mean age of 55.17 years.We found that 37.5 % showed complete response, 41.67 % showed partial response and 16.67 % showed no response. From this study we could observe that only 80% of patients benefited from hydroxyurea therapy and there is unmet need for an oral cytoreductive agent with good safety profile in ET .
ABS019
ITP is a bleeding disorder which is not associated by a systemic disease caused by low platelet count or thrombocytes. However, use of dapsone is limited by adverse effects such as methemoglobinemia, reticulocyte increase, hemolysis, hemoglobin decrease, red cell life span shortened, agranulocytosis, anemia, leukopenia, and pure red cell aplasia. This report relates to an incident to methemoglobinemia after administration of dapsone as the second line agent for treatment of ITP in a tertiary care hospital. A 46-year-old male, with a case of immune thrombocytopenia and a family history of aplastic anemia in mother. Now presented with high grade fever associated with generalized weakness, cough with expectoration and shortness of breath and decreased urine output. He was admitted for further management. Initial laboratory investigations were done. Blood and urine cultures were sent. His arterial blood gas showed elevated methemoglobin (18.2). Peripheral smear revealed microcytic hypochromic anemia with polychromatophils, microspherocytes, and relative neutrophilia. Urine culture showed Escherichia coli and blood culture was sterile. Serum electrolytes were sent. He had elevated international normalized ratio (INR) value (5.93). Warfarin and dapsone were withheld.
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