Many drugs are implicated in causation of disulfiram-like reaction. The disulfiram-like reaction can vary in severity and can occasionally be fatal. The reaction is believed to result from inhibition of metabolism of acetaldehyde to acetate by inhibition of aldehyde dehydrogenase. The increase in serum acetaldehyde results in unpleasant clinical manifestations. Metronidazole is known to cause disulfiram-like reaction. Although no previous report has implicated ornidazole in causation of disulfiram-like reaction, caution has been advised with the use of all imidazoles. We report the case of a 48-year-old male, who was taking ornidazole and developed features of disulfiram-like reaction after taking alcohol. The patient was managed with supportive measures and improved. The report highlights the need for clinicians to advise patients to restrict intake of alcohol if they are being prescribed imidazole derivatives.
Placenta is an organ that is responsible for nourishing and protecting the fetus during pregnancy. Histologic examination of the placenta can yield significant information about pre-uterine and uterine conditions affecting fetal growth. Chorangiosis is defined as the presence of ≥10 terminal villi, each containing ≥10 capillaries per terminal villus in ≥10 low power (×10) fields in at least 3 or more random, non-infarcted cotyledons of the placenta. Chorangiosis is an adaptive response to in-utero hypoxia and its presence signifies better pregnancy outcomes. Abnormalities that lead to multiple cord vessels are rare with the majority of reported cases highlighting four vessels due to a persistent right umbilical vein. We report here a case of chorangiosis of placenta associated with a rare 5-vessel umbilical cord and omphalomesenteric duct remnant. To the best of our knowledge, this is the first case report to document such an association.
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