RESUMEN
Across the globe, snake envenomation causes significant morbidity and mortality. Although many clinical presentations and complications are observed in different types of snake bites, the incidence of leukoencephalopathy is rare. Although most cases of leukoencephalopathy are seen in viper bites, they are rarely seen in neurotoxic snake bites. In this report, we present a unique case of snake bite-induced leukoencephalopathy following a neurotoxic snake bite. The case highlights the importance of considering this rare complication in cases of snake bites presenting with neurological symptoms, particularly in those affecting higher mental functions.
RESUMEN
Much has been written about the well-being and quality of patients in recent years but little attention has been focused on well-being of healthcare workers (HCWs) who provide comprehensive healthcare to patients. It has been found that the HCWs are more stressed because of less staffs, increasing work load, longer working hours, high clientele expectation and peculiar problems and hazards of work place. There is increased morbidity in HCWs in comparison to general population. Though they are aware, measures of well being, engaging the HCWs in promotion of their workplace and making changes to enhance its realization needs to be done to improve their health by themselves, at administrative and institutional level.
RESUMEN
CONTEXT: Literature is replete with studies on zidovudine-induced myopathy after prolonged use (use beyond 270 days on an average). However, all these studies have been done on patients of Caucasian, American and African ethnic origin. No such study has been carried out in Indian patients to our knowledge. AIMS: To determine the correlation of zidovudine usage with serum creatine phosphokinase (CK) levels, clinical muscular weakness and muscle histology in Indian patients, we studied 147 physically active, Human Immunodeficiency Virus infected men on prolonged zidovudine-based antiretroviral therapy (ART). SETTINGS AND DESIGN: Cross-sectional study on hospital follow-up patients of HIV infection. MATERIALS AND METHODS: All cases on ART who reported to our canter during a period of 18 months were evaluated for symptoms (muscle fatigue, myalgia), objective muscle strength (testing clinically) and serum CK levels, and a select group was evaluated by muscle biopsy. These patients were on zidovudine for 1 to 7 years. RESULTS: None of the patients studied had significant symptoms or objective muscle weakness and only a small fraction (10.8% of cases) had marginally raised serum CK levels. All muscle biopsies were normal on light microscopy. CONCLUSIONS: Zidovudine myopathy may be a constraint for use of the drug in the western population; however, it is a well-tolerated drug as regards myopathy in our study on Indian patients.