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Introduction and importance: While 14-day triple therapy with clarithromycin is a common approach for eradicating Helicobacter pylori infection, it is essential to note that this treatment does not come without potential side effects. Case presentation: We present the case of a 34-year-old male who presented to the emergency department with severe vomiting and abdominal pain. Subsequent evaluation revealed that the patient had developed drug-induced liver injury (DILI). Clinical discussion: DILI can cause acute hepatocellular or cholestatic damage, and chronic injury can lead to hepatocellular, cholestatic, vascular, or neoplastic manifestations. Conclusion: Clinicians should exercise caution and be alert to the potential hepatotoxic effects of medications, especially when initiating triple therapy for H. pylori infection.
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Key Clinical Message: Neurogenic fever (NF) is a potentially life-threatening complication commonly seen in patients with pontine hemorrhage. This case report highlights the successful use of oral baclofen and propranolol as an effective treatment strategy to manage NF. Abstract: Neurogenic fever (NF) is a common complication following pontine hemorrhage and poses significant challenges for clinicians in terms of diagnosis, management, and patient outcomes. This study delves into the efficacy of treatment methods involving baclofen and propranolol for neurogenic fever in patients with pontine hemorrhage. The results demonstrated a significant reduction in the duration and intensity of fever. Moreover, the treatment modality was well-tolerated and devoid of any adverse effects. These findings suggest that the use of oral baclofen and propranolol may be a promising therapeutic option for managing neurogenic fever in patients with pontine hemorrhage.
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Rheumatic heart disease results from the damage to heart valves caused by one or more episodes of rheumatic fever leading to a variety of cardiac complications. Although less common in developed parts of the world, it is one of the most common acquired heart diseases in low- and middle-income countries including Nepal, affecting children and young people. Primary prevention with prompt treatment of streptococcal throat infections and long-term secondary antibiotic prophylaxis with benzathine penicillin G are the key intervention strategies. Echocardiography based screening in schoolchildren has become an effective measure for early identification of the cases. More coordinated policies and effective interventions are needed to successfully decrease the burden of the rheumatic heart disease in resource limited settings like Nepal.
