Unmasking the Hidden Threat of Cardiac Involvement in Dengue Fever: A Critical Longitudinal Study.

INTRODUCTION: Dengue fever (DF) arises from the dengue virus (DENV), a common viral illness transmitted by arthropods. This medical condition has the potential to result in severe complications, including but not limited to liver failure, disseminated intravascular coagulation, dengue encephalopathy, myocarditis, acute renal failure, and hemolytic uremic syndrome. Evaluating cardiac manifestations in dengue is crucial for timely intervention and intensive care to save patients' lives. MATERIALS AND METHODS: A longitudinal study involved 104 dengue fever patients admitted to the Department of Medicine at New Civil Hospital, Surat, between May 2021 and October 2021, to identify potential cardiac involvement. RESULTS: The study found that out of the 104 patients, 28 (26.92%) showed cardiac involvement based on clinical manifestations. Among these patients, 28 (26.92%) exhibited abnormal ECG results, and 39 (37.50%) showed elevated creatine kinase-MB (CK-MB) levels. Of the 28 patients who showed ECG changes, 14 (50%) displayed abnormal 2D-echocardiography (ECHO) results. The most common electrocardiographic anomaly was a T-wave inversion in V1-V4. The predominant 2D-ECHO finding was mild pericardial effusion. CONCLUSION: Cardiac involvement in dengue presents atypically and can lead to conditions like myocarditis, arrhythmias, cardiac failure, or shock. Assessing cardiac manifestations in dengue patients is pivotal for appropriate management.

Acid Reflux: A Rare Adverse Effect of Duloxetine.

Duloxetine is a medication that belongs to the serotonin and norepinephrine reuptake inhibitor (SNRI) class of drugs and is commonly used to treat various conditions, such as depression, generalized anxiety disorder, neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. While side effects, such as headaches, constipation, dry mouth, dizziness, and blurred vision, are commonly associated with duloxetine, we present a case of a 59-year-old woman who experienced a rare adverse event of acid reflux while taking a 30 mg dose of duloxetine for fibromyalgia. According to the available literature, this adverse event has been reported in only 1.38% of the population.