Phenytoin-induced bradycardia and hypotension.

Phenytoin is an anticonvulsant which is also a Class IB antiarrhythmic. Its common adverse drug reactions (ADRs) include gastrointestinal symptoms, psychiatric disorders, gingival hyperplasia, and rash. Bradycardia and hypotension following intravenous (IV) phenytoin are rare ADRs. We report the case of a 62-year-old female with subarachnoid hemorrhage and right bundle branch block, who developed sinus bradycardia and hypotension on administration of IV phenytoin. This case report serves as a note for caution on patient selection for the administration of phenytoin and highlights the need for specific guidelines on the same.

The prevalence, risk factors and awareness of hypertension in an urban population of Kerala (South India).

To determine the prevalence and possible risk factors for hypertension and prehypertensive state in Trivandrum City of Kerala (South India) using Joint National Committee (JNC) VII criteria, a team of trained fourth year medical students conducted a 10% random household survey in certain wards of the City. Households were selected using a random start and interval and all the members above the age of 10 years were interviewed using a standard questionnaire. The blood pressure (BP) was measured twice in each participant and the mean value of the two measurements was taken. A total of 482 individuals (212 males and 270 females) were interviewed in the survey. Overall prevalence of hypertension was 47% (n = 226) with equal sex ratio; 109 (21.6%) had stage-I hypertension, 45 (9.34%) had stage-II hypertension and 72 were taking drug treatment. Only 55 (11.4%) individuals had normal BP, while 201 (41.7%) were prehypertensives. Only 81 (16.8%) hypertensive patients were aware of their disease. Among the parameters such as dietary habits, physical activity, educational standards, salt intake, and diabetes mellitus, only high salt diet (P= 0.03) and diabetes mellitus (P= 0.004) had a significant association with hypertensive state. In conclusion, the prevalence of hypertension is high but the awareness is low in our community, and intervention is necessary to impose control measures and to improve awareness.