Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 26 year old woman who had been taking tranexamic acid to prevent uterine bleeding due to an IUD and who died from thrombosis of the left internal carotid artery is reported. The patient's father had died at age 54 of myocardial infarction. Otherwise the family history was entirely negative for thromboembolic disease. The patient was a mild smoker. She had been previously healthy and in particular, she was not affected with hypertension, diabetes, or dyslipidemia. She had carried to term 2 uncomplicated pregnancies. 40 days prior to hospital admission her gynecologist had inserted an IUD. The insertion of the IUD was followed by persistent uterine bleeding, and for this reason she began treatment with tranexamic acid (1.5 g/daily). Uterine bleeding persisted despite this treatment, and the IUD was removed. Because of persistence of a mild uterine bleeding, tranexamic acid was continued. 2 hours before admission the patient suddenly presented a left sided hemiparesis with disarthria and vomiting. On admission she was stuporous. The left side of her face drooped and the strength of the left arm and leg was markedly decreased. Both arm and leg reflexes were symmetrical. Her blood pressure was 110/70. An electroencephalogram on arrival confirmed a right sided cerebral lesion. Subsequently the patient's condition deteriorated rapidly. She developed a full left hemiplegia and became deeply comatose. A CAT scan performed 4 hours after admission showed no abnormalities. A CAT scan performed 3 days after admission showed a large cerebral infarction involving nearly the whole right cerebral hemisphere. The patient's condition remained essentially unchanged until she died 6 days after admission. Permission for autopsy was refused. Antifibrinolytic drugs competitively inhibit plasminogen activators and noncompetitively plasmin. Thromboembolic complications after the administration of antifibrinolytic drugs have long been recognized. The use of IUDs is often associated with troublesome uterine bleeding and particularly excessive menstrual bleeding. To avoid these complaints, antifibrinolytic drugs are increasingly used.
 ...
PMID:Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report. 710 62

Carnitine is a small water-soluble molecule that is present in almost all animal species. It plays an indispensable role in fatty acid metabolism, where it is involved in the transport of activated fatty acids between different cellular compartments. Uremic patients, as well as patients with chronic renal failure, appear to have abnormal renal handling of carnitine leading to dyslipidemia, lethargy, muscular weakness, hypotension, cardiac dysfunction and arrhythmias, and recurrent cramps. It often is difficult to distinguish these symptoms from similar ones related to uremia and dialysis. Many investigators have advocated L-carnitine supplementation in an attempt to alleviate carnitine deficiencies, and good results from this therapy have been reported. Moreover, several studies have shown that L-carnitine supplementation improves the response to erythropoietin. Chronic inflammation is another particular aspect affecting these patients. Anti-inflammatory properties of L-carnitine in hemodialysis patients have been shown by our group. Treatment with L-carnitine (20 mg/kg, given intravenously at the end of each dialysis session for 6 mo), significantly decreased serum C-reactive protein (CRP) levels, a proinflammatory cytokine known to inhibit erythropoiesis. Moreover, data from published literature are indicative of L-carnitine modulation of the immune system by the activation of glucocorticoid receptors and the modulation of the transcription of glucocorticoid-responsive genes. Our study showed that in these patients, treatment with L-carnitine has been able to improve their body mass index, likely by promoting a positive protein balance. This aspect is strictly correlated with the status of insulin resistance, which is well described in patients with renal diseases. Many studies showed that carnitine allowed mitochondrial fatty acid usage to link to the rate of glucose usage, thus improving insulin resistance. In conclusion, clinical beneficial effects of L-carnitine treatment on patients suffering from renal diseases are supported by molecular evidence involving both inflammatory and metabolic aspects of the disease.
 ...
PMID:Carnitine system in uremic patients: molecular and clinical aspects. 1549 Apr 12

An elevated total or low-density lipoprotein (LDL) cholesterol levels or low levels of high-density lipoprotein (HDL) cholesterol is defined as dyslipidemia which is an important risk factor for coronary artery diseases (CADs) and strokes. It is estimated that abnormal cholesterol levels in the blood lead to cause about 18% of cardio vascular diseases (CVDs) and 56% of the ischemic heart diseases at global level. In comparison with others, South Asians have the highest incidence rate of CADs. Acharya Charaka has mentioned Rukshana Upakrama (a type of management which induces dryness) as one amongst the Shad-Upakrama (six principles of management) and can be considered as the best for the reduction of increased Kapha Dosha, Meda Dhatu (adipose tissue) and their related morbid factors. A 42-year-old female patient visited the OPD of the department of Basic Principles, IPGT and RA, Jamnagar, Gujarat, with the complaints of weight gain, heaviness in the body and lethargy. After investigation, she was diagnosed as a case of dyslipidemia due to abnormality in cholesterol levels. She was treated with Takra-Siddha Yavagu (gruel prepared with buttermilk) and Udvartana (dry powder massage) for 30 days. After completion of treatment, hematological investigations revealed that her serum cholesterol level was decreased to 147 mg/dl from 223 mg/dl and serum LDL was reduced to 91 mg/dl from 153 mg/dl. Her weight also reduced to 82 kgs from 88 kgs. Hence, it can be concluded that Rukshana Upakrama in the form of Takra-Siddha Yavagu and Udvartana is effective in the management of dyslipidemia for normalization of lipid in the blood as it possesses Shoshana (absorption) and Kapha-Medohara (alleviation of vitiated Kapha and Meda) properties.
 ...
PMID:Hypolipidemic effect of Rukshana Upakrama in the management of dyslipidemia - A case study. 3078 60