Calcium ions play an important role in the contractility of cardiac muscle. Severe extracellular hypocalcaemia impairs cardiac contractility and results in ventricular dysfunction known as hypocalcemia induced cardiomyopathy. Hypocalcemia induced cardiomyopathy after total thyroidectomy is rare with only few cases reported in the literature. We report a case of post thyroidectomy Hypocalcaemia induced cardiomyopathy in a 45 years old lady who was successfully treated with calcium and vitamin D supplement with complete recovery of her left ventricular function.

Objective — Rapid cycle bipolar disorder may be more resistant to treatment than other bipolar types. However, the effect of the combined use of carbamazepine and lithium in the treatment of outpatients with rapid cycle bipolar disorder without psychiatric comorbidity has not been studied in a double-blind placebo-controlled design. The study periods: from January 1, 2016 to January 2019. Patients were observed at the Mental Health Center of the Ministry of Health of the Republic of Azerbaijan. Materials and methods —Eligible participants to meeting the DSM-5criteria for rapid cycle bipolar disorder was a double-blind, placebo-controlled trial, were required to be between 18 and 65 years. Response and side effects with carbamazepine and lithium and placebo were compared by using analysis of variance (ANOVA) and chi-square tests. The responder was con­ducted by X2 ademonstrated superior for carbamazepine and lithium than for placebo. Carbamazepine and lithium was generally well tolerated by the patients in the study, although more carbamazepine and lithium -treated patients (n = 2) discontinued the study early because of adverse events. Results — Twenty seven of the 36 combined use of carbamazepine and lithium -treated participants responded by 12 weeks, versus six of the 38 placebo-treated participant! (p < 0.001). The responder was con­ducted by X2 demonstrated superior for carbamazepine and lithium than for placebo. Common side effects leading to discontinuation in the carbamazepine and lithium group were allergic reaction and drowsiness. Sweating and headache frequent complaint dur­ing placebo treatment occurred in two of 38 men. There were not unexpected or serious adverse events. Conclusions — The combined use of carbamazepine and lithium in the treatment of outpatients with Rapid cycle bipolar disorder demonstrated superior for carbamazepine and lithium than for placebo.