scholarly journals Organophosphorus Poisoning

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Buddhi Prasad Paudyal
Keyword(s):  
Signs And Symptoms ◽  
Clinical Problem ◽  
Acute Poisoning ◽  
The Body ◽  
Organophosphorus Insecticides ◽  
Basic Principles ◽  
Initial Management ◽  
Organophosphorus Poisoning ◽  
Life Threatening ◽  
History Of

Acute poisoning by organophosphorus (OP) compounds is a major global clinical problem, withthousands of deaths occurring every year. Most of these pesticide poisoning and subsequentdeaths occur in developing countries following a deliberate self ingestion of the poison. Metacid(Methyl parathion) and Nuvan (Dichlorovos) are commonly ingested OP pesticides; Dimethoate,Profenofos, and Chlorpyrifos are other less frequently ingested compounds in Nepal. The toxicityof these OP pesticides is due to the irreversible inhibition of acetylcholinesterase (AChE) enzymeleading to accumulation of acetylcholine and subsequent over-activation of cholinergic receptorsin various parts of the body. Acutely, these patients present with cholinergic crisis; intermediatesyndrome and delayed polyneuropathy are other sequel of this form of poisoning. The diagnosisdepends on the history of exposure to these pesticides, characteristic manifestations of toxicityand improvements of the signs and symptoms after administration of atropine. The supportivetreatment of OP poisoning includes the same basic principles of management of any acutelypoisoned patient i.e., rapid initial management of airways, breathing, and circulation. Gastriclavage and activated charcoal are routinely used decontamination procedures, but their valuehas not been conclusively proven in this poisoning. Atropine is the mainstay of therapy, andcan reverse the life threatening features of this acute poisoning. However, there are no clearcut guidelines on the dose and duration of atropine therapy in OP poisoning. Cholinesterasereactivators, by regenerating AChE, can reverse both the nicotinic and muscarinic effects;however, this benefit has not been translated well in clinical trials. All these facts highlight thatthere are many unanswered questions and controversies in the management of OP poisoningand there is an urgent need for research on this aspect of this common and deadly poisoning.Key Words: poisoning, organophosphorus insecticides, decontamination, antidotes

Vancomycin-Induced Red Man Syndrome

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 572-580
Author(s):  
Maurice Levy ◽  
Gideon Koren ◽  
Lee Dupuis ◽  
Stanley E. Read
Keyword(s):  
Signs And Symptoms ◽  
The Body ◽  
Control Group ◽  
Severe Hypotension ◽  
The Face ◽  
Red Man Syndrome ◽  
History Of ◽  
Serum Vancomycin ◽  
Mild Temperature ◽  
Cold Extremities

A total of 11 cases of red man syndrome collected among 650 children who had received vancomycin in our hospital between 1986 and 1988 (estimated prevalence 1.6%) were retrospectively analyzed. These 11 children were compared with 11 age-matched children who received vancomycin in whom red man syndrome did not develop. Of the patients with red man syndrome, 73%, and of the patients with no reaction, 45.4% received vancomycin for penicillin-resistant Staphylococcus epidermidis-positive cultures, or because of history of penicillin allergy. No difference was observed in the dose per kilogram given to both groups (12.9 ± 3.5 mg/kg per dose in those with red man syndrome vs 12.3 ± 6.9 mg/kg per dose in control childrens. The duration (mean ± standard deviation) of vancomycin infusion was 45.9 ± 16.7 minutes (range 10 to 90 minutes) in patients with red man syndrome and 54.5 ± 7.6 minutes (range 45 to 65 minutes) in the control group (P = .07). In the 5 children with red man syndrome rechallenged with vancomycin, slower infusion rates prevented or reduced the syndrome, which emphasized the fact that the rate of administration is the important determinant of red man syndrome in susceptible cases. Clinically, the syndrome developed at the end of the infusion in most patients, but appeared as early as 15 minutes after initiation of the infusion. It was mostly manifested as a flushed, erythematous rash on the face, neck, and around the ears. Less frequently, the rash was distributed all over the body. Pruritus was usually localized to the upper trunk but was also generalized (2 of 11 children). Associated signs and symptoms were hypotension, watery puffy eyes, tachycardia, respiratory distress, dizziness, agitation, and mild temperature increase. A premature infant with the red man syndrome had skin rash associated with poor perfusion, cold extremities, increased need for oxygen, and severe hypotension. The rash disappeared within 20 minutes (range 5 minutes to 7 hours) after vancomycin infusion was stopped. There was no association between serum vancomycin concentrations and red man syndrome; in both groups of patients therapeutic as well as subtherapeutic concentrations were observed, suggesting that this is an idiosyncratic and not a concentration-dependent phenomenon.

Plasma cholinesterase: double-edged parameter in the diagnosis of acute organophosphorus poisoning

2010 ◽  
Vol 50 (3) ◽  
pp. 159-160 ◽  
Author(s):  
D R Mahadeshwara Prasad ◽  
Hareesh S Gouda ◽  
Vinay R Hallikeri
Keyword(s):  
Biochemical Marker ◽  
Organophosphorus Pesticides ◽  
Clinical Signs ◽  
Organophosphorus Pesticide ◽  
Signs And Symptoms ◽  
Acute Poisoning ◽  
Plasma Cholinesterase ◽  
Pesticide Poisoning ◽  
Organophosphorus Poisoning ◽  
Clinical Signs And Symptoms

Biochemical markers are one of the mainstays in the diagnosis of ill health. Plasma cholinesterase is one such marker of the ill health caused by acute organophosphorus pesticide poisoning. Organophosphorus pesticides are powerful inhibitors of plasma cholinesterase; consequently, the reduced level of this biochemical marker has been used in the diagnosis of cases of acute poisoning. But how dependable is this biochemical marker in the diagnosis of suspected organophosphorus pesticide poisoning without adequate clinical signs and symptoms? In the case reported here, the low level of plasma cholinesterase which was suspected to be due to organophosphorus poisoning was found to be caused by pulmonary Koch's and hepatitis B with associated malnutrition.

Acute Ethanol Intoxication in a Child

PEDIATRICS ◽  
1968 ◽  
Vol 42 (5) ◽  
pp. 837-840
Author(s):  
Joseph D. Dickerman ◽  
William Bishop ◽  
James F. Marks
Keyword(s):  
Young Children ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Acute Poisoning ◽  
The Body ◽  
Ethanol Intoxication ◽  
Metabolic Fate ◽  
Acute Ethanol ◽  
Acute Ethanol Intoxication ◽  
Acute Alcoholism

Acute alcoholism is an important cause of morbidity and mortality in adults. The signs and symptoms of acute ethanol intoxication and the metabolic fate of ethanol in the body are well known.1 There are a few case reports of alcohol-induced hypoglycemia in young children2 and also case reports of withdrawal symptoms in infants of alcoholic mothers.3 Yet there is very little in the literature on the course, treatment, and prognosis of children with acute poisoning due to accidental alcohol ingestion. This report is designed to call attention to this entity, to describe a case whose blood alcoholic level was, as far as we know, the highest recorded in the pediatric literature in a survivor, to Suggest a mode of therapy, and, hopefully, to awaken pediatricians to thew possibility of ethanol intoxication in young children.

scholarly journals Juvenile myasthenia

2011 ◽  
Vol 64 (5-6) ◽  
pp. 295-298
Author(s):  
Marija Knezevic-Pogancev
Keyword(s):  
Muscle Weakness ◽  
Cranial Nerves ◽  
Signs And Symptoms ◽  
The Body ◽  
Myasthenic Crisis ◽  
Eye Muscle ◽  
Life Threatening ◽  
Current Therapies ◽  
Threatening Situation ◽  
Progressive Weakness

Introduction. Juvenile myasthenia is a chronic autoimmune neuromuscular disease characterized by varying degrees of fluctuating, painless muscle weakness and rapid fatigue of any muscles under voluntary control. Juvenile myasthenia is a form of myasthenia appearing in adolescent age, representing 10% to 15% of all cases of myasthenia gravis. Juvenile myasthenia is presented by a defect in the transmission of nerve impulses to muscles, resulting from a breakdown in the normal communication between nerves and muscles. In myasthenia, antibodies produced by the body?s own immune system block, alter, or destroy the receptors for acetylcholine. Juvenile myasthenia is neither directly inherited nor is it contagious. Signs and Symptoms. The first noticeable symptoms may be eye muscle weakness, difficulty in swallowing, or slurred speech. Juvenile myasthenia usually affects muscles innervated by the cranial nerves (face, lips, tongue, neck and throat), but it can affect any muscle group. Symptoms vary in type and severity with typical periods of exacerbation interspersed with periods of remission. When the muscles necessary for breathing are affected, a patient is said to be in a myasthenic crisis, which is a life-threatening situation. Disease Outcome and Treatment. Juvenile myasthenia produces sporadic but progressive weakness and abnormal fatigability of striated (skeletal) muscles, exacerbated by exercise and repeated movement, but improved by rest and anticholinesterase drugs. Juvenile myasthenia follows an unpredictable course of recurring exacerbations and periodic remissions. With current therapies, however, most cases of juvenile myasthenia are not as serious as the name implies. Although there is no known cure, drug treatment has improved prognosis and allows patients to lead relatively normal lives, except during exacerbations.

scholarly journals Characteristics of Acute Transfusion Reactions and its related factors in Cipto Mangunkusumo Hospital Jakarta, Indonesia

2019 ◽  
Vol 10 (1) ◽  
pp. 15-20
Author(s):  
Pustika Amalia Wahidiyat ◽  
Elida Marpaung ◽  
Stephen Diah Iskandar
Keyword(s):  
Fresh Frozen Plasma ◽  
The Body ◽  
Moderate Degree ◽  
Related Factors ◽  
Mild Degree ◽  
Fresh Frozen ◽  
Life Threatening ◽  
History Of ◽  
Incompatibility Reactions ◽  
Transfusion Reactions

Latar belakang: Reaksi transfusi akut (RTA) merupakan sekelompok kejadian yang tidak diinginkan akibat pemberian transfusi darah. Manifestasi dari RTA bervariasi dari yang ringan hingga mengancam nyawa. Saat ini, data mengenai reaksi transfusi di Indonesia masih sangat terbatas. Dalam studi ini, kami bertujuan untuk memberikan gambaran mengenai karakteristik RTA dan faktor-faktor yang mempengaruhinya. Metode: Studi ini merupakan studi retrospektif yang melibatkan 288 subyek dengan RTA. Studi dilakukan di Rumah Sakit Dr. Cipto Mangunkusumo, dimulai sejak Januari hingga Desember 2017. RTA dikelompokkan berdasarkan sistem tubuh yang mengalami manifestasi, serta derajat manifestasinya. Hasil: Sel darah merah merupakan produk darah utama yang ditransfusikan ke subyek, diikuti dengan konsentrat trombosit, plasma segar beku, dan kriopresipitat. Lima gejala utama dari RTA adalah gatal, demam/kenaikan suhu tubuh, menggigil, urtikaria, dan angioedema. Berdasarkan sistem tubuh yang terkena, umumnya RTA bermanifestasi sebagai gejala pada kulit (56.6%). Berdasarkan derajat manifestasinya, RTA umumnya dikategorikan dalam derajat ringan (55.9%). Anak-anak cenderung mengalami manifestasi yang ringan (64.8%) dan utamanya bermanifestasi pada kulit (65.4%). Riwayat transfusi mempengaruhi derajat RTA secara signifikan. RTA derajat sedang dan gejala konstitusional lebih banyak ditemukan pada subyek yang mendapat PRC dibanding produk darah lainnya. Kesimpulan: Umumnya RTA bermanifestasi sebagai gejala dermatologi. Hanya sedikit kasus RTA yang disebabkan oleh reaksi inkompatibilitas. Manifestasi dan derajat RTA juga dipengaruhi oleh umur, riwayat transfusi, dan jenis komponen darah.  Kata kunci: Transfusi darah, reaksi transfusi akut, riwayat transfuse, usia   Abstract   Background: Acute transfusion reactions (ATRs) are a group of adverse events caused by blood transfusions. Manifestations of ATRs vary from mild to life threatening. At present, data about transfusion reactions in Indonesia are still limited. In this study, we aim to determine the characteristics of ATRs and its related factors. Methods: This was a retrospective study of 288 subjects with ATRs. The study was conducted in Cipto Mangunkusumo Hospital, started from January to December 2017. ATRs were categorized based on the body systems affected and degree of manifestations. Results: Packed red cells (PRC) was the predominant blood product (51.4%) which was transfused to subjects, followed by thrombocyte concentrate (TC), fresh frozen plasma (FFP), and cryoprecipitate. Five most common predominant symptoms of ATRs were pruritus/itch, febrile/increased temperature, chills, transient urticaria, and angioedema. Based on the affected body systems, the majority of ATRs manifested as dermatologic symptoms (56.6%). Based on the degree of manifestations, the majority of ATRs were categorized as mild degree (55.9%). Children tended to have milder symptoms (64.8%), which mostly manifested as dermatologic symptoms (65.4%). History of transfusion affected the degree of ATR significantly. Moderate degree of ATRs and constitutional symptoms were found more common in subjects who received PRC than other blood products. Conclusion: Most of ATRs manifest as dermatologic symptoms, which represent allergic reactions. Only a small portion of ATRs are caused by incompatibility reactions. The manifestation and degree of ATRs are also affected by age, history of transfusion, and type of blood components.  Keywords: Blood transfusion, acute transfusion reaction, transfusion history, age

scholarly journals Renal Abscess Caused by Salmonella Typhi

2015 ◽  
Vol 7 (02) ◽  
pp. 121-123 ◽  
Author(s):  
Amarjeet Kaur ◽  
Smita Sarma ◽  
Navin Kumar ◽  
Sharmila Sengupta
Keyword(s):  
Enteric Fever ◽  
Renal Involvement ◽  
Hepatic Abscess ◽  
Clinical History ◽  
Salmonella Typhi ◽  
The Body ◽  
Renal Abscess ◽  
Rare Presentation ◽  
Life Threatening ◽  
History Of

ABSTRACT Salmonella typhi is a true pathogen, which is capable of causing both intestinal and extraintestinal infections. Unusual presentations of Salmonella should always be kept in mind as this organism can cause disease in almost any organ of the body. S. typhi has been reported to cause the life-threatening infections such as meningitis, endocarditis, myocarditis, empyema, and hepatic abscess. Renal involvement by S. typhi is a relatively rare presentation. We report a case of renal abscess caused by S. typhi in an afebrile, 10-year-old child who did not have any clinical history of enteric fever. To our knowledge, this is the first reported case of isolation of S. typhi from the renal abscess, and interestingly this isolate was found to be resistant to quinolones.

scholarly journals Perforated Appendicitis with Appendicular Abscess

2017 ◽  
Vol 8 (1) ◽  
pp. 73-75
Author(s):  
Md Tahminur Rahman ◽  
Abdus Salam Arif ◽  
Md Abdul Wohab Khan ◽  
Mumtahina Setu ◽  
Md Imam Shafique ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Acute Appendicitis ◽  
Perforated Appendicitis ◽  
Signs And Symptoms ◽  
College Hospital ◽  
Medical College ◽  
Paediatric Department ◽  
Life Threatening ◽  
History Of

Most patients with acute appendicitis can be easily diagnosed, but there are many in whom the signs and symptoms are quite variable, and a firm clinical diagnosis is often very difficult to establish. Difficulties in the early diagnosis of appendicitis, particularly in children, often lead to life threatening complications, such as gangrene or perforation of the appendix. Here we report a case where a nine-year-old boy presented to the Paediatric Department at Anwer Khan Modern Medical College Hospital in Dhaka in April 2016 with a history of abdominal pain, vomiting & fever that began nine days before admission.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 73-75

scholarly journals Nevirapine induced Stevens Johnson syndrome

2020 ◽  
Vol 1 (2) ◽  
pp. 35-38
Author(s):  
Himani Prajapati ◽  
Neetu Bala ◽  
Dinesh Kansal
Keyword(s):  
Adverse Effect ◽  
Adverse Event ◽  
Causality Assessment ◽  
Burning Sensation ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Case Presentation ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of

Introduction: Severe and life-threatening SJS is more common with nevirapine than with other NNRTIs Case presentation: A 56-year-old male patient presented with a complaint of lesions all over the body with a burning sensation for 4 days. He was on an ART regimen, containing zidovudine, lamivudine, and efavirenz combination for 4 years. But patient accidentally started nevirapine and after 10 days he developed maculopapular lesions which were diagnosed as SJS syndrome. There was a history of rash with nevirapine when ART was started initially in 2012. This incident of an adverse event could be assigned a term "probable" according to the WHO-UMC scale for causality assessment as the re-challenge was found positive. Conclusion: Physicians and patients must be aware of this adverse effect on early diagnosis and treatment.

scholarly journals Clinico- etiological profile of acute poisoning and intoxication in children in western Nepal

2021 ◽  
Vol 8 (10) ◽  
pp. 1643
Author(s):  
Love K. Sah ◽  
Munu Mahat ◽  
Prince Pareek ◽  
Ram P. Pokhrel ◽  
Reema Garegrat
Keyword(s):  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Acute Poisoning ◽  
Acute Onset ◽  
Accidental Poisoning ◽  
Emergency Physicians ◽  
Medical College ◽  
Different Types ◽  
Common Clinical Presentation ◽  
History Of

Background: Pediatric poisoning is a common emergency. The present study was done to assess the incidence, clinico-etiological profile of acute poisoning and intoxication in children.Methods: This study was conducted in the Department of Pediatrics, Lumbini Medical College and Teaching Hospital, Nepal in which children aged less than 18 years, with history of consumption of poison accompanied or unaccompanied by container or poison or with doubtful history of consumption of poison but with definite signs and symptoms of acute poisoning we included. We also included children with history of bites by poisonous creatures like snakes, scorpions, bees and insects or with doubtful history of bites due to poisonous creatures but with definite acute onset of signs and symptoms locally or systemically.Results: In the present study, during the study duration, 68 children were included. The most common age group of included children was 1 to 5 years (59%). Accidental poisoning was reported in 93% of the cases, while the rest had suicidal poisonings. The most common type of poison used were different types of pesticides (46%). We observed that vomiting was the most common clinical presentation (79%). In our study sample, arrival of 46% of the children was delayed by 30 minutes to 2 hours. Majority of the patients arrived in the afternoon to the hospital (51%).Conclusions: The findings of the present study would enable emergency physicians to identify clinical features of common poisonings among children, which would enable manage the cases better.

scholarly journals The Sabbath as a remedy for human restlessness

2012 ◽  
Vol 46 (2) ◽  
Author(s):  
Volker Kessler
Keyword(s):  
Old Testament ◽  
The Body ◽  
Jewish Tradition ◽  
Basic Principles ◽  
Christian Churches ◽  
The Gift ◽  
History Of ◽  
Effective Remedy ◽  
Short Section ◽  
People Today

Considering that many people today suffer from restlessness, it would be very helpful to remind ourselves of a very old, very simple but very effective  remedy: rest on the Sabbath. In the Christian tradition, Sabbath-keeping often only focused on its  spiritual aspects. This article has focused on the benefit of rediscovering the gift of the Sabbath  as ‘a delight to the soul and a delight for the body’ (Heschel). It has shown how we can explicitly  learn from the Jewish tradition of holistic Sabbath observance. The article consists of four  parts: the phenomenon of human restlessness, ten different facets of the Sabbath in the Old  Testament, a short section on the history of pro-Sabbath and anti-Sabbath attitudes within the  Christian churches and a concluding section about applying the basic principles of the Sabbath  in modern life for the sake of a good work-life balance. Examples from the German context  are included.Die Sabbat as kuur teen menslike rusteloosheid. Wanneer die hedendaagse rusteloosheid van mense in ag geneem word, het dit  waarde om onsself aan ‘n baie ou, eenvoudige dog effektiewe maatreël tot herstel te herinner, naamlik om op die  sabbat te rus. In die Christelike tradisie fokus sabbatsonderhouding dikwels slegs op godsdienstige  aspekte. Hierdie artikel het gefokus op die wins in die herontdekking van die  sabbatsgeskenk as ‘n ‘behae vir die siel en die liggaam’ (Heschel). Dit toon duidelik hoe ons uit die Joodse tradisie van ‘n holistiese sabbatsonderhouding kan leer. Die artikel het bestaan uit vier dele,  naamlik die verskynsel van menslike rusteloosheid, tien verskillende fasette van die sabbat  in die Ou Testament, ‘n kort historiese oorsig oor pro- en teen-standpunte van die  Christelike kerk ten opsigte van die sabbat, en ten slotte die toepassing van basiese  sabbatsbeginsels in die moderne lewe ter handhawing van ‘n goeie balans tussen werk en lewe. Voorbeelde  uit die Duitse konteks is ook ingesluit.

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