More Than Just A Gastroenteritis - Bottle gourd (Lagenaria Siceraria) Toxicity Diagnosed in the Emergency Department

2021 ◽  
Author(s):  
Wey Ting Lee ◽  
Guoyi Geoffrey Ng ◽  
Dong Haur Phua
Keyword(s):  
Emergency Department ◽  
Traditional Medicine ◽  
Complementary Medicine ◽  
Early Recognition ◽  
Public Awareness ◽  
General Medicine ◽  
Bottle Gourd ◽  
Local Context ◽  
Lagenaria Siceraria ◽  
Rare Presentation

Abstract BackgroundBottle gourd (Lagenaria siceraria) is sometimes used in complementary medicine practice for the treatment of chronic ailments. It belongs to the Cucurbitaceae family. However, there have been reports of toxicity due to consumption of bottle gourd juice leading to severe abdominal upset and upper gastrointestinal bleeding. As emergency physicians we need to be aware of such complementary medicine induced haemorrhagic gastroenteritis as possible etiology of gastrointestinal haemorrhage. Case presentationWe present a case of a 41-year-old gentleman who presented to the emergency department (ED) with multiple episodes of vomiting, hematemesis and diarrhoea after consuming bottle gourd juice. The patient was resuscitated and stabilized with fluids, proton pump inhibitors and antiemetics. He was subsequently admitted to General Medicine ward for further management. He continued to receive symptomatic treatment in the ward and underwent esophagogastroduodenoscopy (OGD) during his hospitalization stay. His symptoms improved and he was discharged stable five days later. ConclusionEarly recognition of this rare presentation of bottle gourd toxicity is important in our local context especially where traditional medicine is widely prevalent nowadays. Treatment is supportive. Public awareness of dangerous effects from the consumption of bitter bottle gourd juice and complementary medicine without proper consultation with practitioner plays a crucial role to prevent further cases. Physicians need to advise patients on the use of traditional medicine and their potential side effects.

Pickering syndrome: a rare presentation in emergency department

2021 ◽  
Vol 14 (2) ◽  
pp. e239421
Author(s):  
Prawal Shrimal ◽  
Ankit Kumar Sahu ◽  
Roshan Mathew ◽  
Abhinav Bansal
Keyword(s):  
Emergency Department ◽  
Renal Artery ◽  
Pulmonary Edema ◽  
Young Patient ◽  
Renal Artery Stenosis ◽  
Early Recognition ◽  
Hypertensive Emergency ◽  
Acute Pulmonary Edema ◽  
Rare Presentation ◽  
Life Threatening

Sympathetic crash acute pulmonary edema (SCAPE) is a life-threatening injury, which requires early recognition and intervention to prevent mortality. We present a case of 18-year-old woman with no previous comorbidity, presenting with SCAPE who was successfully resuscitated and eventually diagnosed with renal artery stenosis. Pickering syndrome is a rare cause of hypertensive emergency and should be considered in a young patient presenting with SCAPE in emergency department.

scholarly journals Pengetahuan dan Pola Swamedikasi Penggunaan Obat Tradisional dan Cara Pengobatan Tradisional Sebagai Terapi Komplementer di Wilayah Kerja Yandu Wredasari 07, Warungboto, Umbulharjo, Yogyakarta

2020 ◽  
Vol 1 (2) ◽  
pp. 52
Author(s):  
Wahyu Tusi Wardani ◽  
Muhammad Muhlis
Keyword(s):  
Side Effects ◽  
Traditional Medicine ◽  
Complementary Medicine ◽  
Public Awareness ◽  
Complementary Therapy ◽  
Gelling Agent ◽  
Banana Peel ◽  
Self Medication ◽  
Consecutive Sampling ◽  
Yogyakarta City

ABSTRAKMeningkatnya tingkat pendidikan, informasi dan kesadaran masyarakat akan pentingnya arti  sehat, mendorong masyarakat untuk melakukan swamedikasi. Termasuk swamedikasi menggunakan obat tradisional dan cara pengobatan tradisional sebagai terapi komplementer semakin meningkat. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan dan pola swamedikasi menggunakan obat tradisional dan cara pengobatan tradisional sebagai terapi komplementer pada Yandu Wredasari 07, Warungboto, Umbulharjo, Kota Yogyakarta. Penelitian ini merupakan penelitian observasional yang bersifat non eksperimen, Sampel yang digunakan dalam penelitian ini adalah anggota Yandu Wredasari 07, Warungboto, Umbulharjo, Kota Yogyakarta dan memenuhi kriteria sampel yang ditetapkan oleh peneliti. Pengambilan sampel dilakukan tanpa acak (nonprabability sampling) dengan teknik pengambilan consecutive sampling. Responden yang pernah melakukan pengobatan komplementer dengan obat tradisional sebanyak 81,6%. 83,3% diantaranya merasakan tidak muncul efek samping obat selama menggunakan obat tradisional. Sedangkan Responden yang pernah melakukan pengobatan komplementer dengan cara tradisional sebanyak 39,5%. Hanya satu yang merasakan efek samping yaitu dari pijat tradisional, muncul warna agak biru, njarem dan linu linu.Kata kunci: Kulit pisang Ambon; Antibakteri; Gel antiseptic; Gelling agent; Na-CMC. ABSTRACTThe increasing level of education, information and public awareness of the importance of healthy meaning, encourages people to carry out swamedication. Including self-medication using traditional medicine and ways of traditional medicine as complementary therapies is increasing. This study aims to determine the description of knowledge and patterns of self-medication using traditional medicine and traditional medicine as a complementary therapy in Yandu Wredasari 07, Warungboto, Umbulharjo, Yogyakarta City. This study was an observational study that was non-experimental in nature. The sample used in this study was a member of Yandu Wredasari 07, Warungboto, Umbulharjo, Yogyakarta City and met the sample criteria set by the researcher. Sampling is done without random (nonprabability sampling) with consecutive sampling techniques. Respondents who had taken complementary medicine with traditional medicine were 81.6%. 83.3% of them felt there were no side effects of drugs while using traditional medicines. While the respondents who had done complementary medicine in the traditional way were 39.5%. Only one felt the side effects of traditional massage, appearing a little blue, njarem and rheumatic pain.Keywords: Ambon banana peel; Antibacteria; Antiseptic gel; Gelling agent; Na-CMC. 

Level of use and public awareness in consumption of traditional medicines in work area of Health Center Gombong I

2020 ◽  
Vol 1 (3) ◽  
pp. 26-31
Author(s):  
Naelaz Zukhruf Wakhidatul Kiromah ◽  
Tri Cahyani Widiastuti
Keyword(s):  
Traditional Medicine ◽  
Urban Communities ◽  
Health Center ◽  
Public Awareness ◽  
Modern Medicine ◽  
Traditional Medicines ◽  
Rural And Urban ◽  
Work Area ◽  
Level Of Use ◽  
Minor Ailments

Indonesia has 20,000 types of plants where 300 species have been used as traditional medicines. The use of traditional medicine as an alternative treatment in Indonesia that has been used by both rural and urban communities. The use of traditional medicine is considered safer than modern medicine. The purpose of this study was to identify the level of use of traditional medicine and public awareness in the use of traditional medicine in work area of  Health Center Gombong 1 which consists of 5 villages. This research is a non-experimental and descriptive research that uses a questionnaire. Respondents who participated in this study were 140 people. The characteristics of respondents who participated in this study were the majority of men (50,71%), last educated of elementary school (41,43%), as housewives (27,86%). The majority of people in work area of Health Center Gombong choose treatment with modern medicine (64,29%). In addition there are 35,71% using traditional medicine and the majority use rhizome species (46%) for the treatment of minor ailments. In this study also showed that the majority of people do not know the safety of traditional medicines (50%) due to lack of information so that information is needed on the benefits and safety and the use of good and appropriate traditional medicines.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

Gastrointestinal toxicity due to bitter bottle gourd (Lagenaria siceraria)─a report of 15 cases

2011 ◽  
Vol 30 (5) ◽  
pp. 233-236 ◽  
Author(s):  
Rajesh Puri ◽  
Randhir Sud ◽  
Abdul Khaliq ◽  
Mandhir Kumar ◽  
Sanjay Jain
Keyword(s):  
Gastrointestinal Toxicity ◽  
Bottle Gourd ◽  
Lagenaria Siceraria

Asthma

2020 ◽  
Author(s):  
Haitham Nsour ◽  
Anne E. Dixon
Keyword(s):  
Emergency Department ◽  
Inhaled Corticosteroids ◽  
Early Recognition ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Significant Proportion ◽  
The United States ◽  
Asthma Prevalence ◽  
Public Health Burden ◽  
Asthma Exacerbations ◽  
Oral Corticosteroids

Asthma is one of the most common diseases in developed nations. A pathognomonic feature of asthma is episodic aggravations of the disease; these exacerbations can be life-threatening and contribute to a significant proportion of the public health burden of asthma. In the emergency department, successful management of asthma exacerbations requires early recognition and intervention before they become severe and potentially fatal. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for asthma. Figures show the management of asthma exacerbations in the emergency department and hospital, pooled odds ratio comparing inhaled corticosteroids and oral corticosteroids with oral corticosteroids alone following emergency department discharge, and an asthma discharge plan at the emergency department. Tables list current asthma prevalence among selected demographic groups in the United States, risk factors for fatal asthma exacerbations, differential diagnosis of asthma exacerbations, and dosages of drugs for asthma exacerbations. This review contains 3 figures, 16 tables, and 88 references. Key Words: Asthma, allergic bronchopulmonary aspergillosis, gastroesophageal reflux disease, sinus disease, breathlessness, shortness of breath  

A comprehensive review on the medicinal importance; biological and therapeutic efficacy of Lagenaria siceraria (Mol.) (bottle gourd) Standley fruit

2021 ◽  
Vol 21 ◽  
Author(s):  
Muhammad Zahoor ◽  
Muhammad Ikram ◽  
Nausheen Nazir ◽  
Sumaira Naz ◽  
Gaber El-Saber Batiha ◽  
...  
Keyword(s):  
Herbal Medicines ◽  
High Water ◽  
Bottle Gourd ◽  
Herbal Remedies ◽  
Lagenaria Siceraria ◽  
Synthetic Drugs ◽  
Domestic Plant ◽  
Phytochemical Constituents ◽  
Cucurbitaceae Family ◽  
Water Contents

: Herbal remedies have been employed for the treatment and management of different diseases for ages. Herbal medicines are a promising choice over modern synthetic drugs because of their low side effects and are thus considered safe and effective in treating human diseases. Lagenaria siceraria (Mol.) Standley fruit (Bottle gourd) belongs to the Cucurbitaceae family that has been used in a different system of traditional medication to treat various diseases. This is a domestic plant that provides food as well as medication. This vegetable has low caloric values and high water contents. The edible portion of it contains phytochemicals like vitamins, proteins, choline, minerals, terpenoids, flavonoids etc. Several bioactive compounds have been isolated from L. siceraria, including triterpenoids, sterols, cucurbitacins, flavones, C-glycosides and β-glycosides. Researchers have evaluated various parts of this plant viz., fruit, root, flowers, and leaves for pharmacological activities like antianxiety, antidepressant, diuretic, antimicrobial, cytotoxic, antihyperlipidemic, cardioprotective, analgesic, anti-inflammatory, anthelmintic, anti-hyperglycemic, antihepatotoxic, anti-urolithiatic, antistress, antiulcer, anticancer, hepatoprotective, anthelmintic, immunomodulatory, and antioxidant. In this review, an attempt has been made to explore its phytochemical constituents, traditional, medicinal, and pharmacological uses to highlight the therapeutic importance of this well-known plant. This would be helpful in reviving its importance and highlight its several promising aspects to encourage researchers for further research on L. siceraria.

scholarly journals Meningococcemia Presenting as a Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Lachant ◽  
David Trawick
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiogenic Shock ◽  
Neisseria Meningitidis ◽  
Early Recognition ◽  
Myocardial Dysfunction ◽  
Shortness Of Breath ◽  
Gram Negative ◽  
St Elevation

Neisseria meningitidisis an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure fromN. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.

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