scholarly journals 2:1 Atrioventricular Block and Severe Hypotension Due to Wild Honey Poisoning: A Case Report

2021 ◽  
Vol 8 (8) ◽  
pp. 416-419
Author(s):  
Keshav Budhathok ◽  
Shyam Raj Regmi ◽  
Sudhir Regmi
Keyword(s):  
Atrioventricular Block ◽  
Altered Mental Status ◽  
The Black Sea ◽  
Medical College ◽  
Naturally Occurring ◽  
Uncommon Presentation ◽  
Severe Hypotension ◽  
Himalayan Belt ◽  
Life Threatening ◽  
Medicinal Properties

Wild Honey poisoning is caused by ingestion of wild honey obtained from the nectar of some species of Rhododendron, consuming leaves and flowers of Rhododendron found in the higher altitudes of Nepal which has traditionally been used by indigenous people of Nepal especially Himalayan belt of Nepal for its medicinal properties. The cause of poisoning is the toxin called grayanotoxin which is a naturally occurring sodium channel toxin that leads to life threatening bradycardia, hypotension and altered mental status but sometime it may present with rare life threatening atrioventricular block and cardiovascular collapse. Wild honey intoxication has widely been reported from Turkey, regions around the Black sea, Austria, Korea and some cases from Nepal. Wild honey poisoning is not the uncommon presentation to emergency department of Chitwan Medical College as it is located to central part of Nepal. We report a case of wild honey poisoning who was referred to our hospital with arrhythmia and hypotension. Keywords: 2:1 Atrioventricular block, Grayanotoxin, Hypotension, Nepal, Wild honey.

scholarly journals Cardiovascular collapse due to wild honey Intoxication: A case report

2017 ◽  
Vol 13 (2) ◽  
pp. 170-172
Author(s):  
Bijaya Devi Aryal ◽  
S Niraula ◽  
GB Malla ◽  
S Niraula
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Indigenous People ◽  
Black Sea ◽  
The Black Sea ◽  
Cardiovascular Collapse ◽  
Av Block ◽  
Mad Honey ◽  
Himalayan Belt ◽  
Life Threatening

Background: Wild honey has been traditionally been used by indigenous people for its medicinal, aphrodisiac and hallucinogenic properties in Nepal and some other countries. Wild (mad) honey intoxication is one of the rarest presentations to emergency department and is caused by ingestion of wild honey obtained from the nectar of Rhododendron species on the higher altitudes. The cause of mad honey poisoning is the toxin grayanotoxin, found in such wild honey. It can also be caused by consuming the leaves, flowers of Rhododendron from Himalayan belt. Wild honey intoxication has widely been reported from Turkey and the regions around the Black Sea. Some cases have been reported in the few hospitals in Kathmandu and Chitwan. However, such cases have rarely been reported in eastern Nepal. The intoxication might present with mild symptoms of gastrointestinal, cardiovascular and neurological systems or might also present in rare life threatening form with AV block and cardiovascular collapse. Here, we report a case of a seventy three years old man who presented to our emergency department with cardiovascular collapse in the form of severe bradycardia, AV block and hypotension after wild honey consumption.Health Renaissance 2015;13(2): 170-172

scholarly journals An Uncommon Presentation of Cryptococcal Meningitis in an Immunocompetent Patient: A Case Report

2021 ◽  
Vol 5 (4) ◽  
pp. 450-454
Author(s):  
Kelly Correa ◽  
Scott Craver ◽  
Amar Sandhu
Keyword(s):  
Case Report ◽  
Cryptococcal Meningitis ◽  
Altered Mental Status ◽  
Immunocompetent Patient ◽  
Significant Past Medical History ◽  
Atypical Symptoms ◽  
Presenting Symptoms ◽  
Uncommon Presentation ◽  
Life Threatening ◽  
Immunocompetent Patients

Introduction: Meningitis is a serious and potentially life-threatening infection of the central nervous system. Cryptococcus neoformans is a rare fungal cause of meningitis that commonly presents with atypical symptoms. Although this infection is most common in immunocompromised patients, it also occurs in immunocompetent patients. This case report describes an atypical presentation of cryptococcal meningitis in a seemingly immunocompetent patient. Case Report: A 40-year-old immunocompetent patient with no significant past medical history had visited the emergency department (ED) five times within a span of 30 days reporting dental pain and headache. Throughout each of the visits, no clear symptoms signaling the need for a meningitis workup were observed, as the patient had been afebrile, displayed no nuchal rigidity, and his presenting symptoms subsided within the ED after treatment. A lumbar puncture was performed after emergency medical services brought the patient in for his sixth ED visit, initially for stroke-like symptoms and altered mental status. Spinal fluid was indicative of cryptococcal meningitis. Conclusion: This case highlights the challenge of identifying cryptococcal meningitis in the ED, particularly in immunocompetent patients who do not display classic meningitis symptoms. It also highlights the importance of keeping a broad differential and carefully ruling out diagnoses when patients return to the ED multiple times for the same complaint.

scholarly journals Profile of Organophosphorus Poisoning

KYAMC Journal ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 133-135
Author(s):  
Joya Debnath ◽  
Arpan Kumar Basak ◽  
Md Zubaidur Rahman ◽  
Anujit Saha
Keyword(s):  
Organophosphorus Compound ◽  
Economic Status ◽  
Frequency Pattern ◽  
Major Health Problem ◽  
Major Health ◽  
The Public ◽  
Medical College ◽  
Phosphorus Poisoning ◽  
Life Threatening ◽  
The Government

Background : Self poisoning with organophosphate pesticides is a major health problem in world wide. Organophosphorus compound poisoning is a very common toxicological emergency encountered at Mirzapur in Tangail. It is particularly common among the rural agricultural worker's which comprise a substantial group of the population of this region.Objective: The objective of this study was to find out the incidence, frequency, pattern of poisoning, outcome and aetiological aspect of Organo phosphorus poisoning patient admitted in Kumudini Women's Medical college Hospital.Methods: A total 366 cases of OPC poisoning were analysed during 1 year from January 2015 to December 2015. The emphasis was given on age, sex, socio-economic status, occupation, motive of poisoning, types of compound consumed its quality, place, distance from referral place and the ultimate outcome.Results: Young population of rural background, particularly agricultural workers were the commonest patients (51.91%). The most common motive of poisoning was with a suicidal intent, both in males (27.59%) and females (66.39%). Financial crisis was one of the most common reasons analysed as the motive behind the poisoning (54.20%). Three hundred forty four Patients recovered and 22 were expired. The major cause of death in these cases was respiratory failure followed by multi-organ failure.Conclusion : Strict of the pesticide act and involving a new policy by the government to educate the public and youth in large about the dangerous, life threatening effects of Organophosphorus compound could help amelerioating the harmful effects of such poisoning.KYAMC Journal Vol. 9, No.-3, October 2018, Page 133-135

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

NSAIDS: A RISK FACTOR AFFECTING PEPTIC ULCER PERFORATION

2021 ◽  
pp. 9-9
Author(s):  
Neelkamal Gupta ◽  
Mangtani Jitendra K ◽  
Khandelwal Dheeraj K
Keyword(s):  
Peptic Ulcer ◽  
Statistical Correlation ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Muscularis Mucosa ◽  
Time Duration ◽  
Ulcer Perforation ◽  
Medical College ◽  
Life Threatening ◽  
Gandhi Medical College

INTRODUCTION:Apeptic ulcer is a defect in the upper gastrointestinal mucosa that extends through the muscularis mucosa into deeper layers of the gut wall. Non-steroidal anti-inammatory drugs (NSAIDs) are the major risk factors for peptic ulcer disease.Long-term use of NSAIDs, however, can cause gastrointestinal (GI) ulcers and potentially life-threatening ulcer complications. MATERIALAND METHOD: The present study was conducted on 100 patients of peptic ulcer of either sex in Department of Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. History of any other co morbid illness and any drug being taken with its time duration were recorded in detail. RESULT AND DISCUSSION: From this study, it was observed that among the 69 patients of duodenal perforation, 73.91% were taking NSAID. Similarly among the 31 patients of gastric perforation 80.64% were taking NSAID. Overall total 76% patients were taking these drugs. CONCLUSION: It is concluded from this study that a strong statistical correlation was found between use of NSAIDs and peptic ulcer perforation.

MO650EMPHYSEMATOUS PYELONEPHRITIS IN TYPE 2 DIABETES – CLINICAL PROFILE AND MANAGEMENT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Dr Sanjay Bhat ◽  
Anupma Kaul ◽  
Priyanka Rai ◽  
Rohit Srivastav
Keyword(s):  
Glycosylated Hemoglobin ◽  
Left Kidney ◽  
Diabetic Patients ◽  
Emphysematous Pyelonephritis ◽  
Medical College ◽  
Poor Outcome ◽  
Microbial Profile ◽  
Disturbance Of Consciousness ◽  
Life Threatening ◽  
High Index Of Suspicion

Abstract Background and Aims Emphysematous pyelonephritis (EPN) is a rare but life-threatening acute suppurative infection of the kidney among diabetics. There is no current consensus on management of EPN. Method A prospective observational study was conducted at Department of General Surgery at RML institute of Medical sciences , Lucknow as well as at Eras Lucknow medical college, Lucknow from 2015-2018 to look for clinical, microbial profile and treatment outcome of diabetic patients with emphysematous pyelonephritis. Results A total of 76 Diabetic patients diagnosed with pyelonephritis were identified, of which 15 patients were diagnosed with EPN (26.3%). The mean age of the patients was 58.4±6.5 years. Mean duration of diabetes was 5.3 ± 3.3 years. 12 (82%) of the 15 patients with DM had a glycosylated hemoglobin A1C level higher than 7.5. Renal dysfunction at presentation was seen in 11 (73.3%) patients. Among the unilateral involvement, left kidney was more affected. Escherichia coli in 11 (73.3%), Klebsiella sp. in 1 (6.6%), Pseudomonas in 1 (6.6%), and 1 each with polymicrobial and fungal UTI respectively. Of 15 EPN patients, 13 (86.6 %) survived and 1 (6.6 %) expired. 2 of them underwent nephrectomy both survived. All patients with Stage I, II and IIIa EPN (n = 12) were managed with antibiotics with or without PCD. In EPN Stage IIIb/IV (n = 3), all the 3 (20 %) patients were managed with antibiotics and PCD and later 2 (13.3%) needed nephrectomy. Only time to diagnosis, altered sensorium, shock at presentation and thrombocytopenia were associated with poor outcome in EPN patients (P < 0.05) Multiple logistic regression tests showed shock (P = .04) and and disturbance of consciousness (P = .05) on hospital admission as being the independent factors for poor outcome. Conclusion EPN in diabetics needs high index of suspicion, timely diagnosis and good multidisciplinary approach with adequate antibiotics and surgical management for better patient outcomes.

Bradyarrhythmias

2016 ◽  
Author(s):  
Inna Leybell ◽  
Liliya Abrukin
Keyword(s):  
Atrioventricular Block ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Treatment Options ◽  
Presenting Symptoms ◽  
Threatening Condition ◽  
Node Disease ◽  
Life Threatening ◽  
Sinus Node Disease ◽  
Sinoatrial Block

Bradyarrhythmias can present as an incidental electrocardiographic (ECG) finding or a life-threatening condition requiring immediate intervention. They are caused by sinus node disease or atrioventricular block. This review covers pathophysiology, stabilization and assessment, diagnosis and treatment options, and disposition and outcomes for patients with bradycardia. Figures in the review demonstrate characteristic ECG tracings. Tables list classifications of sinus node dysfunction as well as of sinoatrial and atrioventricular blocks, presenting symptoms, important information to elicit on history taking, various causes of bradycardia, and specific interventions for toxicologic etiologies. Key words: atrioventricular block, atropine, bradyarrhythmia, bradycardia, first-degree atrioventricular block, second-degree atrioventricular block, sinoatrial block, sinus bradycardia, sinus node disease, tachycardia-bradycardia syndrome, third-degree atrioventricular block This review contains 9 highly rendered figures, 7 tables, and 92 references.

Jaundice and life-threatening hemobilia: An uncommon presentation of choledochal cyst

2013 ◽  
Vol 14 (8) ◽  
pp. 451-454
Author(s):  
Peng Soon Koh ◽  
Boon Koon Yoong ◽  
Anushya Vijayananthan ◽  
Ouzreiah Nawawi ◽  
Sanjiv Mahadeva
Keyword(s):  
Choledochal Cyst ◽  
Uncommon Presentation ◽  
Life Threatening

scholarly journals Study of microbial flora in indwelling catheter, drains, CIVP lines and endotracheal tubes

2013 ◽  
Vol 3 (6) ◽  
pp. 469-471
Author(s):  
SB Pradhan ◽  
R Dhakhwa ◽  
CD Shrestha
Keyword(s):  
College Teaching ◽  
Routine Practice ◽  
Clinical Microbiology Laboratory ◽  
Infection Rates ◽  
Intravascular Catheter ◽  
Indwelling Catheter ◽  
Endotracheal Tubes ◽  
Medical College ◽  
Life Threatening ◽  
Very High

Background: The use of indwelling devices like Urinary catheter, Drain tubes, Central intravascular catheter, endotracheal tubes has become routine practice in the medical field. Localized or systematic infection are frequent complications associated with extensive use of these devices, requiring its removal or may even be associated with life threatening consequences. Materials and Methods: Microbiological study was carried out among all the indwelling device samples received from 20th April 2011 to 19th April 2012 at Clinical Microbiology Laboratory, Department of Pathology, Kathmandu Medical College Teaching Hospital. Results: Out of total 205 samples (125 Foley’s catheters, 31 drain tubes, 29 central intravascular catheter lines and 20 endotracheal tubes) received during this study period, 38.4% urinary catheters, 23.33% drain tubes, 6.9% central intravascular catheter lines and 40.0% endotracheal tubes were found to have significant growth. Escherichia coli and Klebsiella were found to be the commonest organisms. Conclusion: The infection rates of indwelling devices used for various reasons are found to be very high. These infections have increased the morbidity and mortality of the hospitalized patients and also increased the duration of hospital stay. Thus aseptic measurements during insertion of these devices periodic change of these devices may help to overcome these complications. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8995   Journal of Pathology of Nepal (2013) Vol. 3, 469-471

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