Diet of the southern ravine salamander Plethodon richmondi

The diets of many small North American Plethodon species are poorly studied despite their important roles in forest ecosystems. Using a non lethal gastric lavage method, we examined the spring-season diet of 31 southern ravine salamanders (Plethodon richmondi) from a second-growth forest in south-eastern Kentucky (USA). We recovered and identified a total of 452 prey items from 14 different prey groups. The three most important prey groups were Formicidae (ants), Acari (mites and ticks), and Collembola (springtails). Together, these groups accounted for more than 80 % of all prey items. Examining the diets of terrestrial salamanders may help us better understand their roles in the regulation of invertebrate communities and the transfer of accessible nutrients back to the soil.

Management of self-inflicted oral organophosphate poisoning in adolescence - a case report

Organophosphate (OP) poisoning is more common in developing countries such as India. Here, we report a case of self-inflicted oral OP poisoning (monocrotophos) by an adolescent male patient who presented to the emergency department of a tertiary care hospital with tachycardia and frothing without seizure episode (non-linear presentation in OP poisoning). Based on the evidence of consumption of OP compound, the management of the patient went as planned and guarded with i.v. administration of pralidoxime and atropine. Gastric lavage was done soon after the patient came to the hospital and was admitted to the Intensive care unit for 5 days and in the general ward for the next 24 h. The patient was discharged from the hospital in a hemodynamically stable state after 6 days of hospital stay by managing the cardiac, muscarinic, and nervous system events as detailed in this case report.

Review of the demographic pattern and outcomes of acute chemical poisoning in patients in a tertiary hospital in South-western Nigeria

Introduction: Acute chemical poisoning is a public health problem especially in developing countries where there is unrestricted access to chemical products, underreporting and absence of poisoning registers. Despite its importance, there is limited information on acute poisoning among adult population in Nigeria. The study was aimed at determining the demographic pattern and short term outcomes of acute chemical poisoning in patients in a tertiary health institution in South-western Nigeria over a 2 year period.Methodology: Records of cases of acute chemical poisoning over a 2-year period were retrieved and the following information extracted: socio-demographic data of patient, type of substance ingested, type of poisoning, reason for poisoning, intervention, and outcome of treatment. Results:There were 58 patients with a M:F ratio of 1:1.1. The mean age was 28.53±13.47 years. The most commonly ingested chemical was organophosphate seen in 31(53.4%). Poisoning was deliberate in 43 (74.1%); 36 patients (62.1%) had atropine; 16 patients (27.6%) had gastric lavage; one patient (1.7%) was dialyzed and 2 patients (3.4%) were admitted into ICU. Mortality rate was 8.6%. Conclusion: Deliberate acute chemical poisoning was common in young adults. Organophosphate is the most commonly ingested chemical. Government should enforce laws that that would restrict access to potentially harmful chemicals. French title: Schéma et résultats à court terme d'une intoxication chimique aiguë dans un hôpital tertiaire du sud-ouest du Nigéria Introduction : Les intoxications chimiques aiguës sont un problème de santé publique en particulier dans les pays en développement où il existe un accès illimité aux produits chimiques, une sous-déclaration et l'absence de registres des intoxications. Malgré son importance, il existe peu d'informations sur les intoxications aiguës parmi la population adulte au Nigéria.Objectif de l'étude: Déterminer le schéma démographique et les résultats à court terme des intoxications chimiques aiguës chez les patients d'un établissement de santé tertiaire du sud-ouest du Nigéria sur une période de 2 ans.Méthode de l'étude : Des dossiers de cas d'intoxication chimique aiguë sur une période de 2 ans ont été récupérés et les informations suivantes extraites : données sociodémographiques du patient, type de substance ingérée, type d'intoxication, raison de l'intoxication, intervention et résultat du traitement.Résultat de l'étude : Il y avait 58 patients avec un rapport M : F de 1:1,1. L'âge moyen était de 28,53 ± 13,47 ans. Le produit chimique le plus couramment ingéré était l'organophosphate vuswzsw3 dans 31 (53,4 %). L'empoisonnement était délibéré dans 43 (74,1 %); 36 patients (62,1%) avaient de l'atropine ; 16 patients (27,6 %) ont eu un lavage gastrique ; un patient (1,7%) a été dialysé et 2 patients (3,4%) ont été admis en réanimation. Le taux de mortalité était de 8,6%. Conclusion : Les intoxications chimiques aiguës délibérées étaient fréquentes chez les jeunes adultes. L'organophosphate est le produit chimique le plus couramment ingéré. Le gouvernement devrait appliquer des lois qui restreindraient l'accès aux produits chimiques potentiellement nocifs.

An Accidental Emamectin Benzoate Poisoning In Child: A Case Report

Background: Emamectin Benzoate has high GABA (Gamma Amino Butyric Acid) receptor affinity and increase chloride membrane permeability. It is the 4'-deoxy-4'-epi-methyl-amino benzoate salt of avermectin B1 (abamectin), obtained from natural fermentation products of Streptomyces Avermitilis.Report: This case report describes the accidental poisoning of Emamectin Benzoate 5% w/ws in a female child. The child was brought to the emergency department(ED) with complaints of nausea, vomiting and abdominal pain. She consumed a packet of “LURA” (5% w/w Soluble Granule (SG) Emamectin Benzoate) supposing it as a packet of “JALJEERA” (a commonly used beverage) since there was no proper labelling. The patient was hemodynamically stable and underwent vigorous gastric lavage with normal saline, activated charcoal and coconut oil. Her blood report was normal for serum electrolytes and renal function. She was admitted in medical ward for symptomatic management and observation. She was given antiemetics, IV fluids and antacids and discharged in 2 days. In follow up after 1 week, she did not have any complain, her gastrointestinal symptoms had completely resolved and she was doing very well.Conclusion: In absence of specific antidote, vigorous gastric lavage with both activated charcoal and coconut oil improves the outcome in Emamectin Benzoate poisoning.

An Epidemiological Study of Acute Poisoning In a Tertiary Care Centre

Introduction: Acute poisoning represents a real health threat in the world. It is a common cause of admission to emergency department and in intensive care unit. Periodic clinical and epidemiological studies are required to understand the pattern of poisoning. This study aims to analyze epidemiological aspect, clinical profile, and outcome of acute poisoning in a tertiary care hospital. Material and Methods: A cross sectional study was conducted at Government Medical College Hospital, Kota, Rajasthan. 102 admitted patients were taken for study from January 2020 to August 2020. Epidemiological variables age, sex, type of poison, mode of exposure, clinical presentation and outcome were studied. Results: The median age was 30.23 years with a male predominance (54.9%). The circumstances of poisoning were suicidal, accidental and unknown in 88.2%, 9.8%, and 1.96% respectively. Ingestion was the major route of exposure (98%) followed by inhalation (1.96%). The majority 33(32.4%) of cases were of Organophosphorus poisoning followed by 17(16.7%) cases of Rodenticide poisoning. The main symptoms were nausea and vomiting in 90(88.2%) cases. Convulsions were noted in 3(2.9%) patients. Gastric lavage was done for 92(90.19%). 8 patients (7.84%) were needed mechanical ventilation. 7 patients (6.86%) were needed vasoactive drugs. The rate of mortality was 8.82%. The aluminium phosphide poisoning was responsible for 44.4% deaths. Conclusion: Study revealed the high mortality associated with acute poisoning. Appropriate approach towards poisoning at tertiary care center and prevention remains the best strategy for reducing morbidity and mortality.

Survival rate after paraquat poisoning: impact of emergency clinical and laboratory variables

Objective: to analyze the association of survival to emergency care measures, clinical symptoms and biochemical markers used for paraquat intoxicated patients. Methods: retrospective cohort, guided by the Strengthening the Reporting of Observational Studies in Epidemiology tool. The data collection and analysis protocol were based on two phases: first, with the survey of the investigation forms of exogenous poisoning from the Secretariat of Epidemiological Surveillance; second, with the analysis of information in printed medical records. Results: of the 36 (100%) patients investigated, 19 (53.0%) survived; regarding the clinical manifestations, there was statistical significance for the respiratory system (p=0.003); regarding the biochemical variables, there was statistical significance for liver enzymes. The initial emergency measures 13(56.5%) of survivors received gastric lavage with activated charcoal. Conclusion: we observed a lack of efficacy of the impacts of emergency care measures and medications in increasing patient survival.

The diagnostic value of urinary culture filtrate protein-10antigen in childhood tuberculosis

Introduction and Aim:Childhood tuberculosis (TB) remains a major problem worldwide.However, diagnosis of tuberculosis in children is often complicated by the difficulty in obtaining a proper sputum specimens and low sensitivity of the gold standard diagnostic test to confirm the presence of Mycobacterium tuberculosis(M.tb)in this age group. Recently, M.tbantigen detection in urinaryspecimenshas become a popular method. It is non-invasiveand handling of specimen is simple. It was reported that urinary CFP-10, a specific protein of M.tb, has emerged as a potential biomarker in the future. However, its diagnostic value as a new biomarker in childhood TB remains poorly understood.The aim of the study is to determine the diagnostic value of urinary CFP-10 in childhood TB. Methods: Seventy children with suspected pulmonary or extrapulmonary TB were enrolled. Tuberculosis was diagnosed by performingTuberculin skin test, chest x-ray, microscopic examination, and microbiological cultureobtainedfrom sputum or gastric lavage specimen. The level ofurinary CFP-10 antigen was analyzedbyELISA (Elabscience, China). Statistical analyseswereperformed using SPSS 21.0 and p-values of <0.05 were consideredstatistically significant. Results: The levels of urinary CFP-10 in subjects diagnosed with TB was higher than that of the non-TB subjects, 4.13(0.62) vs 0.43(0.14) pg/mL, p=0.005. The cut-off value forurinary CFP-10 level reached 0.39 pg/mL (sensitivity 65% and specificity 67%). This value became0.54 pg/mL (sensitivity 61% and specificity 62%)in microbiologically confirmed cases. Conclusion: The urinary CFP-10 level has moderate diagnostic value for diagnosing childhood TB.

Treatment of Pediatric Life Threatening Amitriptilin Intoxication with Plasma Exchange

Tricyclic antidepressant (TCA) overdose is one of the most common causes of serious drug poisoning in children. Amitriptyline is a major TCA drug that is used widely. Tricyclic antidepressant intoxications are very important because of their severe adverse effects and probable fatal outcomes. It may cause cardiovascular, respiratory and neurological side effects. Poisoning results in hypotension, cardiac dysrhythmia, depression of the central nervous system (CNS) and seizures. The most common effects on the central nervous system are agitation, lethargy, seizures, and coma. Cardiovascular toxicities manifest itself especially with electrocardiographic (ECG) abnormalities, arrhythmias, and refractory hypotension and they are the leading cause of fatal outcome. Treatments in TCA overdose are mainly conservative including gastric lavage, activated charcoal and vasopressors for hypotension, sodium bicarbonate for dysrhythmias, and benzodiazepines for seizures. Magnesium sulfate (MgSO4) also has an effective role in the treatment of fatal cardiac arrhythmias occurring in high-dose amitriptyline intoxication. Intravenous lipid emulsions have been increasingly studied as antidotes to reverse acute, life-threatening drug toxicity. Unpredictable and poor results with hemoperfusion (HP) and hemodialysis (HD) should be expected, as the drug binds rapidly to tissues and has a large volume of distribution. But beside it, in the last few years, HP has been successfully used in severe TCA overdose, especially in patients with persistent respiratory, cardiac, and neurologic symptoms. Besides all these, recently, plasma exchange, have been increasingly used. A reduction of plasma levels by 63% after plasmapheresis in TCA poisoning has been reported. Here, we report a successful treatment of plasma exchange 3 year patient with amitriptyline overdose who had arrhythmias and seizures that wasn't respond all to conservative therapies.