Suicide by self-poisoning is a common cause of death, especially in the younger population. More specifically, hair-dye poisoning is being increasingly used for suicide. Paraphenylenediamine (PPD), also known as "Kala pathar", is a highly toxic ingredient present in hair-dye that can cause death. Therefore, this study is designed to assess the demographics, clinical features, laboratory findings, and outcomes of PPD poisoning in patients admitted to the National Poison Control Center in Karachi, Pakistan. Materials and methodsWe conducted a prospective study for a period of six months at the National Poison Control Center, Karachi, Pakistan. A total of eight patients with PPD poisoning with no cardiac, liver, or renal co-morbidities were included in this study. The demographic characteristics, clinical features, laboratory findings, mode of intoxication, and route of intoxication were noted in a proforma. Furthermore, hospitalization time, tracheostomy status, mechanical ventilation status, and mortality rates were also recorded. For continuous variables, the means and SDs were calculated. Whereas for categorical data, percentages were calculated.
Currently, the management strategies aimed at the resolution of migraine are pharmacological. Most of these therapies are known to alter the serotonin balance of the brain. Furthermore, therapies blocking the calcitonin gene-related peptide (CGRP) have also proven to be quite effective in their treatments. However, apart from being expensive, these therapies do not influence premonitory and aura symptoms. This suggests an incomplete approach and an inadequate understanding of the migraine pathophysiology. Recent metabolic studies have indicated that migraine should be considered as an adaptive response to the mismatch between the cerebral energy reserves and expenditure. Therefore, understanding the underlying metabolism helps derive possible novel therapeutic modalities for migraines. In this review, we highlight the underlying metabolic abnormalities found in migraine patients. This will form the basis of our evidence-based discussion on metabolic therapeutic options for migraines.
Background: Thyroid is an important endocrine gland regulating the metabolism of body from utero to maturation. Thyroid related diseases are most common among all endocrine diseases. Hyperthyroidism causes major metabolic derangement and hence the need for a screening test to diagnose the disease holds greater public health importance in a populated country like India. The study aims at finding the sensitivity of Wayne’s Criteria in correlation with Biochemical analysis in screening Hyperthyroidism.Methods: A prospective study done to screen patients with symptoms suggestive of hyperthyroidism coming to surgery department of Dr. S. M. C. S. I. medical college over a period of one year from September 2016 to September 2017 with the aid of Wayne’s Diagnostic criteria and biochemical analysis.Results: Of the total 53 cases studied, 23 cases were biochemically hyperthyroid. of the 23 cases Wayne’s criteria identified 20 cases as hyperthyroid, 2 cases were Disambigous and 1 was diagnosed as Euthyroid. Of the 30 biochemically Euthyroid patients Wayne’s criteria picked up 27 true Euthyroid patients, 2 patients as Disambigous and 1 patient was falsely diagnosed as Hyperthyroid. Sensitivity of the criteria was found to be 86.9%, specificity as 96%, positive predictive value was 95.2% and Negative predictive value was 90%.Conclusions: Wayne’s criteria holds a good deal of diagnostic accuracy. With high sensitivity specificity Wayne’s criteria can be applied as a screening test to diagnose a hyperthyroidism for early diagnosis and referral at the primary health care level in a populated country.
Introduction Myocardial infarction (MI) is a subset of the spectrum of the disease known as acute coronary syndrome (ACS), which comprises three distinct entities including unstable angina (UA) and MI with or without ST-segment elevation. However, many clinicians are unaware that MI itself is classified into five types, the most common being type I, followed by type II. Type II MI occurs due to coronary insufficiency not related to acute plaque change in the coronary vasculature. Data available on type II MI is still limited, particularly in the South Asian setting, despite documented poorer outcomes for the same compared to other types. Therefore, we conducted this study as an attempt to outline the predisposing factors, precipitating elements, and possible outcomes of type II MI. Materials and methods This prospective study was conducted at a tertiary care hospital in Kochi, Kerala for 12 months. A total of 59 patients of ages 10-99 years, with a final diagnosis of MI based on the levels of cardiac biomarkers and electrocardiography (ECG), no previous history of coronary angiography, thrombolysis, percutaneous coronary intervention (PCI), and non-ischemic conditions producing elevations in cardiac biomarkers were included in this study. Demographic features, cardiac biomarker levels, comorbidities, precipitating factors, foci of sepsis, and outcomes of type II MI were noted. The mean was calculated for age and cardiac biomarkers. The frequency and percentages were calculated for gender, comorbidities, precipitating factors, foci of sepsis, and the outcomes of type II MI.
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