This case series highlights a fatal mode of self-poisoning that could be controlled through regulation of the manufacture and sale of the product.

Background. Role of herbs in the management and control of diabetes has emerged fast over the years. We assessed the efficacy of Coccinia grandis (locally known as Ken, Kovakka) leaves as a hypoglycemic agent. Methods. Double-blind phase I clinical trial was conducted at the general hospital and a private hospital in Matara in August 2009. All the participants were given a common meal for dinner, and they maintained a 10-hour fasting period. Sixty-one healthy volunteers were given a meal containing 20 g of leaves of Coccinia grandis which was mixed with a measured amount of scraped coconut and table salt for breakfast, and other 61 were given the placebo meal which also contained scraped coconut and salt. Glucose tolerance test was performed blindly for the two groups. Mixed factorial design analysis of variance and student's t-test were applied. Results. Overall blood sugar levels of the experimental group were also significantly lower than those of the control group (F(1,117) 5.56, P < 0.05). Increase in the blood sugar levels from fasting to one hour (F(1,117) 6.77, P < 0.05) and two hours (F(1,117) 5.28, P < 0.05) postprandially was statistically significant for participants who were in the control group than those of in the experimental group. The mean difference of postprandial blood sugar levels (mg/dL) after one hour (20.2, 95% confidence interval, 4.81 to 35.5) and two hours (11.46, 95% confidence interval; 1.03 to 21.9) was statistically significant between the two groups. Conclusions. Coccinia grandis has a blood sugar lowering effect. However further studies are needed to validate our findings.

Introduction:  The washing powder ‘Prinso' consists of 2 sachets, one containing pink crystals and the other white granules which has become a popular agent amongst the youth for self poisoning. Objectives: To document clinical and biochemical features of ‘prinso' poisoning.  To analyze the chemical constituents of prinso.  Patients and methods: We present a series of 7 patients who were admitted to General hospital Matara following ‘Prinso' poisoning, from 01.06 2006 to 01.10.2007. We chemically analyzed the two sachets in faculty of science university of Ruhuna. Results: The male: female ratio was 3:4.Out of the 7 patients, 1 patient developed acute renal failure. Conclusion: The readily available household product ‘Prinso' has come to recognition in the array of poisons responsible for deliberate self poisoning among young with a preponderance among females ingesting it in the southern province of Sri Lanka.Keywords: poisoning; detergentCitation: Munasinghe MAAK, Fernando WKBKM. The Toxic Laundry Detergent Powder ‘Prinso’ Is Gaining Notoriety Amongst Villagers For Deliberate Self- Poisoning In And Around The Matara District. Sri Lanka Journal of Critical Care 2009;1:29-32DOI: 10.4038/sljcc.v1i1.940

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This study was designed to compare the presence of seven clinical signs in a group of patients with migraine with that of patients with non-migraine headache. Migraine is sometimes misdiagnosed. Therefore additional features are useful to improve the diagnostic accuracy of migraine. A cross sectional descriptive study was conducted in a group of 709 outpatients with headache. The physical signs were named as A–G. These were carefully observed certain gestures exhibited by patients themselves when they describe their headache. Sign A (pointing right side of the forehead) and sign B (pointing left side of the forehead) were significantly higher in patients with migraine (Sign A positive—123/339, Chi-square—15.784, p < 0.001; Sign B positive—146/339, Chi-square—20.813, p < 0.001). Sign F (keeping the head on a table) was significantly higher in patients with non-migraine headache (Sign F positive—132/370, Chi-square—12.954, p < 0.001). Sign A was more commonly associated with unilateral, severe headache which lasted for a longer period of time. However sign B was more commonly associated with unilateral, severe headache only. Sign C was significant in patients who had bilateral headache in both migraine and non-migraine groups than unilateral headache. It is concluded that pointing right or left side of forehead when the patient describes his or her headache is a characteristic sign of migraine. Keeping the head on the table during an attack of headache is not a characteristic sign of migraine.