Purpose: To study the hemodynamic parameters in ophthalmic artery (OA) using color Doppler imaging in subjects with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG) and age matched normals. Methods: Sixty-eight eyes of 68 subjects (41 males and 27 females) constituted material for this prospective observational study. They were divided into three groups; Group A had 24 patients with POAG, Group B had 18 patients with NTG and Group C had 26 normal subjects. They underwent CDI of OA. The outcome variables were peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI) and pulsatility index (PI). Data were compiled and analyzed using one-way ANOVA analysis. Results: The mean ± SD age of POAG patients, NTG patient and normal subjects was 59.
A 48-year-old man was brought to the emergency room after ingesting an unknown amount of carbamazepine. He was unconscious and not responding to the noxious stimuli. He was intubated and was placed on mechanical ventilation because of respiratory insufficiency. Primary detoxification was performed with a gastric lavage and charcoal instillation. His serum carbamazepine level was 25.6 mcg/mL at the time of admission. His computed tomography of the brain was normal. He was managed conservatively but there was no improvement in his neurological status in the next 24 hours. Serum carbamazepine level was repeated and reported to be 28.3 mcg/mL. As there was no improvement in his sensorium and the serum carbamazepine levels remained persistently high, extracorporeal removal of carbamazepine was attempted. As the facility to carry out hemoperfusion was not available immediately, the decision to initiate hemodialysis was taken. After 3 sessions of hemodialysis, his sensorium improved markedly and the carbamazepine level at this time was within the therapeutic range. He was discharged after psychiatry consultation and counseling. We review the literature regarding extra corporeal techniques for the removal of carbamazepine and discuss them in this article.
Background: Poisoning constitutes about 60% of deliberate self-harm in rural Asia. OPCs account for 80% of pesticide poisoning. Ravi et al reported the incidence of organophosphorous poisoning as around 1.26 lakhs in India. Patients will be required ventilator support for management in most of cases and hence study is being done to find the association of factors in patients with prolonged ventilator support.Methods: Statistical analysis was carried out for 50 patients after categorizing each variable like age, sex, type of compound, quantity, serum pseudo cholinesterase levels, respiratory failure, intermediate syndrome and other clinical signs.Results: Out of 50 patients 74% of patients required more than 10 days of ventilation and methyl parathion was the frequent compound associated with prolonged ventilation and 60% of patients who required 4-8 days of atropinisation and also patients who had low pseudocholinesterase levels at the onset had required prolonged ventilation.Conclusions: The results show that outcome of patients with OPC poisoning is associated with type of compound, period of atropinisation, quantity, pseudocholinesterase levels. So immediate treatment is most important to improve mortality in OPC poisoning.
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