There are a variety of pesticides that are used to control the pests in agricultural lands and other places. Newer pesticides, developed as an alternative to highly toxic organophosphates such as imidacloprid including other neonicotinoid compounds, are being increasingly used considering their less harmful effects in case of human exposures. Though it is considered relatively safer to human beings, it can lead to potentially life-threatening complications and acute poisoning with these compounds may be fatal in large ingestion. We report a case of poisoning with imidacloprid compound presenting with a variety of systemic features including respiratory failure and patient's improvement with conservative management.
Background: Neuropathy is a common complication of diabetes mellitus and it may affect both the peripheral nerves and autonomic nervous system. It’s prevalence ranges from 1% to 90%. The present study is therefore designed to investigate autonomic nervous system involvement in diabetes mellitus by using simple bedside tests and to study its association with other diabetic angiopathies.Methods: 100 patients of diabetes mellitus were selected in the study. In Autonomic function tests for evaluating parasympathetic damage E: I ratio, 30:75 ratio and Valsalva ratio test was performed. Sympathetic damage was diagnosed by Blood pressure response to standing test and Blood pressure response to sustained handgrip test.Results: Abnormal E:I ratio was noticed in only 24 patients. The 30:15 ratio was found to be abnormal in 38 patients while the Valsalva Ratio was abnormal in 34 patients. Postural hypotension was observed in only 8% patients. The sustained hand grip test was abnormal in 10 patients. The prevalence of cardiac autonomic neuropathy was 58%. The association between the presence of autonomic neuropathy and peripheral neuropathy was statistically significant. However, the association between autonomic neuropathy and retinopathy and nephropathy was not statistically significant.Conclusions: The overall prevalence of autonomic neuropathy in diabetes mellitus was 58%. There was parasympathetic preponderance over sympathetic nervous system in the involvement of diabetic autonomic neuropathy. There was statistically significant association of diabetic autonomic neuropathy with peripheral neuropathy as compared to retinopathy and nephropathy.
Background: Viral hepatitis is known since ancient times. Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. Different species of viruses, including Cytomegalovirus, Epstein-Barr, Herpes simplex, Adenovirus, Coxsackie virus and others cause parenchymal hepatic inflammation, but the term viral hepatitis generally implies to the five hepatotropic viruses: Hepatitis A, B, C, D and E virus.Methods: This observational study was done from August 2014 to November 2016 in department of medicine of a medical college using a structured questionnaire.Results: Anorexia was the most common symptom; followed by fatigue; nausea and vomiting. Total serum bilirubin and direct serum bilirubin were raised in all cases of hepatitis A and E. Raised SGPT and SGOT were observed in all cases of Hepatitis A and E. Among 43 patients of hepatitis B, SGPT and SGOT were raised in 32 and 31 cases respectively. Raised alkaline phosphatase was observed in 27; 25 and 16 cases of hepatitis A; B and E respectively. Raised prothrombin time was observed in 12; 11; 01and 09 of Hepatitis A; B; C and E cases respectively.Conclusions: Viral hepatitis is an important heath care problem in India as it occurs epidemically and sporadically. The variability in nature of the disease regarding its onset, presenting symptoms, clinical course and development of complications are important aspects. So, it is very essential for health care professionals to be aware of all aspects of it so that it is detected and treated early.
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