ABSTRACT
BACKGROUND: Organophosphorus (OP) compounds are the most common suicidal poison in developing countries and mortality continues to be high. METHODS: A study was done to see butyryl cholinesterase (BuChE) profile after OP poisoning in pralidoxime (P2AM) and placebo treated cases. Highest recommended dose of P2AM was used to study the reactivation of cholinesterase. Clinical outcomes like, correlation of BuChE and severity of poisoning, mortality and complications like Type I and II paralysis, need for ventilation and ICU stay were also studied. RESULTS: Twenty one cases of moderate and severe poisoning with OP compounds were included in the study. Mean BuChE levels came up gradually over 6-7 days, some taking up to two weeks. There was no. difference between the treatment and placebo groups. BuChE levels did not correlate with severity of poisoning nor did it correlate with Type I or II paralysis, need for ventilation, ICU stay or mortality. CONCLUSIONS: Treatment with P2AM does not make any difference in BuChE reactivation or complications of moderate and severe OP poisoning. We have not been using P2AM for OP poisoning in our medical ICU with good patient outcomes.
Subject(s)
Antidotes/administration & dosage , Butyrylcholinesterase/blood , Chemical Warfare Agents/poisoning , Cholinesterase Reactivators/administration & dosage , Developing Countries , Humans , Occupational Exposure/adverse effects , Pesticides/poisoning , Organophosphates/poisoning , Poisoning/drug therapy , Pralidoxime Compounds/administration & dosage , Suicide, Attempted , Treatment OutcomeABSTRACT
Deltopectoral flap and pectoralis major flaps form the basis of most reconstructions following ablative surgeries of head and neck region for cancers. There are many papers reporting acute complications but the literature on one late complication i.e. secondaries at flap donor site is rare. This is one such report and review of literature.
Subject(s)
Carcinoma, Squamous Cell/pathology , Female , Head and Neck Neoplasms/pathology , Humans , Middle Aged , Neoplasm Recurrence, Local/pathology , Pectoralis Muscles , Surgical FlapsABSTRACT
Glutathione (GSH) and GSH-related enzymes, glutathione reductase (GR), gamma-glutamyl cysteine synthetase (gamma-GCS), gamma-glutamyl transpeptidase (gamma-GTP), glutathione S-transferase (GST) and adenosine triphosphatase (ATPase) enzymes were analysed to study the effect of busulfan on the defence mechanisms of the lens. All these enzymes were found to increase significantly except GSH which showed only 7.9% increase as compared to controls in precataractous stage. These results affirm that busulfan is capable of evoking a response from the enzymes involved in the various pathways of GSH enabling the lens to prolong its clarity. The cataractous lenses showed significant decrease in all these parameters. Here, the impairment of the defense mechanism (GST, GR) and the total ATPase may be attributed to the cumulative action of the drug which can react with -SH groups of these enzymes, ultimately causing opacification.