Carbon Monoxide Poisoning due to Gas Water Heater

Background and Objectives: Carbon Monoxide (CO) poisoning is a leading cause of injury and death due to poisoning in many parts of the world. Among numerous sources of CO, the gas water heater can be a potential under looked source causing an accidental Carbon monoxide poisoning. In the perspective of Kathmandu valley, where there are houses with small bathrooms, inadequate ventilation and absent CO detectors, gas water heaters can be extremely dangerous even if it liberates small amount of CO gas. Herein, we present a case of CO poisoning to increase awareness about the gas water heater use and the possible risk of CO poisoning in our community.Presentation of Case: A 34 years old healthy female from Patan, presented with the history of loss of consciousness for 15 minute while taking bath on a gas water heater. There was no spontaneous respiration, no cardiac activity and her body temperature was below normal.Discussion: CO is toxic to all aerobic forms to life. CO binds to hemoglobin 230 times faster than oxygen causing cellular hypoxic damage and death. CO poisoning is not uncommon in our society and many such cases are misdiagnosed for some other illness.Conclusion: Use of the gas water heaters and likelihood of CO poisoning should be notified as a public concern. People need to be aware of these hazards to prevent fatal events and likely death due to exploitation of gas water heaters.

ECG findings in elderly.

There are not sufficient studies on ECG in elderly population in Nepal. This study attempts to evaluate the findings of ECG in elderly population in Nepal. ECG recordings from 171 apparently healthy geriatric subjects aged above 60 yrs (Mean age 70.66 +/- 7.14 yrs) from different geriatric homes were studied. The ECG was entirely normal in 38.6% of the study population. The major abnormalities were sinus bradycardia in 31 (18.1%) subjects, LVH in 25 (14.6%) subjects, premature supraventricular beats in 16 (9.4%) subjects, T wave changes in 11 (6.4%) subjects and right bundle branch block 16 (9.4%) subjects. Poor R wave progression in precordial leads in 9 (5.3%) subjects and right atrial overload in 4 (2.4%) were other common findings. More than one third of the elderly population in our study had entirely normal ECG. Majority of the abnormalities found in this study were very minor. These observations are important for the future studies evaluating healthy ageing in this region.