Acute Liver Failure and Intravascular Haemolysis in Zinc Phosphide Poisoning.

A 37-year-old male presented with symptoms of nausea, vomiting, abdominal pain, jaundice, lacrimation and reddish brown urine discoloration since 2 hours after ingestion of 30 gms of zinc phosphide with suicidal intent 4 hours before arriving at the hospital. There was no history of hematemesis, melena, convulsions. On examination blood pressure: 140/90 mmHg, Pulse: 120 beat per minute, RR: 24 cycles/minute, temperature: 37.5°C and O2 saturation: 91 percent in room air. Visible icterus was present. Diffuse tenderness was reviled by abdominal tests. Organomegaly was not present. The neurological examination was not important. There were flapping tremors. With 0.9 percentage of NaCl solution added with activated charcoal, the patient was given gastric lavage. Table 1 displays laboratory tests in the emergency department.

Carotid and femoral intima-media thickness in adults with sickle cell disease

Background: This study was conducted to evaluate Carotid Intima Media Thickness (CIMT) and Femoral Intima Media Thickness (FIMT) in adults with SCD.Methods: The present prospective cross-sectional study with control group was carried out in Department of Medicine at Acharya Vinoba Bhave rural hospital over a period of 6months from January to June 2018. A total of 100 (50 cases of SCD, 50 normal subjects) were studied. In the SCD group, 35 cases were patients regular follow up cases and 15 patients were in sickle cell crisis. CIMT of both left and right carotids were taken and the mean of the two values were recorded. The IMT was also measured in the right common femoral artery (RCFA) and left common femoral artery.Results: SCD patients in steady state had significantly decreased Hb%, increased WBC counts and platelet counts as compared to healthy controls. The mean right FIMT, left FIMT, right CIMT and left CIMT the patients with SCD with crisis were significantly higher than that of the patients without SCD (P<0.001). One way showed that there were significant differences in duration of disease in mean level of Hb%, WBC count, platelet count of the patients in the three groups (p<0.01).Conclusions: CIMT and FIMT can pick up the macrovascular involvement early and can be utilized as screening tools to predict vascular injury so that at risk individuals would be subjected to proper treatment protocols, especially hydroxyurea therapy early on.