From crisis to recovery: a case report and literature review of early extracorporeal membrane oxygenation and esophagogastroduodenoscopy intervention in a patient with extended-release bupropion overdose

Drug poisoning, including bupropion overdose, presents significant clinical challenges with rising mortality rates. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential therapeutic option, particularly in cases of cardiovascular collapse refractory to conventional treatment. However, the role of early ECMO initiation in bupropion intoxication remains under-explored. We present a case of a 41-year-old male with an extended-release bupropion overdose who developed cardiovascular collapse despite standard interventions. The patient underwent early initiation of ECMO and esophagogastroduodenoscopy for drug removal. Within 72-hours of ECMO initiation, the patient demonstrated significant hemodynamic improvement and was successfully weaned off vasopressors. The patient was extubated and transitioned to the medical floors with continued improvement. Early ECMO initiation may be beneficial in bupropion overdose cases presenting with cardiovascular collapse refractory to standard interventions. This case highlights the potential role of ECMO in managing severe bupropion intoxication and suggests further exploration of ECMO as an early intervention in drug poisoning cases.

safety and efficacy of alminoprofen in the treatment of acute musculoskeletal conditions

Study of efficacy and safety of minalfene in the acute rheumatic pathologies was carried out at Mayo hospital, Lahore during 1996. Thirty one patients were included in the study, out of which thirteen [41.94%] were male and eighteen [58.06%] were female. The age ranged between 16-70 years [mean 39.03 years]. Patients included in the study were suffering from neck pain [6], backache [4], backache with sciatica [3], sciatica with neurological deficit [5], knee pain with effusion [7], and with out effusion [2], shoulder pain with impingement [2], tennis elbow [1] and planter fascitis [1]. Minalfene was given in a dose 300 mg thrice a day for ten days. The results at the end of treatment showed improvement in 27 cases [87.10%] while in 4 [12.90%] there was no improvement. Tolerance of minalfene was good to excellent in 25 cases [80.64%], there were moderate gastric symptoms in 5 cases [16.13%] and there was severe gastric problem in one case [3.23%]. We concluded that minalfene is an effective and a relatively safe drug in the treatment of acute musculoskeletal conditions