Patterns of organophosphorous poisoning attending a teaching hospital.

The objective of this was to study the pattern of patients of organophosphorous (OP) poisoning attending Kathmandu Medical College Teaching Hospital (KMCTH). This is a retrospective study of OP poisoning from hospital records were analyzed meticulously and data extracted. Data collected were: patient's demographics, motive for poisoning, type of OP poison, arrival time, time since ingestion, patient's vitals, predisposing factors, serum cholinesterase levels, treatment given, duration of hospital stay and mortality. A total of 47 patients of OP poisoning attended KMCTH from Aug 2003 to July 2005. 22(46.8%) cases were male and 25(53.2%) were female. The maximum number of patients were between the age of 20-40 (33-70.2%). Married patients outnumbered the unmarried (35/74.5% vs 12/25.5%). The most common motive for poisoning was suicidal, 41 cases (87.2%). Metacid (methyl-parathion) was the most commonly used OP compounds in 32 (68%) patients. Interpersonal marital relationship seemed to be the commonest predisposing factor, 23 cases (48.9%).The commonest time of presentation was between 6 pm-12 midnight. 7(57.4%) cases presented within 2 hours of ingestion of the poison. Serum cholinesterase level measured after full atropinisation was >50% of normal level in 17 cases (36.2%). 10 cases (21.3%) required respiratory support. Intermediate syndrome (IMS) was observed in 3 cases. Overall mortality occurred in 3 cases (6.4%). This study highlights the problem of OP poisoning in our region. Establishment of strict policies against the sale and availability of insecticides and pesticides which are freely available in the market is an effective way to control OP poisoning.

Odontogenic origin of necrotizing fasciitis of head and neck - a case report.

Necrotizing fasciitis (NF) of head and neck is a fulminant infection associated with necrosis of connective tissue which spreads along the fascial planes with high mortality rate. It is usually polymicrobial, odontogenic and occurs more frequently in immunocompromised patients. Because of the rarity of the disease, early diagnosis and early management is often delayed. We present a diabetic patient who developed NF of head and neck following tooth extraction. Because of vigorous teamwork he could be saved from the fatal disease but required extensive plastic repair. Every clinician should be aware of such a disease, particularly in immunocompromised patients and necessitates earliest diagnosis and intervention to save their life. Keywords: Necrotizing fasciitis, necrotizing soft tissue infections.

Seroprevalence of hepatitis "B" in Kathmandu Medical College Teaching Hospital (KMCTH).

A retrospective study conducted in patients attending Kathmandu Medical College Teaching Hospital (KMCTH) Sinamangal Kathmandu over a nine months period from April 2001 to December 2001. The aim of present study is to assess the seroprevalence of viral Hepatitis B in patients attending KMCTH. A total of 200 patients blood were examined for the presence of Hepatitis B virus infection, out of that 5 (2.5%) were found to be positive for Hepatitis B surface antigen (HBsAg) tested by immuno-chromatographic method. All the positive cases were found to be male age between 21 to 80 years and most of them 3 (60%) are young and productive age group (21-40 years).