RESUMEN
Ingestion of corrosive substances and chronic sequelae associated with it is the major public health problem in the developing countries. The most severe forms of injury can lead to mortality; however, the major concern with this type of injury in life-long morbidity. Colonic conduit for bypassing diseased oesophagus with distal anastomosis with stomach is well documented and practiced procedure. Authors have encountered a case of 21-year-old lady with corrosive injuries to oesophagus and stomach, later developed non dilatable oesophageal stricture with completely cicatrised and adherent stomach. Due to unavailability of stomach, authors have used colon as a conduit and colo-jejunal anastomosis bypassing the oesophagus, stomach and duodenum. Colo-jejunal anastomosis for chronic corrosive oesophageal stricture is not commonly practiced procedure which makes this case a rare one.
RESUMEN
Mercury is a heavy metal known for its toxicity and noted for inducing public health disasters in Minamata Bay, Japan, and Iraq. The toxic effects of mercury can either be acute and extremely severe or can manifest very subtly over a long period. Here, we report the case of a 56-year-old gentleman presented with complaints of sudden loss consciousness. On further evaluation and radiological examination, the patient had features suggestive of encephalopathy with a suspected foreign body in the gastrointestinal tract. Foreign body was found to be elemental mercury with elevated serum mercury levels. He was managed conservatively with chelation therapy with dimercaprol and prokinetic drugs such as polyethylene glycol which lead to the advancement of foreign body in the gastrointestinal tract on repeated abdominal x-rays with subsequent complete clearance.
RESUMEN
Objective: To study and compare the efficacy and safety of intranasal midazolam and intravenous diazepam for treatment of children with acute seizures. Subjects: Children beyond neonatal period hospitalized with acute seizures. A total of hundred seizure episodes, 50 in either midazolam or diazepam group. Interventions: Intranasal midazolam (0.2 mg/kg) and intravenous diazepam (0.3 mg/kg). Results: In the midazolam group, the treatment was initiated within 30s in 78% of the patients as compared to 24% in the diazepam group. There was a significant difference between mean time taken from contact with physician to drug administration between the midazolam (29.02 ± 32.64s) and diazepam group (51.92 ± 33.61s) [p < 0.01]. The mean time of contact with physician to cessation of seizure was almost comparable between the two groups (93.07 ± 74.23s Vs 95.74 ± 79.79s). No significant adverse events were noted in either group. Conclusions: Treatment could be initiated quickly with intranasal midazolam and was efficacious for seizure control. As it is easy to administer, it can be safely recommended for use in domiciliary and home settings for control of acute seizures in children.