Hair dye poisoning: "an early intervention"

The use of hair dye has been emerging worldwide however usage of Paraphenylenediamine [PPD] in making hair dye is generally restricted to underdeveloped and developing countries. In particular, prevalence of accidental and suicidal ingestion is more in low socioeconomic areas. The spectra of hair dye toxicity is wide, however, it presents more commonly with severe angioedema of face and neck leading to respiratory failure, rhabdomyolysis complicating into acute kidney injury, myocarditis and acute liver injury. Here we present a unique case of PPD poisoning in a young female presented with laryngeal edema and marked rhabdomyolysis. Preemptive shifting to Critical care unit and elective endotracheal intubation for air way patency obviated the need of tracheostomy and precluded its related complications. Moreover, aggressive intravenous hydration prevented from renal failure despite markedly raised Creatine phospho kinase [CPK] levels

Use of oral Vitamin-D glass ampoule and tablet: experience of patients and physicians

Objective: To ascertain patients and physician views regarding hazard and compliance of oral liquid Vitamin D glass ampoule and tablets

Methods: This cross sectional survey was conducted from November 1st 2016 to 15th December 2016. Patients who were prescribed Vitamin D glass ampoule from oral route in last three months were included along with physicians who routinely prescribe vitamin D after taking informed consent. The participants were asked about injuries related to the use of glass ampoule, ease of using this from, after taste preference of tablet or injectable form as well as demography. Data was analysed with SPSS version 24.0

Results: Total 182 patients were included in the study with mean +/- SD age of 39.4 +/- 12.4 years. Majority of patients, 80.2% [142] said they prefer oral tablet in preference to injectable ampule in oral form if given choice while prescribing Vitamin D. Moreover 66.7% [64] doctors prefer to prescribe tablet form of Vitamin D instead of injection as oral form for vitamin D deficiency among their patients. One third of patients, 33% [n=59] sustained injury while breaking the ampule which included minor self-controlled bleeding by glass particles in 50% [n=35]. Less than half of doctors 46.9% [n=45] said they taught their patients about usage of injectable Vitamin D ampules

Conclusion: Majority of patients prefer Vitamin D tablet instead of Oral liquid in glass ampoule if they got the choice among two. The results of this study provide important implications for our doctors about patients concern of hazard, after taste and compliance with orally administered Vitamin D glass ampoules