Arsenic poisoning can occur through ingestion, inhalation, or skin absorption of arsenic compounds. Acute arsenic poisoning causes gastrointestinal symptoms like vomiting and diarrhea, while chronic exposure can lead to skin lesions, peripheral vascular disease, and cancer. Diagnosis is made through laboratory tests of urine, blood, hair, nails, and tissue samples, which detect elevated arsenic levels. Treatment for acute poisoning involves gastric lavage, administration of chelating agents like BAL, and supportive care, while chronic cases require removing the source of exposure and long-term chelation therapy along with symptom management. Autopsy findings may show inflammation of the gastrointestinal tract and liver congestion in acute deaths.
For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
COPPER POISONING
Appear within 15-30 min
Metallic taste
Increased salivation
Burning pain in stomach
Nausea, vomiting (vomited matter : blue / green colour)
Diarrhoea with much straining (motions are liquid and brown)
Oliguria, haematuria, albuminuria, acidosis, uraemia
In severe cases, haemolysis, jaundice, pancreatitis, convulsions, spasm of legs
Breathing difficulty, cold perception, severe head ache
Death due to HEPATIC or RENAL failure or both
Arsenic poisoning - heavy metal poisoning - clinical toxicologyShaistaSumayya
Arsenic is thought to occur throughout the universe.
It is the 20th most common element in the earth’s crust, having a concentration of 1.8 ppm.
Arsenic is today the commonest source of acute heavy metal poisoning, and is second only to lead in the incidence of chronic toxicity
Arsenic is a metalloid i.e. it is an element which resembles a metal in some respects, and is by itself not very toxic.
However, almost all the salts are toxic to varying degree.
Arsenic is a silver-grey or tin-white, shiny, brittle, crystalline and metallic-looking element.
It is rarely found in its isolated, elemental form.
More commonly, it is present in mineral species, in alloys, or as an oxide or other compound form.
For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
COPPER POISONING
Appear within 15-30 min
Metallic taste
Increased salivation
Burning pain in stomach
Nausea, vomiting (vomited matter : blue / green colour)
Diarrhoea with much straining (motions are liquid and brown)
Oliguria, haematuria, albuminuria, acidosis, uraemia
In severe cases, haemolysis, jaundice, pancreatitis, convulsions, spasm of legs
Breathing difficulty, cold perception, severe head ache
Death due to HEPATIC or RENAL failure or both
Arsenic poisoning - heavy metal poisoning - clinical toxicologyShaistaSumayya
Arsenic is thought to occur throughout the universe.
It is the 20th most common element in the earth’s crust, having a concentration of 1.8 ppm.
Arsenic is today the commonest source of acute heavy metal poisoning, and is second only to lead in the incidence of chronic toxicity
Arsenic is a metalloid i.e. it is an element which resembles a metal in some respects, and is by itself not very toxic.
However, almost all the salts are toxic to varying degree.
Arsenic is a silver-grey or tin-white, shiny, brittle, crystalline and metallic-looking element.
It is rarely found in its isolated, elemental form.
More commonly, it is present in mineral species, in alloys, or as an oxide or other compound form.
A brief presentation on Arsenic poisoning encompassing 40 slides - also included is a quiz on toxicology at the end. This a special article from Telugudoctors.co.in; Hope you find it useful and informative. We have tried to make it as attractive, brief and informative as possible. Your advice would be useful in perfecting our future slides.
toxicology is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
Toxicology of Strychnine poisoning with properties, active principles, uses, metabolites, actions, signs, symptoms, tetanus vs strychnine poisoning, treatment, postmortem findings and medico-legal importance
Heavy metal poisoning is caused by the accumulation of certain metals in the body due to exposure through food, water, industrial chemicals, or other sources. While your body needs small amounts of some heavy metals to function normally — such as zinc, copper, chromium, iron, and manganese — toxic amounts are harmful.
Medical toxicological aspects of snakes with emphasis on classification of snakes and their venom, identification of snakes, fatal dose, fatal period, signs and symptoms of snake bite, diagnosis of snake bite, management, post-mortem findings and medico-legal aspects especially of the common Indian snakes.
A brief presentation on Arsenic poisoning encompassing 40 slides - also included is a quiz on toxicology at the end. This a special article from Telugudoctors.co.in; Hope you find it useful and informative. We have tried to make it as attractive, brief and informative as possible. Your advice would be useful in perfecting our future slides.
toxicology is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
Toxicology of Strychnine poisoning with properties, active principles, uses, metabolites, actions, signs, symptoms, tetanus vs strychnine poisoning, treatment, postmortem findings and medico-legal importance
Heavy metal poisoning is caused by the accumulation of certain metals in the body due to exposure through food, water, industrial chemicals, or other sources. While your body needs small amounts of some heavy metals to function normally — such as zinc, copper, chromium, iron, and manganese — toxic amounts are harmful.
Medical toxicological aspects of snakes with emphasis on classification of snakes and their venom, identification of snakes, fatal dose, fatal period, signs and symptoms of snake bite, diagnosis of snake bite, management, post-mortem findings and medico-legal aspects especially of the common Indian snakes.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
3. INTRODUCTION
• Arsenic is a heavy metallic irritant poison.
• Metallic arsenic is not poisonous ,as it is not absorbed
from GIT.
• It is a normal constituent of all animal tissues.
• Soil, water and some sea fish are the natural sources
of arsenic.
• The most common reason for long-term exposure is
contaminated drinking water.
• Long term exposure to arsenic from drinking-water
and food can cause cancer and skin lesions.
4. TOXIC COMPOUNDS
• Arsenious oxide or arsenic trioxide – most toxic form, no
taste or smell and is sparingly soluble in water. Used in fruit
sprays, insecticides, rat poisons, weed-killers etc.,
• Copper arsenite (Scheele's green)
• Copper acetoarsenite (Paris green or emerald green)
• Sodium and potassium arsenate
• Arsenic sulfide
• Arsine- colorless gas with garlic-like odor
6. ABSORPTION AND EXCRETION
• It is absorbed orally, topically, by inhalation or
parenterally.
• Arsenic is found in greatest quantity in the liver, followed
by kidneys and spleen.
• In cases in which life is prolonged, it is found in the
muscles for days, in the bones, keratin tissues, hair, nails
and skin for years.
• It is excreted mainly by the kidneys but also in the faeces,
bile, sweat, milk, nails and hair.
7. ACTION
• Arsenic compounds act by inactivating the sulphydryl groups of
mitochondrial enzymes which inturn interfere with cellular
metabolism resulting in decreased production of ATP.
• It inhibits cellular glucose uptake, gluconeogenesis, fatty acid
oxidation and further production of acetyl CoA.
• Its particular target is vascular endothelium, leading to increased
permeability, tissue oedema and hemorrhage, especially in the
intestinal canal.
• Locally it causes irritation of the mucous membranes and
remotely depression of the nervous system.
8. ACUTE POISONING
• Acute exposures- cholera like gastrointestinal symptoms,
respiratory failure and pulmonary edema
• Fulminant type- dose- > 3g, death in 1-3 hr from shock and
peripheral vascular failure. GIT symptoms are absent
• Narcotic type- GIT symptoms are less. Giddiness, formication,
tenderness of the muscles, delirium , coma and death.
• Arsine gas exposure – hemolysis , hemoglobinuria , renal failure
and depresses the CNS.
• Fatal dose – inorganic arsenic : 0.6mg/kg/day
arsenic trioxide :120-200mg(adults)
2mg/kg(children)
• Fatal period – 1-2 days
9. Difference between Arsenic poisoning and cholera
FEATURE ARSENIC POISONING CHOLERA
Pain in throat Before vomiting After vomiting
Purging Purging follows vomiting Vomiting follows purging
Vomitus Contains mucus, bile and blood Watery, without mucus,
bile or blood
Stools Rice-watery, may contain blood Rice-watery, not bloody
and passed in continuous
involuntary jet
Tenesmus and
anal irritation
present Absent
Voice Not affected Rough and whistling
Conjunctiva Inflamed Not inflamed
Analysis of
excreta
Arsenic present Vibrio cholerae present
Circumstantial
evidence
Of arsenic poisoning may be
present
Other cases of cholera in
locality
10. CHRONIC POISONING
• Chronic exposure – black foot disease characterized by
diabetes, vasospasm and peripheral vascular insufficiency
• GIT disturbances – gradual weight loss, malnutrition,
fatigue, nausea, vomiting
• Catarrhal changes – running nose, headache, conjunctivitis
• Skin rashes – rain drop pigmentation, hyperkeratosis of skin
of palm and soles
• Nervous disturbances
11. CLINICOPATHOLOGICAL FINDINGS
SYSTEM ACUTE CHRONIC
Skin Skin rash, eruptions ,delayed
hair loss
Melanosis, hyperkeratosis,
cutaneous cancer
Nails - Brittle, Aldrich-Mees lines
Neurologic Hyperthermia, convulsions,
tremors, coma
Encephalopathy,
polyneuropathy, axonal
degeneration
GI tract Abdominal pain, dysphagia,
vomiting, rice-water diarrhea,
mucosal erosions
Nausea, vomiting, diarrhea,
anorexia, weight loss
Liver Fatty infiltration Hepatomegaly, jaundice,
cirrhosis
Renal Oliguria , uremia Chronic nephritis
Hematologic - Bone marrow hypoplasia,
anemia, thrombocytopenia,
leukemia
13. LABORATORY INVESTIGATIONS
• Urine - >50µg/l in 24hr urine, metabolites may be recovered.
• Blood - >0.9µg/dl, microcytic hypochromic anemia.
• Hair - >75µg%, 1.0-3.0 mg/kg(acute) and 0.1-0.5mg/kg(chronic).
• Nails - >100µg%
• Chemical test- Reinsch’s test, Marsh’s test, Gutzeit’s test.
• Abdominal X-ray
• ECG
• Neutron activation analysis
• Atomic absorption spectroscopy
14. TREATMENT
Acute poisoning
• Gastric lavage with warm water and milk.
• Demulcents and purgatives.
• Whole bowel irrigation
• Antidote-BAL- 3-5mg/kg IM 4 hourly for 2 days,
6 hourly for 1 day and then 12 hourly for 10 days
- DMSA-10mg/kg every 8 hourly for 10 days
- DMPS- 200mg iv 4 hourly
• Glucose-saline with sodium bicarbonate
• Hemodialysis or exchange transfusion
15. TREATMENT
Chronic poisoning
• Remove the patient from the source of exposure and
administer BAL in usual doses.
• Vitamin B complex and sodium thiosulfate are useful
• Symptomatic treatment
16. POSTMORTEM FINDINGS
Acute poisoning
External-Body looks emaciated.
-Rigor mortis appears early and putrefaction is delayed.
-Eye balls are sunken and skin is cyanosed.
-Blood tinged vomitus and fecal matter on body and clothes.
Internal- Mucous membrane of small intestine are inflamed
-Stomach- red velvety appearance
-Liver, kidney and heart: congested, enlarged and fatty
degeneration may be seen
17. POSTMORTEM FINDINGS
Chronic poisoning
External
Emaciation, pigmentation, keratosis, alopecia, white
streaks on nails, jaundice, wasting of muscles and
ulceration of nasal septum.
Internal
Stomach - patchy inflammatory redness
Small intestine - reddish with thickened mucosa
Liver - hepatomegaly, fatty degeneration
Kidney - tubular necrosis
Heart - myocardial necrosis
Bone marrow histopathology - hypoplasia
18. MEDICO-LEGAL ASPECTS
• Arsenic is the most popular homicidal poison.
• Suicide is rare
• Accidental death- admixture with food or improper
medicinal use.
• Occupational exposure
• Environmental contamination
• It is sometimes used in abortion sticks
19. REFERENCE :
• Biswas G. Inorganic Metallic Irritants- Arsenic, In:
Review of Forensic Medicine and Toxicology, 4th edition,
Jaypee Brothers Medical Publishers (P) Ltd,
2019.p.492-496.
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