Methyl alcohol is used industrially and is toxic to humans. It is metabolized to formaldehyde and then formic acid, which causes acidosis and is toxic. Symptoms range from dizziness and nausea to seizures, coma and death. Treatment involves correcting acidosis with bicarbonate, using ethanol to competitively bind to the metabolizing enzyme, and potentially haemodialysis. A case study describes a man with a history of alcoholism who was poisoned by methyl alcohol, developed seizures and metabolic acidosis, and died despite aggressive treatment including stomach washing and medications.
Alcohols and management of methanol poisoningAmy Mehaboob
This presentation gives a description of ethanol and methanol, their ADR, mechanism of action, therapeutic uses and also includes treatment for methanol poisoning
This is a case study on ethanol poisoning. Ethanol poisoning involves the consumption of over 25 mg/dL of ethanol. It affects age groups from young to elderly likewise. Treatment involves preliminary ABCD and administration of Disulfiram.
Toxicology
Volatile poisons
Ethyl alcohol (Ethanol)
It is colorless liquid with characteristic odor.
It is obtained from fermentation of food e.g. barley , bread or fruits.
The percentage of alcohol in beverages caries according to the type of alcoholic beverages.
Its most common ingested toxin throughout world,
Thousands of deaths occur due to overdose , suicide and accidental intake of alcohol.
Alcoholic beverage
The alcoholic content of different beverages are:
Beer:2-8%
Ligh wine:5-10%
Heavy wines:10-20%
Brany ,Rhum (rum),vodka and wisky:40-50% .
Absorption and elimination
Ethyl alcohol can be absorbed by the mucus membrane of the stomach and the upper part of the small intestine.
Absorption occurs more rapidly when its taken on an empty stomach. its delayed by the presence of food, especially fatty food.
After absorption : it reaches its maximal concentration in the blood after 0.5-1 hr.
About 90% of the amount absorbed is oxidized in the body into acetaldehyde and then into carbon dioxide + water +energy. the remaining 10% is excreted unchanged in the urine and breath.
The rate of oxidation of alcohol in the body after absorption is 0.1ml/hg/bodywt/hour.
The concentration of alcohol in the blood can be indirectly estimated by measuring its cocentration in alveolar air by aclometer.
Metabolism
Ethanol is oxidized to acetaldehyde by alcohol dehydrogenase and then metabolized into Co2 and water, this is considered the main path of metabolism , microsomal ethanol oxidizing system (MEOS) plays a minor rule.
Because of mucosal and hepatic metabolism , the oral dose yields a lower blood ethanol level than in equivalent
Administered I.V dose.
METHYL ALCOHOL (Methanol)
Methyl alcohol is widely used in industry and laboratories and hospitals as a solvent. Many cases of poisoning occurs due to adulteration of ethyl alcohol by adding methyl alcohol, or methyl alcohol is taken as a substitute for ethyl alcohol .
Metabolism
Methyl ALCOHOL is metabolized mainly in the liver by dehydrogenases to formaldehyde and formic acid, both are more toxic than methanol leading to blindness and acidosis .
Fatal Dose :
60-150 mls 15 mls is enough to cause visual effect.
Action:
retinal edema , optic atrophy , CNS depression, cyanosis, metabolic acidosis , neuritis optic and blindness
Fatal Period : variable
Fomepizole
It is heavy metal and bright silvery in appearance.It is liquid and is non poisonous if swallowed. However, it volatilizes at room temp and inhalation of vapors is toxic. It gets widely distributed throughout the body and causes toxic damage to brain, kidney, peripheral nervous system, mucous membranes etc
Presentation explains about toxicity of alcohol and various methods used by the police to detect the presence of alcohol in the blood and various alcohol composition.
Alcohols and management of methanol poisoningAmy Mehaboob
This presentation gives a description of ethanol and methanol, their ADR, mechanism of action, therapeutic uses and also includes treatment for methanol poisoning
This is a case study on ethanol poisoning. Ethanol poisoning involves the consumption of over 25 mg/dL of ethanol. It affects age groups from young to elderly likewise. Treatment involves preliminary ABCD and administration of Disulfiram.
Toxicology
Volatile poisons
Ethyl alcohol (Ethanol)
It is colorless liquid with characteristic odor.
It is obtained from fermentation of food e.g. barley , bread or fruits.
The percentage of alcohol in beverages caries according to the type of alcoholic beverages.
Its most common ingested toxin throughout world,
Thousands of deaths occur due to overdose , suicide and accidental intake of alcohol.
Alcoholic beverage
The alcoholic content of different beverages are:
Beer:2-8%
Ligh wine:5-10%
Heavy wines:10-20%
Brany ,Rhum (rum),vodka and wisky:40-50% .
Absorption and elimination
Ethyl alcohol can be absorbed by the mucus membrane of the stomach and the upper part of the small intestine.
Absorption occurs more rapidly when its taken on an empty stomach. its delayed by the presence of food, especially fatty food.
After absorption : it reaches its maximal concentration in the blood after 0.5-1 hr.
About 90% of the amount absorbed is oxidized in the body into acetaldehyde and then into carbon dioxide + water +energy. the remaining 10% is excreted unchanged in the urine and breath.
The rate of oxidation of alcohol in the body after absorption is 0.1ml/hg/bodywt/hour.
The concentration of alcohol in the blood can be indirectly estimated by measuring its cocentration in alveolar air by aclometer.
Metabolism
Ethanol is oxidized to acetaldehyde by alcohol dehydrogenase and then metabolized into Co2 and water, this is considered the main path of metabolism , microsomal ethanol oxidizing system (MEOS) plays a minor rule.
Because of mucosal and hepatic metabolism , the oral dose yields a lower blood ethanol level than in equivalent
Administered I.V dose.
METHYL ALCOHOL (Methanol)
Methyl alcohol is widely used in industry and laboratories and hospitals as a solvent. Many cases of poisoning occurs due to adulteration of ethyl alcohol by adding methyl alcohol, or methyl alcohol is taken as a substitute for ethyl alcohol .
Metabolism
Methyl ALCOHOL is metabolized mainly in the liver by dehydrogenases to formaldehyde and formic acid, both are more toxic than methanol leading to blindness and acidosis .
Fatal Dose :
60-150 mls 15 mls is enough to cause visual effect.
Action:
retinal edema , optic atrophy , CNS depression, cyanosis, metabolic acidosis , neuritis optic and blindness
Fatal Period : variable
Fomepizole
It is heavy metal and bright silvery in appearance.It is liquid and is non poisonous if swallowed. However, it volatilizes at room temp and inhalation of vapors is toxic. It gets widely distributed throughout the body and causes toxic damage to brain, kidney, peripheral nervous system, mucous membranes etc
Presentation explains about toxicity of alcohol and various methods used by the police to detect the presence of alcohol in the blood and various alcohol composition.
Poisoning is one of the very alarming topic now a days. This presentation will give you a basic idea on poisoning, drug poisoning, animal poisoning, plant poisoning, household poisoning, industrial poisoning, treatment of poisoning e.t.c
Toxic alcohol includes Methanol, Ethylene Glycol, Isopropyl alcohol. The toxicokinetics, clinical features are explained separately. Pathophysiology of toxic alcohols explained using diagrams. diagnosis can be done using HAGMA, High osmolar gap, UFR and ECG. Management is determined by block metabolism, correct pH and eliminate toxic metabolites.
- 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 Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
3. Introduction
Methyl alcohol is a non drinking type of alcohol
containing single carbon and is used in industrial and
automotive purpose.
4. MECHANISM OF ACTION
METHANOL FORMALDEHYDE FORMIC
ACID
ALDEHYDE DEHYDROGENASEALCOHOL DEHYDROGENASE
METHANOL ITSELF NOT TOXIC. FORMALDEHYDE VERY TOXIC, BUT VERY
RAPIDLY METABOLISED TO FORMIC ACID. FORMIC ACID RESPONSIBLE
FOR THE TOXICITY RELATED TO METHANOL INGESTIONS
5. MECHANISM OF ACTION
METHANOL
FORMALDEHYDE
FORMIC
ACID
ACIDOSIS
Early stage
of poisoning
ACIDOSIS
TISSUE
HYPOXIA
LACTIC ACID
PRODUCTION
CIRCULATORY
FAILURE
GENERAL TOXICITY
INCREASED FORMIC ACID TOXICITY
OCULAR
TOXICITY
INHIBITION OF MITOCHONDRIAL RESPIRATION
CIRCULUS
HYPOXICUS
6. SIGNS AND SYMPTOMS
In small doses Dizziness (vertigo)
Headache
Nausea & Vomitting
Abdominal pain
In Moderate doses Tachy cardia
Drowsiness
Mydriasis (dilation of the pupil)
In High doses Metabolic Acidosis
Convulsions
Retinal Oedema
COMA
Respiratory failure and death
7. SIGNS AND SYMPTOMS
CNS – CONVULSIONS, PROGRESSING TO COMA
RETINAL - BLURRED VISION, PHOTOPHOBIA, VISUAL
ACUITY LOSS, DILATED NON-REACTIVE PUPILS,
OPTIC NERVE BECOMES OEDEMATOUS
GIT - NAUSEA, VOMITING
CARDIAC - TACHYCARDIA, HYPERTENSION PROGRESSING
TO HYPOTENSION AND CARDIOGENIC SHOCK
RESPIRATORY - TACHYPNOEA
12. Name : Mr. X Age :
Sex : Male DOA :
CHIEF COMPLAINTS :
C/O Right Shoulder pain in the morning following which he
faints and then goes into unconscious state
convulsions (before going unconscious) (tongue bite mark seen)
HISTORY OF PRESENT ILLNESS :
N/K/C/O – BA / HTN / Epilepsy
Consumption of high levels of alcohol (12 hrs ago)
PAST MEDICAL HISTORY :
Known Diabetic, wound present over the right foot for over 7 months
PERSONAL HISTORY/ SOCIAL HABITS
K/C/O Alcoholism – 25 yrs
Smoking – 14 yrs
13. PHYSICAL EXAMINATION :
Pt was Unconscious/ disoriented
ON EXAMINATION :
Temp : 103° F BP : 110 / 70
Pulse : 88 RR 16
SYSTEMIC EXAMINATION :
CVS: S1 S2 +ve CNS : pupils not responding (dilated)
Initially responded to painful stimuli
followed by no response
RS : NVBS P/A : Soft
15. OTHER TESTS :
CT - subcortical white matter and basal ganglia hyperintensity and low-signal-
intensity
ECG – Bradycardia
DIAGNOSIS
Alcohol Poisoning ( Methyl Alcohol)
16. TREATMENT
Initially - Stomach wash given, Commercially available Ethanol 10 %
soln (30 ml)
DRUGS DOSE R.O.A FREQ No of Days
Inj Fosolin (Fos Phenytoin)
(anti convulsant)
150 mg IV stat 1
Inj Ceftum (cefuroxime) 250 mg IV OD 1
Inj Pantocid (pantoprazole) 40 mg IV BD 1
Inj Strocit ( citicoline)
(a Neurotonics/Neurotrophics)
250 mg IV BD 1
Inj Lasix 20 mg IV Stat 1
Inj Sodium Bicarb 500 mL IV Stat 1
17. PROGNOSIS OF CASE
The Subject goes into irreversible COMA
Respiratory Depression occours ( put on mechanical ventilation)
Sudden Cardiac Failure
Death