Rodenticides are chemicals used to kill rodent pests that can destroy large amounts of grains. They are commonly used but also pose risks to humans and pets through secondary poisoning. Common rodenticides include inorganic preparations like phosphorus and organic preparations like fluoroacetate compounds. Symptoms depend on the specific rodenticide ingested or inhaled and can include abdominal pain, vomiting, seizures, and bleeding. Treatment involves decontamination, supportive care, and antidotes like vitamin K for anticoagulants.
Rodenticide Poisoning + Rat Killer paste poisoning managementVasif Mayan
Rodenticide paste poisoning
Case Study
Clinical features
Management
Investigations
Treatment guidelines
pathogenesis
N acetyl cysteine
Coumarins
other rodenticides
Toxicology on aluminium phosphide, the characteristics, fatal dose,fatal period, sign and symptoms, postmortem appearance and medicolegal importance are discussed.
Rodenticide Poisoning + Rat Killer paste poisoning managementVasif Mayan
Rodenticide paste poisoning
Case Study
Clinical features
Management
Investigations
Treatment guidelines
pathogenesis
N acetyl cysteine
Coumarins
other rodenticides
Toxicology on aluminium phosphide, the characteristics, fatal dose,fatal period, sign and symptoms, postmortem appearance and medicolegal importance are discussed.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Severe hypertension that is a potentially life-threatening condition refers to a hypertensive crisis.
Severe hypertension is further classified into hypertensive emergencies or hypertensive urgencies.
Hypertensive emergency refers to a severe hypertension that is associated with new or progressive end-organ damage. In these clinical situations, blood pressure should be reduced immediately to prevent or minimize organ dysfunction.
Hypertensive urgency refers to severe hypertension without evidence of new or worsening end-organ injury.
A hypertensive emergency is hypertension with acute impairment of one or more
organ systems that can result in irreversible organ damage. Especially:-
Central nervous system
Cardiovascular system
Renal system.
The term hypertensive emergency is primarily used as a specific term for a hypertensive crisis with a diastolic blood pressure greater than or equal to 120mmHg and/or systolic blood pressure greater than or equal to 180mmHg.
Hypertensive emergency differs from hypertensive crisis in that, in the former, there is evidence of acute organ damage.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Severe hypertension that is a potentially life-threatening condition refers to a hypertensive crisis.
Severe hypertension is further classified into hypertensive emergencies or hypertensive urgencies.
Hypertensive emergency refers to a severe hypertension that is associated with new or progressive end-organ damage. In these clinical situations, blood pressure should be reduced immediately to prevent or minimize organ dysfunction.
Hypertensive urgency refers to severe hypertension without evidence of new or worsening end-organ injury.
A hypertensive emergency is hypertension with acute impairment of one or more
organ systems that can result in irreversible organ damage. Especially:-
Central nervous system
Cardiovascular system
Renal system.
The term hypertensive emergency is primarily used as a specific term for a hypertensive crisis with a diastolic blood pressure greater than or equal to 120mmHg and/or systolic blood pressure greater than or equal to 180mmHg.
Hypertensive emergency differs from hypertensive crisis in that, in the former, there is evidence of acute organ damage.
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Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
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The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
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Basic phrases for greeting and assisting costumers
Rat poisoning management
1.
2. Any Substance that is used to kill rats, mice and other rodent pests.
In India and in many parts of the world, huge quantity of grains is eaten up and
destroyed by rats.
Hence for preservation of grains use of rodenticidal agents has become
imperative.
Single feed baits are chemicals ,sufficiently dangerous enough to kill the rats at
its first dose.
Rodenticides are controversial due to secondary poisoning due to their risk to
humans and pets.
3. These rat poisons have recently become a common means
of self poisoning in Northern India , with a mortality rate
of 60%.
Poisoning may be:
-Suicidal
-Accidental
-Homicidal
Modes of poisoning:
-Ingestion
-Inhalation
-Dermal contact
6. Zinc phosphide:
- It is a single dose fast acting rodenticide.
-Death occurs with in 1-3days after ingestion.
-MOA:
Acid in the stomach reacts with the phosphide to yield toxic
phosphine gas which is a potent pulmonary toxicant.
Calciferols:
-MOA:
On ingestion in toxic doses these affect calcium and
phosphate homeostasis causing hypercalcemia.
7. -On accumulation in stomach , kidney , lungs , blood vessels and
heart are all calcified/mineralised.
-It has a synergistic effect with anticoagulant , thereby increasing
the chances of death and decrease in the time involved.
ANTI COAGULANTS:
-After ingestion of lethal dose , it effectively blocks the vit-k
cycle , resulting in inability to produce essential blood clotting
factors mainly factors II and VII.
8. - massive toxic doses of 4-hydroxycoumarin cause
damage to tiny blood vessels , increasing their
permeability , causing diffuse Internal Bleeding.
-These effects are gradual , developing over several days.
-This is the preferred type of rat bait , as the antidote is
available i.e, Vit-K.
11. Do not have onset symptoms , which might manifest days
later.
Haematuria
Bloody diarrhoea
Extensive Bruising
Epistaxis
Haematemesis
Low Blood pressure
Confusion , Lethargy , Altered mental status
Shock
With Warfarin: Pin point Purplish red spots
12. WITH BARIUM: Nausea , Weakness , Abdominal pain.
WITH THALLIUM: Acute GI distress , Anorexia ,
Myalgias , Painful neuropathy and
hair loss.
WITH STRYCHNINE: Anxiety , Generalized seizure like
appearance without loss of
consciousness , Muscle twitching ,
Facial grimacing.
WITH ARSENIC: Nausea , Vomiting , Bloody diarrhoea
and garlic taste in mouth.
13. APPROACH CONSIDERATIONS:
• Complete blood count
• PT
• INR
• Activated PTT
• BT
• Platelet count
• Lab verification of Brodifacoum , Difenacoum.
• CPK
• LA
• Blood test for arsenic & Thallium
14. • Abdominal Plain Film Radiography
• Detecting phosphine in exhaled air/stomach aspirate using
either a silver nitrate impregnated strip or specific
phosphine detector tube is diagnostic.
• But Gas chromatography provides the most sensitive
indicator.
15. Always look for a container , so that the specific
product can be determined.
Decontamination may be necessary.
16. Secure airway and place IV lines in Haemodynamically unstable
patients.
ACTIVATED CHARCOAL is used as soon as possible to prevent
further systemic absorption of ingested toxin.
GI EVACUATION in cases of huge over dosage and in which the
patient presents early to an emergency facility.
Inducing Vomiting is likely only with in 1-2hrs
after ingestion.
17. ZINC PHOSPHIDE:
-Supportive therapy remains the only available form as there is no
specific antidote.
-Gastric lavage with vegetable oil to
reduce the release of toxic phosphine.
-Patients with severe respiratory
compromise require endotracheal
intubation for ventilatory support.
-Severe haemolysis from phosphine gas may require exchange
transfusion of RBCs.
18. If no coagulopathy is found in the setting of an anti-
coagulant exposure ,prophylactic treatment with Vit-K is
absolutely contraindicated.
If a coagulopathy is documented , Vit-K therapy is
suggested.
Patients who present with life threatening haemorrhage ,
in addition to Vit-K, Prothrombin complex conc. and/or
fresh frozen plasma may be needed to reverse anti
coagulation.