The intention with the suicidal thoughts, hair dye (super vasmol-33) poisoning cases are increasing in many parts of world to free their souls. Hence we felt it as a social need to conduct this type of study. Objective to understand the prevalence of ―Vasmol‖ poisoning cases and to analyze the presenting features, clinical course and their outcome in general medicine and emergency units of a tertiary care teaching hospital. This is a Prospective observational Study conducted for a period of six months. Any adult individual who consumed the vasmol poison intentionally were included as the study subjects. A total number of 380 vasmol poisoning cases have been collected. Out of them, 168(44.21%) cases were in the age group of 11-20 years, 120 (31.57%) were in between 21-30 years. 347 (91.31%) patients were illiterates. Out of 380 cases, 258 (67.89%) were recovered with the supportive therapy, 14 (3.68%) were died and 83 (21.84%) were referred to higher institution for better treatment. The death rate was found to be 1:27 i.e. out of every 27 cases 1 death was observed. Out of 14 deaths, 8 were due to cardio-respiratory failure, 3 were due to Myocarditis, 1 due to cardiac arrest, and 2 were due to acute renal failure. Vasmol hair dye ingestion is a life threatening condition and is a serious social issue to be addressed immediately. Early recognition, prompt referral, and supportive therapy are the factors on which clinical outcomes depend.
Iron poisoning (physical appearance, sources- dietary and environmental, uses- industrial and biological, usual fatal dose, toxicokinetics, mode of action, clinical features, diagnosis, treatment, autopsy features
Wolfram syndrome, otherwise known by an acronym DIDMOAD SYNDROME which comprises, Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness. We report three siblings with clinical features of Wolfram syndrome.
The trend of consuming hair dyes intentionally to free their souls is increasing day by day especially among rural indian population. Among them super vasmol 33 is a well known emulsion base type hair dye brand. The main content in vasmol is paraphenylenediamine (PPD).the major toxic effects of this chemical were found to be cervicofacial edema, rhabdomyolysis and renal failure. Quick recognition and immediate supportive therapy helps to recover completely. We report a case which highlights the toxic effects upon vasmol ingestion.
Iron poisoning (physical appearance, sources- dietary and environmental, uses- industrial and biological, usual fatal dose, toxicokinetics, mode of action, clinical features, diagnosis, treatment, autopsy features
Wolfram syndrome, otherwise known by an acronym DIDMOAD SYNDROME which comprises, Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness. We report three siblings with clinical features of Wolfram syndrome.
The trend of consuming hair dyes intentionally to free their souls is increasing day by day especially among rural indian population. Among them super vasmol 33 is a well known emulsion base type hair dye brand. The main content in vasmol is paraphenylenediamine (PPD).the major toxic effects of this chemical were found to be cervicofacial edema, rhabdomyolysis and renal failure. Quick recognition and immediate supportive therapy helps to recover completely. We report a case which highlights the toxic effects upon vasmol ingestion.
Study of Spectrum of Adrenal Changes Autopsied at J.L.N. Hospital AjmerAI Publications
Background- Adrenal glands are the least studied organ. Aim and Objectives- 1. To analyse gross and microscopic morphology of adrenals in posmortem cases and their correlation if any with the cause of death. 2. To compare the adrenal changes in various layers along with sudden natural death. 3. To compare the adrenal changes in person dying due to debilitated condition like TB, CANCER. 4. To compare the adrenal changes in chronic hypertensive and end stage renal disease. 5. Death in corona pandemic due to COVID-19. 6. Death due to poisoning. Material and Methods- This observational cross section study will be carried out in the department of forensic medicine and toxicology on 100 cases in JLN Medical college and attached hospitals with cooperation from the department of pathology after obtaining due permission from the institutional ethical committee. Conclusion- Adrenal lesion can present in various forms at autopsy. Non-neoplastic Lesions should be given equal importance as neoplastic. An enlarged adrenal does not always indicate malignancy. There are many clinical conditions in which adrenals are affected as secondary phenomenon. Gross and histo-morphological examination of the tissue can diagnose the adrenal lesions with great accuracy and is beneficial for patient’s further survival, in setups where facilities to perform adrenal biopsies are available. Adrenals should be investigated as a part of routine autopsy procedure in all post-mortem cases.
Corticosteroids are the steroid hormones, which are mainly used in the treatment of rheumatoid arthritis, osteoarthritis, rheumatic fever, gout, allergic reactions, renal disease, haematological disorders and shock. The use of glucocorticoids in supra physiological doses for more than 2-3 weeks causes a number of undesirable effects. Most of the adverse effects are extension of pharmacological actions such as hyperglycaemia, Cushing syndrome, oedema, hypertension, CCF, steroid myopathy, glaucoma, various fungal infections etc. Diclofenac is a Non-Steroidal Anti Inflammatory Drug; it is high potent anti-inflammatory and analgesic drug. The mechanism of acute bronchitis due to the diclofenac still not known but increased production of leukotrienes may cause bronchitis. Here we report a 45 years old female patient was experienced moon face, pedal oedema, increased RBS, LDL, total cholesterol, abdominal striae, acute bronchitis and increased blood presser due to the prolonged using of corticosteroids and NSAIDs since 2 years regularly.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
INTRODUCTION: This research aims at enlightens and emphasizing the most prevailing disease conditions and disorders which are most common in mahabubnagar locality ,were category A(augmented) type ADR are more followed by type C(continous).
METHODS: A retrospective research study was conducted using Naronji's and WHO standard scales have been used to categorise the ADR into category A, category B, category C and category D for the given cases.
Epidemological data like age, ADR, and disease condition prevailing in hospitalised patients are noted and categorised department wise.
Forensic pharmacovigilance: Newer dimension of pharmacovigilanceRosmirella Cano Rojas
Drug safety for the patients is of paramount importance for a medical professional. Pharmacovigilance attempts to ensure the safety of patients by keeping a close vigil on the pattern of adverse events secondary to drug use. Number of medicolegal cases is at rise since last few years. Forensic sciences and pharmacovigilance need to work hand in hand to unlock the mystery of many criminal and civil proceedings. Pharmacovigilance offers its wide scope in forensic sciences by putting forward its expertise on adverse profile of drugs which may be instrumental in solving the cases and bringing the justice forth. It may range from as simple affairs as defining the adverse drug reaction on one hand to putting expert advice in critical criminal cases on the other one. Pharmacovigilance experts have to abide by the ethics of the practice while executing their duties as expert else it may tarnish the justice and loosen its dependability. As a budding discipline of science, it is confronted with several hurdles and challenges which include reluctance of medical professionals for being involved in court proceedings, extrapolations of facts and data and variations in law across the globe etc. These challenges and hurdles call the medical fraternity come forward to work towards the momentous application of pharmacovigilance in the forensic sciences. Evidence based practice e.g. testing the biological samples for the presence of drugs may prove to be pivotal in the success of this collaboration of sciences.
Study of clinical and etiological profile of community acquired pneumonia in ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Assessment of trend of mortality due to poisoning in the northern zone of india and comparison with other international & national researches
Authors:Naveen Sharma, Kunal Khanna, Kuldeep Kumar, Tarun Dagar, Sandeep Kumar Giri, Vijay Pal Khanagwal
Int J Biol Med Res. 2024; 15(1): 7741-7745
https://www.biomedscidirect.com/2824/assessment-of-trend-of-mortality-due-to-poisoning-in-the-northern-zone-of-india-and-comparison-with-other-international-national-researches
Risk factors for medical complications of acute hemorrhagic strokePavan Lomati
Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality
rate was more when compared to males.
Amlodipine is a 4th generation dihydropyridine calcium channel blocker which is permitted for the treatment ofessential hypertension and angina pectoris. The main mechanism of calcium channel blockers are blocks the voltage sensitive L-type calcium channels by binding to alpha-1 subunit, so prevent the entry of calcium in to the cells finally no excitation-contraction coupling in the heart and vascular smooth muscles. It is absorbed slowly after oral administration. But its bioavailability is high. It has a longer duration of action than ahenefidipine. It dilates both peripheral as well as coronary vessels. It is an alternative anti-hypertensive drug for patients with Nefidipine induced pedaledema. This drug is expected to produce a more incidence of pedal oedema, as compared to Nefidipine and other calcium channel blockers, based on the limited data available from clinical trials. The common adverse effects of Amlodipine are nausea, abdominal pain, vomiting, dry mouth, constipation, gingival hypertrophy, dizziness, heartburn, photosensitivity, headache, light headedness and insomnia. We report a case of Amlodipine induced pedal edema.
There are numerous studies that report anemia and hematological
abnormalities in patients with human immunodeficiency virus (HIV) infection
and acquired immunodeficiency syndrome (AIDS). Highly Active Antiretroviral
therapy (HAART) is the best suited regimen that is potent enough to reduce the
viral load in patients with HIV/AIDS. On the other hand, this regimen has the
tendency to cause anemia and bone marrow suppression. We report a case of 26
years female patient confirmed with HIV infection since 6 months and is on
Zidovudine, Lamivudine and Nevirapine therapy for the past 4 months. While the
patient was in this regimen it leads to severe anemia and acute gastritis. The
relationship between the suspected drug and reaction was established by
performing casualty assessment. There is a need of close monitoring at regular
intervals to find the development of bone marrow toxicity and other
complications which help in prevention and better management of disease and
therapy problems
Enoxaparin is extensively used in the treatment of venousthrombo-embolic disease (VTED) which inhibits blood clotting inside the blood vessels by the inhibition of factor Xa activity through antithrombin. Local hypersensitivity reactions are one of the rare adverse drug reactions (ADR) of enoxaparin which may lead to hospitalization and excessive burden to the patient. A 72 years male patient was admitted in general medicine department with retrosternal pain even at rest and was diagnosed with unstable angina pectoris. He was administered with anti-coagulantEnoxaparin 0.4ml (40 I.U)subcutaneouslyalong with other supportive medications. Patient have developed severe local hyper sensitivity reactions like erythema,pain,swelling,irritation at the site of injection, and suspected as an ADR of Enoxaparin and immediately drug was withdrawn, then it was confirmed through causality assessment and this ADR have shown +ve for rechallenge;patient was fallowed for improvement and the symptoms especially swelling and irritations were not subsidedeven on 9th day. By this case study we strongly recommend the testingof drug sensitivity before initiating Enoxaparin therapy,and need to collect past history comprehensively for safe and effective outcome of therapy.
Candidiasis is a fungal infection caused by yeasts from the genus Candida. It is commonly called oral candidiasis or thrush when it affects the mouth. It is one of the common side effects associated with the long term use of steroid inhalers. Nebulizing therapy with corticosteroids is widely accepted treatment approach for patients with acute exacerbations of Chronic Obstructive Pulmonary Disease. The other side effects of steroid inhalers include hoarseness of voice and dysphonia, which are usually ignorable. We report this case of 74 year old male patient who was on metered dosage inhaler and nebulizer therapy with corticosteroid and presented with oral candidiasis. If oral thrush develops, treatment with oral fluconazole or nystatin mouth wash is beneficial. Proper patient education by the clinical pharmacist to the patient regarding safe and effective usage of inhalers and nebulizers especially corticosteroids can minimize these drug related problems.
Number of people exposed to traumatic events is on rise
day by day. Despite of this increased rate of exposure, little
is known about the disease, treatments available for
preventing/relieving PTSD symptoms. As research is a
continuous process and huge body of evidence is being
added to the existing literature, it is very important to
update ourselves. All the conclusions made by various
researchers are the result of experiments performed in
their set up which is different from ours. The applicability
of those conclusions in our kind of population has to be
evaluated and build our own body of evidence.
Effect of Patient Counseling in Improving Physical and Mental Health of Type-...Gangula Amareswara Reddy
The present study concluded that chronic diseases like diabetes affect the quality of life of patients.As the main goal of any medical care is the improvement of the patients’ overall quality of life, the clinical pharmacist imparted patient education through counseling has a major role in improving the physical as well as mental health outcomes.
A PILOT STUDY ON DRUG - DRUG INTERACTIONS AMONG THE SCHIZOPHRENIA PATIENTS IN...Gangula Amareswara Reddy
As the improvement in schizophrenia patients is seen with only long term therapy, being adhered to the regimen all the way is very important. Development of drug-drug interactions among prescribed agents is the main reason for drug non adherence.Hence prior assessment of prescriptions is mandatory for the prescriptions with multiple drug therapy.The study opens door for larger studies to emphasize the role of pharmacist in identifying and preventing drug-drug interactions.
Digoxin is extensively used in the treatment of congestive heart failure
(CHF). It improves blood circulation to peripheral tissues by increasing
contractility of myocardial cells by binding to Na+-K+ ATPase pump.
Arrhythmias are the major Adverse Drug Reaction (ADR) of Digoxin which
may lead to hospitalization, morbidity and even mortality. A 60 years male
patient was admitted with breathlessness, pedal edema and was diagnosed as
CHF. He was prescribed with Digoxin 5 day therapy along with other
medications, on 5th day we observed Electro Cardio Gram (ECG) changes
indicating ventricular tachycardia as a suspected ADR of Digoxin and was
confirmed by causality assessment, immediately suspected drug was stopped,
patient was monitored for progression and on 9 th day ECG showed no
tachycardia changes. We strongly recommends to monitor the patients receiving
digoxin (especially those aged > 60years of age) for safe and effective outcome
of therapy.
ASSESSMENT OF SELF MEDICATION AMONG RURAL VILLAGE POPULATION IN A HEALTH SCRE...Gangula Amareswara Reddy
THE STUDY AIMS AT IDENTIFYING SELF MEDICATION PATTERN AMONG RURAL POPULATION AND VARIOUS FACTORS INFLUENCING IT LIKE OCCUPATION, HABITS, LITERACY RATE, EXTENT OF AWARENESS, SOURCE FOR DRUG INFORMATION ETC.......
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
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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.
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.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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
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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
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.
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e-ISSN 2248 - 9169
Print ISSN 2248 - 9150
International Journal of
Experimental Pharmacology
www.ijepjournal.com
STUDY OF VASMOL POISIONING CASES IN A TERTIARY CARE
TEACHING HOSPITAL
M.Sureswara Reddy1
, Gangula Amareswara Reddy2*
, P Venkata Ramana2
,
Samjeev Kumar E2
1
MD, Associate Professor, Department of General Medicine, RIMS, Kadapa, India.
2
P.Rami Reddy Memorial College of Pharmacy, Kadapa, Andhra Pradesh, India – 516003.
INTRODUCTION
All over human times gone by, intentional use of
poison was seen as a method of killing, suicide, and
execution [1,2]. The history of poison [3] bounces from
before 4500 BC to the current day. As per law, any
substance, irrespective of its quality or quantity, when
given with an intention to endanger, injure, or kill a person
is called a poison[4]. The term poison with regards to
biology and chemistry is often misused due to lack of a
universal definition. Biologically speaking, any substance if
given in large enough amounts is poisonous and can cause
death[5]. The incidence of Hair dye poisoning cases are
Corresponding Author
Amareswara Reddy Gangula
Email id: amarpdtr@gmail.com
increasing in many parts of India[6,7]. It constitutes an
important proportion of the poisoning cases in some areas
[8]. Hair dyes are easily available in the home for young
adults [6] as their parents use hair dye as a need. Among
such hair dyes, vasmol is an emulsion based hair dye
commonly used in India[9]. Paraphenylene- diamine (PPD),
resorcinol, propylene glycol, liquid paraffin, cetostearyl
alcohol, sodium lauryl sulfate, EDTA sodium, herbal
extracts, preservatives and perfumes are the ingredients.
Some of these ingredients like paraphenylene diamine and
resorcinol are known toxicants with multi-organ effects,
while the toxicity profiles of others are not known [9]. A
study measuring the plasma level of paraphenylene diamine
in hair dressers showed very low levels in plasma [10].
Many studies relate the toxicity of the dye with the dose
ingested [11]. Mortality rates in the larger studies of vasmol
poisoning cases varied from 6.8% to 22.48% [12].
ABSTRACT
The intention with the suicidal thoughts, hair dye (super vasmol-33) poisoning cases are increasing in many parts of
world to free their souls. Hence we felt it as a social need to conduct this type of study. Objective to understand the prevalence
of ―Vasmol‖ poisoning cases and to analyze the presenting features, clinical course and their outcome in general medicine and
emergency units of a tertiary care teaching hospital. This is a Prospective observational Study conducted for a period of six
months. Any adult individual who consumed the vasmol poison intentionally were included as the study subjects. A total
number of 380 vasmol poisoning cases have been collected. Out of them, 168(44.21%) cases were in the age group of 11-20
years, 120 (31.57%) were in between 21-30 years. 347 (91.31%) patients were illiterates. Out of 380 cases, 258 (67.89%)
were recovered with the supportive therapy, 14 (3.68%) were died and 83 (21.84%) were referred to higher institution for
better treatment. The death rate was found to be 1:27 i.e. out of every 27 cases 1 death was observed. Out of 14 deaths, 8 were
due to cardio-respiratory failure, 3 were due to Myocarditis, 1 due to cardiac arrest, and 2 were due to acute renal failure.
Vasmol hair dye ingestion is a life threatening condition and is a serious social issue to be addressed immediately. Early
recognition, prompt referral, and supportive therapy are the factors on which clinical outcomes depend.
Keywords: Vasmol Poisoning, Super vasmol 33, Outcomes of vasmol poisoning.
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Paraphenylene diamine (PPD)
Unintentional or suicidal intake of PPD causes
systemic poisonousness, displayed by severe edema of neck
and face and laryngeal edema with respiratory suffering
frequently requiring emergency tracheostomy and
mechanical ventilation. It also causes rhabdomyolysis and
acute renal failure, ending in death if not treated in a hostile
way [9]. Other symptoms include [13] angioneurotic
edema, intravascular haemolysis, haemoglobinuria,
asphyxia and respiratory failure, Severe hypocalcaemia and
hyperuricaemia, hypercalcaemia, myoglobinuria,
myocarditis [14] and arrhythmias leading to sudden death.
Resorcinol
Resorcinol is a Phenolic chemical used in taking
pictures (photography), tanning (to go brown) and cosmetic
industry. It is also a pharmaceutical agent applied topically
in skin ailments. Resorcinol is a moderately toxic and
corrosive substance. After taking orally, resorcinol is freely
absorbed from the gastrointestinal tract, metabolized, and
excreted by male and female rats, indicating little potential
for bioaccumulation in animal tissues. It is known to cause
eye, skin, oral and gastrointestinal injuries. Systemic
toxicity is demonstrated as vomiting, dyspnea,
methemoglobinemia, hypothermia, tachypnea, pallor,
profuse sweating, hypotension and tachycardia [9]. Other
symptoms include [13] renal and neurotoxicity, pulmonary
edema, bronchospasm, seizures followed by CNS
depression.
Mechanism of Rhabdomyolysis
Demolition or breakdown of striated muscle is
called Rhabdomyolysis. This condition is characterized by
muscle breakdown and necrosis brings about in the escape
of intracellular muscle constituents into the circulation and
extracellular fluid. Rhabdomyolysis ranges from an
asymptomatic illness with increase in the creatine kinase
(CK) level to a life intimidating condition associated with
extreme elevations in CK, imbalance in electrolytes and
acute renal failure (ARF) [15]. With the intention of
suicidal thoughts, usage of vasmol to free their souls has
become more common in our area. Also we had increase in
number of queries from the physicians and other health
professionals about chemical contents in vasmol and
protocol in management of vasmol poisoning to our drug
information center located at Rajiv Gandhi institute of
medical sciences, run by P Rami Reddy College of
Pharmacy, Kadapa. Hence we felt it as a social need to
conduct this type of study.
Aim
To understand the prevalence of ―Vasmol‖
poisoning cases and to analyze the presenting features,
clinical course and their outcome in general medicine and
emergency units of a tertiary care teaching hospital.
METHOD
This is a Prospective observational Study
conducted in general medicine and emergency (ICU) units
at “Rajiv Gandhi institute of medical sciences”, Kadapa, an
850 bedded tertiary care teaching hospital. The study was
conducted for a period of six months from January 2014 to
June 2014. Any adult individual who consumed the vasmol
poison intentionally were included as the study subjects. A
total number of 380 cases were studied from all general
medicine and emergency (ICU) units. We have prepared a
patient data collection sheet which was set by slight
changes from the standard case sheet. Poisoning cases were
categorized based on the type of poisoning, amount of
poison taken, reason for ingestion and on other
demographic limits. Data was collected by studying the
Patients case sheets and the following were collected i.e.,
age, gender, education particulars, occupation, other
available laboratory data, quantity of dye consumption,
reason for poisoning, vital signs, colouration of urine,
clinical presentations, patient medication were clearly
detected and the results were evaluated. Primary care
details right after consumption onwards till reporting to the
hospital, were investigated and recorded. The collected and
analyzed data were correlated with reported data in
different articles.
Table 1. Gender wise categorization of vasmol poisoning cases
Name of poison substance Men Women Total
Vasmol 124 (32.63%) 256 (67.36%) 380
Table 2. Age wise categorization of vasmol poisoning cases
Name of poison substance
Age in years
Total11-20 21-30 31-40 41-50 51-60 >61
M F M F M F M F M F M F
Vasmol 63 105 32 88 12 30 12 17 4 14 1 2 380
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Table 3. Socio demographic status of vasmol poisoning cases
Literates Illiterates
Total
Students Working Coolie House wives Farmers Drivers Others
12 21 195 49 78 3 22 380
Table 4. Month wise categorization of vasmol poisoning cases
Month
Vasmol cases
Total
Men Women
September 21 35 56
October 14 30 44
November 29 45 74
December 21 44 65
January 17 52 69
February 22 50 72
Total 124 256 380
Table 5. Reasons for intentionally consuming vasmol poison
Reason Number of cases
Financial problems 162
Family problems 171
Psychiatry problem 26
Others 21
Table 6. Clinical presentations of vasmol poisoning cases
Clinical presentation Number of cases Percentage (%)
Cervico-facial Edema 284 74.73
Myalgia 87 22.89
Stridor 75 19.73
GI disturbances 103 27.10
Head numbness 53 13.94
Seizures 16 4.21
Table 7. Mean of Serum Creatinine and Blood urea nitrogen values in vasmol poisoning patients
Renal function test Mean value
Serum creatinine 1.58 mg/dL
Blood urea nitrogen 26.68 mg/dl
Figure 1. showing quantity of vasmol consumed vs. number
of cases
Figure 2. Outcome of vasmol poisoning cases
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Figure 3. Percentage of cases in which Tracheostomy done
and not done
Figure 4. Complications which lead to death in vasmol
poisoning cases
Figure 5. Characterization of urine in vasmol poisoning cases
RESULTS AND DISCUSSION
A total number of 380 vasmol poisoning cases
have been collected in the departments of General Medicine
and Emergency (ICU). Out of 380 Vasmol poisoning cases,
256 (67.36%) were women and 124 (32.63%) were men.
All of them had taken the poison intentionally. Results were
shown in table-1. Out of 380 cases, 168(44.21%) cases
were found between the age group of 11-20 years, 120
(31.57%) were in between 21-30 years, 42 (11.05%) were
in between 31-40 years, 29 (7.63%) were in between 41-50,
18 (4.73%) were in between 51-60 years and 3 (0.78%)
were above 61 years, results were shown in table-2. Out of
380 cases, 347 (91.31%) patients were illiterates, and
remaining were literates (8.68%). Majority of them were
coolies (195) and farmers (78). Results were represented in
table-3. Table-4 shows month wise distribution of cases.
Out of 380 cases majority of cases were observed in the
month of November 74 (19.47%) followed by February 72
(18.94%), January 69 (18.15%), December 65 (17.10%),
September 56 (14.73%) and October 44 (11.57%). Majority
of the patients 171 (45%) consumed poison because of their
family problems, 162 (42.63%) due to financial difficulties,
26 (6.84%) due to psychiatry problems and 21 (5.52%)
were due to other reasons like health problems, to threat
their family members and few were unexplainable
problems. Results were shown in table-5. Categorization of
patients based on quantity of vasmol poison consumed was
done. Out of 380 cases, 277 (72.89%) consumed < 50 ml of
Vasmol hair dye, 51 (13.42%) consumed 50-100 ml, 23
(6.05%) consumed 100-150 ml and 29 (7.63%) consumed
above 150ml. Results were represented in figure-1. Out of
380 cases, 258 (67.89%) were recovered with the
supportive therapy given by the hospital and discharged. 14
(3.68%) were died and 83 (21.84%) were referred to higher
institution for better treatment, 12 (3.15%) cases were
absconded and 13 (3.42%) were discharged by request.
Results were represented in figure-2. The death rate was
found to be 1:27 i.e. out of every 27 cases 1 death was
observed. Out of 380 Vasmol poisoning cases, 55 were
undergone tracheostomy. And all 55 patients were found to
be taken more than 150 ml or in the range of 100-150 ml
vasmol poison (figure-3). Out of 14 deaths, 8 were due to
cardio-respiratory failure, 3 were due to Myocarditis, 1 due
to cardiac arrest, and 2 were due to acute renal failure
(figure-4). Out of 380 cases the important clinical features
(table-6) was edema in Cervico-facial region observed in
284 (74.73%) cases, followed by myalgia 87 (22.89%)
cases, stridor 75 (19.73%) cases, gastrointestinal
disturbances 103 (27.10%), head numbness 53 (13.94%),
and seizures 16 (4.21%). Out of 380 cases,
Rhabdomyolysis was observed in 127 (33.42%) cases, the
severity elucidated with chocolate brown colour of urine,
42 (11.05%) patient’s urine was found to be yellow colour
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and 211 (55.52%) patients had normal urine colour (figure-
5). Renal function was also evaluated in all 380 cases with
serum creatinine and blood urea nitrogen. The mean of
serum creatinine in the range of 0.5-2.6 mg/dl was found to
be 1.58 mg/dl and the mean of blood urea nitrogen in the
range of 2.10-57.0 mg/dl was found to be 28.68 mg/dl
(table-7). Para-phenylenediamine (PPD) 4 % and resorcinol
are the major ingredients contained in vasmol. PPD
intoxication is most harmful than resorcinol, which is the
reason for most of the complications in Vasmol poisoning.
Generally Para-phenylenediamine has moderate acute
toxicity by the oral route and low toxicity by the dermal
route, in our study entire poisoning was by ingestion. It is
worth mentioning that the amount of PPD that can cause
systemic poisoning is only three grams, while the lethal
dose is 7-10 grams. In this study the consumed
concentration was found to be around 4 grams. The main
toxicities of this compound include severe edema of the
face and neck frequently requiring emergency
tracheostomy. This is followed by Rhabdomyolysis and
acute renal failure (ARF), culminating in death if not
treated aggressively. Treatment is mainly supportive
depending on clinical features at presentation.
Tracheostomy is a life saving measure for an obstructed
airway, and some patients may need endotracheal
intubation. Antihistamines and steroids are commonly used
because of the possibility of a hypersensitivity reaction to
Vasmol poisoning but there is no evidence to support this
mode of treatment. There is no specific antidote
availability, and the trials of Vasmol poison removal using
haemoperfusion and haemodialyis had variable results,
even though, dialysis is an effective supportive measure in
case of oliguria.
CONCLUSION
Super Vasmol poisoning is becoming a serious
social issue which is to be addressed immediately. Vasmol
hair dye ingestion is a life threatening condition. Early
recognition, prompt referral, and supportive therapy in
collaboration with different specialties are the factors on
which clinical outcomes depend. Even though the label of
Super Vasmol 33 is showing that Para-phenylenediamine
(PPD) concentration is not exceeding 4%, but the exact
concentration has not been mentioned. The PPD at various
concentration i.e., 0.3 – 7% can be fatal to the humans if
consumed orally. The other toxic component of the hair dye
was resorcinol, which is a corrosive and also causes renal
toxicity. The present study highlights the major toxicities of
hair dye and also the importance of a detailed review of the
toxicology of all components of any ingested substance.
This study showed that Vasmol hair dye poisoning
mortality had 4%. Deaths occurred by the following
reasons, they are: Cardio respiratory failure, Myocarditis,
Acute renal failure and cardiac arrest. The poisoning of
PPD was not more common in this region during past few
years. Organo Phosphorous (OP) poisoning cases were
more common but due to the strict control of sale of OP,
poisoning of hair dye (PPD) has become common in recent
days. The measured supervision over dealing of hair dye is
necessary to stop super Vasmol poisoning. This has to be
reported to the concerned poisoning control experts to make
sure about the concentration of PPD in Super Vasmol 33.
This will help in introducing appropriate treatment
approaches. We recommend that the selling of Vasmol hair
dye containing PPD should be controlled and public
education programme should be initiated in this regard, so
that mortality from Vasmol poisoning may be prevented,
because availability of Vasmol hair dye containing PPD in
home causes easy availability of this poison. Awareness
must be created in public for not to do such actions which
put their lives in risk.
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