A rare case of Cartap Poisoning

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Presentation transcript:

A rare case of Cartap Poisoning V MEDICAL UNIT PROF: DR.J.SANGUMANI ASST. PROF: DR.R.SUNDARAM ASST. PROF: DR.K.S.RAGAVAN

Complaints 25yrs old male Alleged H/O Cartap poison ( 50% Cartap hydrochloride) ingestion on 3/3/17

Present history H/O vomiting No H/O increased salivation / lacrimation / increased sweating No H/O involuntary micturition / loose stools No H/O seizures No H/O breathlessness

Past history Not a K/C/O DM / HTN / BA / CVA / psychiatric illness. No previous H/O deliberate self harm.

Personal history Takes mixed diet Smoker and alcoholic Family history Nil significant

On examination, Pt was conscious, oriented Not dyspneic / Not tachypneic Afebrile No pallor No cyanosis / clubbing Not icteric No generalised lymphadenopathy No pedal edema

Vitals PR-96/min BP-130/80mmHg SpO2- 97% in room air Temperature- Normal

Systemic examination CVS-S1,S2 heard, No murmurs RS- B/L air entry present, NVBS heard No added sounds Per abdomen- soft, non tender, BS Present, no organomegaly CNS Pt conscious, oriented B/L pupils 4mm,RTL Moves all 4limbs normally No neck stiffness/Neck muscle weakness No fasciculations

TONE RIGHT LEFT UPPER LIMB NORMAL LOWER LIMB POWER RIGHT LEFT UPPER LIMB 5/5 LOWER LIMB PLANTAR REFLEX FLEXOR DTR RIGHT LEFT BICEPS BRISK TRICEPS SUPINATOR KNEE JERK ANKLE JERK

A case of Cartap Poisoning Diagnosis A case of Cartap Poisoning

Investigations Hb- 15.2g% UREA-29mgs% TC- 8700cells/cumm CREATININE-0.7mgs% DC- 57/35/8 Sr.Pseudocholinesterase- 8000U/L PLC-2.32L/cumm LFT-Normal PCV- 43% SODIUM-139mEq/L ESR-12mm in 1hr POTASSIUM-4.2mEq/L S.CALCIUM- 9.5mgs% RBS-101mgs%

Treatment NPO / RTA / Stomach wash IV Fluids Inj.Ranitidine 50mg iv bd Inj.Thiamine 100mg IM od Pt improved clinically and had been discharged on 7/3/17

Aim of presentation A rare Poisoning and its different mechanism of action.

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