Acute organophosphorus poisoning.
Explore the source record for details and available documents.
Atropine↗
Biomedical subjects
Surjit Singh
Publications and source records attributed to Surjit Singh.
Dangerous bodies: a case of fatal aluminium phosphide poisoning.
A case of fatal aluminium phosphide poisoning that forced the evacuation of the emergency department of a Sydney teaching hospital highlights the importance of hospitals being able to safely manage hazardous materials incidents.
Adult↗
Lung scintigraphy in the diagnosis and follow-up of pulmonary thromboembolism in children with nephrotic syndrome.
Thromboembolic phenomenon and pulmonary embolism is quite frequent in children with nephrotic syndrome (NS). The incidence of pulmonary thromboembolism in children with NS is as common as in adults, and severity is also reported to be relatively high. The mortality rate in NS with thromboembolic complications may be significantly increased if not diagnosed and treated well in time. For establishing the diagnosis of pulmonary embolism, although the combined use of magnetic resonance venography and CT angiography has been proposed, V/Q scan is still the best modality. We performed serial lung perfusion scans in two young patients with NS who developed sudden onset tachypnea during their stay in the hospital. Initial lung perfusion scans showing marked perfusion defects and normal chest X-rays indicated a high probability for pulmonary embolism. The patients were treated with streptokinase, and the study was repeated. Marked improvement was seen in lung perfusion, thereby highlighting the importance of lung perfusion scan in the follow-up of such patients.
Child, Preschool↗
Kawasaki disease.
Kawasaki disease (KD) is a common vasculitic disorder usually seen in children below 5 years of age. The disease can present with protean clinical manifestations which include high grade fever (for at least 5 days), rash, redness of the lips and a typical strawberry tongue, cervical lymph node enlargement (often unilateral), swelling over the hands/feet and, later a characteristic peripheral desquamation over the fingers and toes. These clinical features appear sequentially and the findings may change from day-to-day. Thus, all these features may not be seen together at any one point of time. The diagnosis rests on the recognition of this characteristic temporal sequence of clinical events, none of which are, by themselves, pathognomonic. Establishing a diagnosis of KD may be further complicated by the occurrence of several other, seemingly unrelated, clinical features. These include irritability, neck stiffness, sterile pyuria, pneumonitis, hydrops of the gallbladder and hepatitis among many others. There is no laboratory test that can help in confirming a diagnosis of KD. Left untreated, up to 20% of children with KD can develop coronary aneurysms with catastrophic long term sequelae. It is important to diagnose KD in the first 10 days of the illness so that appropriate therapy with intravenous immunoglobulin and aspirin can be Initiated. All paediatricians, and physicians looking after children, need to be aware of this condition which is now being increasingly recognized in India.
Diagnosis, Differential↗
Pseudomesotheliomatous presentation of primary signet ring cell carcinoma of lung.
Signet ring cell carcinoma is a unique mucin secreting adenocarcinoma. It generally arises from stomach, colon, rectum or breast and rarely from lung. Pleural membrane involvement is common in lung cancer manifesting as pleural effusion. Rarely, it may encase the whole lung without effusion mimicking mesothelioma and is termed as "pseudomesothelioma". A 35-year-old male presented with a pleural mass encasing the whole of the right lung without any pleural effusion and investigations revealed it to be primary signet ring cell adenocarcinoma of the lung.
Adult↗
Idiopathic endogenous lipoid pneumonia.
Lipoid pneumonia is a rare pulmonary disorder having no classical radiological appearance. We report a 33-year-old male, ex-smoker who was referred to us with history of cough, mild mucoid expectoration and progressively increasing dyspnoea since one year. He was investigated at local hospital and was treated with 30 mg prednisolone per day for 6 months for sarcoidosis without any response. On examination, he was normal except for fine basal crepitations in chest. Pulmonary function test (PFT) revealed mild airway obstruction. High resolution computerised tomographic scan (HRCT scan) revealed bilateral reticulonodular shadows and bronchiectasis in lower zones. Open lung biopsy revealed lipoid pneumonia. As there was no history of nasal distillation of oils, it was diagnosed to be idiopathic. The relevant literature is reviewed.
Adult↗
Poor responses to recombinant HBV vaccination in patients with HIV infection.
The study was conducted with an aim to assess the efficacy of recombinant HBV vaccination in untreated HBV seronegative HIV/AIDS subjects as compared to normal controls. The second objective was to identify differences in CD4 and CD8 T cell numbers/kinetics/functions and levels of TH2 cytokines (IL4 and IL10) in different groups during the three-dose vaccination regimen. 40 HIV/AIDS patients were subdivided into groups 1A where patients had a high CD4 (> 200/mm3) count and IB where patients had a low CD4 (< 200/mm3) count. Twenty normal healthy control subjects were also recruited in the study (group II). Patients received 40 micro and controls received 20 micro of recombinant HBV vaccine in each dose. All subjects received 3 doses of the vaccine. Detection of CD4 and CD8 cells was done by flowcytometry. TH2 type of cytokines IL4 and IL10 were estimated in the culture supernatant of PHA stimulated leukocyte rich plasma by sandwich ELISA. Anti-HBs levels were estimated in the serum by ELISA. Anti-HBs response was severely compromised in patients as compared to controls. Groups II, 1A and 1B showed titers of 16906 +/- 21303, 8834 +/- 14136 and 462 +/- 814 m/U/m/ respectively. Both CD4 and CD8 cells increased significantly after vaccination in all the groups irrespective of the disease status. On the other hand, IL4/IL10 responses to PHA stimulation in the HIV-positive groups were much lower than in controls (P< 0.1). Despite a double dose of vaccine in patients, the antibody response was significantly lower which correlated with a lower CD4 count. Cytokines IL4 and IL10 which regulate antibody response, were also lower in-patients and this together with a low CD4 count possibly accounted for the low anti-HBs levels. All patients with high CD4 lymphocyte count were responders while only 47% of patients with low CD4 lymphocyte count responded to immunization. Patients with a CD4 count of less than 50 failed to respond. Thus early immunization is advocated in all HIV patients at a stage when they are still capable of mounting an adequate immune response.
Adult↗