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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: Education,Emergency Medicine,foreign doctors
- چکیده:
- چکیده انگلیسی: A rapidly increasing number of foreign qualified emergency physicians of Pakistani descent are conducting workshops and seminars in Pakistan to contribute to this emerging field of emergency medicine (EM) for sole purpose of capacity building. This phenomenon has witnessed an additional surge in the wake of the COVID-19 pandemic. For capacity building, the local EM trainees are contributing by delivering personally constructed courses and workshops to various institutions. Their efforts are commendable however this letter provides some insight into the way EM has undergone development especially in context to Pakistani origin and the struggle of locally trained emergency medicine physicians. We hope to provide certain observations to our readers to look for parallels in their own situations they can make use of. It is important to recognize the restraints of local resources however the supply of trained emergency physicians will increase the demand for them. Each country must develop its own way of providing care to their acutely ill and injured, and thereby have ownership of it.
- انتشار مقاله: 16-07-1399
- نویسندگان: Sadaf Sheikh,Muhammad Akbar Baig
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Loperamide,Cardiac Toxicity,Ventricular tachycardia
- چکیده:
- چکیده انگلیسی: Background: Loperamide is an insoluble meperidine analog that is commonly used for diarrhea. It is an inexpensive and frequently available over the counter drug. While physicians are aware of its opioid effects, Loperamide use is also linked to cardiac conduction disturbances.
Case presentation: We present a case of Loperamide toxicity with QRS, Corrected QT interval (QTc) prolongation and ventricular arrhythmias such as ventricular tachycardia leading to cardiopulmonary resuscitation (CPR). The patient survived and was evaluated to have prolonged QT interval. He later disclosed over the counter (OTC) and continued a regular use of Loperamide as an anti-diarrheal agent. During the rest of hospital stay, serial Electrocardiograms (ECGs) showed improvement in QT interval and patient was successfully discharged.
Conclusion: Loperamide inhibits intestinal peristalsis through its peripheral µ-opioid receptor agonism, as well as calcium channel blockade. Loperamide abuse is increasing, as patients use it either to experience euphoric effects or to attenuate the effects of opioid withdrawal.At high doses, Loperamide blocks cardiac sodium and potassium channels, resulting in prolonged QRS and QT intervals which can proceed to cardiac rhythm disturbances. Our case shows the acute and delayed cardiac effects of Loperamide toxicity which the treating physician should be made well aware of.- انتشار مقاله: 13-05-1398
- نویسندگان: Sadaf Sheikh,Muhammad Akbar Baig
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Pakistan,Emergency,Lead toxicity,Plumbism
- چکیده:
- چکیده انگلیسی: Background:Lead toxicity continues to remain a concerning health problem for developing nations like Pakistan. Due to the lack of studies, we aim to highlight the clinical spectrum of lead poisoning in patients presenting to an urban-based tertiary care hospital in Pakistan.
Method:This is a retrospective review of patients admitted form January 2011 to December 2014 using a structured questionnaire for recording demographics, comorbidities, clinical findings, biochemical abnormalities, clinical findings and treatment provided. Patients were categorized as children (≤18yrs) and adults (>18yrs), further divided into three groups; desired blood lead levels (BLLs) [lead levels <2ug/dl in children and <10ug/dl in adults], high but non-toxic [children 2-10ug/dl, adults 10-70ug/dl] and toxic [children >10ug/dl, adults >70ug/dl].
Result: A total of 86 patients were included in the final analysis, majority (69.6%) of whom were adult males with median age of 35 yrs. Median (IQR) BLL was 6.3 ug/dl (12.8-2.7) in all age groups with BLL in children and adults of 4.2 ug/dl (3.1-5.7) and 6.5 ug/dl (2.6-14.7), respectively. 72% of the children had complaints related to the central nervous system with majority complaining of irritability. The gastrointestinal system was most commonly implicated in adults (93%) with most common complaint of abdominal pain. The commonest risk factor showing a positive correlation with BLLs was battery handling in adults [median (IQR) BLL 18.4ug/dl (8.35-36.1)] and pica eating in children with BLLs in high but non-toxic range [median (IQR) BLL 5.2ug/dl (2.7-5.7)]. The highest BLLs were observed to lie within the high but non-toxic range group in one adult herbal medicine user (54.4 ug/dl) and in children observed in the toxic range group (>10ug/dl) due to occupational battery work exposure and residence in a congested zone.
Conclusion:Lead toxicity continues to be hazardous due to unchecked environmental and occupational exposure. Increasing awareness is tantamount in order to find a solution.- انتشار مقاله: 26-07-1396
- نویسندگان: Lena Jafri,Nadeem Ullah Khan,Muhammad Akbar Baig,Noman Ali,Hafsa Majid,Ayesha Habib Khan
- مشاهده