Clinical toxicology : the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
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Clin Toxicol (Phila) · Sep 2008
Case ReportsFatal injury in eastern Sri Lanka, with special reference to cardenolide self-poisoning with Cerbera manghas fruits.
Self-poisoning with plant seeds or fruits is a common method of self-harm in South Asia. While most deaths follow ingestion of Thevetia peruviana (yellow oleander) seeds, other plants are locally common. During review of fatal injuries seen in a teaching hospital in eastern Sri Lanka, we noted cases of fatal self-poisoning with Cerbera manghas (sea mango, pink eyed cerbera, odollam tree) fruits. ⋯ C. manghas self-poisoning has only previously been reported from Kerala and Tamil Nadu in south India. While uncommon in other parts of Sri Lanka, it has become a common method of self-harm in one east coast district, accounting for 20% of fatal self-harm with plants in one hospital. Management was inadequate with the available resources, emphasising the need for an affordable antitoxin for plant cardenolide poisoning.
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Clin Toxicol (Phila) · Sep 2008
Risk factors and mechanisms of anaphylactoid reactions to acetylcysteine in acetaminophen overdose.
Adverse effects to N-acetylcysteine (NAC) are well recognized, but their etiology and incidence are unclear. ⋯ Severity of adverse effects correlates with the extent of histamine release. Histamine release appears independent of tryptase suggesting a non-mast cell source. Acetaminophen is protective against adverse effects of NAC, and mechanisms by which acetaminophen might lessen histamine release require further attention.
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Alachlor and butachlor are commonly used herbicides. However, data on acute human poisonings are scarce. We retrospectively analyzed the data of human alachlor/butachlor poisoning in Taiwan. ⋯ Alachlor and butachlor poisonings are usually of low toxicity. However, severe neurological and cardiovascular outcomes may develop rarely, especially following oral ingestion. Medical management of such poisonings is primarily supportive.