BMJ case reports
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Case Reports
Hydroxocobalamin treatment of acute cyanide poisoning with a jewellery-cleaning solution.
Acute cyanide poisoning by ingestion is often severe and lethal among jewellery industry workers. Clinical experience with hydroxocobalamin alone in severe acute cyanide poisoning by ingestion remains limited. This case concerns a 50-year-old goldsmith who tried suicide by ingestion of a jewellery cleaner solution containing approximately 1.2 g of potassium cyanide. ⋯ Following hydroxocobalamin treatment, neurologic and metabolic disorders rapidly improved. He was discharged home 4 days later, without neurological sequelae. The case reinforces the safety and effectiveness of hydroxocobalamin in acute cyanide poisoning by ingestion.
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A 7-year-old known asthmatic presented with an acute severe asthma attack to the Accident and Emergency department. Following a poor response to salbutamol and ipratropium nebulisers, he was given intravenous salbutamol and aminophylline. Over the course of the following 3 h, there was improvement in his bronchospasm with decreasing oxygen requirement, however, his respiratory rate showed an upward trend. ⋯ His blood gases and lactate level returned to normal within 3 h after stopping intravenous salbutamol. He was recommended on salbutamol nebulisers while still continuing on intravenous aminophylline. He continued to improve and was discharged home after 4 days.
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Joubert's syndrome is a rare autosomal recessive disease, which is under-diagnosed, associated with other brain and body malformations, and carries a poor prognosis. We describe a 6-year-old boy who presented with non-progressive instability of stance and gait, mental retardation and a new onset of generalised seizures with the typical brain imaging findings of Joubert's syndrome. We believe this is the first diagnosed case of Joubert's syndrome in Iraq.
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We present a case of a 43-year-old lady who presented with an acute coronary syndrome, but without any cardiac risk factors or previous cardiac symptoms, and who had a spontaneous coronary artery dissection. This was successfully treated with percutaneous coronary intervention. A brief discussion of this clinical entity and literature review is presented.
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Review Case Reports
Right thoracoabdominal stab injury penetrating the liver and gallbladder: lessons in penetrating knife wounds to the chest and abdomen.
The authors report a patient who suffered a penetrating knife injury to the right thoracoabdominal region which penetrated through the liver and both sides of the gallbladder. This injury was treated successfully by laparotomy and cholecystectomy.