RESUMO
The packing and composition of ORS has undergone a change since its introduction. In India, some companies are manufacturing smaller pouches (4.2 g) to be dissolved in 200 ml of water. Therefore, out of confusion some prescribers routinely advise the patients to dissolve the standard formulation ORS pouch (21 g) in a glass (200 ml) of water. Two cases are discussed. First patient developed salt poisoning due to improper dilution and recovered after rapid correction. In the second patient improper reconstitution led to hypernatremia and death.
Assuntos
Diarreia Infantil/terapia , Hipernatremia/etiologia , Solução Salina Hipertônica/efeitos adversos , Solução Salina Hipertônica/intoxicação , Cloreto de Sódio/efeitos adversos , Cloreto de Sódio/intoxicação , Administração Oral , Evolução Fatal , Humanos , Lactente , Masculino , Solução Salina Hipertônica/administração & dosagem , Cloreto de Sódio/administração & dosagem , Resultado do TratamentoRESUMO
Primary erythromelalgia is characterized by burning pain, redness, and warmth in the extremities. We present two cases of primary erythromelalgia both of whom presented with a history of several months of severe burning pain in both hands and feet. Both patients had received multiple pain medications with no improvement in symptoms. Pain was relieved by putting affected parts in ice cold water, which resulted in immersion injury of the affected parts. Both patients stopped taking part in school and social activities. We tried oral mexiletine, a class Ib antiarrythmic agent, in view of its reported role in various chronic painful conditions. Dramatic improvement was observed with its use. Both patients improved after several weeks of use, and there were fewer soaking episodes. We observed no adverse effects with mexilitine therapy.
