Sublingual administration of atropine eye drops for treating organophosphorus poisoning.

An 89-year-old patient with fenitrothion toxicity received sublingual atropine eye drops, reducing the intravenous atropine requirement. This alternative method enabled rapid rehabilitation, and he walked unaided, leading to discharge.

Guanfacine poisoning resulting in transient ST-segment elevation: a case report.

BACKGROUND: Guanfacine is an alpha-2 adrenergic agonist that decreases norepinephrine release and sympathetic outflow. With the increased use of guanfacine for attention-deficit hyperactivity disorder (ADHD), reports of guanfacine poisoning have also risen. CASE PRESENTATION: A 15-year-old male (height: 170 cm, weight: 48 kg), who was taking 2 mg/day of guanfacine for ADHD, was brought to our emergency department after ingesting 40 tablets of guanfacine due to poor exam results. He presented with impaired consciousness and sinus bradycardia on an electrocardiogram (ECG), leading to diagnosis of guanfacine poisoning. Gastric lavage (5 L) was performed, and activated charcoal was administered. Although his consciousness gradually recovered, he developed ST-segment elevation on the ECG. Despite the absence of chest pain and elevated myocardial enzymes, coronary artery stenosis was not observed on coronary artery computed tomography. As his blood guanfacine level decreased, his ECG returned to normal. CONCLUSIONS: This case highlights the need for careful monitoring of guanfacine poisoning patients due to the potential for various cardiovascular events.

Intestinal obstruction caused by consuming diet food containing psyllium.

A 26-year-old man presented to our institution with abdominal pain and nausea after eating food containing Psyllium to lose weight. Since patients undergoing extreme slimming regimens may cause intestinal obstruction if psyllium is taken without adequate fluid intake caution should be taken when eating psyllium.

Commercial massage tool-induced spinal epidural hematoma.

Background: Spinal epidural hematoma (SEH), which may develop into an emergency condition, is a rare disease. Here, we present the case of a patient with SEH caused by cervical massage using a commercial massage tool. Case Presentation: A 75-year-old man was brought to our hospital with a chief complaint of posterior neck pain during sleep. He had used a commercial massage tool before going to bed. Upon arrival, hypotension and respiratory failure were observed. His muscle strength in both the upper and lower extremities rated 0 on the manual muscle test, and sensory loss below the papillae was observed. His symptoms resolved spontaneously after 2 h. Magnetic resonance imaging suggested a spinal cord epidural hematoma at the C2/C3 to C3/C4 level. On day 6, the patient was discharged without any impairment. Conclusion: Fatal complications could occur by cervical massage using a commercial massage tool.

Coronavirus disease 2019 with Chilaiditi sign.

In patients with the Chilaiditi sign, pulmonary lower lobes collapse occurs because of interposition of the bowel between diaphragm and liver. When such patients suffer from COVID-19 pneumonia, clinicians should carefully monitor respiratory status.