1. Ethylene Di-bromide Poisoing – Outcome of Sixty Four Cases of Ethylene Di-bromide Ingestion Treated in Tertiary Care Hospital

N Singh, RK Gupta, OP Jatav, MK Tailor, R Jain
GR Medical College, Gwalior, MP.

Background and Aims : In view of high attendance and mortality due to Ethylene di-bromide poisoning a prospective study was planned to assess demographic profile, toxicological profile, clinical profile and outcome with management given in Intensive Care Unit.

Material and Methods : Prospectively collected data of 64 patients with Ethylene di-bromide poisoning was reviewed. All the patients were from Gwalior and neighbouring districts.

Results : Majority were males in the age group 25-30 years. Out of 64 cases 26 patients (40.6%) survived and 38 patients (59.4%) expired. Nausea vomiting and pain abdomen were most common symptoms at presentation. Loose motion, drowsiness, palpitation and reduced urine output were other features. Out of 26 patients who survived 22 (84.6%) had normal pulse rate (< 100) at admission and out of 38 patients who died, 24 patients (63.1%) had tachycardia (pulse rate > 100) at the time of admission (P value = 0.0004199). half ampoule (1.5 ml) of ethylene dibromide was sufficient as fatal dose. Mortality was 20%, 53.8% with half and one ampoule respectively. Best outcome was when the patients presented in less than six hours. Death was as early as 12 hours upto five days. Gastrointestinal toxicity was predominant at presentation. In addition Nephrotoxicity, Hepatotoxicity, Cardiotoxicity, Central Nervous System Toxicity and Hypoglycemia were also observed.

Conclusion : Ethylene di-bromide is highly toxic. Patients who consumed half to one ampoule usually survived with good management and supportive care provided they came within six hours. Pulse rate more than 100 (tachycardia) at presentation is a poor prognostic factor. Patients with normal pulse and blood pressure at admission give time for management.

2. Toluene Induced Neurotoxicity

N Raghani, NK Moulick, G Rajadhakshya, N Padwal, S Kaminwar
Lokmanya Tilak Medical College, Sion, Mumbai – 22.

Toluene (methylbenzene, toluol, phenylmethane) is an aromatic hydrocarbon (C7H8) commonly used as an industrial solvent for the manufacturing of paints, chemicals, pharmaceuticals, and rubber. Toluene abuse or glue sniffing has become widespread, especially among children or adolescents, because it is readily available and inexpensive. Here we are reporting a rare case of toluene induced neurotoxicity. A 19 year old boy presented to our hospital with sub acute onset bilateral cerebellar and upper motor neuron signs. He was addicted to toluene in the form of sniffing of ink whitener since one year. MRI brain showed demylination of bilateral corticospinal tract and cerebellar atrophy secondary to toluene. CSF for oligoclonal band and IgG index were negative, so patient was given pulse methylprednisolone therapy for three days. There was no improvement in clinical status. Patient was kept on physiotherapy thereafter.