Fipronil is an N-phenylpyrazole insecticide, a second-generation insecticide which is relatively new and now commonly used in cotton growing community of rural Central India. Farmer suicide and deliberate self-poisoning is menace to the Vidarbha region of rural Central India. There is paucity of research published on fipronil poisoning, clinical features, complications and treatment data. It is scarcely documented worldwide. Agricultural insecticides are common household items in rural areas of developing countries. Because of their easy availability, insecticides became a major source of deliberate self-poisoning. As per World Health Organization (WHO), around 3 million poisoning cases with around 0.2 million deaths are noted annually in the world. 1 About 99 % of these deaths occur in developing countries. Insecticide poisoning is an important public issue in India.Around 168,000 deaths occurred from pesticide self-poisoning which totals to almost 19.7 % of the global suicides.2 The most common cause of self-poisoning in Central India is ingestion of organophosphorus compounds (OPC). Poisoning with organophosphorus compound insecticides has high mortality rate.1 In the last 20 years, there is development of a new class of insecticides in view of mortality due to accidental exposures of organophosphorus and organochlorine compounds. Fipronil being one of these chemicals, is considered less harmful to humans. According to WHO classification fipronil is class II moderately hazardous pesticide.3 Fipronil, an N-phenylpyrazole with a trifluoromethyl sulfinyl substituent, one of the first second generation insecticides, acts at the γ-aminobutyric acid (GABA) receptor and blocks the chloride channel. Fipronil is often used to control pests, fleas and ticks on pets. There is, however, very less evidence or research on human beings on their toxicity; thus, post marketing surveillance is important to detect any undesirable health issues associated with these chemicals. Until now only 3 case reports are published regarding fipronil poisoning, two cases form India and others from Sri Lanka. Hence, we are reporting a case of acute fipronil poisoning which presented as acute gastritis and sinus bradycardia.

Pulmonary arteriovenous malformation (PAVM) is one of the rare pulmonary vascular anomalies. Pulmonary arteriovenous malformation results in right to left shunt due to the abnormal communications between the pulmonary arteries and the pulmonary veins bypassing the normal capillary bed.1 This condition being rare could be easily missed, hence, it is essential for clinicians to suspect it based on the classical clinical features. This helps in early diagnosis and deciding further appropriate treatment option. Here we report the case of a patient affected by a large idiopathic pulmonary arteriovenous malformation in the right lung. Most patients with pulmonary arteriovenous malformation are asymptomatic. This is due to the chronic compensation and secondary erythrocytic response. Dyspnoea due to PAVMs are a result of right-to-left shunt. Initial diagnostic tools include chest radiography and contrast enhanced computed tomography but the gold standard is pulmonary angiography.2 Because AVM has substantial morbidity rates associated with it, all patients with PAVMs who can undergo embolization should be treated with transcatheter embolization. In rest of the patients, surgical excision should be considered. The main objective of this study was to highlight the early suspicion and diagnosis of pulmonary arteriovenous malformation as this is easily missed and leads to undue delay of treatment.