Wild (Mad) honey poisoning is due to ingestion of honey containing a toxin known as grayanotoxin, which is also known as rhodotoxin because it is derived from the nectar of a few rhododendron species primarily found in the mountainous region of Bhutan, India, Nepal, and Turkey. 1 Mad honey is used as an alternative medicine for hypertension, diabetes, flu, gastrointestinal disorders (peptic ulcer, gastritis, dyspepsia, indigestion, and bowel disorder), and arthritis, stimulating sex (dysfunction, impotence, enhancement, and performance), viral infections, and cold. 2 Mad honey can cause dramatic side effects such as nausea, vomiting, dizziness, sweating, impaired consciousness, and various cardiac side effects like bradycardia and hypotension. 3 Ingestion honey containing grayanotoxin can result in hypotension, bradycardia, and cardiac rhythm disorders (first-, second-, and third-degree AV block, asystole, and sinus bradycardia). 4,5 Here, we present a case of mad honey poisoning, which developed bradycardia, hypotension, and dizziness. | CASE REPORTA 55-year-old woman presented to the emergency department with complaints of sudden onset of dizziness and vomiting for 2 h. Further history revealed that the symptoms appeared after 45-60 min after ingestion of 10-15 ml of wild honey. There was no history of trauma, alcohol, or drugs. The patient was a known case of hypertension under treatment with Losartan 25 mg per orally once daily

Introduction: Understanding anatomy of the lumbar vertebrae is necessary to achieve clinical success during surgery, for the development of the spinal implants and instruments and to understand changes in elderly and in male and female patients. Methods: A cross-sectional study was done in 50 patients in Nepal to study the lumbar morphometric analysis of the vertebral body, intervertebral disc and spinal canal. Patients who underwent CT IVU for nephrolithiasis at our center were included for analysis of the lumbar morphometry. All the traumatic cases and pathological lesions, such as infection, tumor were excluded from the study. Patients having low backache due to probable intervertebral disc pathology were also excluded from the study. Data analysis was done from Microsoft excel and the mean, standard deviation and range were calculated. Results: The anterior-posterior diameter of the vertebral body, varied from 25.97 mm at L1 to 29.39 mm at L5. The transverse diameter of the body ranged from 31.55 mm at L 1 to 44.13mm at L5. There were changes in height of body. First from L1 - L3 there was increase in height and from L4-L5 there was decrease in height with least height at L5 (22.71mm). According to our study the L1 vertebra has narrowest transverse diameter of spinal canal(21.25mm) whereas L4 has narrowest antero-posterior diameter of spinal canal(12.37mm). Conclusion: In the lumbar area, detailed anatomical knowledge is critical for performing a safe operation. These findings give guidance to the surgeons during various approach while performing operative procedure like pedicle screws, vertebral body screws, cages and laminar hooks.