No abstract

Cattle are socioeconomically important animals with frequent and close contact with humans. Due to the size and power of these animals, injury and deaths related to contact with cows and bulls do occur. It is impossible to be certain of the worldwide burden of morbidity and mortality. It is clear however that trauma presents as specific injury patterns, often related to particular activities. Research identifies groups such as dairy farmers, veterinarians and abattoir workers who are at a higher risk of injury. The general public also increase their risk of injury just by being near cattle. The assessment and treatment of injuries due to cattle trauma should follow some clear and well-defined principles. Reduction in the frequency and severity of injury is possible and should be a priority.

Ingestion of Amanita muscaria mushrooms results in transient central nervous system excitation and depression mediated by its components, ibotenic acid and muscimol. The mushroom is distributed worldwide and ingestions occur with some frequency. Although these ingestions have traditionally been considered benign, serious complications can occur. We present 2 cases of serious toxicity, including a fatality. The first case was a 44-y-old man who presented to the emergency department (ED) after cardiopulmonary arrest approximately 10 h after ingesting 4 to 5 dried A muscaria mushroom caps, which he used for their mind-altering effects. Despite successful resuscitation, he remained unresponsive and hypotensive and died 9 days later. The second case was a 75-y-old man who presented to the ED after accidentally consuming one large A muscaria mushroom cap he foraged in Eastern Turkey. The patient initially presented to the ED with hallucinations followed by lethargy, and he was intubated for airway protection. The patient's condition gradually improved, and he made a full recovery. A muscaria ingestion should not be considered benign as serious outcomes do occur. An understanding of how the main neuroactive chemicals, ibotenic acid and muscimol, affect the brain can help anticipate outcomes. Several high-risk features that portend a more serious course are identified.

Background: Lead toxicity in adults is rare and often presents with vague symptoms leading to diagnostic uncertainty. Occupational exposure can guide the clinician toward the correct diagnosis, but when no exposure is identified, there may be a delay in identifying the condition. Case Presentation: We present a case of lead poisoning in a patient using Ayurvedic medicines. Ayurvedic medicine is a formal traditional medical system in India and South Asia with traditions dating back over 3000 years. Ayurvedic medications, a component of Ayurvedic practice, are considered natural but can contain heavy metals such as lead, mercury, and arsenic. Conclusion: Ayurvedic medications are an infrequent cause of lead poisoning, but this may increase as nontraditional, and natural medicines become more popular. Clinicians should consider the possibility of lead poisoning in patients who have used Ayurvedic medications and present with nonspecific symptoms.