Organophosphorus compounds (OPC) poisoning is a major public health problem in low and middle income countries. The incidence varies from country to country depending on easy availability of poison, socio-economic condition and educational background of the people. This study aimed to determine the frequency, outcome and aetiological aspect of OPC poisoning patient admitted in Rangpur medical college hospital. It was a cross sectional study carried out in the department of Medicine, Rangpur medical college hospital from 1st December 2011 to 30th November, 2012. During the study period a total of 703 patients have been studied. The most of the patients were between the age of 18- 40 years (91.9%), male (51.6%), married (71.3%) and from rural areas (67.8%). People of different occupations were involved in OPC poisoning, house-wives were the maximum (33.6%) followed by farmers (31.7%). 92% cases were suicidal and 8% accidental. Familial disharmony was the prime cause (92.3%) of suicidal motive. 88% of the patients were survived and 5% died. OPC poisoning is an important health care problem in our country. Improved awareness, restricting availability and banning more toxic organophosphorus compounds will reduce the incidence of OPC poisoning. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21313 Medicine Today 2014 Vol.26(1): 46-48

gastroenteritis and other toxic conditions in infants there was extreme hyperuricaemia-20 mg/100 ml was often recorded. With such levels precipitation of urate in the kidney had to be considered.To investigate this possibility experimental production of the syndrome was, effected in rats by blocking the uricase activity with oxonic acid.3 By application of sublethal tourniquet shock in these animals we regularly found hyperuricaemia and massive uric acid precipitation in the renal tubules.4It is possible that "shock" kidney is provoked by this mechanism, and the particular purine metabolism of man may also be the explanation of his special proneness to kidney damage in shock. Forty-eight patients were studied. In 18 patients 24-hour urine collections were made for seven days following an injection of sodium aurothiomalate (Myocrisin) 50 mg. In the other 30 patients a 24-hour urine collection was made during either the second, third, fourth, fifth, or sixth day after injection, selected at random. Aliquots of urine samples and of standard gold solution were irradiated for five minutes in a thermal neutron flux of 1.3 x 1013 neutrons/cm2/second in the DIDO reactor (UKAEA, Harwell). After allowing the 24Na to decay to an acceptable level, the '98Au radioactivity was measured by gamma ray spectrometry.The seven-day excretion studies (18 patients) showed a remarkably flat curve (Fig. 1). In only one patient was a high excretion rate observed (Fig. 2). In this patient most of the injected gold was excreted within the first week, and probably a therapeutic level could not be achieved on conventional dosage. Apart from this patient, the maximum daily excretion of gold during a seven-day period of observation (Fig. 3), the mean daily excretion rate during the second to sixth day following injection, and the daily excretion rate of random 24-hour sample. during the same period (Fig. 4) all showed variation within a relatively narrow range only.We conclude that following an injection of sodium aurothiomalate for rheumatoid arthritis in most patients the gold is excreted slowly and fairly uniformly. In our experience, the type of hyperexcretion envisaged by Smith et al.I is a rare occurrence.We thank the East Anglian Regional Hospital Board who sponsored this research, and Messrs.May and Baker who contributed to the cost of the activation analysis.-We are, etc., R.

Background: Rheumatoid arthritis is a chronic, autoimmune, inflammatory disorder of unknown aetiology that is characterized by symmetric synovitis and the propensity to cause joint destruction, disability and premature death. Disease-modifying anti-rheumatic drugs (DMARDs) slow the natural course of the disease, reduce joint damage and pain, and retard loss of function and disability. Disease modifying agents should be started as early as possible. A number of studies demonstrating the effectiveness of combinations of DMARDs in early RA.Methods: This is a comparative descriptive type of study was conducted in the Department of Medicine, Rangpur Medical College and Hospital, Rangpur & Medicine Specialists Chambers, Rangpur, over a period of 2 (two) years from July 2010 to June 2012 on newly diagnosed RA patients on the basis of ACR criteria. The 30 patients were divided into 3 groups. Group I got MTX, Group II got SSZ and Group III got MTX & SSZ. Purposive consecutive sampling method was employed. The objective of the study was to evaluate the outcome of patients of rheumatoid arthritis treated with MTX or SSZ alone versus MTX and SSZ in combination. The primary outcome measure was change in DAS28.Results: The mean DAS 28 score baseline was found 7.23±0.44 in group I, 7.29±0.39 in group II and 7.86±0.41 in group III. The mean DAS 28 score end of the study was 4.24±0.39 in group I, 4.85±0.54 in group II and 3.08±0.36 in group III. The difference was statistically significant (P<0.001) among the three groups. There is no toxicity found in any group. Regarding side effects, the difference was not statistically significant (P>0.05) among the three groups.Conclusion : This study suggests that the mean changes in the DAS28 score significantly lower in those who received combination therapy compared with those who received either MTX or SSZ alone during one year follow up.Bangladesh J Medicine Jul 2015; 26 (2) : 67-75