Capsaicin, one of the major active components of cayenne pepper pills, is an over-the-counter substance with sympathomimetic activity used commonly by young individuals for weight loss. Here we report the case of a previously healthy young male who developed severe chest pain after using cayenne pepper pills for slimming and sustained an extensive inferior myocardial infarction. Electrocardiography combined with a bedside transthoracic echocardiogram confirmed the diagnosis of acute myocardial infarction. The patient denied using illicit substances, and he had no risk factors for coronary artery disease. His medication history revealed that he had recently started taking cayenne pepper pills for slimming. A subsequent coronary angiogram revealed patent coronary arteries, suggesting that the mechanism was vasospasm. We postulate that the patient developed acute coronary vasospasm and a myocardial infarction in the presence of this known sympathomimetic agent. This case highlights the potential danger of capsaicin, even when used by otherwise healthy individuals.

Analysis of serum thiol levels and SH/SS homeostasis might be useful in order to determine the head trauma in pediatric patients.

Abdominal injuries following a bicycle accident are frequent, serious, and preventable. Most patients were treated conservatively. Bicycle injuries can be prevented.

Objective: The purpose of this study was to predict the clinic and demographic profile of patients who attempt suicide by poisoning with zinc phosphide. Material and Methods: All cases presenting to the ED from January 1 st 2009 to April 30 th 2011 due to Acute Zinc Phosphide Poisoning were retrospectively reviewed. Results: All cases had taken the pharmaceutical product in an attempt to commit suicide. The average age of the cases was 25.4 years. Sixteen of the cases were female (76%), and five (24%) were male; all of the cases who died were female. In terms of marital status, 4 (19%) of the cases were single or unmarried. A total of 8 (38%) cases were unconscious and had low pH levels (<7.35), and 9 (43%) cases had signs of shock, such as hypotension and tachycardia. The average level of bicarbonate in the arterial blood gas of the cases was 23.20 mmol/L and the average amount of time (admission time) taken to bring the patients from the place where they were poisoned to the ED was 2.40 hours. According to the autopsy results of the dead patients, there were findings of liver congestion, liver necrosis, pancreatic edema and hemorrhagic points together with inflammation in the kidneys. Conclusion: Although it is a rare form of suicide attempt, the mortality rate for patients with zinc phosphide poisoning is high. Early resuscitation can have positive effects on morbidity and mortality. Patients who suffer from zinc phosphide poisoning must be monitored under intensive care conditions. (JAEM 2013; 12: 76-9 Olguların yaş ortalaması 25,4 yıl idi. Olguların 16'sı (%76) bayan ve 5'i (%24) erkek idi; ölen olguların hepsi bayan idi. Dört (%19) olgu bekar veya yanlızdı. Sekiz (%38) olguda şuur kaybı ve düşük pH (<7,35) düzeyi ve 9 (%43) olguda hipotansiyon ve taşikardi gibi şok bulguları vardı. Ortalama bikarbonat düzeyi 23,20 mmol/L ve zehirlenmenin olduğu yer ile acil servise kabul edilinceye kadar geçen zaman ortalaması 2,40 saat idi. Otopsi sonuçlarına göre ölen olgularda,karaciğer konjesyonu,karaciğer nekrozu,pancreas ödemi ve böb-reklerde kanama odakları ile beraber enflamasyon vardı. Sonuç: Nadir bir özkıyım şekli olmasına rağmen, çinko fosfid zehirlenmesi olan hastalar için mortalite oranı yüksektir. Erken müdahale mortalite ve morbiditeye olumlu etki yapabilir. Çinko fosfid zehirlenmesine maruz kalan hastaların yoğun bakım şartlarında takibi yapılmalıdır. (JAEM 2013; 12: 76-9) Anahtar kelimeler: Özkıyım girişimi, çinko fosfid, zehirlenme, acil servis

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