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A bstract Nicotine is one of the most easily accessible, commonly abused drugs worldwide and if taken in overdose can cause serious clinical presentation, including cardiac arrhythmias and neurotoxicity mediated through oxidative stress. Its toxicity though rare can cause sudden deaths by cardiovascular arrest, respiratory muscle paralysis, and/or central respiratory failure. Here, we describe a case of intentional fatal ingestion of nicotine sulfate decoction used as a mean for fatal suicidal attempt by a 15-year-old adolescent male who was suffering from childhood-onset depression since about 3 months. He developed drooling of saliva, syncopal attacks, paroxysmal episodes of hematemesis, abdominal pain, signs and symptoms of hypoxia, nonfatal atrial tachycardia, and encephalopathy after ingestion of heavy dose of nicotine-containing concoction; however, he recovered successfully within 24–48 hours without any significant cardiac, respiratory, or neurological deficits (except short-term verbal memory). Authors discussed the details of management and reasons behind the reversible encephalopathy and molecular mechanism of nicotine toxicity. How to cite this article Kamble A, Khairkar P, Kalantri SP, Babhulkar S. Fatal Suicidal Attempt by Deliberate Ingestion of Nicotine-containing Solution in Childhood-onset Depression Mediated through Internet Suicide Guideline: A Case Report. Indian J Crit Care Med 2020;24(8):719–721.

Background:The deleterious effects of alcohol on the brain are replete in literature. Only a few neurophysiologic measures can pick up the neuronal dysfunctions, one of them being visual-evoked potential (VEP). A very limited amount of data exists on the progression of neural abnormalities related to the spectral severity of alcoholism.Aim of the Study:To evaluate the impact of spectral severity of alcoholism through VEP and to understand the emergence of any specific pattern or morphometric abnormalities related to alcohol-induced neuropsychiatric presentations.Methodology:A total of 90 cases were recruited in addition to 180 age- and sex-matched controls using purposive and random sampling. The Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version and Campbell Neuropsychiatric Inventory were used to evaluate alcohol disorders and its neuropsychiatric complications apart from the mandatory consultant-specific clinical evaluations of all the cases. Of 90 cases of alcohol dependence, 15 patients were currently abstinent for >6 months, 15 had alcohol intoxication, 15 had signs of alcohol withdrawal, 15 had physical complications, 15 had psychiatric comorbidity, and 15 had neurological complications such as epilepsy. VEP recordings were taken using an Evoked Potential Recorder (RMS EMG. EP MARK II) where the stimulus configuration consisted of transient pattern-reversal method in which a black and white checkerboard was generated full field.Results:Mean age of cases was 37.71 ± 11.49 years compared to 39.43 ± 10.67 years in controls (range 18–65 years). VEP abnormalities comprising of prolonged latencies (62.5%) with a statistically significant difference (P < 0.001) from the healthy controls was observed in cases of alcohol withdrawal syndrome. Predominant amplitude reduction with normal latency was obtained in 37.5% cases of withdrawal. Severe VEP abnormalities, i.e., both latency delay and amplitude reduction, were found in 75% patients with psychiatric comorbidity, 66.67% patients with neurological complications, i.e., epilepsy, and 33.34% patients with physical complications. An explicit finding of prominent interocular differences was a prominent feature present in 25% of patients with complications.

Introduction: Minor physical anomalies (MPA), are mild errors of the morphogenesis, having prenatal origin and may bear major information for diagnostic and prognostic purposes. The notion that early brain insults predispose to depression is supported by findings that some patients with the disorder exhibit morphologic evidence of subtle developmental abnormalities. Aim: The aim is to study MPA in depression. Objectives: (1) To study the association of MPA in depression, if any. (2) To study the most common MPA in depression . Materials and Methods: The study was conducted on 60 patients suffering from depression attending outpatient services and 60 healthy controls. Patients were evaluated for MPA using the Waldrop and Halverson Scale. Data were tabulated and analyzed using unpaired t-test. Results: The scores in the study group are significant than the control group suggesting an association between MPA and depression. The score of anomalies in the head, ear, and in the study group was significant. Correlation between age of onset and MPA was negative which suggests that as age increases the frequency of MPA decreases. More physical anomalies were found in the patient with a positive family history of psychiatric illness than the control group. Conclusion: A few number of studies have stressed on the need to screen and identify the link between MPA with underlying etiopathogenetic mechanisms in depression. Therefore, this is one of the few studies where a physical endophenotypic marker was evaluated helping to support the neurodevelopmental hypothesis of depression.