Deltamethrin is a newer class of insecticide used on crops, pets, and livestock, in home pest control, and malaria vector control belonging to the synthetic pyrethroid group, which is being promoted in the place of organophosphate compounds due to the harmful and persistent effects of the latter. Unfortunately, as its usage increased, so has the number of poisoning cases associated with deltamethrin. Fortunately, the mortality in deltamethrin poisoning cases is low. However, deltamethrin poisoning causes signs and symptoms similar to the clinical features of organophosphate poisoning. This case report is of a 20-year-old man who consumed an unknown substance in a suicidal attempt and presented with clinical signs of organophosphate toxicity. Later the compound was identified as deltamethrin. This case report adds to the medical literature on deltamethrin poisoning. It showed that apart from the similarity in their clinical features in toxicity, deltamethrin can even give a positive result on atropine challenge tests like organophosphate and that the fasciculations induced by deltamethrin may be temporary. This case report will also benefit the clinician in unknown compound poisoning cases as it shows that the clinician can suspect deltamethrin toxicity alongside organophosphate toxicity in the differential diagnosis when the atropine challenge test gives a positive result.

Patients receiving cardiopulmonary resuscitation (CPR) may rarely experience cardiopulmonary resuscitation-induced consciousness (CPRIC), manifesting as body movements, eye-opening, or even awareness. We present a case report of a 55-year-old male patient who experienced CPRIC but did not survive despite resuscitative measures. The patient suffered a sudden cardiac arrest and received early initiation of CPR. However, CPRIC posed a treatment dilemma for our resuscitation team as the patient displayed body movements, requiring careful management to avoid interruptions in CPR. The challenge of differentiating CPRIC from the return of spontaneous circulation (ROSC) highlights the need for further research and evidence-based guidelines. Effective management strategies for CPRIC are necessary to guide resuscitation teams in making informed decisions. Understanding and addressing CPRIC can improve the quality of CPR and post-resuscitation care, supporting the well-being of both patients and healthcare providers. Further investigation is essential to developing comprehensive approaches to managing CPRIC and improving patient outcomes.

Acute proptosis is a very rare condition presenting to the emergency department. As there are very few case reports of patients with acute onset proptosis, it is important to report each new case. This case report is of a 38-year-old lady who presented to our emergency department with a headache for three days, altered sensorium for eight hours, and acute proptosis of the left eye for 40 minutes. She was diagnosed to have a venous hemorrhagic infarct in the left parietal-occipital-temporal region with thrombosis of the left transverse and sigmoid sinuses. To the best of our knowledge, there is no documented case report or study which featured acute proptosis as a clinical sign in a patient with venous hemorrhagic infarct or where acute proptosis was associated with thrombosis of a cerebral venous sinus other than cavernous sinus. This study shows that acute proptosis can be a presenting sign even in venous hemorrhagic infarct and acute proptosis can be associated with cerebral sinus venous thrombosis even without the involvement of cavernous sinus. So although rare, venous hemorrhagic infarct and cerebral venous sinus thrombosis irrespective of the venous sinus involved should be considered in any patient presenting to the emergency department with acute onset proptosis.