Neem oil poisoning

Twelve children were admitted with convulsions and altered sensorium following ingestion of locally obtained neem oil. Ten died within 24 hours. Of the six children investigated completely, four showed significant acidosis and all showed significant rise in serum transaminases suggesting liver damage. All had normal CSF values. Liver biopsy done in one showed fatty degeneration.     

Neem oil poisoning

We report an unusual case of neem oil poisoning in a previously normal 5 year old child. The child presented with refractory seizures and was having metabolic acidosis. Late neurological sequelae in the form of auditory and visual disturbances, and ataxia were present.     

Eucalyptus oil poisoning

Accidental ingestion of eucalyptus oil by a 3-year-old boy caused profound central nervous system depression within 30 minutes, but he recovered rapidly after gastric lavage. The extreme toxicity of eucalyptus oil is emphasised.     

Ingestion of tea tree oil (Melaleuca oil) by a 4-year-old boy

A 4-year-old boy ingested a small quantity of tea tree oil. Within 30 minutes, he became ataxic and shortly thereafter progressed to unresponsiveness; he was endotracheally intubated by paramedics. His neurologic status improved gradually over 10 hours, and he remains well on follow-up. Tea tree oil is an increasingly popular topical antiseptic that is available in a wide variety of products, often without warning labels. Healthcare providers should be aware of the common uses of tea tree oil, as well as its potential toxicity.     

Eucalyptus oil poisoning.

Accidental ingestion of eucalyptus oil by a 3-year-old boy caused profound central nervous system depression within 30 minutes, but he recovered rapidly after gastric lavage. The extreme toxicity of eucalyptus oil is emphasised.     

Pediatric silicone oil surgery

PURPOSE: To evaluate clinical characteristics, surgical aspects, and visual outcomes of pediatric patients who underwent pars plana vitrectomy and silicone oil injection for complicated retinal detachment. PATIENTS AND METHODS: The records of 24 patients (25 eyes) younger than 18 years were retrospectively reviewed. All patients underwent pars plana vitrectomy and silicone oil injection for complicated retinal detachment between January 1995 and June 2004 in the Ophthalmology Department of Dokuz Eylul University, Izmir, Turkey. All patients had follow-up at or beyond 6 months. RESULTS: Nineteen (79.2%) boys and 5 (20.8%) girls were included. Mean age was 12.6 years (standard deviation, +/- 3.5; range, 5 to 17). Five eyes (20%) had blunt ocular trauma. Eleven eyes (44%) had penetrating trauma. Three eyes (12%) had high myopia. Four eyes (16%) had congenital cataract surgery. One eye (4%) had redetachment 1 month after vitreoretinal surgery performed at another clinic. One case had bilateral proliferative vitreoretinopathy with an undefined cause. The retina remained attached in 18 (72%) of 25 eyes at the final examination (17 were totally attached; 1 was partially attached). Mean follow-up was 23.4 months (standard deviation, +/- 20.5; range, 6 to 108). Postoperative visual acuity improved to 1/10 or better only in 6 eyes (24%) at the last examination. CONCLUSION: In pediatric patients with complicated retinal detachment, silicone oil injection for intraocular tamponade is an option for treatment, but visual outcome is poorer than for adults.     

Near fatal ingestion of oil of cloves

A case of ingestion of oil of cloves is presented, which resulted in coma, fits, a coagulopathy, and acute liver damage. This is not unlike the syndrome produced in the late stages of a substantial paracetamol overdose, and a similar treatment regimen is proposed.     

Near fatal ingestion of oil of cloves.

A case of ingestion of oil of cloves is presented, which resulted in coma, fits, a coagulopathy, and acute liver damage. This is not unlike the syndrome produced in the late stages of a substantial paracetamol overdose, and a similar treatment regimen is proposed.     

Kerosene oil poisoning--a childhood menace.

This study documents 3-year retrospective analysis of accidental kerosene oil poisoning in 70 children with regard to clinical profile, radiological changes and outcome. About 77% of cases were between 1 and 3 years old. Fifty children (71.4%) developed significant symptoms, with onset soon after to within 10 hours of ingestion. These included breathlessness (55.7%), fever (47.1%), cough (31.4%), restlessness (25.7%) and abdominal distension (15.7%). Chest X-rays were obtained in 65 children. Abnormal radiographs were seen in 45 (69.2%) children with right basal infiltrates being the commonest picture (21.4%). Ingestion of more than one ounce of kerosene oil adversely affected the clinical and radiological profile. Severely malnourished children had extensive radiological changes and poorer clinical outcome. One case developed myocarditis, a complication which has not been reported to the best of our knowledge. Mortality rate was 4.3%. All deaths occurred within 48 hours of admission.     

Docosahexaenoic acid status of term infants fed breast milk or infant formula containing soy oil or corn oil.

The objective of this study was to compare circulating lipid docosahexaenoic acid [22:6(n-3), DHA] levels in term infants fed a powdered (CORN oil) or liquid (SOY oil) infant formula or human milk (HM). Infants whose mothers chose not to breast feed were randomly assigned to the CORN or SOY formula group. The formula fat differed in linolenic acid [18:3(n-3)] content: it was 0.8% for the CORN and 4.8% for the SOY. Linoleic acid [18:2(n-6)] was 31.5 and 34.2% fatty acids in the CORN and SOY formula, respectively. The formulas or HM were fed from birth through 8 wk of age, and growth and the plasma and red blood cell (RBC) phospholipid fatty acid composition was determined at 3 d, 4 wk, and 8 wk of age. Growth did not differ among groups. The plasma phospholipid and RBC phosphatidylethanolamine DHA was similar in the CORN and SOY formula groups at all ages. Plasma and RBC phosphatidylethanolamine levels of DHA were significantly lower in infants fed the CORN or SOY formula than in infants fed HM during wk 4 and 8. Plasma and RBC 22:5(n-6) was not increased in the formula groups at any age. The formula content of linolenic acid had no effect on the RBC or plasma DHA levels of the infants. The biologic or functional significance of the lower plasma and RBC DHA in infants fed formula rather than HM is unknown. The need for a dietary source of DHA and specificity of plasma or RBC phospholipid DHA as a measure of desaturation and elongation of linolenic acid in developing organs remains uncertain.     

Randomized, double-blind trial of long-chain polyunsaturated fatty acid supplementation with fish oil and borage oil in preterm infants

OBJECTIVE: To test the efficacy and safety of long-chain polyunsaturated fatty acid (LCPUFA) supplementation with gamma-linolenic acid, a precursor of arachidonic acid, and docosahexaenoic acid in preterm infants. STUDY DESIGN: Preterm (<35 weeks, < or =2000 g birth weight) infants (n=238) randomly assigned to unsupplemented or LCPUFA-supplemented formula to 9 months after term. The main outcome measure was the Bayley Mental and Psychomotor Indexes (MDI, PDI) at 18 months after term. Safety outcome measures were anthropometry (9 and 18 months), feed tolerance, infection, and clinical complications. RESULTS: There were no significant differences in neurodevelopment between groups overall. In preplanned subgroup analyses, LCPUFA-supplemented boys had significantly higher Bayley MDI than did control boys (difference, 5.7 points; 95% CI, 0.3 to 11.1; P=.04). LCPUFA-supplemented infants showed significantly greater weight gain (difference, 310 g; 95% CI, 30 to 590 g; P=.03) and length gain (difference, 1.0 cm; 95% CI, 0.02 to 1.9; P=.05) between birth and 9 months, with greater effect in boys (weight difference at 9 months, 510 g; 95% CI, 80 to 930 g; P=.02; length difference at 18 months, 1.8 cm; 95% CI, 0.1 to 1.8; P=.03). CONCLUSIONS: This trial, using the strategy of providing gamma-linolenic acid as a source of arachidonic acid, showed efficacy for growth and for neurodevelopment in boys, with no adverse effects. These data have important implications for LCPUFA-supplementation strategy in preterm infants.