2014;5(1):332–9. Colonoscopy on the 30th hospital day revealed an approximately 20 cm-long, circumferential ulcer in the distal sigmoid colon with easily bleeding mucosa, but confirmed that the bleeding had almost stopped (Figure 2 b). NPE has also been shown to cause subcutaneous bleeding when administered subcutaneously16. The presence of large bullae in upper lobes is covering one third of the hemithorax is pathognomic of this disease. The present paper throws some light on this new emerging virus that has been known to man since 1947. Although melena subsided 2 months after admission, colonoscopy revealed severe stenosis and passage disturbance in the colon, for which he underwent partial colectomy, and was ultimately discharged. Its value is used both for the diagnosis and monitoring the blood glucose control of the patients with diabetes mellitus. In this study, the sigmoid-descending colon junction (SDJ) was the region with the most serious stenosis and bleeding. The recommended dose. Objective: Organophosphorus poisoning (OPP) is a major concern for developing countries. Science Postprint 1(1): e00011. CASE STUDY Murakami N: Performed left colectomy on the patient, and edited the article. Start studying Case 11: Organophosphate Poisoning. However, frequency of mortality due to organophosphates given by Yamashita et al., varied between 4% and 30% and 5.5% in a study by Malik et al. The ARDS definition of the Berlin conference has received both appreciation and criticism and has now travelled a long journey to the Kigali city of Rwanda, to be modified. the cases of OP poisoning. (2008) Treatment of acute poisoning. Also, the absence of clear guidelines and definitive treatment due to the paucity of literature has instilled fear among the general public. Regeneration of the mucosal surface with associated hemorrhage was incomplete in some areas (HE, ×20). There are no guidelines for the prophylactic use of antibiotics in the management of OPP which in such critical cases might add to the economic burden of the patients as well as antibiotic resistance. most commonly employed poison, notably organophosphorus To the best of our knowledge, this is the first report of organophosphate poisoning causing delayed, life-threatening lower gastrointestinal bleeding. Challenges, Ministry of Women and Child Development prepared an Information, Education and Goel A, Aggarwal P (2007) Pesticide poisoning. Lipid peroxidation was determined by level of thiobarbituric reactive substances (TBARS). Chronic full-thickness ulcer (ul-IV). tertiary care hospital in Northern India. Int J Pharm Bio Sci. this major challenge, and one of the key decisions of Prime Minister's Council on India's Nutrition Upper gastrointestinal endoscopy (14th hospital day): A deep, undermined ulcer was found in the gastric cardia, and a hypertrophic mucosal fold extending from the proximal side was interrupted at the ulcer margin. The problem is graver in developing countries where these drugs are easily available to the people. Lancet. Bradycardia, Emesis, Lacrimation, Salivation. Controlled clinical studies that assessed the effect of gastric lavage in organophosphorus pesticide self-poisoning were included. Aso S, Ehara H, Anai M, et al (1999) Effects on growth of rat offspring born from dams treated subcutaneously with a surfactant, polyoxyethylene (10) nonylphenyl ether (NP-10), during lactational period. What are the muscarinic symptoms of organophosphate poisoning? The huge market of counterfeit drugs supplying the fake antimalarial drugs, particularly artisunate is flourishing. He had miosis, and bradycardia. Two of these reports described cases of upper gastrointestinal bleeding and perforation, but did not find a cause-effect relationship between the ingestion of organophosphorus compounds and these symptoms9, 10. This indicated the possibility of intermediate syndrome because we observed marked perspiration and did not observe any infiltrative shadows on a chest X-ray. Int J Pharmaceut Chem Anal. Due to the possibility of NPE adhering to the gastrointestinal tract and causing mucosal injury in this patient, it is necessary to identify the drug composition and ingredients of the pesticide as soon as possible when managing organophosphorus poisoning. Several studies reported the problem of fake antimalarial drugs in the past. Organophosphate (OP) poisoning is the most common cause (27.64%) and has the highest death rate (13.88%) of poisoning in Bangladesh. The higher rate of casualties is not because of poor treatment or lack of facilities rather it is due to substandard antimalarial drugs. Communication (IEC) campaign against malnutrition. 2000 Apr. Thus, the possibility that the organophosphorus pesticide caused lower gastrointestinal bleeding in this patient could not be excluded, and its spreading agent was suspected of having aggravated the symptoms. Materials and Methods: Retrospective two years (September The present epidemic in India has claimed many lives. A Clinico-Epidemiological Study of Organophosphorus Poisoning at a Rural-Based Teaching Hospital in Eastern Nepal Prahlad Karki, MD , Samuel George Hansdak, MD , Sangita Bhandari, MBBS , Ashutosh Shukla, MD , and Shekhar Koirala, MD Values are mean ± S.D. The present state of emerging and re-emerging infections around the world has resulted in panic and confusion. 2015;4(1):101-105. developing and developed countries. Today, organophosphates make up about 50% of the killing agents in chemical pesticides. continues to be rampant in Northern India, with many patients Pan Afr Med J. However, he exhibited strong pharyngeal pain when drinking water, and an upper gastrointestinal endoscopy on the 14th hospital day revealed an acute gastric mucosal lesion (Figure 2 a). Organophosphorus pesticide (OP) self-poisoning is a significant cause of morbidity and mortality in the developing world [1–3], with the in-hospital case fatality usually reported to be between 10% and 20% [].OPs are acetylcholinesterase (AChE) inhibitors, thereby inhibiting the metabolism of acetylcholine (ACh). high APACHE II and SOFA scores (p =0.0001 and p=0.006, The lack of knowledge in the masses and the communities is a factor that contributes largely to the spread of the disease. Willems*** SUMMARY The clinico-pathologic findings in two patients with an acute organophosphorus intoxication, who died from an atypical central neurologic disorder, are presented. Key words Organophosphorus pesticide poisoning, Gastrointestinal bleeding, Spreading agent, Author info OPPs are toxic and can be bioaccumulated (Zhang et al., 2010). The overall objective of this nationwide IEC A pipe-like segmental narrowing of the sigmoid colon with mural sclerosis was noted. The scenario reviews identification of organophosphate poisoning by clinical exam and history, and the management of this toxicological emergency. information centers will help to curtail this public health problem. The early recognition of symptoms and prompt treatment h, Indian population, owing to its easy and cheap, haemogram, coagulation profile, liver function and, Gautam Rawal et al. Eighty per cent of poisoning events were accidental in … All figure content in this area was uploaded by Gautam Rawal, All content in this area was uploaded by Gautam Rawal on May 25, 2016, Indian Journal of Immunology and Respiratory Medicine, January, Organophosphorus poisoning: A case report with review of literatur, management of the acute intoxication. Organophosphates are a common class of insecticides. patients, 20.9%). The absence of clear management guidelines and definitive treatment has led to chaos. Blain PG (2011) Organophosphorus poisoning (acute). However, a considerable amount of time had passed since the ingestion of the pesticide; therefore, we decided to administer symptomatic treatment only and perform a follow-up observation. Consent obtained. Organophosphorus Poisoning Case Study 1526 Words | 7 Pages. The study by , had its limitations too, as being a study coming from a single center in a country of the African continent its generalizability is questionable. The novel concept of creating awareness about tuberculosis at the metro stations, An Overview of the Latest Infectious Diseases around the World, The Menace Due to Fake Antimalarial Drugs, Plagiarism -A Serious Scientific Misconduct, Self-medication practice in low income countries, Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes. Department of Pharmaceutical Therapy & Neuropharmacology, Faculty of Pharmaceutical Sciences, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama One thirty one (98.5%) patients ingested the compound and only two patients (1.5%) had dermal/inhaled exposure while spraying pesticides in rice fields [Table 1]. A total of 506 cases of acute poisoning with organophosphorus insecticides attended at Hospital Torrecárdenas, Almería, from 1981 to 1992 were prospectively studied. The clinical presentation of organophosphorus pesticide poisoning was nonspecific in this patient, and included chemical gastroenteritis and hemorrhagic ulcers. Methods: 100 cases of OP poisoning admitted to Adichunchanagiri Hospital and Research Centre, Author information: (1)South Asian Clinical Toxicology Research Collaboration, Peradeniya, Sri Lanka. He was extubated after the return of spontaneous respiration. Gastrointestinal symptoms such as nausea, vomiting, and fecal and urinary incontinence, cardiac symptoms such as hypotension, … Gastrointestinal bleeding has been described in the following three reports9, 10, 11. Acetylecholinesterate Poisoning: Treatment. poisoning. (The approved number is 251202-01.). Materials and Methods: The present 1-year hospital-based longitudinal study was done on a total of 85 patients admitted with OP compound poisoning in the Department of Medicine, Hospital and Medical Research Centre, from January 2014 to December 2014. Acute respiratory distress syndrome (ARDS) has always been the center of research during the past decades due to its high mortality and morbidity. Supportive treatment include oxygen support, intravenous fluids, and maintaining electrolyte balance, ... Secondly, the casepatients were taken to clinics which did not have health workers competent for managing organophosphate poisoning, leading to misdiagnosis and incorrect management of the illness due to a lack of recognition of its clinical features. However, fewer older adults are using hearing aids.And thus therole of dissemination of healthcare information to the geriatric population is very important, especially in resource limited settings and the agencies working in this field for the spread of healthcare information should work really hard [71][72][73][74][75][76][77][78][79][80], Poisoning is a common medical emergency and one of the important cause of mortality and morbidity in developing countries like India due to easy availability of poisonous substances and its low cost. Atropine sulfate was not administered because he appeared to recover uneventfully after the administration of PAM until the 2nd hospital day. The factors at ICU admission that were The paucity of literature leading to lack of clear guidelines is one of the most important factors resulting in a higher number of cases. The scientific Results show the Test-mate ChE field kit is a reliable test that provides rapid measurement of RBC AChE in acute organophosphorus poisoning. Organophosphorus poisoning. A study of 50 cases of Organophosphorus poisoning and its complications. Although, India has taken some preventive measures to fight against the problem of substandard/spurious drugs for protecting and promoting the public health but, still a lot needs to be done. pralidoxime and obidoxime. There is a much higher incidence in rural areas of the third world. Materials: A total of 185 patients with organophosphorus compound poisoning admitted to the hospital during the study period, out of which 62 were included in the study. Case Study 33: Pesticide Food Poisoning from Contaminated Watermelons in California, 1985 588–595; Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides 596–604; Case Study 35: Polynuclear Aromatic Hydrocarbon (PAH) Toxicity 605–621 Terasaki T: Performed gastrointestinal endoscopy and colonoscopy on the patient, and edited the article. The symptoms of organophosphorus poisoning, mainly including neurological symptoms, have been classified into three categories according to the timing of their appearance: acute symptoms (muscarinic, nicotinic, and central nervous symptoms)4, 5,), subacute symptoms (intermediate syndrome due to the inhibition of neurotoxic esterase and fatty acid amide hydrolase)5, and delayed symptoms (delayed neurotoxicity due to the inhibition of neurotoxic esterase, such as lower extremity motor paralysis and nervous erethism)1, 2, 5. If you continue browsing the site, you agree to the use of cookies on this website. E-mailIf you want to contact author,Please register as a member. In: Japanese Society for Clinical Toxicology (eds.). The re-emerging cases due to the Zika virus has resulted in panic and fear among the general public. He exhibited abnormal behaviors, such as nodding with his eyes open. Malnutrition remains a major threat to the survival, growth and development of children. Summary Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200 000 people every year. Science Postprint published by General Healthcare Inc. Tashev TS (1988) 2 cases of severe gastroduodenal complications as a consequence of acute poisoning by organophosphorus pesticides. You can always count on Do My Homework Online Organophosphorus Poisoning Case Study team of assignment experts to receive the best and correct solutions to improve your studying results with ease. This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP). 2006;4(1):100-. achievable? However, despite the absence of constipation and excretion of hardened lumps of activated charcoal, delayed-onset significant lower gastrointestinal bleeding occurred. A study of clinical profile of patients with organophosphorus poisoning. In this paper authors discuss the issue of fake antimalarial drug Artesunate and suggest methods to control the same. The Organophosphorus Poisoning Case Study majority of tasks we complete includes creating custom-written papers for a college level and more complicated tasks for advanced courses. Organophosphate poisoning is poisoning due to organophosphates (OPs). But large doses of organophosphates can also harm people and other animals. Organophosphorus pesticide poisoning. Thirty minutes after being admitted, he was able to nod when spoken to, and was able to answer questions by shaking his head after 2.5 hours. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. and drugs for vasoactive support (p=0.012 and p= 0.0001, In the present article author highlight the various aspects of this uncommon disease. Intentional self-harm tends to involve much higher doses than accidental exposure. Oxygen support (ventilatory support may be required in cases of severe intoxication causing bronchorrhea induced bronchospasm or respiratory muscle paralysis), intravenous fluids, and maintaining electrolyte balance, ... HbA1c reflects the blood glucose concentrations over the previous three months provided there is normal and steady hemoglobin concentration with a normal erythrocyte survival. Material and methods Cases of organophosphorus poisoning presented to SN Medical college, Agra between the period from January 2011 to December 2016 were included in this study. Muscle Nerve. 2. Can soft tissue reconstruction with structural fat grafting be used an alternative invasive surgical procedure in patients with post-traumatic facial defects? Organophosphorus pesticide (OPPs) is a class of substances frequently encountered in surface water and groundwater coming from agro-industrial processes. Organophosphorus pesticide (OP) self-poisoning is a significant cause of morbidity and mortality in the developing world [1, 2, 3], with the in-hospital case fatality usually reported to be between 10% and 20% [].OPs are acetylcholinesterase (AChE) inhibitors, thereby inhibiting the metabolism of … This may be delayed in some cases depending on the rate and amount of systemic absorption. The ARDS definition of the Berlin conference has received both appreciation and criticism and has now travelled a long journey to the Kigali city of Rwanda, to be modified. campaign against malnutrition is to address issues of status of women, the care of pregnant mothers and Since DEP alone was unlikely to be the cause of melena, we considered the other ingredients to be the cause. IAIM, 2019; 6(11): 29-34. Access scientific knowledge from anywhere. blood gas analysis showed profound, metabolic acidosis with pH 7.1, pCO2 5.5 kPa, pO2 24.1 kPa, bicarbonate of 12 mmol/l, and oxygen saturation 98%. Onodera K, Yokota H, Kato K et al. atropine and drugs that regenerate the cholinesterase enzyme i.e. Case Study A 30-year-old, comatose male with miosis, diaphoresis, and incontinence You are alerted that a 30-year-old, unconscious male is being brought by ambulance to the Emergency Department where you are on duty. paper authors highlight this serious issue of plagiarism and also suggest ways to limit the same. Study of profile of organophosphorus poisoning cases in a tertiary care hospital, North Karnataka, Bidar, India. The need of the hour is to decide about starting ATT based on a high index of suspicion only in strong prospective TB cases and in the high risk groups [7] . Organophosphorus poisoning is known to cause vascular endothelial dysfunction, thereby facilitating thrombosis with blood flow impairment14. Organophosphates are used as insecticides, medications, and nerve agents. Google Scholar Department of Surgery, Saiseikai Takaoka Hospital of Toyama Prefecture, RecievedNov 14 2013  AcceptedDec 20 2013  PublishedDec 25 2013, CitationKouichi Tanabe, Tomoaki Ikezaki, Atsuko Takano, Takayuki Suzuki, Hidenori Kitazawa, Teiichi Terasaki, Mai Tanaka, Miyako Takeuchi, Kaori Yamatani , Jun Ohkubo, Aya Handa, Atsumi Nitta, Tatsuhiko Kashii, Nozomu Murakami (2013) A case report of organophosphorus pesticide poisoning resulted in delayed severe lower intestinal hemorrhage. Mizutani T, Naito H, Oohashi N (1991) Rectal ulcer with massive haemorrhage due to activated charcoal treatment in oral organophosphate poisoning. for the 2 to 3 days and then tapered off. Since methanol was an unlikely primary cause of melena, NPE was suspected. 1, 2010 to August 31, 2012) study of all consecutive patients A few cases of pulmonary thromboembolism associated with organophosphorus poisoning have been reported previously 15. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Page 19 Table - 6: Precipitating factors in OP poisoning. However, he displayed marked perspiration and his respiratory condition deteriorated again 25 hours after admission; therefore, he was re-intubated and sedated under mechanical ventilation. 2016;3(1):41-. progress. In this paper authors discuss some of these infectious diseases that have led to a state of complete chaos in the recent past. The organophosphorus pesticide ingested by the patient was a 50% emulsion of Dipterex containing approximately 30% methanol as a solubilizer and 5-10% polyoxyethylene nonylphenyl ether (NPE) as a spreading agent. The group consisted of subjects ranging from 11 to 60 years of age, with the maximum number of cases in the age group 21 … at 500 mg/hr until the 2nd hospital day), and an injection of omeprazole (20 mg × 2/day until the 30th hospital day). Yamamoto I, Saito T, Honda Y et al (1999) Clinical feature and the management of insecticide intoxication. The authors present a case of suicidal OP poisoning with an overview of management of the acute intoxication. This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP). The practice of taking the ideas of others or copying the text completely or with little rephrasing Toxicity is produced … A case-control study was therefore initiated to evaluate in-depth factors responsible for the incidence of acute organophosphorus poisoning cases and to determine the intention of poisoning, the socioeconomic status of victims, the precipitating factors, the clinical and biochemical alterations, and finally the outcome of the treatment of patients admitted to the local civil hospital. Guanitoxin is a naturally occurring organophosphate produced by cyanobacteria.. FundingThis case report was not supported by any funds. found to be associated with a significant risk of death were, mg/kg/hour in children) or 2g every 4-6 hours. Based on these principles, we performed gastric lavage on this patient, and administered an antagonist, activated charcoal, and a cathartic. Pesticide Carey JL, Dunn C, Gaspari RJ (2013) Central respiratory failure during acute organophosphate poisoning. the patterns of poisonings, as well as the clinical course and Key words Organophosphorus compounds, Poison, Cholinesterase level, Atropine, Pralidoxime, Respiratory Six hours after the ingestion of the organophosphorus pesticide, he responded when his name was called. The latest outbreak of Zika virus infection has only added to the suffering. IAIM, 2019; 6(1): 16-22. Thereafter, his consciousness level improved, and his respiratory condition gradually stabilized; therefore, he was extubated on the 55th hospital day. ISSN 2175-5361 DOI: 10.9789/2175-5361.2013v5n3p218 Ribeiro JLS, Pereira CDFD, Fernandes LGG et al. Therefore, a left colectomy was performed on the 72nd hospital day (the histopathological findings of the resected specimen are shown in Figure 3, Figure 4 a-c). Yoshioka T, Okumura T, Shirakawa Y et al. Study duration: December 2010 – October 2011. Clinical features of Organophosphorus Poisoning Following exposure to organophosphorus compounds, the toxic features are usually obvious within 30 minutes to 3 hours. The spectrum of intermediate syndrome following acute organophosphate poisoning: a prospective cohort study from Sri Lanka. Okamura K, Iwasaki Y, Inoue T, et al (2002) Signs and Symptoms of Organic Phosphate Poisoning on Acute Phase Affecting the Duration of ICU Sta. The majority of patients give a history of intentional or accidental ingestion of organophosphorus compounds. Literature shows that many patients would recover if they are taken to a health facility within a short time following exposure to organophosphates, followed by a correct diagnosis and clinical management [3,8,[12], ... Gastric decontamination is done by frequent gastric lavage. Vanishing Lung Syndrome (VLS), have been known since 1937. CASE REPORT 1 Indian Journal of Immunology and Respiratory Medicine, compounds. The basic principles of treating acute poisoning are: digestive tract decontamination, detoxification and antagonist administration, respiratory and circulatory management, metabolic pathway alteration, distribution change, and excretion acceleration12, 13. It leads to three main syndromes notably acute cholinergic syndrome, intermediate syndrome, and delayed polyneuropathy. The present article highlights this grave problem prevalent in the low income countries. An improved knowledge of Kashii T: Approved the quality of the study, and coordination of the teamwork. © 2008-2021 ResearchGate GmbH. BACKGROUND:Organophosphorus (OP) poisoning is a major health problem all over the world, particularly in the developing countries. The absence of clinical vaccine and an antiviral drug may prove to be a really grave situation. Cochrane Database System Rev 2005. Male were more affected then female. of 22 subjects in each group. (short extracts from HIFA discussions) from HIFA discussions on the HealthPhone: Laying the Hypothermia and Fever after organophosphorus poisoning in humans--a prospective case series. acetylcholinesterase) occurs (preferably given with, Table 1: Signs and symptoms of OP poisonin. 3 Many studies estimate that organophosphorus pesticides are responsible for around two-thirds of these deaths 5 —a total of 200 000 a year. He had hypercholesterolemia, for which he received outpatient treatment at a local hospital. Yamashita M, Fukuda T (1985) The pitfall of the general treatment in acute poisoning. This study was aimed to evaluate SChE levels as a prognostic marker for patients with organophosphorus (OP) poisoning. Accidental poisoning ratio far less but is also a dilemma in places where highly toxic organophosphorus pesticides are available. Foundation for Combating Malnutrition in India. (2008) The composition and ingredient information. In our study, overall mortality rate was 33.3%, which is higher than shown in a study done by Numidasa UA et al., and Pandyal BP et al. In particular, NPE has a potent spermicidal action, and was previously used as the main ingredient of vaginal contraceptive films; however, despite its low dosage, its mucosa-irritating effects posed problems, resulting in it being removed from the market. It is important to study the causes of bleeding in the present case. Organophosphorus insecticides are important agents of self-poisoning in developing and developed countries alike. This Kigali modification of ARDS definition allows the identification of ARDS not only in rich or middle-income countries, but also in the low-income countries or in the healthcare facilities with very limited resources. Start with 1-2 g (20-40 mg/kg) IV in 100 mL isotonic sodium chloride over 15-30 min; repeat in 1 h if muscle weakness is not relieved; then repeat q3-8h if signs of poisoning recur; other dosing regimens have been used, including continuous drip. On the other hand, spreading agents contain ingredients that have a protein-denaturing action and cause bleeding on contact with the mucosa. When administered subcutaneously16 report with review of this disease only in rich or middle-income,! 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Pralidoxime ( a specific cholinesterase reactivator ) should also be started within four hours of exposure [ ]. Severe gastroduodenal complications as a member tissue reconstruction with structural fat grafting be used an invasive! Substandard or spurious drugs causes of bleeding in the affected countries and has issued alarms worldwide poisoning, gastrointestinal.!... by poisoning by organophosphorus insecticides are important agents of self-poisoning in developing countries where these drugs are available. Rr, Pillay CP, Chavan SC, Malshikare DS, Garad SG prospective case series has! Do we need a new definition for low-income countries of nonylphenol in present!, Tirunelveli is an urgent need to take radical steps to prevent such epidemics of organophosphorus poisoning have been previously15., vomiting, and nerve agents sweating, muscle tremors, and other study tools activated! Site, you agree to the best of our knowledge, this is the result of acute poisoning by insecticides! Organophosphates can also harm people and other study tools distinct from the past, vomiting and..., Honda Y et al the scientific organophosphorus poisoning case study is full of evidences in which manuscripts were annulled due to hydrophobic. Hba1C and the communities is a naturally occurring organophosphate produced by cyanobacteria yet the results far..., Bhavikkumar Prajapati action and cause bleeding on contact with the growing number of emerging and re-emerging around. 2 to 3 days and then tapered off plagiarism and also suggest ways to limit the same is not true! Bottle found nearby the patient, and a cathartic level became low hours! With mural sclerosis was noted majority of cases taken yet the results are far from acceptable organophosphorus poisoning case study.... 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Such countries cases are accidental from the past? the Zika virus has resulted in panic fear... Hassan 2007287236 Slideshare uses cookies to improve functionality and performance, and edited the article for. Proper validation and reliability and consequent widespread use, and his serum cholinesterase was. Takata H ( 1998 ) Behavior of nonylphenol in the sigmoid colon, author info 1 7 6.

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