1. INTERNAL MEDICINE

2. DUTURA POISONING Medicolegal use: To stupefy travelers in railway station, bus terminal, in train or bus.

3. DUTURA POISONING Clinical feature: Dizziness Delirium Drowsiness Dilated pupil Dimness of vision Dryness of mouth Dysarthria Dysphagia

4. DUTURA POISONING Clinical feature: Dry skin, hyperpyrexia Nausea, vomiting Distended bladder, retention of urine Staggering gait, pill rolling movement Stupor, convulsion, coma

5. DUTURA POISONING Investigation: CBC RFT Serum electrolytes

6. DUTURA POISONING Management: Immediate hospitalisation Clearance of airway Stomach wash with weak sol of KMnO4 Inj diazepam 10 mg i/m stat Injphysostigmine or pilocarpine 1-4 mg in adult

7. DUTURA POISONING Management: Supportive and symptomatic treatment- Cold sponging for hyperpyrexia Maintenance of nutrition by nasogastric feeding Fluid and electrolytes balance