177 Indian Journal of Emergency Medicine Editor-in-Chief Indraneel Dasgupta, Peerless Hospital & B.K. Roy Research Center, Kolkata Associate Editor Sajid Nomani, AMRI Hospital, Odisha National Editorial Board Anoop Chakrapani, Trivandrum S. P. Patel, Lucknow Bidita Khandelwal, Sikkim S.K. Sharma, New Delhi C.L. Nawal, Jaipur, Saptarshi Saha, Kolkata Habib Md. Reazaul Karim, Port Blair Sayan Misra, Kolkata Indranil Mitra, Kolkata Sudip Chakraborty, Kolkata Jigar kumar Gosai, Ahmedabad Sujoy Das Thakur, Kolkata Ketan Patel, Ahmedabad Suman Kumar Kotwal, Jammu Kishalay Datta, New Delhi P.K. Sasidharan, Calicut International Editorial Board Jeffrey Smith, Director, Ronald Reagan Institute of Emergency Medicine, U.S.A. George P. Abraham, President, Indian Institute of Emergency Medical Services Managing Editor Publication Editor A. Lal Manoj Kumar Singh Indian Journal of Emergency Medicine (IJEM) (pISSN: 2395-311X, eISSN: 2455-8370) is an international peer review journal covering pre­hopsital and hospital emergency medicine, and critical care. The journal publishes original research, reviews and evidence based articles on resuscitation, major trauma, minor injuries, acute cardiology, acute paediatrics, toxicology, toxinology, disasters, medical imaging, audit, teaching and reflections on clinical practice. The journal is aimed at doctors, nurses, paramedics and ambulance staff. Indian Journal of Emergency Medicine / Vol. 3 No. 2 / July ­ December 2017 178 Indian Journal of Emergency Medicine / Vol. 3 No. 2 / July ­ December 2017 179 Indian Journal of Emergency Medicine Vol. 3 No. 2, July - December 2017 CONTENTS Original Research Articles Study of Serum Sodium and Potassium Levels in Patients of Acute Myocardial Infarction 183 Amith Kumar, Sathyanarayan T.B., Virupakshappa V. Achieving Sustainable Door-To-Balloon Time of 90 Minutes in a Tertiary Centre Hospital for St-Segment Elevation Myocardial Infarction 188 Gulati V., Datta K. Rational Use of Anti-Snake Venom: Trial of Various Use Regimes in Hemtoxic Snake Envenomation 190 Aravinda C.L., Nagabhushana S., Ranganatha M., Virupakshappa V. Management and outcome of Acute Kidney Injury at a Tertiary Care Hospital 197 Cijo John, Selin Abraham Prognosis of Haemodynamically Unstable Patients Secondary to Trauma Based on Lactate Clearance 203 Khan Khader Ali, Begum Naheeda Shaik, Shabbir Mohammed, Samir Mohammed Spectrum of Acute Febrile Illness in Children Presenting in Emergency of a Tertiary Care Hospital and Its Clinico - Laboratorial Correlation 211 Kishalay Datta, Rigenjyoti Kalita Non-Invasive Ventilation: First Line Therapy in the Acute Exacerbations of COPD in Emergency Department 217 Mohammed Ismail Nizami, Narendra Kumar N., Ashima Sharma, G. Vishwa Reddy, S. Raghavendra Goud The Study of the Clinical Profile and Laboratory Parameters of Acute Neonicotinoid Compound Poisoning at a Rural Tertiary Care Public Hospital in Central India 223 Mundhe Sanjay A., Birajdar Siddheshwar V., Chavan Sheshrao S., Kendre Vitthal M. Role of Intravenous Magnesium Sulphate in Predicting Outcomes of ICU in Acute Organophosphate Poisoning 231 Sri Harsha J., Srinivas Prabhu N.C., Ronak M. Raheja, O.R. Ranjan Patient Expectations in the Emergency Department of a Super-Speciality Hospital 236 Sudip Chakraborty, Saptarshi Saha, Indraneel Dasgupta Indian Journal of Emergency Medicine / Vol. 3 No. 2 / July ­ December 2017 180 Clinical Presentation of Renal Injury at a Tertiary Care Hospital 244 Cijo John, Selin Abraham ‘Tetpro Score’ for Evaluation of Progression in a Case of Tetanus 249 Vinay Swamy P.M., Bopanna C.A. Review Article Myotonic Dystrophy: A Rare Autosomal Dominant Disorder 252 Vikram Shah, Kishalay Datta, Sarat Naidu, Balasubramanyam E.V., Sonal Singh, Jitesh K. Bhandarkar Case Reports A Rare Serious Ocular Side Effect of Topiramate: Bilateral Acute Angle Closure Glaucoma 255 Dhruvkumar M. Patel, Mukundkumar V. Patel, Ajay V. Garg A Case Report on Stroke in Young 258 Aisvarya Girotra, Balasubramanyam E.V., Hilal Ahmad Yatoo, Kishalay Datta A Case Report on Acute Myocardial Infarction in Young: Atypical ECG Changes Vs. Angiographic Correlation 261 Aisvarya Girotra, Kishalay Datta, Rigenjyoti Kalita One and Half Syndrome in Acute Pontine Infarct: A Rare Entity 264 Anita Rawat, Kishalay Datta, Vaibhav Gulati Carcinoma Prostate with Metastasis to Vertebral Column and Right Cerebellum Causing Sol and Hydrocephalus 266 E.V. Balasubramanyam, Sonal Singh, Indranil Das, Kishalay Datta Renal Thrombotic Microangiopathy Due to Malignant Hypertension 269 Harini Agnes, Venugopal A.V. A Case of Infant with Factor VII Deficiency Presenting as ICH 272 Hilal Ahmad Yatoo, Vaibhav Gulati, Kishalay Datta, Rupinder Kahlon An Unusual Presentation of Recurrent Hypoglycemia 275 Singh A., Datta K., Das I., Kalita R., Govil P., Patel M. Cerebral Venous Thrombosis and Hyperhomocy-steinemia, How Important is the Co-Relation?-A Review of 3 Cases 278 Lipoktemsu Jamir, Dina J. Shah Asymmetrical and Late Onset of Pulmonary Edema Post Scorpion Sting: Case Report of Rare Manifestation 282 Susmeet Mishra, Gouri Kumar Rath, Sajid Nomani Acute Isolated Posterior Myocardial Infarction; Challenges in Recognition and Management in the Emergency Department 286 Sarat Kumar Naidu, Ankur Pandey, Kishalay Datta Indian Journal of Emergency Medicine / Vol. 3 No. 2 / July ­ December 2017 181 Petrol Ingestion Causing Methaemoglobinaemia in Glucose 6-Phosphate Dehydrogenase (G6PD) Deficiency Patient 290 Nasir Shakilli, Mohammad Kamal, Bakshi Surrinder Kumar, Madhusudhanan M., Moosa Al Abri, Almur Abdullah Alabri Early Diagnosis and Treatment not Always a Key to Favorable Outcome: A Case Report of ADEM Correctly Diagnosed and Treated Still Surviving for Better Life 293 Aakansha Singh, Vaibhav Gulati, Kishalay Datta, Hilal Ahmad Yatoo Traumatic Cardiac Tamponade: Relearning Old Lesions to Avoid Delay in Diagnosis and Management of a Life-Threatening Thoracic Injury 296 Sarat Kumar Naidu, Vikram Shah, Gurjit Kaur, Kishalay Datta Torsion of Non-Gravid Uterus with Myoma Presenting to Emergency with Shock 301 Muhammad Aamir Mir, Kritika Nanda, Kamal Preet Palta, Kishalay Datta A Rare Case of Complicated Neuroleptic Malignant Syndrome with Rhabdomyolysis and Acute Kidney Injury Sarat Kumar Naidu, Gurjit Kaur,Vikram Shah, Kishalay Datta 304 Life Threatening Rhabdomyolysis, A Rare and Unusual Presentation with Rosuvastatin Ingestion 308 Umran Rafeeq Sheikh, Kishalay Datta, Priya Govil, Deepika Mittal Beyond ACLS Protocol: A Rare Case of Refractory Supraventricular Tachycardia Responding Only to a Much Higher Dose of Adenosine 311 Sarat Kumar Naidu, Hilal Yatoo, Kishalay Datta An Unusual Presentation of Fat Embolism Syndrome as Cerebral Fat Embolism in Trauma: A Rare Clinical Entity 316 Nitish Dhand, Kishalay Datta, Vaibhav Gulati, Indranil Das, E.V. Balasubramanyam, Vikram Shah Bilateral Acute Lower Limb Arterial Occlusion after Long Term Tranexamic Acid Usage 319 P. Anvesh, A.V. Venugopal, Harini Agnes, Siddardh Glossopharyngeal Neuralgia Leading to Sinus Pause: A Rare Entity 322 Vaibhav Gulati, Kishalay Datta, Naveen Bhamri G6PD Deficiency as a Precipitant of Haemolysis in Hepatitis E Patients 325 Umran R. Sheikh, Kishalay Datta, Shahid Mustafa Khan, Indranil Das, Deepika Mittal Guidelines for Authors 329 Subject Index 333 Author Index 335 Indian Journal of Emergency Medicine / Vol. 3 No. 2 / July ­ December 2017 182 Subscription Information Institutional (1 year) INR12000/USD857 Here is payment instruction for your reference. Check: Please send the US dollar check from outside India and INR check from India made: Payable to ‘Red Flower Publication Private Limited’. 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Ltd. 48/41­42, DSIDC, Pocket­II Mayur Vihar Phase­I Delhi ­ 110 091(India) Indian Journal of Emergency Medicine / Vol. 3 No. 2 / July ­ December 2017 Original Research Articles Indian Journal of Emergency Medicine183 Volume 3 Number 2, July ­ December 2017 DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.1 Study of Serum Sodium and Potassium Levels in Patients of Acute Myocardial Infarction Amith Kumar1, Sathyanarayan T.B.2, Virupakshappa V.3 Author’s Affiliation: Abstract 1Assistant Professor 2Associate Professor 3Professor and HOD, Dept. of Medicine, Shimoga Institute of Medical Sciences, Background: Cardiovascular disease is one of the leading causes of morbidity Shivamogga, Karnataka 577201, and mortality across the world. World Health Organization (WHO) has India. declared cardiovascular disease as a modern epidemic. Acute Myocardial Infarction is one of the manifestations of coronary heart disease leading to Corresponding Author: Sathyanarayan T.B., morbidity and mortality. Arrhythmias and hemodynamic abnormalities in Associate Professor, left ventricular dysfunction are the major causes of mortality along with Department of Medicine, acute myocardial