हमारा समूह 1000 से अधिक वैज्ञानिक सोसायटी के सहयोग से हर साल संयुक्त राज्य अमेरिका, यूरोप और एशिया में 3000+ वैश्विक सम्मेलन श्रृंखला कार्यक्रम आयोजित करता है और 700+ ओपन एक्सेस जर्नल प्रकाशित करता है जिसमें 50000 से अधिक प्रतिष्ठित व्यक्तित्व, प्रतिष्ठित वैज्ञानिक संपादकीय बोर्ड के सदस्यों के रूप में शामिल होते हैं।
ओपन एक्सेस जर्नल्स को अधिक पाठक और उद्धरण मिल रहे हैं
700 जर्नल और 15,000,000 पाठक प्रत्येक जर्नल को 25,000+ पाठक मिल रहे हैं
Sheraz Majeed and Wee Jin Ng
Here we present a case of hypercalcaemia mimicking opioid toxicity. This is a 50 year old lady with a neuroendocrine tumour who presented with worsening back pain, thoracic wall pain, constipation, fatigue, confusion and nausea. Her regular morphine dose had recently been increased and she was initially admitted to hospice for management of these symptoms, which were believed to be due to opioid toxicity. However, investigations showed hypercalcaemia and she was treated adequately for this. Her symptoms were well controlled, although she continued to deteriorate due to the underlying malignancy and she remained on opioids for her end-of-life pain management. Hypercalcaemia and opioid toxicity have several overlapping symptoms, including fatigue, confusion, nausea and vomiting, constipation and abdominal pain. However there are specific signs and symptoms to help distinguish the two. Specifically, opioid toxicity can cause respiratory depression, miosis and myoclonic jerks while hypercalcaemia can cause bone pain, renal colic, arrhythmias, polyuria and polydipsia. Therefore attention should be paid to these specific features on assessment of patients and blood tests should be done if there is any uncertainty.