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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v3i4.2269</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v3i4.2269</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Ethylene Glycol Toxicity Following Brake Oil Ingestion</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Khan</surname>
            <given-names>Mohsin</given-names>
          </name>
          <email>mohsinkhan1464@yahoo.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ahmad</surname>
            <given-names>Tauqir</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Khan</surname>
            <given-names>Niama</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Saifuddin</surname>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Ayub iTeaching Hospital/Ayub Medical College, Abbottabad, Pakistan</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Mohsin Khan (mohsinkhan1464@yahoo.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2022-12-18">
        <day>18</day>
        <month>12</month>
        <year>2022</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2022</year>
      </pub-date>
      <volume>3</volume>
      <issue>4</issue>
      <fpage>345</fpage>
      <lpage>348</lpage>
      <history>
        <date date-type="received" iso-8601-date="2022-07-25">
          <day>25</day>
          <month>07</month>
          <year>2022</year>
        </date>
        <date date-type="accepted" iso-8601-date="2022-10-02">
          <day>02</day>
          <month>10</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2022 The Author(s)</copyright-statement>
        <copyright-year>2022</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v3i4.2269" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v3i4.2269.pdf" content-type="application/pdf"/>
      <abstract>
        <p>Break oil is used as a lubricant in automobiles. Children and predisposed individuals with a history of mental illness are particularly at risk of intoxication. The wide range of toxic doses and delay in onset made it difficult to categorise the severity of intoxication at presentation. A 17-years-old boy presented to emergency department with excruciating abdominal pain. He was drowsy had a GCS of 12/15 and had been anuric for the previous 24hrs. The Patient disclosed that he ingested about 50ml of break oil as a suicidal attempt. Labs revealed severe metabolic acidosis with acute kidney injury at presentation. Due to late presentation and severe metabolic acidosis with kidney injury, immediate hemodialysis was planned. Three sessions of hemodialysis yielded considerable improvement over course of 3 days but patient died due to cardio toxicity on 4th day of treatment. Break oil poisoning has several clinical evolutions through the deposition of harmful metabolites. After intoxication patient can present in any phase of toxicity. Cardiopulmonary involvement and delayed treatment could be fatal as seen in this case. Early treatment of metabolic acidosis should be done to prevent vital organs from toxicity</p>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>Break lubricants</kwd>
        <kwd>cardio toxicity</kwd>
        <kwd>Acute kidney injury.</kwd>
      </kwd-group>
    </article-meta>
  </front>
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  <back>
    <ref-list>
      <title>References</title>
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  </back>
</article>
