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Aidah Abu El Soud Alkaissi An-Najah National University Faculty of Nursing Signs and symptoms Consciousness is not depressed unless other drugs have also been taken or there is a very high plasma paracetamol concentration of the order of 6.62 mmol/l (1000 mg/l) with a metabolic acidosis Nausea and vomiting usually develop within a few hours of ingestion of a hepatotoxic dose of paracetamol Elevation of the plasma alanine and aspartate transaminase activity from normal values of less than 40 to as much as 10 000 or even 20 000 U/l caused by their release from a large mass of necrotic hepatocytes Dr

Front Genet 2014;5:314

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Neurologic, cognitive, hematologic, or mucosal features can point to a shortfall, as can risk factors such as malabsorption, autoimmune gastritis, relevant medications, or nitrous oxide exposure