Posted by: ojhasamajdhangadhi April 16, 2026
CASE STUDY: BINOD SINGH DHAMI IN AMERICA
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A man of 40 years went to United States at the age of 18 and was exposed to carbon monoxide of car and American snow in the winter a lot. He did not get proper hygiene and was exposed to different kind of torture by law enforcement over there. He drank a lot of alcohol while working at liquor store in New Jersey. He drove car for over 5 years in America. He had lot of restaurant food and multivitamins from nutrition company.
https://www.youtube.com/watch?v=JqjAjJlbfw0
He also ate lot of protein bars and energy drinks while in America containing a lot of creatinine. He seemed to have lost his memory for some time. It is also suspected that he was poisoned in different ways including paracetamol poisoning in government linked operation. He lived in East Coast of United States for over 8 years and about a year in Texas before returning to Nepal. In Nepal, he was subjected to heavy doses of medicines by psychiatrist including benzex, topiramate, reisper and quetiapine. He joined gym and went to swimming pool occasionally in Kathmandu.
https://www.youtube.com/watch?v=JqjAjJlbfw0
He was 93 kg for a long time but is now 83 kg. He had pneumonia as a kid. He still has respiratory condition. Dr. Deepak of ENT Kathmandu Medical College recommended Sofex 180 and Metaspray. He also used Ayurvedic products like Triphala and Sitopaladi in Kathmandu for over 8 years. He has resumed steam therapy at Rajpur Ayurvedic facility Dhangadhi Rajpur. What do you suggest?
https://www.youtube.com/watch?v=RUDcEMCph3c&pp=0gcJCdMKAYcqIYzv

Get a coordinated medical re‑evaluation now in Nepal at a tertiary hospital (neurology, hepatology/toxicology, pulmonology, and psychiatry) with a full medication review and targeted tests (liver panel, toxicology screen, neuroimaging, pulmonary function). If he has new confusion, jaundice, severe breathlessness, or worsening mood/behavior, seek emergency care immediately.

https://www.youtube.com/watch?v=VF_1TWmXbpM

Why this matters (key medical facts)

  • Carbon monoxide exposure can cause delayed and persistent cognitive problems (memory loss, brain fog, mood change) even after the acute event; these are called delayed neurological sequelae and may require specialized neurorehabilitation.

  • Paracetamol (acetaminophen) overdose can cause delayed liver injury and liver failure; early testing and treatment (N‑acetylcysteine) are critical if overdose is suspected.


Immediate action plan (first 1–2 weeks)


  • If acute red flags (confusion, fainting, jaundice, severe abdominal pain, vomiting, severe breathlessness, chest pain): go to the nearest emergency department now.


  • Arrange a coordinated outpatient workup at a tertiary center in Kathmandu (e.g., Kathmandu Medical College or equivalent): request a joint review by neurology, hepatology/toxicology, pulmonology, and psychiatry. Bring any medication lists, past records, and a timeline of exposures.

  • Stop alcohol and avoid acetaminophen, energy drinks, and unverified supplements until reviewed by a clinician.


Recommended tests and evaluations (prioritized)

  • Blood tests: CBC, liver function tests (AST/ALT, bilirubin, INR), renal panel, electrolytes, fasting glucose, thyroid, vitamin B12/folate. If recent acetaminophen ingestion is possible, measure serum acetaminophen level and INR.

  • Toxicology screen (including common recreational/occupational toxins if available) and review of supplement ingredients.

  • Neurocognitive assessment and brain MRI (to evaluate structural or delayed CO effects); consider EEG if seizures or episodic confusion.

  • Pulmonary evaluation: chest X‑ray or CT if chronic respiratory symptoms, and pulmonary function tests for chronic lung disease.

  • Medication review by a psychiatrist or clinical pharmacologist to assess polypharmacy risks and interactions (risperidone, quetiapine, topiramate, benzodiazepines or similar agents).

Practical steps and documentation

  • Collect and bring: all preskriptions, supplement bottles (protein bars/energy drink labels), any US medical records, and a written timeline of exposures and symptoms.

  • Ask for written plans: medication tapering strategy if polypharmacy is suspected, and a follow‑up schedule for labs and imaging.

  • Consider forensic/toxicology consultation if intentional poisoning is suspected; preserve any remaining pills or samples.

Risks, limitations, and follow‑up

  • Risks: untreated liver injury, progressive cognitive decline, medication side effects from multiple psychotropics.

  • Limitations: some specialized toxicology tests and neurorehabilitation services may be limited locally; transfer to a higher center may be needed.

  • Follow‑up: repeat LFTs and neurocognitive testing at intervals recommended by specialists.


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