Pregled otrovanja aluminijevim fosfidom i prijedlog dijagrama tijeka njegova liječenja

The use of pesticides such as aluminium phosphide (AlP) has increased in the recent years and improved the quantity and quality of agricultural products in a number of developing countries. The downside is that AlP causes severe chronic and acute health effects that have reached major proportions in countries such as India, Iran, Bangladesh, and Jordan. Nearly 300,000 people die due to pesticide poisoning in the world every year. Poisoning with AlP accounts for many of these deaths. Unfortunately, at the same time, there is no standard treatment for it. The aim of this article is to give a brief review of AlP poisoning and propose a treatment flowchart based on the knowledge gained so far. For this purpose we reviewed all articles on the management of AlP poisoning published from 2000 till now. Using a modified Delphi design, we have designed a handy flowchart that could be used as a guide for AlP poisoning management of patients in emergency centres.Primjena pesticida poput aluminijeva fosfida (AlP) raste iz godine u godinu, povoljno utječući na količinu i kakvoću poljoprivrednih proizvoda u mnogim zemljama u razvoju. Nažalost, AlP može uzrokovati i snažne kronične i akutne zdravstvene posljedice, koje su u zemljama poput Indije, Irana, Bangladeša i Jordana dosegnule zabrinjavajuće razmjere. U svijetu svake godine od otrovanja pesticidima umre gotovo 300.000 ljudi. Mnoge od tih smrti uzrokovane su aluminijevim fosfidom. Svrha je ovoga članka dati kratak pregled literature vezane uz otrovanje AlP-om te predložiti algoritam njegova liječenja koji se temelji na dosadašnjim spoznajama. U tu smo svrhu pregledali sve članke o liječenju otrovanja AlP-om od 2000. naovamo. Oslanjajući se na prilagođeni Delphi-dizajn, osmislili smo koristan dijagram tijeka koji bi se mogao koristiti kao vodič kroz liječenje otrovanja aluminijevim fosfidom u hitnim službama

The Protocol of Choice for Treatment of Snake Bite

The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF), and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89%) were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS). Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values