Poisoned after Dinner: Dolma with Datura Stramonium

SUMMARYDatura stramonium, which is also known as Thorn Apple or Jimson Weed, is an alkaloid containing plant that is entirely toxic. The active toxic constituents of the plant are atropine, scopolamine and hyoscyamine. It has been abused worldwide for hundreds of years because of its hallucinogenic properties. Previous reports have shown that herbal medication overdose and accidental food contamination are ways it can cause poisoning. Herein we present a family that had three of its members poisoned after eating a traditional meal “dolma” made of datura flowers. None had fatal complications and all were discharged healthy. Datura stromonium may be used accidentally as a food ingredient. Since its poisonous effects are not known, people should be informed and warned about the effects of this plant

Alcohol Withdrawal Mimicking Organophosphate Poisoning

Organophosphates, which can cause occupational poisoning due to inappropriate personal protective measures, are widely used insecticides in agricultural regions of southern Turkey. Therefore, the classical clinical findings of this cholinergic poisoning are myosis, excessive secretions, bradicardia and fasciculations are easy to be recognized by local medical stuff. Diseases and conditions related to alcoholism such as mental and social impairments, coma, toxicity, withdrawal, and delirium are frequent causes of emergency visits of chronic alcoholic patients. Here we present a case diagnosed and treated as organophosphate poisoning although it was an alcohol withdrawal in the beginning and became delirium tremens, due to similar symptoms

Utilization of plasmapheresis in the management of bismuth intoxication with acute renal failure

A 34-year-old female patient who ingested 2400 mg bismuth subcitrate in a suicide attempt was brought to the emergency department. She had mild encephalopathy and acute renal failure on admission. One session of plasmapheresis was performed to remove bismuth, and needed three sessions of hemodialysis and was discharged on the 24th day of hospitalization with the recovery of the renal function

Utilization of plasmapheresis for organophosphate intoxication: A case report

Organophosphate (OP) compounds are extremely toxic chemicals that may be absorbed via skin, conjunctiva, gastrointestinal and respiratory systems. Treatment of OP poisoning is a critical and aggressive process which includes decontamination, antidote administration (atropin and oximes), mechanical ventilation support and extracorporeal elimination procedures if needed. Here we present a young female patient who was unintentionally poisoned by an OP (trichlorfon) after using it to moisture her skin. The importance of this patient is the dermal disease that makes her unprotective to dermal exposure of chemicals and application of plasmapheresis to treat her poisoning. Keywords: Organophosphate, Intoxication, Plasmapheresis, Dermal exposure, Ichthyosi

Role of intravenous lipid emulsions in the management of calcium channel blocker and beta-blocker overdose: 3 years experience of a university hospital

WOS: 000353453200001PubMed ID: 25684131Objectives: The objective of this study was to assess the efficacy of lipid emulsion as antidotal therapy in severe calcium channel blocker (CCB) and beta-blocker (BB) intoxications. Patients and methods: This is a retrospective study in which we have summarized data of patients who were admitted to a university-based emergency department in a period of 3 years and were given intravenous lipid emulsion (ILE) to manage cardiogenic shock due to CCB and BB overdose. Results: We identified 15 patients who received ILE therapy for CCB and BB toxicity. Hospitalization durations variated between 3 and 33 days (mean 7.46 perpendicular to 7.41 days). Drug exposures included CCBs (n = 8, 53.3%), CCBs and paracetamol (n = 1, 6.6%), and BBs (n = 6, 40%). ILE therapy was effective in 12 patients (80%). Three patients (20%) had resistant hypotension, one of whom progressed to pulmonary edema. Adverse effects of ILE therapy were seen in three patients (20%). Two patients underwent mechanical ventilation. Two patients developed hypoxic ischemic encephalopathy, one patient died, and 14 patients (93.3%) were discharged from hospital. Conclusion: There was 93.3% survival in patients receiving ILE for drug-induced cardiovascular collapse. Clinically significant adverse effects were uncommon. We suggest ILE administration for the treatment of cardiogenic shock due to CCB and BB overdose

Successful Treatment of Aluminum Phosphide Poisoning with Continuous Veno-venous Hemofiltration: A Case Report

WOS: 000381858100005Introduction: We aim to discuss the case of a patient with aluminum phosphide (AP) poisoning in a suicide attempt and who was successfully treated with continuous veno-venous hemofiltration (CVVH). Case Report: A-24-year old lady was admitted to a hospital with the complaints of dizziness, numbness in the face, and nausea and vomiting after taking two tablets of AP. She was transferred to our emergency clinic 10 h later because of persistent hypotension and metabolic acidosis. Her Glasgow Coma Scale score was 13 on admission. Her vital signs were as follows: blood pressure, 80/50 mmHg; pulse rate, 128/min; pulse oximetry, 90%; and respiration rate, 26/min. Her laboratory tests revealed the following: pH, 7.13; bicarbonate level, 10.1 mmol/L; and serum lactate level, 10.2 mmol/L. Other blood test results were normal. CVVH (Prismaflex hemofiltration set M150) was started in the intensive care unit because hypotension and metabolic acidosis were persistent; oliguria was added despite fluid resuscitation and inotrope infusion. Hemofiltration was continued until the 32nd hour when blood pressure and blood gas levels returned to normal. She was discharged healthy on the 4th day of hospitalization. Conclusion: We suggest the utilization of CVVH in the early stages of AP poisoning before the development of multiple organ failure because AP causes metabolic acidosis and hypotension resistant to medical treatment

Vitamin D levels in Cukurova Region

WOS: 000406284600016Purpose: The aim of ths study was to evaluate the increase in the request of plasma 25-hydroxy vitamin D level assay tests in Balcali Hospital of the Cukurova University during last 13 years and levels of 25-hydroxy vitamin D to determine the frequency of deficiency among the regional adult population admitting this hospital. Material and Methods: This study was performed by using pre-recorded electronic files and laboratory results of patients admitted to Balcali Hospital of the Cukurova University between 2003 and 2015. The number of 25-hydroxy vitamin D tests assayed of all ages between 20032015 and the diagnoses, age, gender, sampling, request, acceptance, confirmation times of tests, plasma 25-hydroxy vitamin D were evaluated. Results: The number of 25-hydroxy vitamin D tests assayed in the last 13 years was 77,569. When compared between years 2003-2013, number of 25-hydroxy vitamin D tests was increased 6785%. Mean plasma 25-hydroxy vitamin D levels were found to be higher in men (52.95 +/- 0.92 nmol/L) than women (48.42 +/- 0.54 nmol/L) (p<0.001). Among 6,198 patients included, 24.65% had 25-hydroxy vitamin D insufficiency and 35.95% had 25-hydroxy vitamin D deficiency. Only 15.62% of patients had optimal 25-hydroxy vitamin D levels. Conclusion: Although it is an extremely sunny environment, vitamin D insufficiency is a common and public health problem in Cukurova region. Many diseases may be prevented by education of how to benefit from sunrays and dietery supplements of vitamin D in risky population