Acute Lithium Intoxication and Factors Contributing to its Morbidity: a 10-Year Review

Background: Lithium has been commonly used for the treatment of several mood disorders particularly bipolar disorder in the last 60 years. This study aimed to analyze patients with lithium intoxication referred to Loghman- Hakim teaching hospital.Methods: This is a cross sectional study that has been done on 108 patients with lithium intoxication during 2001 to 2010. Necessary data were collected by checklists and then analyzed by statistical methods in SPSS version 20.Results: 39.8% of patients were male and most of them were in age group 20-40 years (47.2%). The rate of lithium use in 66.7% of patients was lower than 20 grams and the level of lithium in blood was 1 mEq/lit in 44.4% of patients. The rate of recovery has been significantly relation with BUN, creatinin, Intubation, pCO2 and pH. There was a significant relation between hospitalized with pH, pCO2, Na, absorbent materials, intubation and bicarbonate.Conclusion: Results showed that we should note to the rate and time of lithium used and also severity of signs in management and treatment of patients with the lithium toxicity

Nutri One-on-One: Improving Patients’ Metabolic Profile with One-on-One Nutritional Coaching

Introduction: More than one-third of U.S. adults (35.7%) are obese. Some of the leading causes of death are due to complications of chronic conditions related to metabolic disorders and obesity. One on one health coaching will assist people in adopting healthy lifestyle behaviors that prevent and control diseases through phases of effective goal setting, motivational interviewing, and collaboration with health care providers. Objectives: This study’s aim was to positively influence patients’ nutritional habits and lifestyle through a brief one on one coaching session. The effects of one on one nutritional education are analyzed through goal setting, motivational lessons, and follow-up to improve lifestyle. Methodology: Patients were interviewed to gain insight into their daily nutritional routines and patients’ anthropometric histories were obtained. Patients were then encouraged to set a primary health goal. A personalized nutritional lesson was administered to address the health goal and current nutritional behaviors. The patient and health coach then arrived at three simple and obtainable lifestyle modifications to reach the initial goal. Obstacles were addressed and a follow-up phone call was scheduled to obtain self-reported results and insure accountability and support. Results: The study included 57 adult patients (39 female, 18 male) with metabolic disorders and demonstrated an overwhelming success with nutritional fact recollection, progress on the readiness scale, goal achievement, and in office experience satisfaction. A majority of patients showed willingness and motivation to continue implementing a healthy lifestyle. Conclusion: Personalized one on one nutritional coaching tailored to patient’s goal proved to be successful. Tailored education on healthy living, nutrition, and motivational techniques continued to create positive behavior modification. The follow-up sessions provided reinforcement in sustaining success

The combined molecular adjuvant CASAC enhances the CD8+ T cell response to a tumor-associated self-antigen in aged, immunosenescent mice

BACKGROUND: Ineffective induction of T cell mediated immunity in older individuals remains a persistent challenge for vaccine development. Thus, there is a need for more efficient and sophisticated adjuvants that will complement novel vaccine strategies for the elderly. To this end, we have investigated a previously optimized, combined molecular adjuvant, CASAC (Combined Adjuvant for Synergistic Activation of Cellular immunity), incorporating two complementary Toll-like receptor agonists, CpG and polyI:C, a class-II epitope, and interferon (IFN)-γ in aged mice. FINDINGS: In aged mice with typical features of immunosenescence, antigen specific CD8+ T cell responses were stimulated after serial vaccinations with CASAC or Complete/Incomplete Freund's Adjuvant (CFA/IFA) and a class I epitope, deriving either from ovalbumin (SIINFEKL, SIL) or the melanoma-associated self-antigen, tyrosinase-related protein-2 (SVYDFFVWL, SVL). Pentamer analysis revealed that aged, CASAC/SIL-vaccinated animals had substantially higher frequencies of H-2K(b)/SIL-specific CD8+ T cells compared to the CFA/IFA-vaccinated groups. Similarly, higher frequencies of H-2K(b)/SVL-pentamer+ and IFN-γ+ CD8+ T cells were detected in the aged, CASAC + SVL-vaccinated mice than in their CFA/IFA-vaccinated counterparts. In both antigen settings, CASAC promoted significantly better functional CD8+ T cell activity. CONCLUSION: These studies demonstrate that functional CD8+ T cells, specific for both foreign and tumour-associated self-antigens, can be effectively induced in aged immunosenescent mice using the novel multi-factorial adjuvant CASAC

Study Clinical Symptoms and Para-Clinical Findings in Poisoning Patient with Aluminum Phosphide in Patients Referred to Imam Khomeini Hospital in Ardabil (Northwest of Iran)

Background: Aluminum phosphide is used in different area in Iran. According to that the herbal form of these pills are used increasingly, comparison and evaluation of these patients in terms of clinical and laboratory symptoms are important. We studied on clinical and Para-clinical findings in patients who had taken aluminum phosphide and its herbal form in this study.Methods: This is a descriptive and analytic study which carried out during 2006-2012. In this study, laboratory variables, white blood cell count, hematocrit, blood glucose, sodium, potassium and bicarbonate, arterial blood gas also clinical finding after taking aluminum phosphide pills, and vital signs of poisoned patients were extracted.Results: In this study 386 poisoned patients were evaluated. We divided poisoned patients in two groups, case and herbal. 35% had been taking original Aluminum phosphide (case group) and 65% herbal form (herbal group). In totally 18.7% of poisoned patients were male. The average age of patients in herbal group was 23.22 ±8.20 years and in case group was 24.78±7.04 years. In both groups, nausea and vomiting were the most prevalent clinical signs. Experiments in a separate group showed significant different in blood pressure upper (P<0.001), Po2 level lower (P<0.001), pH lower (P<0.001) and bicarbonate lower (P<0.001) but there was no significant difference in respiratory rate, temperature, hemoglobin level and hematocrit. Also was observed that 70.4% of patients in case group died but all patients in herbal group survived (P<0.001).Conclusion: The results of this study indicated that arterial blood gas of patients is a useful tool for differentiating oral poisoning with original and herbal rice pill. Hence, in patients with clinical toxicity of rice tablet can be used to differentiate these two tablets

Analysis of relationships between altitude and distance from volcano with Stomach Cancer incidence using a geographic information system

Gastric cancer (GC) is the fifth most common cancer in the world, with a wide variation in incidence rates across different geographical areas. In Iran GC is the most common cancer in males and it is reported to be the third most prevalent after breast and colorectal in females. A geographical information system (GIS) allows investigation of the geographical distribution of diseases. The purpose of the present study was to explore the relationship between gastric cancer and effective climatic factors using GIS. The dispersion distribution and the relationship between environmental factors effective on cancer were measured using Arc GIS. Of all cases, 672 (73.8) were in males with a sex ratio of 3 to1. The highest incidence by cities was seen in Namin with 137.5 per 100,000. The results of this study showed that the distribution of GC around the Sabalan volcanic mountain was significantly higher than other places in the same province. These results can be considered as a window to future comprehensive research on gastric cancer

Merkel cell carcinoma in a 17-year-old boy, report of a highly aggressive fatal case and review of the literature

Merkel cell carcinoma is a rare tumor frequently involving the skin with an aggressive behavior and fatal outcome. It occurs mostly in the caucasian race between 60–80 years of age and it is rare in children. Herein we report our experience with a highly aggressive fatal Merkel cell carcinoma in an immunocompetent 17-year-old boy. Its characteristics and treatment modalities will be also discussed

Sustainable wastewater management in Indonesia's fish processing industry: Bringing governance into scenario analysis

The government of Indonesia has pledged to meet ambitious greenhouse gas mitigation goals in its Nationally Determined Contribution as well as reduce water pollution through its water management policies. A set of technologies could conceivably help achieving these goals simultaneously. However, the installation and widespread application of these technologies will require knowledge on how governance affects the implementation of existing policies as well as cooperation across sectors, administrative levels, and stakeholders. This paper integrates key governance variables--involving enforcement capacity, institutional coordination and multi-actor networks--into an analysis of the potential impacts on greenhouse gases and chemical oxygen demand in seven wastewater treatment scenarios for the fish processing industry in Indonesia. The analysis demonstrates that there is an increase of 24% in both CH4 and CO2 emissions between 2015 and 2030 in the business-as-usual scenario due to growth in production volumes. Interestingly, in scenarios focusing only on strengthening capacities to enforce national water policies, expected total greenhouse gas emissions are about five times higher than in the business-as-usual in 2030; this is due to growth in CH4 emissions during the handling and landfilling of sludge, as well as in CO2 generated from the electricity required for wastewater treatment. In the scenarios where there is significant cooperation across sectors, administrative levels, and stakeholders to integrate climate and water goals, both estimated chemical oxygen demand and CH4 emissions are considerably lower than in the business-as-usual and the national water policy scenarios