Prognostic Factors of In-Hospital Mortality in Adult Patients With Aluminum Phosphide (ALP) Poisoning in Southern Iran (2014-2018): Prognostic factors of mortality in ALP poisoning

Background: The suicide with aluminum phosphide, known as rice tablet, has increased significantly. This study aimed to investigate the epidemiology of Aluminum Phosphide (ALP) poisoning and determine the in-hospital mortality prognostic factors in adult people referring to ALP poisoning to one of the main poisoning centers in southern Iran.Methods: This retrospective cross-sectional study (March 21, 2014, to March 21, 2018) was conducted on all adult patients (>16 years) with ALP poisoning who were referred to Ali-Asghar Hospital (affiliated with Shiraz University of Medical Sciences). All data were extracted from the patients’ medical files. The patients were categorized into two groups of survived and non-survived. Univariate and multivariate logistic regression analyses were conducted to determine prognostic factors for in-hospital mortality, and Odds Ratios (ORs) were reported.Results: Totally, 97 patients were enrolled in this study. The patients’ Mean±SD age was 29.3±12.2 years. Both study groups (survived and non-survived) were matched in most demographic and poisoning characteristics. Nausea (62.9%) and vomiting (49.5%) were the most symptoms at the time of admission. Castor oil (66%), N-acetyl cysteine (56.7%), and magnesium sulfate (52.6%) were the most frequent treatment in these patients. The multivariate analysis showed that age (OR=1.12, 95%CI: 1.03-1.22), body temperature (OR=0.02, 95%CI: 0.01-0.48), resistant acidosis (OR=77.10, 95%CI: 5.05-1176.86), and taking sodium bicarbonate (OR=12.35, 95%CI: 1.25-122.10) were the prognostic factors of in-hospital mortality.Conclusion: The in-hospital mortality rate in patients with ALP poisoning was 29.9%. Age, illiteracy, body temperature, resistant acidosis, and taking sodium bicarbonate were the prognostic factors of in-hospital mortality in these patients

Association of erythrocyte sedimentation rate and C-reactive protein and clinical findings with HLA-DQ8 allele in Rheumatoid Arthritis patients

Background ― Rheumatoid arthritis (RA) is an inflammatory, autoimmune disease induced by certain auto-antigens. HLA-DRB1*0401 allele has a significant relationship with RA incident. Additionally, DQβ1*0301, *302(DQ8), *303, and *304 can increase RA risk especially in DQA1*0301 and *302 coincident. Recent studies suggest that distribution of this allele is different in various populations Material and Methods ― 70 patients and 70 healthy controls were analyzed for human leukocyte antigen (HLA) allele by specific primer-polymerase chain reaction (SSP-PCR) method. Patients were evaluated in terms of ESR and CRP. Data analysis was performed in SPSS V.17. Results ― HLA-DQ8 allele was significantly more frequent in RA patients compared to control (P<0.0001). However, no significant relationship was observed between increased ESR (P=0.527), CRP (P=0.505), and mean counts of arthritic (P=0.691) and tender joints (P=0.669) among the patients who were carriers of HLA-DQ8. Conclusion ― There is a significant association between RA and HLA-DQ8 allele, this allele can increase susceptibility to RA. These findings might relate to the ethnical variations of RA patients but we couldn’t find a significant association between CRP and ESR with HLA-DQ8. We recommend to add specific inflammatory markers to CRP as well as assess ESR in larger sample sizes to obtain accurate results