Aluminum Phosphide Poisoning in Animals

Several articles have showed the effect of ALP toxicity on different organs. Toxicity mechanisms are not clearly understood yet. Due to the potential increased use of ALP as a fumigant and the lack of adequate toxicity data, previous studies were re-evaluated to characterize the epidemiological, toxicological, and clinical/ pathological aspects of ALP poisoning and its management. Related terms were looked up in bibliographical databases such as the Tehran University Medical Science Digital Library, PubMed, Scopus, Google Scholar, and British library. The studies suggest that phosphine targets the mitochondria and inhibits respiration in rat liver mitochondria, insect mitochondria, and intact nematodes. On the other hand, glutathione (GSH) levels are reduced in various tissues of ALP-poisoned rats, while remaining unchanged in insects and mammalian cells. Also, acetylcholine signaling is an important component of phosphine toxicity. Phosphine (PH3) induces oxidative stress and lipid peroxidation in insects, mammalian cells, and other animals. There is no known antidote for ALP intoxication; but, melatonin as an effective antidote protects against oxidative damage in the brain, lung, and liver of the rats and suggests the involvement of ROS in the genotoxicity of PH3. Cholinesterase inhibition responds to treatment with atropine, pralidoxime, and oral sweet almond oil, especially if used immediately after ALP poisoning. Several treatments have been used in animals some of which have not been tested in human-beings yet. Such treatments should be given in controlled situations with the hope they may be helpful in treating these patients

Hepatotoxicity Due To Mushroom Poisoning: A Case Report

Background: Although the majority of mushroom ingestions are benign, some result in significant toxicity and death. Of greatest concern is the hepatotoxic amatoxin-containing mushroom, which may be fatal even small ingestions. Identification of amatoxin poisoning can prove to be difficult due to delay in onset of symptoms and difficulty with identification of mushrooms.Case Report: We present one case of mushroom ingestion in Kerman, province what according to clinical course and laboratory finding, we believe to be an amanita species, treated with multiple dose of activated charcoal, N-acetylcysteine, high-dose penicillin and liver Gol (silymarin).Conclusion: We present the successful treatment a patient who ingested hepato-toxicity induced mushrooms, further, this case is evidence of a mushroom variety responsible for toxicity never previously implicated in the southeastern Iran

Pattern of Acute Pediatric Poisonings in Birjand City, East of Iran

Background: Acute pediatric poisoning represents a frequent cause of admission to the emergency departments. This descriptive and retrospective study was conducted in Birjand, eastern Iran, with the aim of evaluating the pattern of pediatric poisoning in this region.Methods: During the 6-year period from 21st March 2006 to 20th March 2012, all files of pediatrics poisoned patients admitted to the emergency department of Vali Asr teaching hospital was reviewed and the data were recorded in a pre-designed form. The results were analyzed by relevant statistical tests.Results: During this period, 246 cases (41.1% female and 58.9% male) were admitted with a diagnosis of acute poisoning. The mean age was 37.6 +/-32.64 (range: 0.06-156) months. The majority of poisonings occurred in the children aged about 2 to 5 years. The most common agents involved were opioids (39.43%), pharmaceuticals (22.76%) and envenomations (15.9%). Most of the patients were living in urban areas (56.91%).  There was a significant correlation between older age and intentional poisoning (P<0.01). There were also significant correlations between the toxic agent and either the season (P<0.0001), or patients’ age (P<0.0001), residential status (P=0.008) and or consciousness (P<0.0001). Moreover, we introduced Majoon Birjandi as a new cause of poisoning in the literature.Conclusion: Acute opium poisoning was the most common in terms of morbidity and mortality in this region. Health authorities should consider preventive programs in this regard. Moreover, Majoon-e-Birjandi as a new cause of poisoning should be considered in this region, which is not previously reported in the literature

Epidemiological Profile of Snakebite in Iran, 2009-2010 Based on Information of Ministry of Health and Medical Education

Background: Snake bite is one of the significant health problems in the tropical and subtropical regions. It is a common medical emergency in Iran. The current study was conducted to characterize related risk factors for snake bite accidents.Methods: This research was a descriptive retrospective study. Data were collected by gathering snake bite records of 42 Medical Sciences Universities in Iran from March 2009 to March 2010. Information included: age and sex of the victims, region of incident, site of bite and outcome.Results: The results showed that the majority of snake bite patients were male (66.1%). The age distribution of patients indicated that the greatest rate of snake bites occurred among the 25-34 years old. Of 5172 snake bite, 2851 (54.7%) observed on lower limbs, 12019 (38.9%) on upper limbs and 303(5.8%) on head and Trunk and 20 (0.3%) unknown site. The average incidence of snake bite  was estimated 6.9 Per 100,000, however, the highest and the lowest affected cases were observed in Semnan province (with incidence of 111.6 per 100000 individuals) and Rafsanjan, Sabzevar cities  (with incidence of 0 per 100000), respectively. The mortality and recovery rates of cases with and without anti venom, was evaluated (0.12%, 99.88%) and (0.4%, 99.6%) respectively.Conclusion: The high incidence of snake bites in some of provinces of Iran suggests the necessity of preventive programs for minimizing the incidence

Treatment of 2, 4-Dichlorophenoxyacetic Acid (2, 4-D) Poisoning; a Case Study

Background: 2, 4-Dichlorophenoxyacetic Acid (2, 4-D) is an herbicide in chlorophenoxy group that use as a weed killer. Acute poisoning with 2, 4-D may be fatal in large ingestion. There is no specific antidote for 2, 4-D herbicide poisoning. We report here a case of 2, 4-D toxicity with rhabdomyolysis.Case Report: In this case study we present a case of intentional consumption of 2, 4-D herbicide with main gastrointestinal complain that became toward   rhabdomyolysis and liver damage during hospital course. Successful treatment with sodium bicarbonate and other conservative therapies was performed.Conclusion: In cases of 2, 4-dichlorophenoxyacetic acid poisoning, rhabdomyolysis should be in mind and an alkaline diuresis can increase herbicide elimination as well as treatment of rhabdomyolysis should be considered

Evaluation of Causes of Death in East of Iran during 2004-2010

Background: Analysis of the leading causes of death in a community and comparing it with other communities is crucial for planning public health policy. The aim of this study was to determine mortality statistics in South Khorasan Province of Iran by using causes of death data which are classified based on the 10th revision of the International Classification of Diseases (ICD10).Methods: In this cross-sectional study, data related to 20281 deaths for the period of 2004 to 2010 which were under the coverage of Birjand University of Medical Sciences were used. These data were collected by the office of statistical system of mortality (Death Registry) and the causes of deaths were classified based on ICD10. The obtained data was analyzed statistically with Pearson's Chi-square (χ2) test, t test and ANOVA in order to find out the pattern of mortality trend in South Khorasan Province.Results: Cardiovascular diseases (CVD) were the leading cause of death (29.8%) with the mean age of 72.6±15.5 in all registered deaths. Moreover, ischemic heart disease (44.87%) and cerebrovascular disease (25.67%) were the most common causes in CVD group, respectively. The second leading cause was unintentional injuries (12.9%) which are mostly due to road traffic accidents. The mean age in this group was 36.8±24. Cancers ranked the 3rd place during the period of study with the mean age of 64.86±18.26. The most frequent cancers are related to stomach (15.3%) followed by liver and biliary system (11.4%), lungs and bronchus (9.5%).Conclusion: Three leading causes of death were cardiovascular diseases, unintentional injuries and cancers which may be prevented by changing life style, diet and reducing risk factors like smoking, obesity and stress

Late extensive intravenous administration of N-acetylcysteine can reverse hepatic failure in acetaminophen overdose

Acetaminophen is a commonly used analgesic and has been shown to be a main cause of drug-induced liver failure. N-acetylcysteine (NAC) should be employed as the antidote in case of acetaminophen poisoning within the first 8-10 hours. Oral administration of NAC is universally recommended and due to the adverse effects, the intravenous administration of the agent is reserved for patients with oral intolerance and severe complications. We here report an 18-year-old man with severe liver failure due to a huge ingestion of acetaminophen, who was taken into the Loghman Hakim Hospital Poison Center 72 hours after attempted suicide. Regarding the poor prognostic clues as his level of consciousness and impaired liver functions, an extensive intravenous regimen of NAC was started. The patient survived the condition with an additional intravenous administration of NAC past the first 72 hours of treatment. We discuss that even in late phases of intoxication; high-dose intravenous NAC can serve a substantial improvement. © The Author(s) 2011

Role of Diffusion-Weighted MRI (DWI-MRI) in the Diagnosis of Brain Complications caused by Heroin Substance Abuse

Background: Magnetic resonance imaging (MRI) offers higher diagnostic accuracy for brain lesions caused by heroin abuse compared to compute tomography (CT) scan. These lesions have a low signal on T1-weighted (T1W) images and a high signal on T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) images. This study aimed to evaluate the role of diffusion-weighted MRI (DWI-MRI) in heroin addicts.Methods: This cross-sectional study was conducted on 20 patients with heroin addiction (vapor inhalation/injection) referring to Imam Reza Hospital of Mashhad, Iran. Patients in whom heroin abuse was only cause of consciousness, loss and neurological symptoms were enrolled in this study. Demographic data of the patients were recorded, including MRI, FLAIR, T1W and T2W images. In addition, DWI of axial and sagittal sections of the brain was performed in the following sequences.Results: In this study, mean age of patients was 40.15±7.673 years, and 95% of patients were male. The most common mode of heroin use was inhalation, and mean duration of addiction was 5.48±3.393 years. Mean daily intake of heroin was 13.4±15.30 grams, and mean duration of heroin abuse was 10.3 and 4.6 years in patients with and without MRI changes, respectively. A significant correlation was observed between MRI changes and duration of heroin use (r=0.721) (p=0.001). In addition, a significant correlation was observed between MRI changes and daily intake of heroin (p=0.006).Conclusion: According to the results of this study, brain lesions caused by heroin abuse have a low signal on T1W images and a high signal on T2W and FLAIR images. Therefore, it could be concluded that heroin intake has significant effects on the brain of users

Identify successful restrictions in suppressing the early outbreak of COVID-19 in Arizona, United States: Interrupted time series analysis

COVID-19 was responsible for many deaths and economic losses around the globe since its first case report. Governments implemented a variety of policies to combat the pandemic in order to protect their citizens and save lives. Early in 2020, the first cases were reported in Arizona State and continued to rise until the discovery of the vaccine in 2021. A variety of strategies and interventions to stop or decelerate the spread of the pandemic has been considered. It is recommended to define which strategy was successful for disease propagation prevention and could be used in further similar situations. This study aimed to evaluate the effect of people's contact interventions strategies which were implemented in Arizona State and their effect on reducing the daily new COVID-19 cases and deaths. Their effect on daily COVID-19 cases and deaths were evaluated using an interrupted time series analysis during the pandemic's first peaks to better understand the onward situation. Canceling the order of staying at home (95% CI, 1718.52 to 6218.79; p<0.001) and expiring large gatherings (95% CI, 1984.99 to 7060.26; p<0.001) on June 30 and August 17, 2020, respectively, had a significant effect on the pandemic, leading to the daily cases to grow rapidly. Moreover, canceling the stay at home orders led to an increase in the number of COVID-19 daily deaths by 67.68 cases (95% CI, 27.96 to 107.40; p<0.001) after about 21 days while prohibiting large gatherings significantly decreased 66.76 (95% CI: 20.56 to 112.96; p = 0.004) the number of daily deaths with about 21 days' lag. The results showed that strategies aimed at reducing people's contact with one another could successfully help fight the pandemic. Findings from this study provide important evidence to support state-level policies that require observance of social distancing by the general public for future pandemics. Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Examining of Thallium in Cigarette Smokers

Abstract Smoking is one of the sources of thallium which is considered as a toxic heavy metal. The aim of this study was to determine urinary thallium levels and related variables in smokers, compared to a control group. The study was conducted on 56 participants who had smoked continuously during the year before they were referred to Kashan Smoking Cessation Clinic. Fifty-three nonsmokers who were family members or friends of the smokers were selected as the control group. Urinary thallium was measured in both groups (n = 109) using atomic absorption spectrophotometry. The mean value (with SD) for urinary thallium in the smokers (10.16 ± 1.82 μg/L) was significantly higher than in the control group (2.39 ± 0.63 μg/L). There was a significant relationship between smoking duration and urinary thallium levels (P = 0.003). In a subgroup of smokers who was addicted to opium and opium residues (n = 9), the mean level of thallium (37.5 ± 13.09 μg/L) was significantly higher than in the other smokers (4.93 ± 4.45; P = 0.001). Multiple regression analysis showed opioid abuse, insomnia, and chronic obstructive pulmonary disease (COPD), together were strong predictors of urinary thallium levels in smokers. There was no significant difference in thallium level in hookah smokers (P = 0.299) or in those with COPD compared to other smokers (P = 0.375). Urinary thallium levels of smokers with clinical signs of depression, sleep disorders, memory loss, and sweating were higher than those of smokers without these signs. Since thallium, as other toxic metals is accumulated in the body, and cigarette smoking also involves carcinogenic exposures and health hazards for passively exposed people, the need for cigarette control policies is emphasized. Keywords: Thallium Smoking Urinary level Poisonin