Radiological Features of Paraquat Herbicide Poisoning: A Case Report

Paraquat (PQ) is a herbicide with potent toxicity. The most frequent human poisoning occurs by ingestion and inhalation. Its clinical feature includes pulmonary edema in the first 48 hours post-toxicity with progression to acute respiratory distress syndrome. A 50-year-old male poisoned patient referred to the emergency department with the complaint of shortness of breath. His companions had an herbicide poison bottle. Respiratory failure gradually intensified. The patient was intubated and under mechanical ventilation for one month. kidney and liver insufficiency were gradually added to the patient’s clinical feature in the following days. He died with multiorgan failures one month later. Standard chest X-ray is not beneficial for assessing PQ intoxication. High resolution computed tomography scan is recommended at day 7 post-ingestion for evaluating PQ poisoning

Performance Assessment of the Acute Physiology and Chronic Health Evaluation IV Scoring System in Outcome of Patients fallowing Acute Poisoning

Background: The present study aims to assess the ability of the acute physiology, chronic health evaluation IV (APACHE IV) scoring system to predict in-hospital mortality of intensive care unit (ICU) patients with acute poisoning.Materials and Methods: Using data from 622 consecutive ICU admitted poisoned patients, Loghman-e-Hakim Hospital, Tehran, during May 2015-April 2016. Various statistical tools used to assess the correlation, significance, and predictability.Results: Overall APACHE IV scoring system was statistically significant (P=.001). Death rate prediction, increased from 79.4% to 86.8 % by model, with SMR =0.83%. A meaningful association between APACHE-IV score and the risk of mortality with good discrimination and, calibration (p value of 0.978) was evident.Conclusion: The present study demonstrates that the APACHE IV system performs acceptably in our patients with acute poisoning and can be utilized as a performance assessment tool in poisoning centers

Effect of Main Factors on Fracture Mode of Mortar, A Graphical Study

One of the most effective ways to identify the concrete properties is to understand further about the cement mortar, which is a mixture of cement paste and fine aggregate. In order to identify the behavior of cement mortar, all required materials including cement, fine aggregate, water as well as the different ratios of each material should beinvestigated. The main objective of this research is to study the effectiveness of main parameters of mortar on the fracture mode and related factors. Specifically 26 mixing designs of flexural mortar with three cement strength classes (32.5, 42.5 and 52.5 MPa), three water to cement (W/C) ratios (0.25, 0.3 and 0.35) and three sand to cement (S/C) ratios (2.5, 2.75 and 3) were first prepared. The prepared samples were then tested using a stress-strain apparatus. Some pictures were finally taken from the fracture surfaces to investigate the mode and angle of fractures. The results indicated that any change in the main parameters of mortar changes the fracture mode and the fracture angle

Status of Total Antioxidant Capacity and Malondialdehyde Level in Methamphetamine Addicts: A Cross Sectional Study

Background: Methamphetamine (MA) is an illegal amphetamine-like which stimulate the central nervous system. In recent years, MA has been widely abused worldwide. Previous studies have suggested that oxidative stress (OS) plays an important role in MA-induced toxicity. From this view, antioxidant therapy could be considered as a potential drug therapy in MA abusers. Therefore, the objective of this study was to evaluate OS status in MA abusers.Methods: This was a cross-sectional study conducted on 21 MA abusers who referred to Iranian National Center for Addiction Studies and Congress 60 Humane Revivification Society, and 15 healthy males as a control group. The demographic data and peripheral blood sampling was obtained from both groups. The serum malondialdehyde (MDA) level as a marker of plasma lipid peroxidation and total antioxidant capacity (TAC) of plasma were analyzed.Results: Significant decrease in plasma TAC in case group was observed (101.85±12.5 vs. 130.7±16.12 mmol/L). No significant increase in MDA serum level was detected in case group in comparison with control (27.35±2.6 vs. 26.67±2.22 µmol/L, respectively). Neither the serum MDA levels nor the plasma TAC were significantly correlated with the duration and amount of MA abuse.Conclusion: It seems that, MA abuse is associated with prooxidant-antioxidant imbalance, which suggests evaluation the role of antioxidants administration for the prevention and treatment of MA-induced toxicity

Akutni respiratorni distres sindrom uzrokovan sirupom metadona

Acute respiratory distress syndrome (ARDS) due to methadone (MTD) toxicity is a known but rather uncommon phenomenon. In most of the previously reported cases of MTD-related ARDS, MTD was ingested orally in the form of tablets in high or unknown amounts. Despite the findings from the available literature, this case report is aimed at demonstrating that even small amounts of MTD syrup can cause ARDS earlier than it is usually expected. We present a non-addicted MTD-overdosed patient who developed ARDS after ingesting a very small amount of MTD syrup. We suggest close monitoring of MTD-overdosed patients from at least 48 h to 72 h for possible respiratory complications such as pulmonary oedema.Akutni respiratorni distres sindrom (ARDS) uzrokovan toksičnošću metadona (MTD) poznat je ali rijedak fenomen. U većini dosadašnjih slučajeva ARDS-a uzrokovanog MTD-om, MTD je konzumiran u obliku tableta te u velikoj ili nepoznatoj količini. Unatoč nalazima dostupne literature, ovaj prikaz slučaja dokazuje kako čak i mala količina sirupa MTD-a može uzrokovati ARDS, i to ranije nego što bi se očekivalo. Obrađen je slučaj pacijentice koja nije bila ovisnica, a oboljela je od ARDS-a nakon konzumacije tek male količine sirupa MTD-a. Predlažemo pomnije praćenje pacijenata predoziranih MTD-om od najmanje 48 sati do 72 sata usmjereno na detekciju respiratornih komplikacija poput plućnih edema

Scorpion Stings in Tehran Province, Iran: A Seven-Year Hospital-Based Study

Background: Scorpion sting is an important public health problem in Iran. This study aimed to describe the demographics, clinical and laboratory findings of the scorpion stings victims in Tehran Province.Methods: This cross-sectional retrospective study evaluated demographic characteristics, clinical presentations, laboratory findings, treatments, and disposition of scorpion sting patients in Tehran Province, Iran, during 7 years (2012-2018).Results: A total of 199 cases of scorpion sting cases with a mean (SD) age of 30 (18.7) years were studied. The majority of patients were males (62.8%). The most affected age group was 20-30 years (31.1%). The majority of victims (45.7%) were residents in the southern districts of Tehran. The yellow scorpions (33.2%) were responsible for a larger number of envenomations. Most of the stings have been occurred in summer (68.8%). Also, the most affected limbs were hands and legs (94.4%). Most patients (58.8%) had localized manifestations, and the common systemic clinical presentations were hypotension (41.7%) and hypertension (17.1%). Also, the common laboratory findings increased blood urea nitrogen (48.7%), hyperglycemia (20.1%), and anemia (15.1%). The polyvalent anti-scorpion serum had been administered for 33.2% of victims. All patients had been recovered and were discharged in good condition without any complications. There was no fatality report. Conclusion: The demographic characteristics of scorpion sting in Tehran Province are similar to those previously reported from other Iran provinces. It seems that the incidence and clinical severity of scorpionism in Tehran are lower than those compared to other tropical and sub-tropical zones in Iran

Prevalence of Delayed Neuropathy and Intermediate Syndrome in Acute Organophosphorus Poisoning: A Cross-sectional Toxicological/Clinical Study

Background: Organophosphates are among the most common causes of poisoning worldwide—responsible for 3 million poisoning and 200000 deaths every year. Nearly 15% of people who are poisoned die. This cross-sectional toxicological/clinical study aimed to investigate the prevalence and influential factors in the incidence of delayed peripheral neuropathy and intermediate syndrome in acute poisoning with organophosphorus toxins. The study was conducted in Loghman Hakim Hospital, Tehran City, Iran, from 2017 to 2020.Methods: The study data were obtained from the patients’ records during follow-up. Data included demographic information (age, sex, etc.), vital signs, muscarinic, nicotinic, and neurological symptoms at admission, atropine therapy status, and pralidoxime intake status. Post-discharge complications were obtained, and patients’ Electromyography (EMG) and Nerve Conduction Velocity (NCV) results were recorded and evaluated during hospitalization and follow-up. Statistical analysis was performed using SPSS software, version 22.Results: Of 63 studied patients, 61.9% were female. The Mean±SD age of the patients was 31.90±13.128 years. Male patients were significantly (P<0.010) older than female ones. The most common muscarinic symptoms were nausea and vomiting (73.2%), diarrhea (34.92%), and abdominal pain (33.33%). Regarding the nicotinic symptoms, sweating (30.16%) and fasciculation (19.05%) were the commonest. Neurological complications were less common; seizures were observed in 3 cases (4.76%) and coma in 2 cases (3.17%). Most patients (79.4%) received pralidoxime with atropine. The Mean±SD days of treatment with atropine and pralidoxime were 5.51±3.52 and 4.06±4.62 days, respectively. Only one death was recorded. The results of the initial EMG-NCV test on the second day of hospitalization showed abnormalities in 4 patients (6.3%), indicating the presence of the intermediate syndrome.Conclusion: The results of the EMG-NCV tests at our patients’ follow-up (30 days) showed no abnormalities. Hence no cases of delayed neuropathy were seen. During hospitalization, one patient had flaccid paralysis and showed significant impairment on the EMG-NCV test (P<0.01)

Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients

Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU. Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expected duration of mechanical ventilation of more than 48 hours were recruited and randomly assigned into two groups: (1) subglottic secretion drainage (SSD) group who were intubated by Evac ETT (n = 43) and (2) control group who were intubated by C-ETT (n = 48). Results. Of the 91 eligible patients, 56 (61.5) were male. VAP was detected in 24 of 43 (55.8) patients in the case group and 23 of 48 (47.9) patients in the control group (P = 0.45). The most frequently isolated microorganisms were S. aureus (54.10) and Acinetobacter spp. (19.68). The incidence of VAP and ICU length of stay were not significantly different between the two groups, but duration of intubation was statistically different and was longer in the SSD group. Mortality rate was less in SSD group but without a significant difference (P = 0.68). Conclusion. The SSD procedure was performed intermittently with one-hour intervals using 10 mL syringe. Subglottic secretion drainage does not significantly reduce the incidence of VAP in patients receiving MV. This strategy appears to be ineffective in preventing VAP among ICU patients. © 2016 Ahmad Ghoochani Khorasani et al

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

What amount of alcohol is not harmful for human health?

For downloading the full-text of this article please click here.Oh, Prophet! They ask you about wine and gambling. Tell them that they are great sins and also have some benefits for people; and their sins exceed their profitFor downloading the full-text of this article please click here.Please cite this article as: Ziaee S.A.M, Shadnia S. What amount of alcohol is not harmful for human health. J Res Relig Health. 2019; 5(1): 1- 6. doi:  https://doi.org/10.22037/jrrh.v5i1.2408