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

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)

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

Lead Contamination of Opium, Opium Tincture, and Methadone Oral Solution, in Iran

Background: The present study is conducted with the aim to assess the lead contamination in opium tincture,methadone oral solution, and opium.Methods: 10 samples from each of the matters of opium tinctures, methadone oral solutions, and opium(provided by the Law Enforcement Force of the Islamic Republic of Iran) were collected. Then, an atomicabsorption spectrophotometer (AAS) was used to measure lead concentration in each of the samples. Datawere analyzed using the SPSS software. A P value of 0.05 or less was considered to be statistically significant(Two-tailed).Findings: In this study, the amount of lead measured in all samples was equal or less than 5 parts per million(ppm) and the only exception was the lead level of 5.6 ppm in one of the opium tincture samples, which wasslightly higher than the standard lead level.Conclusion: The results of the current study showed that lead was present in opium tincture, methadone oralsolution, and opium, but it was not in toxic levels. It is reasonable for opium derived medicinal products, butthe low levels of lead in opium may need to be addressed at different times in different regions of the countr

Association between intoxication with psychoactive substances and adverse effects occurrence in consumers

BackgroundThe prevalence of psychoactive substance use is increasing worldwide and identifying adverse effects of these types of drugs is necessary in intoxicated patients.ObjectiveWe aimed to investigate the association of psychoactive substance intoxication with their adverse effects on the functioning of the bodily organs.MethodsThis was a single-center study between March 2019 and April 2022 on intoxicated patients with psychoactive substances. Inclusion criteria were intoxication with alcohol, opioids, and stimulants, and having available results of laboratory biomarkers. Demographic and clinical data of patients at the time of admission as well as during hospitalization were reviewed, retrospectively. Data were analyzed using a generalized linear mixed model in R software and the Adjusted Odds Ratio (AOR) was estimated.ResultsA total of 800 hospitalized patients in the ICU (n = 400) and general ward (n = 400) were divided into two groups of intoxicated with alcohol (n = 200) and opioids or stimulants (n = 200). Liver (AOR = 0.15, p = 0.033; AOR = 0.13, p = 0.007) and kidney (AOR = 0.46, p = 0.004; AOR = 0.24, p = 0.021) dysfunction occurred less in the ICU and general ward, respectively, in opioids or stimulants intoxication compared to alcohol. Cardiovascular dysfunctions occurred more in opioids or stimulants intoxication compared to alcohol in both ICU (AOR = 10.32, p < 0.0001) and general ward (AOR = 4.74, p < 0.0001).ConclusionKidney dysfunctions had a greater effect on mortality compared to other dysfunctions. During the follow-up, the incidence of dysfunctions increased in those intoxicated with opioids or stimulants. Men experienced more liver and kidney dysfunctions as well as mortality, but psychoactive substance experience was a protective factor in cardiovascular dysfunctions and mortality

Acute Lidocaine Toxicity: a Case Series

Introduction: Parenteral form of lidocaine is the best-known source of lidocaine poisoning. This study aimed to evaluate the characteristics of acute lidocaine toxicity.Methods: In this retrospective cross-sectional study, demographics, clinical presentation, laboratory findings, and outcome of patients intoxicated with lidocaine (based on  ICD10 codes) admitted to Loghman Hakim Hospital, during April 2007 to March 2014 were analyzed.Results: 30 cases with the mean age of 21.83 ± 6.57 year were studied (60% male). All subjects had used either 6.5% lidocaine spray or 2% topical formulations of lidocaine. The mean consumed dose of lidocaine was 465 ± 318.17 milligrams. The most frequent clinical presentations were nausea and vomiting (50%), seizure (33.3%), and loss of consciousness (16.7%). 22 (73.3%) cases had normal sinus rhythm, 4 (13.3%) bradycardia, 2 (6.7%) ventricular tachycardia, and 2 (6.7%) had left axis deviation. 11 (36.6%) cases were intubated and admitted to intensive care unit (ICU) for 6.91 ± 7.16 days. Three patients experienced status epilepticus that led to cardiac arrest, and death (all cases with suicidal intention).Conclusion: Based on the results of this study, most cases of topical lidocaine toxicity were among < 40-year-old patients with a male to female ratio of 1.2, with suicidal attempt in 90%, need for intensive care in 36.6%, and  mortality rate of 10%

Toxicology and Metabolic Effects of Methanol and Formaldehyde on the Brain, a Review Article

Background: Methanol is a toxic alcohol for the human body. The molecular biology of methanol metabolites affecting different organs, such as the brain, is under investigation. This systematic review aimed to consider methanol toxic molecular biology, based on the original articles obtained from data banks to figure out recent achievements.Methods: Scientific articles regarding the toxic effects and metabolites of methanol on the central nervous system (CNS) were collected from valid databases and classified based on their validity. Exclusion criteria were articles with duplicates, no available full text, review articles, case reports, and letters.Results: Current metabolic reactions were addressed in the development of CNS diseases, such as optic neuropathy, basal ganglia lesions, and Alzheimer’s disease. However, proteomic investigations introduced new metabolic changes, and serum proteins regarding blood coagulation, vitamin A metabolism, and immune responses were suggested for early detection of toxicity.Conclusion: Besides CNS disorders introduced for methanol toxicity, there is no exact proteomic serum marker to diagnose toxicity soon; however, the interleukin-1 beta system is suggested as a candidate, and more investigation is required to improve its competency