Unilateral Visual loss Due to Methanol Intoxication: A Case Report

Methanol is a toxic alcohol which can cause severe bilateral visual impairment. In this study we report a case of unilateral visual loss due to methanol intoxication. A 45-year-old man referred to toxicology department of Loghman Hakim Hospital complaining of bilateral blurred vision, vomiting, nausea. He was oriented and he had drunk about 500 cc alcohol two days ago, he underwent 4 hours of emergency hemodialysis and we also prescribed erythropoietin, Methylprednisolone, Amp folinic acid, Na/HCO3. then he was referred to ophthalmologist that reported: right eye’s acuity 7/10, left eye’s acuity 3m, RADP positive, left eye’s abducent movement and its color was disturbed and retinal examination was consistent with methanol intoxication. Visual impairment due to methanol poisoning usually occurs bilaterally, but rare cases of unilateral vision damage have also been reported in two studies which they stated may be due to anatomical or structural variation

Assessment of Risk Factors and the Effect of Drug Abuse on the Incidence of Ischemic Heart Disease in Patients Less Than 40 Years Old

Background: in this study, we examined the risk factors and the effects of substance abuse on the incidence of ischemic heart disease in patients less than 40 years old in Shahid Rajaei Hospital in Karaj from 2019-2020.Methods: This case-control study was done on 70 patients in the cases and 70 cases in the control groups. All demographic data, including age, gender, place of residence, weight, height, body mass index, cardiovascular (CVD) risk factors, including hypertension, high levels of blood fats, diabetes, a history of smoking cigarettes, tobacco, crystal meth, and cocaine, alcohol consumption, as well as a history of taking supplements for bodybuilding, and sex-enhancing drugs were obtained. Afterward, blood levels of glucose and fats were evaluated and urine analysis for the presence of drugs, such as amphetamine, methamphetamine, buprenorphine, benzodiazepines, cannabinoids, cocaine, morphine, methadone, tramadol, and tricyclic antidepressants (TCA) was done. SPSS software v. 22 was used for data analysis.Results: Among the studied underlying factors and drugs, family history, high blood pressure, diabetes, smoking, and low-density lipoprotein (LDL) levels above 130 mg/dL were significantly associated with a higher risk of acute myocardial infarction (MI) (P<0.05). Interestingly, alcohol consumption and the use of tobacco, opium, methadone, heroin, cocaine, cannabis, amphetamines, methamphetamine, tramadol, benzodiazepines, TCA, buprenorphine, and anabolic steroids were not significantly associated with acute MI under 40 years (P>0.05).Conclusion: according to the results of the present study, it seems that a positive family history of MI under the age of 55, hypertension, diabetes, smoking, and LDL levels above 130 mg/dL are more significant risk factors for acute MI in patients under 40 years of age in comparison with the consumption of alcohol and the use of hookah, opium, methadone, heroin, cocaine, cannabis, amphetamine, methamphetamine, tramadol, benzodiazepines, TCA, buprenorphine, and anabolic steroids. It should be noted that further studies in this area are recommended

Demographic and Clinical Characteristics of Patients Who Died of Methanol Toxicity During COVID 19 Period in Loghman-e Hakim Hospital in Tehran

Background: Outbreaks of methanol poisoning were observed during the COVID-19 pandemic. Acute methanol poisoning is a global crisis. Methanol can cause acute and fatal toxicity through metabolic acidosis. In the present study, we evaluated demographic, clinical, and paraclinical characteristics of patients who died in the recent outbreak of methanol poisoning in Tehran from March to April 2020. Methods: This cross-sectional study was accomplished at the Loghman-Hakim Hospital in Tehran on 80 patients who died of methanol toxicity. Demographic, clinical, and laboratory data were collected retrospectively from the patient’s files and analyzed with appropriate statistical tests.Results: Men were significantly more involved than women (%85 vs. %15). There were no significant differences between other characteristics of male and female patients, including the time between consumption to arrive hospital, dialysis sessions, pulse rate, respiratory rate, loss of consciousness, seizure, acute kidney injury, brain CT, and Intracerebral Hemorrhage ( ICH). Blood sugar, serum potassium, and liver function tests were higher than average in most of the patients.Conclusion: Our study showed that this outbreak of methanol poisoning was due to the use of alcoholic drinks that contain methanol. Men were primarily affected that could be because of the cultural and social status of our country. The greater seizure probability in females could be because of enhancing the NMDA receptor by estrogen. Abnormalities in Alanine aminotransferase (ALT), Aspartate Aminotransferase (AST), and Prothrombin Time (PT) were seen in most patients, indicating liver damage. Misbeliefs about the protective effects of alcohol consumption against COVID-19 may lead many to consume poorly made alcohols that contain methanol and outbreaks of methanol intoxication

Prognostic Factors in Metformin Intoxication; A Case Control Study

Background: Metformin is one of the most orally used antidiabetic agents. Intentional and unintentional overdose of metformin can be associated with life threatening condition. In this study we evaluate prognostic factors for metformin intoxication. Methods: This case-control study was performed on patients referred to Loghman Hakim toxicology emergency department due to metformin intoxication. The patient’s information and lab data were subsequently extracted from their medical file and data processing and analysis performed. Results: There was a significant difference between two groups in multiple items, patients in died group had higher age, blood sugar, BUN, Cr, PT, INR, WBC, on the other hand this group had lower blood pressure, O2 saturation, pH, HCO3 and PTT. Receiver operating characteristic curve showed that five items including: Bp, O2sat, pH, HCO3 and Cr had ability to predict the risk of mortality in patients with metformin poisoning. Univariate as well as multivariate analysis showed, factors including: BP<95 (P=0.0184), O2sat<93 (P=0.0094), pH<6.94 (P0.0032), HCO3<17.25 (P=0.0302), and Cr>1.15 (P=0.0216) were related to patient’s mortality. Discussion and conclusion: Our study showed that mentioned clinical and laboratory findings may have an important role in determining the prognosis of patients with metformin poisoning. Extracorporeal treatments may be considered sooner in those who have poorer prognostic factors since admission