Silymarin as a Promising Potential Therapeutic Agent for Treatment of Patients with Paraquat Poisoning: An Issue that Merits Further Research

Having an extremely toxic compound for humans and most animals, paraquat (PQ) is known as one of the most frequently used herbicides. Accordingly, PQ poisoning has been recognized as a serious medical problem across the world, with a severe case fatality rate (CFR). In this respect; accidental or intentional ingestion of PQ, even in a small amount, can be significantly associated with poor clinical prognosis and increased mortality. Moreover; inherent toxicity of PQ, absence of specific antidotes, as well as lack of effective treatments have been principally attributed to high fatality of PQ poisoning. Once PQ is ingested, it can be absorbed through skin and the digestive and respiratory system and often progresses to multi-organ failure, particularly the lungs as the main target. In this respect, PQ accumulates predominantly in the lungs and can lead to lung fibrosis, pneumonitis, and consequently respiratory failure and death. Given the nonexistence of specific and widely accepted guidelines for treatment of PQ poisoning, a range of conservative therapeutic modalities have been proposed and administered by clinicians to moderate PQ absorption and to prevent organ failure in these patients. In spite of this, PQ-induced mortality rate is high and disappointing

Effect of Chelation Therapy on Lead-induced Hepatotoxicity: A Case Series

Background: Opium use is one of the common causes of lead toxicity. Lead poisoning can lead to hepatic, hematologic, musculoskeletal, neurological, and cardiovascular damages. In this study, we investigated the reversibility of lead-induced liver damage following chelation therapy.Methods: We reviewed the medical records of patients with opium-induced lead poisoning regarding elevation in hepatobiliary enzymes level including Alanine Transaminase (ALT), Aspartate Transaminase (AST), and Alkaline Phosphatase (ALP) to normal level and recorded patients’ age, treatment regimen, liver enzymes level before and after treatment; we also investigated other laboratory findings to rule out other causes of liver enzymes increase.Results: We evaluated 10 male patients with the mean age of 48.3±7.42 years. All patients were referred with the chief complain of abdominal cramps (100%). The mean lead level in patients was 84.48±9.95 µg/dL. The mean serum levels of ALT, AST, and ALP significantly decreased after the treatment with chelating agents ([ALT=117.8±60.22µg/dL-76.9±40.73µg/dL, P=0.022], [AST=100.9±63.96µg/dL-69.9±37.41µg/dL, P=0.028], [ALP=449.8±234.81 µg/dL-338.3±131.22µg/dL, P=0.037]). There was no significant correlation between patients’ lead level and liver enzymes level before and after the treatment.Conclusion: The results of this study showed that the treatment with chelating agents reverses the liver injury following the lead intoxication

Lead poisoning with unusual manifestations in an opium‐addicted man

Abstract One of the contributing causes of hypertension or exacerbation of ischemic heart disease (IHD) has been suggested to be environmental pollution and occupational exposure to particular metals, such as lead. Here, we describe a 43‐year‐old man with a history of oral opium with symptoms of IHD due to chest pain

Mild‐to‐severe poisoning due to Conium maculatum as toxic herb: A case series

Abstract Conium maculatum toxicity may occur by mistakenly or intentionally eating this plant. Due to muscarinic or nicotinic symptoms associated with this plant toxicity, supportive care and treatment with atropine are urgently important

Lead Poisoning in Opium Abusers: A Five-year Retrospective Study

Background and purpose: Lead is a metal present in nature that does not play a role in physiological processes of the body. Today, the use of lead in many materials and industries causes environmental contamination. But, the prevalence is unclear among people and the concentration of lead in the blood has never been tested in general .This study was conducted to compare clinical observations and laboratory results in patients with lead poisoning. Materials and methods: In this retrospective, descriptive cross-sectional study, the records of 99 patients admitted to the poisoning department in Ghaemshahr Razi Hospital between 2011 and 2016 were studied. None of the patients had occupational exposure to lead and all consumed opium. Results: The most common symptoms were abdominal pain (91%), constipation (54%), and weakness due to anemia (53%). The mean lead level was 95.03 mg/dl before treatment and 56.33 mg/dl after treatment, indicating the effect of chelation therapy. Conclusion: The opium sold illegally in the market could be contaminated with lead. The level of lead poisoning is different in individuals according to the concentration of lead added to the opium. Opioid users with abdominal pain, constipation, anemia, weakness, and lethargy should be tested for blood lead levels

Bilateral Dislocation of Temporomandibular Joint Induced by Haloperidol Following Suicide Attempt: A Case Report

Drug induced dystonic reactions are among common presentations of patients in emergency departments, and typically occur with antidopaminergic agents as their extra-pyramidal side effects. Dystonic reactions usually occur within the first few hours or days after commencing a drug or dose increase. Unlike other extra-pyramidal side effects, a patient may experience acute dystonic reactions (ADRs) with the administration of just a single dose. Oromandibular dystonia is a subtype of dystonia which can present with perioral manifestations. In extreme cases, it can lead to temporomandibular dislocation. Haloperidol, as a high potent typical antipsychotic drug, can induce dystonia with blocking D2 dopamine receptors. The present paper reports a case of bilateral dislocation of temporomandibular joint following ingestion of haloperidol in a suicidal attempt in a 17 years old girl

Rectal foreign body in adult male: Unusual case report and literature review

Abstract The majority of rectal foreign bodies inserted by adults are for self‐gratification. As a result, they will probably be smooth, rounded, tubular, or egg‐shaped to make insertion and extraction easier. Herein, we describe a 50‐year‐old man who inserts a water bottle into a region 10 mm from the anorectal junction

Nasal Leishmaniasis Misdiagnosed With Intranasal Polyp in a Patient Candidate for Rhinoplasty

Mucosal leishmaniasis (ML) is a chronic and rare form of leishmaniasis that causes malignant lesions in the mucosa of the nasal, pharyngeal, and laryngeal regions. We describe a 29-year-old woman who had been suffering from an intranasal polyp for 3 years. The polyp recurred annually after surgical removal, and was diagnosed as nasal leishmaniasis

Epidemiological Aspects of Opioid Poisoning in Northern Iran: A Registry-Based Clinical Study

Opioids are a class of drugs that are commonly used to manage pain due to their analgesic and sedative effects. However, the high consumption of opioids in the community has led to an increase in the incidence of overdoses and poisonings caused by various types of these drugs, whether intentional or unintentional. Therefore, comprehending the epidemiological features of patients experiencing opioid poisoning is crucial. We decided to investigate various epidemiological aspects of patients with opioid poisoning in the Mazandaran province, located in northern Iran, during the period of 2020 to 2021. The present investigation was conducted as a descriptive cross-sectional study, wherein we collected data on patients registered in the Mazandaran Registry Center of Opioid Poisoning (MRCOP) who had a history of using any kind of opioid. We collected information on various parameters, including patient demographics, the type of opioid consumed, the mode of consumption, and clinical outcomes. A total of 240 patients were initially registered at the registry center. However, 17 cases were excluded with personal consent, and eventually, a total of 223 patients were included in the investigation. The majority of the patients 70.9% (n = 158) were male, and the average age was 34.4 ± 16.55 years. The most common cause of poisoning reported in our study was intentional, which was mainly due to a suicide attempt. Furthermore, the most prevalent type of opioid consumed was methadone. The most frequently observed symptoms of poisoning among the patients were drowsiness, a decreased level of consciousness, and reduced arterial oxygen saturation levels. Based on the results of our study, several factors were found to be significant in methadone poisoning, including addiction, age, gender, suicide attempt, and a history of psychiatric disorder. These findings highlight the need for public education and awareness campaigns on the risks associated with opioid use, particularly methadone

Respiratory and intestinal trichobezoar in a female: An unusual case report and literature review

Abstract Trichobezoars are hairballs in the gastrointestinal tract that usually develop due to the consumption of hair after pulling it. However, some rare case reports suggest that trichobezoar can also occur in the respiratory system. In this context, we present an unusual case of a 25‐year‐old woman who experienced dyspnea, productive cough, and leukocytosis. The patient was found to have a trichobezoar in her respiratory tract, accompanied by the presence of hair in her digestive tract