Hunting Meth Mites by a Cigarette Fire: A Case Study

Background: Meth mites is a false sense annoys methamphetamine abusers forces them to self-harm by picking the skin, scratching it.Case Presentation: We reported the photos showed a regular small round skin injuries on the forearms of a middle-age multi-drug abuser man. He explained about his injuries: "I was hunting annoying ants by cigarette fire, however they were fire-resistant and skipped". He had isolated tactile hallucination without visual part. He explained that every time he abuses methamphetamine (Shisheh in Iran) the ants attack him and bite him. Conclusion: Drug induced formication could be a very dangerous hallucination that forces the patient to self-harm to get rid of it, especially in multidrug abusers

Litarge (Murdar Singh) Ingestion Induced Lead Toxicity: A Case Report.

Background: Litarge (Lead II oxide) is named Murder-sang, Murdar Singh or Mordab-Sangh (MS) in person, is applied to reduce body odor in the axillary and legs. Several other indications were mentioned in ancient medicine such as syphilitic chancre wound healing, bed sore, and so forth. We reported lead intoxication by eating a few MS.Case: A 34-year-old man was visited due to accidentally consuming his wife’s MS powder by adding to his food instead of spices, 10 days earlier. He experienced acute abdominal pain and non-bloody diarrhea 6 hours after ingestion. His symptoms were finally treated by supportive therapy despite their persisted. Ten days later, his blood lead level was 1250 µg/L. His hemoglobin level reduced and transaminase raised to 1.5 times more than the upper limit. He was treated with oral Succimer 10 mg/kg three times a day in the first 5 days and continued by 10mg/kg twice a day up to 21 days. On the 5th day of treatment, his symptoms improved. His blood lead level was 545.5 µg/L on the 8th day of treatment and reduced to 254 µg/L and 245 µg/L one and two months later.Discussion: Mordab-Sangh could induce lead toxicity if ingested. However, other metal poisoning should be considered in MS ingestio

N-Acetylcysteine Overdose: A Case Report

Background: N-Acetylcysteine (NAC) is a cost-effective antioxidant and very useful treatment for several diseases. Methods: Here we report a rare case of iatrogenic NAC overdose following the mistake in calculation of the loading dose. Results: The patient was 14 years old girl referred to a local hospital due to history of intentional ingesting about 7grams acetaminophen. The physician prescribed her 6 grams NAC as a loading dose but 42grams NAC were infused by mistake. After infusion, the patient showed signs of anaphylactic shock and then transferred to Imam Reza toxicology-unite with weakness, lethargy, extreme fatigue, nausea, and dizziness. NAC overdosing, in a short period of time, led to coagulopathy, reduced platelet count, acute renal failure and metabolic acidosis. After 24 h, the patient died. The Medical forensic examination showed minor lung hemorrhage and presence of little amount of Aluminum phosphide in tissues they did not find no vital organ hemorrhage. It is unclear related to NAC overdose, phosphine intoxication or synergic effects. Conclusion: Massive transfusion of NAC was associated with impairment of coagulation factors, intracranial hypertension, renal failure and metabolic acidosis. Thus, NAC administration should be with caution. The medical history of patients committed suicide are not always accurate and complete evaluation are recommended

Prompt Reversing the Neurologic and Cardiac Manifestations of Valproate Poisoning by Hemodialysis: A Case Report

SV (sodium valproate) is an antiepileptic drug that is often prescribed for epilepsy, bipolar disorders, and migraine. We reported an SV intoxicated case that cardiac and neurologic abnormalities were promptly responded to hemodialysis (HD). She ingested a large amount of SV (150 pills of SV 200mg) for a suicide attempt. She was initially alert but her Glasco coma scale (GCS) decreased to 6 thought 11 hours. However, valproate (>150mg/l) and ammonia serum (164µg/dL) levels were not excessively elevated. The serial electrocardiography (ECG) showed QT prolongation and a signs of sodium channel block such as dominant R wave in AVR lead and T-wave inversion in the precordial leads. She had low level of calcium and potassium serum levels. Supportive treatment, charcoal, and L-carnitine, were not effective and HD was started due to the resistant cardiac and neurologic symptoms. After a 3-hour HD session, decreased GCS, pathological ECG findings, and laboratory abnormalities dramatically disappeared. In conclusion, HD is an effective and rapid response treatment for Valproate-induced loss of consciousness and life-threatening cardiac abnormality

Recent advances in nanocarriers containing Bromelain: In vitro and in vivo studies

Medicinal products of plant origin have long been considered the most affordable and accessible sources to treat different health problems. Bromelain (Br) is a mixture of enzymes derived from pineapple (Ananas comosus L.) with a wide field of applications including medicine, health, food, and cosmetics. Br has various therapeutic effects, such as antimicrobial, antioxidant, anticancer, wound healing, burn treatment, pain relief, anti-inflammatory, inhibition of platelet aggregation, and fibrinolytic activity. On the other hand, most proteins are susceptible to denaturation and structural changes that may reduce their activities. Encapsulation of drug molecules into nanoparticles (NPs) could increase their stability, bioavailability, and overcome other challenges in drug delivery and therapy. This review aimed to highlight various Br nano-formulations approaches, toward the improvement of Br therapeutic efficiency

Evacuation the Effect of Single- and Multi-dose Administration of Ethanolic Extract of Pinus eldarica Pollen Against Acetaminophen-induced Rat Liver Injury

Introduction: Acetaminophen (APAP)-induced liver injury is one of the main causes of acute liver failure in the world. Pinus eldarica is specially distributed in the north of Iran and has been used for decades to treat wounds, pain, infection, fever, bronchitis and inflammation in many countries. This study was undertaken to evaluate the role of pine pollen extract (PE) on APAP-induced hepatotoxicity. Methods: This study was conducted in two separate parts: single- and multi- dose administration of PE. In a multiple dosing regimen, different doses of extract (10, 20, 30, 40 and 50 mg/kg) were orally administrated for 2 weeks and then on the 15th day, the animals received a single dose of APAP (600 mg/kg). In the second part, the highest dose of PE (50 mg/kg) was orally administrated half an hour after receiving the APAP at dose of 600 mg/kg. The negative and positive control groups were treated with normal saline and N-acetylcysteine (NAC), respectively. At the end of procedure, the biochemical parameters including alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP) as well as pathological findings were evaluated. Results: A single and multiple oral dose of APAP increased the serum level of ALT, AST and ALP that were significantly attenuated by PE administration in both model. Indeed, exposure to APAP caused extensive necrosis and lymphocytic inflammation that were completely prevented by single- and multi-dose administration of PE, specially at a high dose. Conclusion: Finally, the present results indicate that PE could reverse the reduction of aminotransferases and improve histological changes of APAP-induced liver toxicity. Further research is needed to confirm this finding and reveal the exact mechanisms

Gastric Obstruction by Opium Packets: A Case Report

Background: We reported a case of gastric obstruction in a body packer who swallowed a large number of opium packets. Case Report: A 36-year-old man opium addict visited the emergency department with epigastric pain for three days. He swallowed nearly 90 packets of opium for smuggling purposes four days earlier. He self-administered laxatives. In contrast, many times vomiting, he defecated only four packets and vomited one packet. The abdominal X-rays showed some amounts of fluid-air levels and multiple cylindrical opacities with the double-condom sign, corresponding to the distended stomach. Due to the worsening of his abdominal symptoms, he underwent an urgent laparotomy and 84 packets (4-6 cm in size and 8-10 g/ packet of opium) with a total weight of 870 g. They were wrapped in some layers of plastic and tied at the ends. He was discharged in stable condition. Conclusion: A large number of ingested drug packets can induce gastrointestinal obstruction

Exploring the effect of intravenous lipid emulsion in acute methamphetamine toxicity

Objective(s): The increasing use of methamphetamine (METH) in the last decades has made it the second most abused drug. Advancs in the area of intravenous lipid emulsion (ILE) have led to its potential application in the treatment of poisoning. The present study aims to investigate the potential role of ILE as an antidote for acute METH poisoning. Materials and Methods: Two groups of six male rats were treated by METH (45 mg/kg), intraperitoneally. Five to seven min later, they received an infusion of 18.6 ml/kg ILE 20% through the tail vein or normal saline (NS). Locomotor and behavioral activity was assessed at different time after METH administration. Body temperature and survival rates were also evaluated. Brain and internal organs were then removed for histological examination and TUNEL assay. Results: ILE therapy for METH poisoning in rats could prevent rats mortalities and returned the METH-induced hyperthermia to normal rates (

Effects of multiple doses of montmorillonite, alone and in combination with activated charcoal, on the toxicokinetics of a single dose of digoxin in rats

Objective(s): A narrow margin between the therapeutic and toxic doses of digoxin can result in an increased incidence of toxicity.  Since digoxin has an enterohepatic cycle, multiple oral doses of absorbents like montmorillonite may be useful in the treatment of digoxin toxicity.Materials and Methods: In this study, 4 groups of 6 rats received intraperitoneal digoxin (1 mg/kg), and half an hour later, distilled water (DW) or oral adsorbents, including montmorillonite (1 g/kg), activated charcoal (1 g/kg) (AC) alone or in combination in the ratio of 70:30. Half of the mentioned doses were also gavaged at 3 and 5.5 hr after digoxin injection. The serum level of digoxin, biochemical factors, and activity score were assessed during the experiment. Three control groups only received DW, montmorillonite, or AC.Results: All adsorbents were able to significantly decrease the serum level of digoxin compared to the digoxin+DW group (P<0.01). Only montmorillonite reversed the digoxin-induced hyperkalemia (P<0.05). Multiple dose administration of adsorbents also significantly reduced the digoxin area under the curve and half-life and increased digoxin clearance (P<0.05). However, there was no significant difference in the kinetic parameters between groups that received digoxin plus adsorbents.Conclusion: Multiple-dose of montmorillonite reversed digoxin toxicity and reduced serum digoxin levels by increasing the excretion and reducing the half-life. Montmorillonite has also corrected digoxin-induced hyperkalemia.  Based on the findings, a multiple-dose regimen of oral montmorillonite could be a suitable candidate for reducing the toxicity issue associated with drugs like digoxin that undergo some degree of enterohepatic circulation

Effect of citalopram and sertraline on the expression of miRNA- 124, 132, and 16 and their protein targets in patients with depression

Objective(s): This study aimed to evaluate the effect of SSRIs on the expression of miRNAs and their protein targets.Materials and Methods: In a 100 day open-label study of citalopram (n=25) and sertraline (n=25), levels of miRNA 16, 132, and 124 and glucocorticoid receptor (GR), Brain-derived neurotrophic factor (BDNF), and serotonin transporter (SERT) protein expression were measured by QRT-PCR and western blot in healthy control (n=20), patients with depression at the baseline, and same patients after 100 days of treatment.Results: Expression levels of GR and BDNF proteins were lower in the depressed group before treatment as compared with the healthy group (P<0.0001). The SERT level was higher among the depressed group before treatment in comparison with the healthy group (P<0.0001). The level of GR and BDNF significantly increased, and SERT expression decreased after receiving sertraline (P<0.05). When the depressed group received citalopram, only SERT and GR were altered (P<0.05). Among the microRNAs’ expression investigated, mir-124 and mir-132 were higher, and mir-16 was lower among the depressed compared with the healthy group (P<0.0001). Individuals receiving citalopram only showed an increase in the expression of mir-16 while administration of sertraline led to a significant increase in the expression of mir-16 and a decrease in mir-124 and mir-132 (P<0.05).Conclusion: This elucidated the relationship between antidepressant treatment and the expression of different microRNA that control gene expression in various pathways involved in depressed patients.  Receiving SSRI can affect the level of these proteins and their relevant microRNAs