Pub Date : 2020-09-14DOI: 10.22038/APJMT.2020.16750
Z. Abubaker, Maheen Nisar, A. Jamshed, M. Abbas, Kayhan Nasir Hashmi, Muhammad Arsalan
Background In Pakistan, most of the data on poisoning comes from scattered case series with data on poisoning mortality, and especially relating to people of lower socioeconomic status, lacking. We aim to shed some insight on the factors relating to poisoning mortality in Pakistan in an effort to appreciate the potential measures required to reduce it Methods A total of 204 cases of poisoning fatalities, occurring between May 29, 2013, and September 10, 2019, were reviewed retrospectively from the National Poison Control Centre at Karachi, Pakistan. Cases of poisoning by accident, suicide, and homicide were included and animal bites and food poisoning were excluded. Patients less than 13 years of age were excluded. Results From our deceased patient medical records, 67.2% were males and 32.8% were females. The mean age of the patients was 29.20 ± 13.04 years. Most of the deaths from poisoning were attributed to organophosphate consumption, mainly through the ingestion of rat killer (30.9%), dichlorvos based pesticide (23.5%), and insecticides (10.3%). A noteworthy number of the deceased patients were housewives (12.7%) and students (11%) and a significant association was seen between occupation and poison consumed (p=0.048). Treatment for most of the cases was non-specific. Conclusion Poisoning is a serious threat to all demographics and mortality can be attributed to substances that can be easily obtained and are widely used. This indicates a gap in safety measures and calls for tighter regulation standards.
{"title":"A Retrospective Analysis on Poison Related Mortalities in a Tertiary Care Centre in Pakistan","authors":"Z. Abubaker, Maheen Nisar, A. Jamshed, M. Abbas, Kayhan Nasir Hashmi, Muhammad Arsalan","doi":"10.22038/APJMT.2020.16750","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16750","url":null,"abstract":"Background In Pakistan, most of the data on poisoning comes from scattered case series with data on poisoning mortality, and especially relating to people of lower socioeconomic status, lacking. We aim to shed some insight on the factors relating to poisoning mortality in Pakistan in an effort to appreciate the potential measures required to reduce it Methods A total of 204 cases of poisoning fatalities, occurring between May 29, 2013, and September 10, 2019, were reviewed retrospectively from the National Poison Control Centre at Karachi, Pakistan. Cases of poisoning by accident, suicide, and homicide were included and animal bites and food poisoning were excluded. Patients less than 13 years of age were excluded. Results From our deceased patient medical records, 67.2% were males and 32.8% were females. The mean age of the patients was 29.20 ± 13.04 years. Most of the deaths from poisoning were attributed to organophosphate consumption, mainly through the ingestion of rat killer (30.9%), dichlorvos based pesticide (23.5%), and insecticides (10.3%). A noteworthy number of the deceased patients were housewives (12.7%) and students (11%) and a significant association was seen between occupation and poison consumed (p=0.048). Treatment for most of the cases was non-specific. Conclusion Poisoning is a serious threat to all demographics and mortality can be attributed to substances that can be easily obtained and are widely used. This indicates a gap in safety measures and calls for tighter regulation standards.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42152746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-10DOI: 10.22038/APJMT.2020.16749
R. Yadav, Muniba Alim, Y. Yadav, D. Singh, Alok Kumar
Background: Scorpion envenomation is a common public health problem worldwide and children are at greater risk of developing severe cardiac, respiratory and neurological complications. Scorpion envenomation is a preventable life-threatening medical accident. This study aims at identifying the demographic parameters, clinical features, complications, outcome and response to prazosin in scorpion envenomation of children admitted at tertiary care hospital. Material and Methods: It was a retrospective cross sectionalstudy conducted on 52 pediatrics cases admitted in department of Paediatrics, Uttar Pradesh University of Medical Science (UPUMS), Saifai from Jan 2016 to Dec 2019 with history of scorpion sting. The clinical details, investigations, treatment and prognosis of all children were evaluated based on the scorpion envenomation. Parameters were expressed as percentage. Results: Majority of children were in the age group of 1 to 6 years 34 (65.38%) with 32 (61.53%) male and belonging to rural area 44 (84.62 %) with sting at lower limb 27 (51.92%) and gap b/w sting and hospitalization was < 6 hours 28 (53.85%). Most common clinical presentation was pain 46 (88.46%) and pulmonary edema 10 (19.23%) was common complications. Majority of children had received prazosin 49 (94.23%) within 6 hours 26 (51.02 %) with 3-6 doses 24 (48.98 %). 51 (98.0%) were successfully discharged and one patient was expired. Conclusion: Scorpion envenomation in children is a significant environmental health hazard especially in rural areas. Scorpion envenomation is an acute lifethreatening emergency, and recovery from scorpion sting is hastened by administration of prazosin therapy with excellent prognosis without use of scorpion antivenom
背景:蝎子中毒是世界范围内常见的公共卫生问题，儿童发生严重心脏、呼吸和神经系统并发症的风险更大。蝎子中毒是一种可预防的危及生命的医疗事故。本研究旨在了解三级医院收治的儿童蝎子中毒的人口学参数、临床特征、并发症、结局和对哌唑嗪的反应。材料与方法:对2016年1月至2019年12月印度北方邦医科大学(UPUMS)儿科收治的52例有蝎子蜇伤史的儿科患者进行回顾性横断面研究。对所有患儿的临床资料、调查、治疗及预后进行评价。参数以百分比表示。结果:1 ~ 6岁儿童占多数，34例(65.38%)，其中男性32例(61.53%)，农村44例(84.62%)，下肢蜇伤27例(51.92%)，蜇伤间隙比(b/w)和住院时间< 6 h 28例(53.85%)。最常见的临床表现为疼痛46例(88.46%)，常见并发症为肺水肿10例(19.23%)。绝大多数儿童在6小时内接受了吡唑嗪49(94.23%)26(51.02%)，3-6次24(48.98%)。51例(98.0%)顺利出院，1例死亡。结论:儿童蝎子中毒是严重的环境健康危害，特别是在农村地区。蝎子中毒是一种严重的危及生命的紧急情况，从蝎子蜇伤中恢复是由给予普拉唑嗪治疗加速，预后良好，不使用蝎子抗蛇毒血清
{"title":"Retrospective Study of Children with Scorpion Envenomation in a Tertiary Care Center of North India","authors":"R. Yadav, Muniba Alim, Y. Yadav, D. Singh, Alok Kumar","doi":"10.22038/APJMT.2020.16749","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16749","url":null,"abstract":"Background: Scorpion envenomation is a common public health problem worldwide and children are at greater risk of developing severe cardiac, respiratory and neurological complications. Scorpion envenomation is a preventable life-threatening medical accident. This study aims at identifying the demographic parameters, clinical features, complications, outcome and response to prazosin in scorpion envenomation of children admitted at tertiary care hospital. Material and Methods: It was a retrospective cross sectionalstudy conducted on 52 pediatrics cases admitted in department of Paediatrics, Uttar Pradesh University of Medical Science (UPUMS), Saifai from Jan 2016 to Dec 2019 with history of scorpion sting. The clinical details, investigations, treatment and prognosis of all children were evaluated based on the scorpion envenomation. Parameters were expressed as percentage. Results: Majority of children were in the age group of 1 to 6 years 34 (65.38%) with 32 (61.53%) male and belonging to rural area 44 (84.62 %) with sting at lower limb 27 (51.92%) and gap b/w sting and hospitalization was < 6 hours 28 (53.85%). Most common clinical presentation was pain 46 (88.46%) and pulmonary edema 10 (19.23%) was common complications. Majority of children had received prazosin 49 (94.23%) within 6 hours 26 (51.02 %) with 3-6 doses 24 (48.98 %). 51 (98.0%) were successfully discharged and one patient was expired. Conclusion: Scorpion envenomation in children is a significant environmental health hazard especially in rural areas. Scorpion envenomation is an acute lifethreatening emergency, and recovery from scorpion sting is hastened by administration of prazosin therapy with excellent prognosis without use of scorpion antivenom","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43371371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.22038/APJMT.2020.16748
K. Soltaninejad
Abstract Background: Synthetic cannabinoids (SCs) are highly abused of New Psychoactive Substances (NPS). SCs has known under street names such as “Spice”, “herbal incense” and “K2”, act as endocannabinoids (CB) receptor full agonists and have unpredictable toxicity and abuse potential. This narrative review was conducted to update the present evidence about the clinical and forensic toxicological aspects of SCs. Methods: PubMed, Scopus and Google Scholar databases from 2015 to 2020 (up to 1st May) were searched using the terms “synthetic cannabinoids”, “synthetic cannabimimetics”, “ K2”, “Spice”, “clinical toxicology”, “forensic toxicology”, “poisoning”, “toxicity”, “abuse” , “addiction “analysis” and “determination” to identify the relevant articles. In addition, a manual search of reference lists of the retrieved articles was conducted. Results: ADB-FUBINACA , XRL-11, 5F-ADB, 5F-PB-22, MDMB-CHMICA and MMB-2201 are the commonly reported SCs analogues among acute toxicities and fatalities cases. Adverse reactions and toxic effects of SCs includes psychoneurological, cardiovascular, renal and gastrointestinal involvements. Deaths related to SCs have been reported due to stroke and cardiac dysrhythmia. Analysis of SCs in biological samples in the clinical and postmortem setting needs sophisticated analytical instruments. Liquid gas chromatography tandem mass spectrometry (LC-MS/MS) has a crucial role for detection of SCs and their metabolites in biological samples. Conclusion: Unlike natural cannabinoids, the SCs abuse/poisoning has serious and life-threatening effects in abuser. Also, analysis of SCs is not included in the routine forensic urine drug testing. Therefore, suitable measures of informing the public and health care professionals for prevention of SCs abuse are recommended.
{"title":"Clinical and Forensic Toxicological Aspects of Synthetic Cannabinoids: A Review and Update","authors":"K. Soltaninejad","doi":"10.22038/APJMT.2020.16748","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16748","url":null,"abstract":"Abstract \u0000Background: Synthetic cannabinoids (SCs) are highly abused of New Psychoactive Substances (NPS). SCs has known under street names such as “Spice”, “herbal incense” and “K2”, act as endocannabinoids (CB) receptor full agonists and have unpredictable toxicity and abuse potential. This narrative review was conducted to update the present evidence about the clinical and forensic toxicological aspects of SCs. \u0000Methods: PubMed, Scopus and Google Scholar databases from 2015 to 2020 (up to 1st May) were searched using the terms “synthetic cannabinoids”, “synthetic cannabimimetics”, “ K2”, “Spice”, “clinical toxicology”, “forensic toxicology”, “poisoning”, “toxicity”, “abuse” , “addiction “analysis” and “determination” to identify the relevant articles. In addition, a manual search of reference lists of the retrieved articles was conducted. \u0000Results: ADB-FUBINACA , XRL-11, 5F-ADB, 5F-PB-22, MDMB-CHMICA and MMB-2201 are the commonly reported SCs analogues among acute toxicities and fatalities cases. Adverse reactions and toxic effects of SCs includes psychoneurological, cardiovascular, renal and gastrointestinal involvements. Deaths related to SCs have been reported due to stroke and cardiac dysrhythmia. Analysis of SCs in biological samples in the clinical and postmortem setting needs sophisticated analytical instruments. Liquid gas chromatography tandem mass spectrometry (LC-MS/MS) has a crucial role for detection of SCs and their metabolites in biological samples. Conclusion: Unlike natural cannabinoids, the SCs abuse/poisoning has serious and life-threatening effects in abuser. Also, analysis of SCs is not included in the routine forensic urine drug testing. Therefore, suitable measures of informing the public and health care professionals for prevention of SCs abuse are recommended.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"108-118"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48778630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.22038/APJMT.2020.16753
T. Schiestel
Abstract Introduction: Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat major depressive episodes and anxiety. The risk of hypoglycemia is mentioned in the Summary of Product Characteristics (SmPC) of venlafaxine in the “warnings and precautions” section in diabetic patients. This effect appears neither in the “adverse reactions” nor in the “overdose” section. We herein report a case of severe hypoglycemia with coma in relation to venlafaxine poisoning. Case Report: A 35-year-old non-diabetic obese woman (BMI, 29 kg/m2) was found unconscious a few hours after ingesting venlafaxine and bromazepam in a suicide attempt. Vital signs on day 1 were as follows: Glasgow Coma score of 7, blood pressure of 99/66 mmHg and heart rate of 100/min. Electrocardiogram showed no abnormality. She was admitted to the intensive care unit. Due to sustained hypoglycemia [0.5 g/L (day1); 0.41 g/L (day2); 0.8 to 1.20 (day3)], she received continuous intravenous 10% glucose infusion for 3 days to normalize blood glucose. Plasma venlafaxine concentration was 11.7 times the upper the limit of therapeutic dose range (UTDR) on day 2 and reached the therapeutic dose range (TDR) on day 6. Plasma bromazepam concentration was 6.7 times UTDR on day 3 and reached TDR on day 8. Alternative etiologies of hypoglycemia were excluded, i.e. hypoglycemic sulfonamide, insulin poisoning, insulinoma, and disease of the adrenal gland, liver and thyroid. She was transferred to a psychiatric unit after one week. Discussion: Impairment of blood glucose homeostasis is rarely described with venlafaxine. In our patient, hypoglycemia appeared to be correlated with plasma venlafaxine concentrations and may be explained by increased insulin sensitivity, considering her obesity. Conclusion: Healthcare professionals should be aware of hypoglycemia induced by venlafaxine or other SNRIs in non-diabetic patients.
{"title":"Venlafaxine poisoning-induced severe hypoglycemia in a non-diabetic patient: a case report","authors":"T. Schiestel","doi":"10.22038/APJMT.2020.16753","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16753","url":null,"abstract":"Abstract Introduction: Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat major depressive episodes and anxiety. The risk of hypoglycemia is mentioned in the Summary of Product Characteristics (SmPC) of venlafaxine in the “warnings and precautions” section in diabetic patients. This effect appears neither in the “adverse reactions” nor in the “overdose” section. We herein report a case of severe hypoglycemia with coma in relation to venlafaxine poisoning. Case Report: A 35-year-old non-diabetic obese woman (BMI, 29 kg/m2) was found unconscious a few hours after ingesting venlafaxine and bromazepam in a suicide attempt. Vital signs on day 1 were as follows: Glasgow Coma score of 7, blood pressure of 99/66 mmHg and heart rate of 100/min. Electrocardiogram showed no abnormality. She was admitted to the intensive care unit. Due to sustained hypoglycemia [0.5 g/L (day1); 0.41 g/L (day2); 0.8 to 1.20 (day3)], she received continuous intravenous 10% glucose infusion for 3 days to normalize blood glucose. Plasma venlafaxine concentration was 11.7 times the upper the limit of therapeutic dose range (UTDR) on day 2 and reached the therapeutic dose range (TDR) on day 6. Plasma bromazepam concentration was 6.7 times UTDR on day 3 and reached TDR on day 8. Alternative etiologies of hypoglycemia were excluded, i.e. hypoglycemic sulfonamide, insulin poisoning, insulinoma, and disease of the adrenal gland, liver and thyroid. She was transferred to a psychiatric unit after one week. Discussion: Impairment of blood glucose homeostasis is rarely described with venlafaxine. In our patient, hypoglycemia appeared to be correlated with plasma venlafaxine concentrations and may be explained by increased insulin sensitivity, considering her obesity. Conclusion: Healthcare professionals should be aware of hypoglycemia induced by venlafaxine or other SNRIs in non-diabetic patients.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68231717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.22038/APJMT.2020.16751
A. Rahmani, Shahrzad Molavinia, Fatemeh Boustani
Background: Iron is an important element for normal cell metabolism, but in excess amounts is quite cytotoxic, and even deadly. Iron poisoning is a calamity repeated many times in the world. The clinical signs of the patients include gastrointestinal symptoms, a short period of relative stability, Cardiogenic shock, liver failure, and scarring of the gastrointestinal tract. Iron tablets are specifically tempting to children because they are similar to candy. Iron overdose in adults is usually to attempt suicide. Methods: The present study is a descriptive-analytic study based on hospital information, that was conducted among the patients affected with iron poisoning admitted to Razi hospital (a referral medical setting for poisoning treatment in southwest Iran) during 2014-2017. Patient information has been extracted and inserted in the inquiry form and data were analyzed by SPSS software. Results: In this study, 52 patients (94.2% female) were studied. 5 (9.6%) of women were pregnant. The majority of them (69.2%) were between 15-25 years of age. Nausea and vomiting (50%) are two of the most common side effects. 5 patients (9.6%) received deferoxamine. All Patients who received deferoxamine, symptoms had less than 6 hours of onset. Most patients were hospitalized between 6-24 hours. 25% of patients took vitamins simultaneously with iron. The Serum level of iron in 3 patients (5.8%) was above 300 µg/dL. Based on this research, mortality was reported in one patient. Conclusion: In this study, the prevalence of iron poisoning was examined based on demographic and clinical characteristics. Considering the most prevalent iron poisoning in the young age group (96.2% suicides), more research in the psychological and social problems is critical for preventative behaviors.
{"title":"Prevalence of symptoms in patients poisoned with iron in Ahvaz Razi Hospital in 2014-2017","authors":"A. Rahmani, Shahrzad Molavinia, Fatemeh Boustani","doi":"10.22038/APJMT.2020.16751","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16751","url":null,"abstract":"Background: Iron is an important element for normal cell metabolism, but in excess amounts is quite cytotoxic, and even deadly. Iron poisoning is a calamity repeated many times in the world. The clinical signs of the patients include gastrointestinal symptoms, a short period of relative stability, Cardiogenic shock, liver failure, and scarring of the gastrointestinal tract. Iron tablets are specifically tempting to children because they are similar to candy. Iron overdose in adults is usually to attempt suicide. Methods: The present study is a descriptive-analytic study based on hospital information, that was conducted among the patients affected with iron poisoning admitted to Razi hospital (a referral medical setting for poisoning treatment in southwest Iran) during 2014-2017. Patient information has been extracted and inserted in the inquiry form and data were analyzed by SPSS software. Results: In this study, 52 patients (94.2% female) were studied. 5 (9.6%) of women were pregnant. The majority of them (69.2%) were between 15-25 years of age. Nausea and vomiting (50%) are two of the most common side effects. 5 patients (9.6%) received deferoxamine. All Patients who received deferoxamine, symptoms had less than 6 hours of onset. Most patients were hospitalized between 6-24 hours. 25% of patients took vitamins simultaneously with iron. The Serum level of iron in 3 patients (5.8%) was above 300 µg/dL. Based on this research, mortality was reported in one patient. Conclusion: In this study, the prevalence of iron poisoning was examined based on demographic and clinical characteristics. Considering the most prevalent iron poisoning in the young age group (96.2% suicides), more research in the psychological and social problems is critical for preventative behaviors.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"102-111"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46456997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.22038/APJMT.2020.16752
S. Afzali, A. Moradi, Hasti Alinaghizadeh
Background: Drug abuse is a global problem in most countries and poisoning caused by them has involved the emergency department (ED). This paper aims to investigate the changes in the epidemiological pattern of poisoned cases due to drugs in Hamadan province of Iran. Methods: In this five year cross - sectional study, we assessed the epidemiologic pattern of poisoned cases due to drugs hospitalized in Farshchian - Sina Hospital of Hamadan, west Iran from March 2015 to March 2019. Results: During this period, 7199 poisoned patients referred to hospital and 1773 of them hospitalized due to any kind of drugs.81% were male and 19% were female (p <0.001). The mean age in male cases was 40.85 ± 16.85 and in female cases was 42.37 ± 18.36. 86.4% of the cases lived in urban areas and 13.6% of them lived in rural areas. The most common drugs were opium (33%), methadone (22.7%) and methamphetamine (20.9%). In 35.1% male cases and in 45.8% female cases the most common drugs were opium and methamphetamine, respectively (p <0.001). In 79.2% of cases, overdose and in 20.5% of them, suicide attempt was the most common causes of use. Most cases were alive and only 1.7% were deceased. Conclusions: Although, poisoning by traditional drugs was still the most common cause of poisoning at the time of the study in this province, poisoning by synthetic drugs are on the rise.
{"title":"Epidemiologic Characteristics and Outcomes of Drugs Poisoning in the Hamadan, Iran: (2015-2019))","authors":"S. Afzali, A. Moradi, Hasti Alinaghizadeh","doi":"10.22038/APJMT.2020.16752","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16752","url":null,"abstract":"Background: Drug abuse is a global problem in most countries and poisoning caused by them has involved the emergency department (ED). This paper aims to investigate the changes in the epidemiological pattern of poisoned cases due to drugs in Hamadan province of Iran. Methods: In this five year cross - sectional study, we assessed the epidemiologic pattern of poisoned cases due to drugs hospitalized in Farshchian - Sina Hospital of Hamadan, west Iran from March 2015 to March 2019. Results: During this period, 7199 poisoned patients referred to hospital and 1773 of them hospitalized due to any kind of drugs.81% were male and 19% were female (p <0.001). The mean age in male cases was 40.85 ± 16.85 and in female cases was 42.37 ± 18.36. 86.4% of the cases lived in urban areas and 13.6% of them lived in rural areas. The most common drugs were opium (33%), methadone (22.7%) and methamphetamine (20.9%). In 35.1% male cases and in 45.8% female cases the most common drugs were opium and methamphetamine, respectively (p <0.001). In 79.2% of cases, overdose and in 20.5% of them, suicide attempt was the most common causes of use. Most cases were alive and only 1.7% were deceased. Conclusions: Although, poisoning by traditional drugs was still the most common cause of poisoning at the time of the study in this province, poisoning by synthetic drugs are on the rise.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46880241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.22038/APJMT.2020.16747
Zeba Khan, R. Afshari
{"title":"Proper Mask Disposal: How Toxicology Helps Fight the Covid-19 Pandemic","authors":"Zeba Khan, R. Afshari","doi":"10.22038/APJMT.2020.16747","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16747","url":null,"abstract":"","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"82-84"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49035517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-08DOI: 10.22038/APJMT.2020.43616.1277
A. Ebadollahinatanzi, Gholamreza Arab-Rahmatipour
Background: Psyllium seeds, produced from Plantago ovata Forsk, are an herbal treatment generally used as a laxative. It has also reportedly lowering effects on some metabolic parameters such as blood glucose, lipids and uric acid. In this paper, reducing effect of sole use of this herbal medicine on serum levels of uric acid, while causing no major adverse effects, in a hyperuricemic patient has been reported.Case report: A 51-year-old patient with a history of hyperuricemia (10.5 mg/dL in a recent measurement) gave consent to undergo a 40-day treatment using psyllium seeds with dosage of 83.3 mg/kg. Treatment was given in two 20-day courses, as in the first, the seeds was given daily but in the second the same dosage was given every other day. Serum levels of uric acid decreased to 8.1 mg/dL at 20th day and 6.8 mg/dL, at the 40th day. No major adverse effects including skin rashes, digestive disorders, muscular pain, allergic manifestations, and abnormalities in liver and kidney function tests as well as blood parameters were observed.Conclusion: Psyllium seeds may be effective in reducing serum levels of uric acid in hyperuricemia patients, while lacking major adverse effects. These data can be used for further research and designing clinical trials.
{"title":"Uric Acid Lowering Effects of Psyllium Seeds on a Hyperuricemic Patient, While Lacking Major Adverse Effects: A Case Report and Review of Literature","authors":"A. Ebadollahinatanzi, Gholamreza Arab-Rahmatipour","doi":"10.22038/APJMT.2020.43616.1277","DOIUrl":"https://doi.org/10.22038/APJMT.2020.43616.1277","url":null,"abstract":"Background: Psyllium seeds, produced from Plantago ovata Forsk, are an herbal treatment generally used as a laxative. It has also reportedly lowering effects on some metabolic parameters such as blood glucose, lipids and uric acid. In this paper, reducing effect of sole use of this herbal medicine on serum levels of uric acid, while causing no major adverse effects, in a hyperuricemic patient has been reported.Case report: A 51-year-old patient with a history of hyperuricemia (10.5 mg/dL in a recent measurement) gave consent to undergo a 40-day treatment using psyllium seeds with dosage of 83.3 mg/kg. Treatment was given in two 20-day courses, as in the first, the seeds was given daily but in the second the same dosage was given every other day. Serum levels of uric acid decreased to 8.1 mg/dL at 20th day and 6.8 mg/dL, at the 40th day. No major adverse effects including skin rashes, digestive disorders, muscular pain, allergic manifestations, and abnormalities in liver and kidney function tests as well as blood parameters were observed.Conclusion: Psyllium seeds may be effective in reducing serum levels of uric acid in hyperuricemia patients, while lacking major adverse effects. These data can be used for further research and designing clinical trials.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46601351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.22038/APJMT.2020.16386
Amina A. Farag, Emtenan Said, H. Fakher
Background: Acute children poisoning is considered a serious issue worldwide, and a common cause of children morbidity and mortality. It is a preventable burden on emergency departments and healthcare facilities. Thus, surveillance of epidemiology and patterns of children acute poisoning in each country is beneficial to define the scope of the problem and its management regarding prevention and treatment. The aim of this work is to study the patterns of children acute poisoning in Banha poisoning control center, Banha University, Egypt. Methods: One year prospective cross-sectional study of the pattern of acute poisoning of children equal to or less than 18 years old, who presented to Banha poisoning control center from January 1st 2019 to December 31st 2019. The analyzed data included demographics, mode and route of poisoning, causative poisonous agents, clinical presentation and patients' outcome. Results: The peak of poisoning occurred in children from 2 to 6 year old accounted for (36.5%) of all cases. Accidental poisoning was the predominant method representedrepresented 82.1% of all cases. Pharmaceutical drugs were the most common cause of poisoning (42.3%) followed by household cleaning products (27.8%). In addition, poisoning occurred more indoors (91%) and in the summer season (45.2%). The majority of poisoned cases presented by mild symptoms (70.9%) and mainly were gastrointestinal (70.8%). As regards the outcome, most of the cases recovered and discharged. Conclusion: Pediatric acute poisoning is still a matter of great concern in Egypt. More attention and prevention strategies are needed.
{"title":"Pattern of Acute Pediatric Poisoning at Banha Poisoning Control Center, Egypt: One-Year Prospective Study","authors":"Amina A. Farag, Emtenan Said, H. Fakher","doi":"10.22038/APJMT.2020.16386","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16386","url":null,"abstract":"Background: Acute children poisoning is considered a serious issue worldwide, and a common cause of children morbidity and mortality. It is a preventable burden on emergency departments and healthcare facilities. Thus, surveillance of epidemiology and patterns of children acute poisoning in each country is beneficial to define the scope of the problem and its management regarding prevention and treatment. The aim of this work is to study the patterns of children acute poisoning in Banha poisoning control center, Banha University, Egypt. Methods: One year prospective cross-sectional study of the pattern of acute poisoning of children equal to or less than 18 years old, who presented to Banha poisoning control center from January 1st 2019 to December 31st 2019. The analyzed data included demographics, mode and route of poisoning, causative poisonous agents, clinical presentation and patients' outcome. Results: The peak of poisoning occurred in children from 2 to 6 year old accounted for (36.5%) of all cases. Accidental poisoning was the predominant method representedrepresented 82.1% of all cases. Pharmaceutical drugs were the most common cause of poisoning (42.3%) followed by household cleaning products (27.8%). In addition, poisoning occurred more indoors (91%) and in the summer season (45.2%). The majority of poisoned cases presented by mild symptoms (70.9%) and mainly were gastrointestinal (70.8%). As regards the outcome, most of the cases recovered and discharged. Conclusion: Pediatric acute poisoning is still a matter of great concern in Egypt. More attention and prevention strategies are needed.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"44-51"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43374842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.22038/APJMT.2020.16388
H. Fakher, Eslam S. Metwally, Rabab El-Shafey
Background: Antineoplastic drugs are commonly used globally. They directly interact with the tumor cell deoxyribonucleic acid and inhibit their growth. These actions are non-selectiveaffecting both tumor cells and healthy cells producing toxic effects. The present study was designed to evaluate oxidative stress and genotoxic effects of antineoplastic drugs in occupationally exposed nurses under routine working conditions. Methods: The studied groups included 28 nurses working in Hematology and Oncology unit, Benha University Hospitals and 20 non exposed subjects that work in academic jobs in Benha Faculty of Medicine, matched in age, gender & socioeconomic status. Malondoaldehyde (MDA) & reduced glutathione (GSH) were measured for all participants as markers of oxidative stress. Extent of DNA damage in leucocytes was also evaluated by comet assay as a biomarker of genotoxicity. Results: There were a significant increase in MDA & reduction in GSH in occupationally exposed subjects than control. Also, extent of DNA damage in the lymphocytes of occupationally exposed participants has a high significance than the controls. The work duration and age had a significant impact on degree of DNA damage. Conclusion: occupationally exposed nurses to antineoplastic agents are at greater risk of oxidative stress with consequent DNA damage and potential genotoxic damage.
{"title":"The Potential Genotoxic Effects of Antineoplastic Drugs in Occupationally Exposed Nurses","authors":"H. Fakher, Eslam S. Metwally, Rabab El-Shafey","doi":"10.22038/APJMT.2020.16388","DOIUrl":"https://doi.org/10.22038/APJMT.2020.16388","url":null,"abstract":"Background: Antineoplastic drugs are commonly used globally. They directly interact with the tumor cell deoxyribonucleic acid and inhibit their growth. These actions are non-selectiveaffecting both tumor cells and healthy cells producing toxic effects. The present study was designed to evaluate oxidative stress and genotoxic effects of antineoplastic drugs in occupationally exposed nurses under routine working conditions. Methods: The studied groups included 28 nurses working in Hematology and Oncology unit, Benha University Hospitals and 20 non exposed subjects that work in academic jobs in Benha Faculty of Medicine, matched in age, gender & socioeconomic status. Malondoaldehyde (MDA) & reduced glutathione (GSH) were measured for all participants as markers of oxidative stress. Extent of DNA damage in leucocytes was also evaluated by comet assay as a biomarker of genotoxicity. Results: There were a significant increase in MDA & reduction in GSH in occupationally exposed subjects than control. Also, extent of DNA damage in the lymphocytes of occupationally exposed participants has a high significance than the controls. The work duration and age had a significant impact on degree of DNA damage. Conclusion: occupationally exposed nurses to antineoplastic agents are at greater risk of oxidative stress with consequent DNA damage and potential genotoxic damage.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":"9 1","pages":"60-66"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42046185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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