Pub Date : 2019-03-01DOI: 10.22038/APJMT.2019.12401
M. Umakanth
Background: Organophosphates (OPs) are regularly utilized as pesticides all over the world. Exposures to OPs cause countless cases of poisoning and death annually. Organophosphates inebriation generates a range of muscarinic, nicotinic, and cholinergic side effects including both central and peripheral nervous systems. OP compound’s simple accessibility is responsible for expanding rates of pesticide poisoning and the fact that it is a noteworthy reason for morbidity and mortality that presents general medical issues in a growing district. Methods: I performed a review of the published literature. The databases Medline, Embase, Scopus and Google Scholar were searched using the terms intermediate syndrome, organophosphate induces intermediate syndrome and organophosphate poisoning. Databases were merged and a duplicate was removed. Results: In intense organophosphate poisoning, serious and delayed acetylcholinesterase restraint comes with oxidative stress, identified in erythrocyte membranes, that takes place in the initial phases of poisoning and may add to the progress and seriousness of intermediate syndrome (IMS). Conclusion: It normally appears 2-4 days after presentation when the side effects and indications of the intense cholinergic disorder (e.g., muscle fasciculations, muscarinic signs) are not evident anymore. However, IMS has been considered as a noteworthy causative factor of organophosphate-related morbidity and mortality due to its incessant presence and potential occurrence of breathing malfunction. The aim of the article is to bring down the clear idea about the IMS.
{"title":"Intermediate Syndrome Following Organophosphate Poisoning; Review Article","authors":"M. Umakanth","doi":"10.22038/APJMT.2019.12401","DOIUrl":"https://doi.org/10.22038/APJMT.2019.12401","url":null,"abstract":"Background: Organophosphates (OPs) are regularly utilized as pesticides all over the world. Exposures to OPs cause countless cases of poisoning and death annually. Organophosphates inebriation generates a range of muscarinic, nicotinic, and cholinergic side effects including both central and peripheral nervous systems. OP compound’s simple accessibility is responsible for expanding rates of pesticide poisoning and the fact that it is a noteworthy reason for morbidity and mortality that presents general medical issues in a growing district. Methods: I performed a review of the published literature. The databases Medline, Embase, Scopus and Google Scholar were searched using the terms intermediate syndrome, organophosphate induces intermediate syndrome and organophosphate poisoning. Databases were merged and a duplicate was removed. Results: In intense organophosphate poisoning, serious and delayed acetylcholinesterase restraint comes with oxidative stress, identified in erythrocyte membranes, that takes place in the initial phases of poisoning and may add to the progress and seriousness of intermediate syndrome (IMS). Conclusion: It normally appears 2-4 days after presentation when the side effects and indications of the intense cholinergic disorder (e.g., muscle fasciculations, muscarinic signs) are not evident anymore. However, IMS has been considered as a noteworthy causative factor of organophosphate-related morbidity and mortality due to its incessant presence and potential occurrence of breathing malfunction. The aim of the article is to bring down the clear idea about the IMS.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48979833","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 : 2019-03-01DOI: 10.22038/APJMT.2019.12397
Abdelkarim Manyani, N. Rhalem, O. Ennibi, R. Hmimou, A. Soulaymani, R. Bencheikh
Background: Dental amalgam has been the subject of several studies mainly on the emission of mercury vapor during its handling. The World Health Organization considers that the inhalation of mercury vapor can have adverse effects on the digestive, nervous, immune, pulmonary and renal levels. The aim of this study was to evaluate current practices in the management of dental amalgam waste produced at the level of dental practices in the cities of Rabat and Kenitra in Morocco. Methods: A questionnaire has been established to assess the situation of mercury waste management in dental practices and to make these physicians aware of the importance of this management. This study was conducted for a period of three months from April 15 through July 15, 2017. Results: Of the 172 questionnaires submitted to the dentists, 50 completed and usable questionnaires were retrieved. The response rate was 29%. The survey revealed that 68% (17) stated that their dental chair was not equipped with an amalgam separator, the spittoon being connected directly to the sewers. The average amount of dental amalgam used per dental office and per month was 5.6±17.33g. Among the dentists interviewed, 96% had no idea of the Minamata convention. 54% (27) still use dental amalgam. Of these, 42% (21) still throw this waste into public garbage cans. Conclusion: Dentists share the overall responsibility for the reduction and elimination of toxic waste that can harm human health and the environment.
{"title":"Management of Dental Amalgam Waste Produced in Private and Public Dental Practices in Two Cities of Morocco: Rabat and Kenitra","authors":"Abdelkarim Manyani, N. Rhalem, O. Ennibi, R. Hmimou, A. Soulaymani, R. Bencheikh","doi":"10.22038/APJMT.2019.12397","DOIUrl":"https://doi.org/10.22038/APJMT.2019.12397","url":null,"abstract":"Background: Dental amalgam has been the subject of several studies mainly on the emission of mercury vapor during its handling. The World Health Organization considers that the inhalation of mercury vapor can have adverse effects on the digestive, nervous, immune, pulmonary and renal levels. The aim of this study was to evaluate current practices in the management of dental amalgam waste produced at the level of dental practices in the cities of Rabat and Kenitra in Morocco. Methods: A questionnaire has been established to assess the situation of mercury waste management in dental practices and to make these physicians aware of the importance of this management. This study was conducted for a period of three months from April 15 through July 15, 2017. Results: Of the 172 questionnaires submitted to the dentists, 50 completed and usable questionnaires were retrieved. The response rate was 29%. The survey revealed that 68% (17) stated that their dental chair was not equipped with an amalgam separator, the spittoon being connected directly to the sewers. The average amount of dental amalgam used per dental office and per month was 5.6±17.33g. Among the dentists interviewed, 96% had no idea of the Minamata convention. 54% (27) still use dental amalgam. Of these, 42% (21) still throw this waste into public garbage cans. Conclusion: Dentists share the overall responsibility for the reduction and elimination of toxic waste that can harm human health and the environment.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47383845","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 : 2019-03-01DOI: 10.22038/APJMT.2019.12402
A. Toussi
Background: One of the side effects of tramadol is seizure. Tramadol is a synthetic analgesic used to treat mild to moderate pain. Tramadol can cause seizures in the range of treatment and toxic doses. This seizure is usually in a generalized tonic-clonic from and usually occurs in the first 24 hours after ingestion. Case Presentation: The patient was a 32-year-old man referring to the emergency department with a right shoulder joint dislocation. It was reported that after a tonic-clonic seizure for about 1 minute, it has been followed by foaming at the mouth, eye lifting, urinary incontinence and loss of consciousness for about 5 minutes. He used a combination substance of sildenafil and tramadol to treat an early ejaculation. The patient has referred to the hospital 5 times with shoulder dislocation, without providing a detailed explanation about the use of tramadol and subsequent seizures Discussion: Tramadol misuse and overdose is a common medical issue in Iran and around the world. Regarding the arbitrary use of tramadol in Iran, especially through the non-scientific prescriptions by apothecaries in some cases such as early ejaculation treatment, attention to patient records along with the cause of referral is essential. Conclusion: Considering the prevalence of tramadol use, the community of physicians is advised to think of tramadol as a common cause for shoulder dislocation.
{"title":"Effect of Using Tramadol on Shoulder Dislocation","authors":"A. Toussi","doi":"10.22038/APJMT.2019.12402","DOIUrl":"https://doi.org/10.22038/APJMT.2019.12402","url":null,"abstract":"Background: One of the side effects of tramadol is seizure. Tramadol is a synthetic analgesic used to treat mild to moderate pain. Tramadol can cause seizures in the range of treatment and toxic doses. This seizure is usually in a generalized tonic-clonic from and usually occurs in the first 24 hours after ingestion. Case Presentation: The patient was a 32-year-old man referring to the emergency department with a right shoulder joint dislocation. It was reported that after a tonic-clonic seizure for about 1 minute, it has been followed by foaming at the mouth, eye lifting, urinary incontinence and loss of consciousness for about 5 minutes. He used a combination substance of sildenafil and tramadol to treat an early ejaculation. The patient has referred to the hospital 5 times with shoulder dislocation, without providing a detailed explanation about the use of tramadol and subsequent seizures Discussion: Tramadol misuse and overdose is a common medical issue in Iran and around the world. Regarding the arbitrary use of tramadol in Iran, especially through the non-scientific prescriptions by apothecaries in some cases such as early ejaculation treatment, attention to patient records along with the cause of referral is essential. Conclusion: Considering the prevalence of tramadol use, the community of physicians is advised to think of tramadol as a common cause for shoulder dislocation.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41677044","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 : 2019-03-01DOI: 10.22038/apjmt.2019.12399
C. So, K. C. Chu, K. A. Yeung
Background: Glasgow coma scale (GCS) was originally designed to be used in standardizing the assessment of conscious level in head trauma patients. However, GCS is now widely used in emergency departments as an indicator of the CNS status in patients regardless of their primary etiology. Alongside with GCS, AVPU scale (an acronym from “alert, verbal, painful and unresponsive”) is a simpler system which can be used to measure and record a patient’s level of consciousness. Therefore, the study investigated the values of admission GCS and AVPU as outcome predictor in mixed poisoned patients. Method: A retrospective study in toxicology unit was performed on patients presented with mixed poisoning. Outcomes were recorded as patient necessity of GI decontamination, length of neurology observation and the length of hospital stay in toxicology unit. Results: There was longer duration of hospital stay in toxicology unit and requirement of neurology observation in patients presented with lower GCS score (whether using cut-off point at 13 or 8). Similar findings were observed in AVPU scale analysis. Majority of patients did not require GI decontamination in both GCS score and AVPU analysis. However, it did not show any statistical significance (P > 0.05) in both group analyses. Conclusion: Admission GCS score and AVPU scale both are not good indicators to predict severity in acute mixed poisoning patients. However, the use of AVPU scale may not be inferior to the use of GCS score in assessing acute poisoning patients.
{"title":"The Prognostic Value of Admission AVPU and Glasgow Coma Scales in Acute Drug Poisoning Patients","authors":"C. So, K. C. Chu, K. A. Yeung","doi":"10.22038/apjmt.2019.12399","DOIUrl":"https://doi.org/10.22038/apjmt.2019.12399","url":null,"abstract":"Background: Glasgow coma scale (GCS) was originally designed to be used in standardizing the assessment of conscious level in head trauma patients. However, GCS is now widely used in emergency departments as an indicator of the CNS status in patients regardless of their primary etiology. Alongside with GCS, AVPU scale (an acronym from “alert, verbal, painful and unresponsive”) is a simpler system which can be used to measure and record a patient’s level of consciousness. Therefore, the study investigated the values of admission GCS and AVPU as outcome predictor in mixed poisoned patients. Method: A retrospective study in toxicology unit was performed on patients presented with mixed poisoning. Outcomes were recorded as patient necessity of GI decontamination, length of neurology observation and the length of hospital stay in toxicology unit. Results: There was longer duration of hospital stay in toxicology unit and requirement of neurology observation in patients presented with lower GCS score (whether using cut-off point at 13 or 8). Similar findings were observed in AVPU scale analysis. Majority of patients did not require GI decontamination in both GCS score and AVPU analysis. However, it did not show any statistical significance (P > 0.05) in both group analyses. Conclusion: Admission GCS score and AVPU scale both are not good indicators to predict severity in acute mixed poisoning patients. However, the use of AVPU scale may not be inferior to the use of GCS score in assessing acute poisoning patients.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49519605","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 : 2019-03-01DOI: 10.22038/APJMT.2019.12396
R. Afshari
{"title":"History as Educational Materials and to Popularize the Science of Toxicology","authors":"R. Afshari","doi":"10.22038/APJMT.2019.12396","DOIUrl":"https://doi.org/10.22038/APJMT.2019.12396","url":null,"abstract":"","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49386073","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 : 2019-03-01DOI: 10.22038/APJMT.2019.12769
N. Ramadan
Background: Aluminum phosphideis a commonly used as a pesticide in Egypt and other agricultural countries to protect grains from pests. Phosphine gas (PH3) is a highly toxic gas, which is released when the tablet is exposed to humidity, causing cardiogenic shock and severe metabolic acidosis. Case presentation: A 22-year-old female patient with history of ingestion of 1 tablet of Aluminum phosphide presented with recurrent vomiting, severe hypotension and metabolic acidosis. Discussion: Although Aluminum phosphide is considered a highly toxic substance and its rate of death is very high, this case survived even after development of severe toxic manifestations like hypotension and severe metabolic acidosis. Conclusion: Aluminium Phosphide is a highly effective insecticide and rodenticide. However, it is highly toxic with high mortality rate if ingested. It produces severe metabolic acidosis and cardiogenic shock with no available antidote, so management may be the only supportive treatment
{"title":"Aluminum Phosphide Poisoning; a Case of Survival","authors":"N. Ramadan","doi":"10.22038/APJMT.2019.12769","DOIUrl":"https://doi.org/10.22038/APJMT.2019.12769","url":null,"abstract":"Background: Aluminum phosphideis a commonly used as a pesticide in Egypt and other agricultural countries to protect grains from pests. Phosphine gas (PH3) is a highly toxic gas, which is released when the tablet is exposed to humidity, causing cardiogenic shock and severe metabolic acidosis. Case presentation: A 22-year-old female patient with history of ingestion of 1 tablet of Aluminum phosphide presented with recurrent vomiting, severe hypotension and metabolic acidosis. Discussion: Although Aluminum phosphide is considered a highly toxic substance and its rate of death is very high, this case survived even after development of severe toxic manifestations like hypotension and severe metabolic acidosis. Conclusion: Aluminium Phosphide is a highly effective insecticide and rodenticide. However, it is highly toxic with high mortality rate if ingested. It produces severe metabolic acidosis and cardiogenic shock with no available antidote, so management may be the only supportive treatment","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42955395","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 : 2019-03-01DOI: 10.22038/APJMT.2019.12400
Mohammadreza Yazdan Nasab, Erfan Babahoseinpour, Jamil Kheirvari Khezerlo, M. Tabasi, Fatemeh Mavalizadeh, Abdolrazagh Barzegar, M. Ghadirzadeh, Isa Akbarzadeh, A. Radmanesh
Background: Medications nowadays have been commonly used items in the world and are sometimes available without prescription. This causes a range of effects on public health. This study evaluated the frequency and the involved factors of uncontrolled prescription drugs consumption. Methods: The present study is a cross-sectional study on 1,000 citizens of Tehran between 2016 and 2017. The various factors such as age, gender, and educational background have been carefully surveyed. The questionnaires were presented to interested people in printed form. For analyzing the data, descriptive statistics and analytical statistics were performed using SPSS software version 19. Results: 67% of participants use OTC drugs and 34% of them were between 20 and 30 years old. Although 12% of the OTC pills were used regularly as a pain killer, 95% of the people did not know anything about the side effects of the drugs. Moreover, 45% used the pill to relieve the common and acute pain and 34% of people lived in poverty and 12% suggested lack of adequate time as a reason to refuse visiting a doctor. Conclusion: Self-administered drug is one of the problems in the medical field. Headache is the main reason of self-medication. In the other hand, drug resistance is also rising among repeated drug users. According to the results, public education, the prohibition of the sale of some high-risk drugs and the reduction of drug doses are ways to prevent the development of such high-risk habits.
{"title":"Prevalence of Self-Administered Drug Use among Population of Tehran, Iran","authors":"Mohammadreza Yazdan Nasab, Erfan Babahoseinpour, Jamil Kheirvari Khezerlo, M. Tabasi, Fatemeh Mavalizadeh, Abdolrazagh Barzegar, M. Ghadirzadeh, Isa Akbarzadeh, A. Radmanesh","doi":"10.22038/APJMT.2019.12400","DOIUrl":"https://doi.org/10.22038/APJMT.2019.12400","url":null,"abstract":"Background: Medications nowadays have been commonly used items in the world and are sometimes available without prescription. This causes a range of effects on public health. This study evaluated the frequency and the involved factors of uncontrolled prescription drugs consumption. Methods: The present study is a cross-sectional study on 1,000 citizens of Tehran between 2016 and 2017. The various factors such as age, gender, and educational background have been carefully surveyed. The questionnaires were presented to interested people in printed form. For analyzing the data, descriptive statistics and analytical statistics were performed using SPSS software version 19. Results: 67% of participants use OTC drugs and 34% of them were between 20 and 30 years old. Although 12% of the OTC pills were used regularly as a pain killer, 95% of the people did not know anything about the side effects of the drugs. Moreover, 45% used the pill to relieve the common and acute pain and 34% of people lived in poverty and 12% suggested lack of adequate time as a reason to refuse visiting a doctor. Conclusion: Self-administered drug is one of the problems in the medical field. Headache is the main reason of self-medication. In the other hand, drug resistance is also rising among repeated drug users. According to the results, public education, the prohibition of the sale of some high-risk drugs and the reduction of drug doses are ways to prevent the development of such high-risk habits.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47642911","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 : 2019-01-03DOI: 10.22038/APJMT.2019.30201.1213
D. R. M. Prasad, S. S. Malini, Shashank Kumar, S. Manjula
Objective: To study the Oxidative stress response Introduction: Exposure to various inflammatory agents causes oxidative stress in humans and is the route cause numerous chronic degenerative diseases. Every organism on Earth has been exposed to small and minute foreign particles by direct contact and/or by inhalation. They enter the organ system of humans and animals and potentially disrupt the cellular processes, interact with membranes, cell organelles, DNA, and other proteins to establish a series of dynamic bio-physico-chemical interactions and results in bio-compatible or bio-adverse outcomes causing diseases and/or disorders. Although studies are available on lipid peroxidation products and the antioxidant status in experimental animals, a detailed report with respect to oxidative stress markers on human exposed to diesel combustion nanoparticles is meagre. We aimed to study the variation in oxidative stress markers among exposures. Methodology: The study was conducted among 500 male garage workers of age group 25-40years with exposure for 6-8hrs a day without using any protective aids during work, for 6-12years and 300 controls. Serum oxidative stress markers were estimated and compared. Results: A significant variation among the oxidative stress markers were observed among the exposures with surge in MDA and reduction in SOD and CAT. Conclusion: Oxidative stress markers can be good biomonitoring factor in primary care.Key words: Diesel combustion nanoparticles, oxidative stress markers, superoxide dismutase, catalase, lipid peroxidation, melanaldehyde
{"title":"Effects of Diesel Combustion Nanoparticles on Oxidative Stress Markers among the Exposures","authors":"D. R. M. Prasad, S. S. Malini, Shashank Kumar, S. Manjula","doi":"10.22038/APJMT.2019.30201.1213","DOIUrl":"https://doi.org/10.22038/APJMT.2019.30201.1213","url":null,"abstract":"Objective: To study the Oxidative stress response Introduction: Exposure to various inflammatory agents causes oxidative stress in humans and is the route cause numerous chronic degenerative diseases. Every organism on Earth has been exposed to small and minute foreign particles by direct contact and/or by inhalation. They enter the organ system of humans and animals and potentially disrupt the cellular processes, interact with membranes, cell organelles, DNA, and other proteins to establish a series of dynamic bio-physico-chemical interactions and results in bio-compatible or bio-adverse outcomes causing diseases and/or disorders. Although studies are available on lipid peroxidation products and the antioxidant status in experimental animals, a detailed report with respect to oxidative stress markers on human exposed to diesel combustion nanoparticles is meagre. We aimed to study the variation in oxidative stress markers among exposures. Methodology: The study was conducted among 500 male garage workers of age group 25-40years with exposure for 6-8hrs a day without using any protective aids during work, for 6-12years and 300 controls. Serum oxidative stress markers were estimated and compared. Results: A significant variation among the oxidative stress markers were observed among the exposures with surge in MDA and reduction in SOD and CAT. Conclusion: Oxidative stress markers can be good biomonitoring factor in primary care.Key words: Diesel combustion nanoparticles, oxidative stress markers, superoxide dismutase, catalase, lipid peroxidation, melanaldehyde","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46853250","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 : 2018-12-20DOI: 10.22038/APJMT.2018.12283
M. Akhgari, B. Mohammadi, F. Jokar, Z. Mousavi
Introduction: Given the growing prevalence of obesity in industrial societies including Iran, there is a growing demand for herbal weight loss drugs. Taking into account the heavy advertisements to sell the capsule as an herbal medicine, the present study was conducted in 2012 to determine the effective substance of prevalent super slim weight loss capsule. Methodology: Twenty-six super slim capsules were purchased from Tehran-based pharmacies and herbal medicine shops in 2012. Afterwards, 0.5 gram of the samples was solved in 2.5ml methanol. The samples were filtered and brought up to the volume by adding 5ml of ethanol and placed in an ultrasound device for 30min. 50µl zolpidem was then added as an internal standard. From each sample, 30µl was injected into high performance liquid chromatograph at mobile phases including water, methanol, and triethylamine at volumetric ratios of (0.5+79.5+20v/v/v, pH=5.65) and the obtained peaks were analyzed after 30mins. Findings:The results showed that prevalent super slim weight loss capsules found in Iran market were not herbal based and the effective substances were synthetic compounds known as sibutramine and mirtazapine. The results of quantitative analysis of the samples showed that pharmaceutical concentration of sibutramine in the capsules ranged from 33.51µg/ml to 286.78µg/ml. In addition, pharmaceutical concentration of sibutramine in the capsules ranged from 33.51µg/ml to 286.78µg/ml – pharmaceutical variables (placebo). Conclusion:Despite the claims and advertisements by the producers, the drug is not herbal based and contains illicit compounds. Therefore, it is essential to improve transparency in the assessments of the damages caused by weight loss drugs.
{"title":"Determining the Effective Substance of Prevalent Super Slim Weight Loss Capsule","authors":"M. Akhgari, B. Mohammadi, F. Jokar, Z. Mousavi","doi":"10.22038/APJMT.2018.12283","DOIUrl":"https://doi.org/10.22038/APJMT.2018.12283","url":null,"abstract":"Introduction: Given the growing prevalence of obesity in industrial societies including Iran, there is a growing demand for herbal weight loss drugs. Taking into account the heavy advertisements to sell the capsule as an herbal medicine, the present study was conducted in 2012 to determine the effective substance of prevalent super slim weight loss capsule. Methodology: Twenty-six super slim capsules were purchased from Tehran-based pharmacies and herbal medicine shops in 2012. Afterwards, 0.5 gram of the samples was solved in 2.5ml methanol. The samples were filtered and brought up to the volume by adding 5ml of ethanol and placed in an ultrasound device for 30min. 50µl zolpidem was then added as an internal standard. From each sample, 30µl was injected into high performance liquid chromatograph at mobile phases including water, methanol, and triethylamine at volumetric ratios of (0.5+79.5+20v/v/v, pH=5.65) and the obtained peaks were analyzed after 30mins. Findings:The results showed that prevalent super slim weight loss capsules found in Iran market were not herbal based and the effective substances were synthetic compounds known as sibutramine and mirtazapine. The results of quantitative analysis of the samples showed that pharmaceutical concentration of sibutramine in the capsules ranged from 33.51µg/ml to 286.78µg/ml. In addition, pharmaceutical concentration of sibutramine in the capsules ranged from 33.51µg/ml to 286.78µg/ml – pharmaceutical variables (placebo). Conclusion:Despite the claims and advertisements by the producers, the drug is not herbal based and contains illicit compounds. Therefore, it is essential to improve transparency in the assessments of the damages caused by weight loss drugs.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46178563","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 : 2018-12-20DOI: 10.22038/apjmt.2018.12293
Tharindu Ruwanpathiranage, K. Sellahewa, S. Sivakumaran, Shane Halpe, Manjula Thampoe
Abstract Background: Niyangala poisoning used to be a common method of deliberate self-harm among people living in rural areas of Sri lanka. It is a plant that grows in the wild and has no usage. All parts of this plant are poisonous.The toxic ingredient in Niyangala is Colchicine. Even though Colchicine poisoning is uncommon, it can lead to life threatening complications and be considered a toxicological emergency. It can cause severe gastroenteritis, abdominal pain, hypotension, electrolyte imbalance in the initial phase, as well as granulocytopenia, thrombocytopenia, clotting defects, hepatic insufficiency and renal failure after the first 24 hours. Case presentation: A 62-year-old male presented to our medical unit with several episodes of severe watery diarrhea 6 hours after the ingestion of 3 tubers of Niyangala. He also had epigastric pain, nausea and vomiting. He had eaten Niyangala after consuming alcohol and claimed it was after a dispute with his wife. On admission, the patient was in pain with some dehydration but he was afebrile. Discussion: SIADH consists of hyponatremia, inappropriately elevated urine osmolality (>100 mOsm/kg), and decreased serum osmolality in a euvolaemic patient. SIADH should be diagnosed when these findings occur in the setting of otherwise normal cardiac, renal, adrenal, hepatic, and thyroid function; in the absence of diuretic therapy; and in the absence of other factors known to stimulate ADH secretion, such as hypotension, severe pain, nausea, and stress. Conclusion: SIADH is a well-recognized complication of colchicine poisoning. We report for the first time SIADH after the ingestion of tubers of Gloriosa superba. Hyponatremia in a patient after poisoning with Gloriosa superba is usually attributed to severe diarrhea which is a common and dominant clinical feature often managed with fluid replacement.
{"title":"Niyangala (Gloriosa Superba) Poisoning Complicated with SIADH","authors":"Tharindu Ruwanpathiranage, K. Sellahewa, S. Sivakumaran, Shane Halpe, Manjula Thampoe","doi":"10.22038/apjmt.2018.12293","DOIUrl":"https://doi.org/10.22038/apjmt.2018.12293","url":null,"abstract":"Abstract Background: Niyangala poisoning used to be a common method of deliberate self-harm among people living in rural areas of Sri lanka. It is a plant that grows in the wild and has no usage. All parts of this plant are poisonous.The toxic ingredient in Niyangala is Colchicine. Even though Colchicine poisoning is uncommon, it can lead to life threatening complications and be considered a toxicological emergency. It can cause severe gastroenteritis, abdominal pain, hypotension, electrolyte imbalance in the initial phase, as well as granulocytopenia, thrombocytopenia, clotting defects, hepatic insufficiency and renal failure after the first 24 hours. Case presentation: A 62-year-old male presented to our medical unit with several episodes of severe watery diarrhea 6 hours after the ingestion of 3 tubers of Niyangala. He also had epigastric pain, nausea and vomiting. He had eaten Niyangala after consuming alcohol and claimed it was after a dispute with his wife. On admission, the patient was in pain with some dehydration but he was afebrile. Discussion: SIADH consists of hyponatremia, inappropriately elevated urine osmolality (>100 mOsm/kg), and decreased serum osmolality in a euvolaemic patient. SIADH should be diagnosed when these findings occur in the setting of otherwise normal cardiac, renal, adrenal, hepatic, and thyroid function; in the absence of diuretic therapy; and in the absence of other factors known to stimulate ADH secretion, such as hypotension, severe pain, nausea, and stress. Conclusion: SIADH is a well-recognized complication of colchicine poisoning. We report for the first time SIADH after the ingestion of tubers of Gloriosa superba. Hyponatremia in a patient after poisoning with Gloriosa superba is usually attributed to severe diarrhea which is a common and dominant clinical feature often managed with fluid replacement.","PeriodicalId":30463,"journal":{"name":"Asia Pacific Journal of Medical Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41704068","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：