Search published articles
Volume 65, Issue 4 (7-2007)
Background: The object of this study was to determine the epidemiological characteristics of deliberate self-poisoning in adolescents referred to the only poisoning center in Tehran.
Methods: In a cross-sectional study, all cases of acute poisoning at the Loghman Hakim Hospital from May to December 2003 were reviewed. Data for adolescents (13-19 years of age) were analyzed by SPSS for Windows, version 13 and STATA, version 8.
Results: From a total of 9203 cases of deliberate self-poisoning, 28.5% were adolescents (2626 cases). The male/female ratio was 1/2.2. Approximately 87% were unmarried and 56% were students, while a total of 4859 different drugs/agents were used for self-poisoning (an average of 1.85 for each case). The majority of patients was from urban areas and had no history of attempted suicide. There was no difference between males and females regarding history of psychiatric and somatic disorders, though there was a significant difference in the average of age between male and female adolescents.
Conclusions: Among adolescents, self-poisoning is more common in girls while the mean of age is younger in boys. Although the prevalence of psychiatric disorders in adolescents appears to be less than the general population, this may be related to differences in their situations or due to underestimation of their frequencies. Psychiatric care should be a necessary component of the care administered to adolescents who attempt suicide and must be based on the needs and basic assessment of the patient’s status. Research regarding the familial history of abuse, neglect, self-harm/ poi- soning should be undertaken so that such social issues can be prioritized and addressed.
Volume 65, Issue 8 (11-2007)
Background: Lead poisoning has proven to be one of the most important environmental health problems among developing countries with both direct and indirect effects on human life. Lead is known to cross the blood-brain barrier and placenta, and accumulates in soft and hard tissues. Lead can be excreted in urine, stool, milk, sweat, nails and saliva. During pregnancy and lactation, lead is released from bones into the blood along with Ca2+. The toxic effects of lead on various human tissues have been studied extensively, but few studies have addressed its impact on fetal development during pregnancy. Blood levels of lead are higher in people living in lead-polluted regions. It has been reported that Tehran (central and southern parts) is the most problematic city in terms of lead poisoning.
Methods: From 86 sets of mothers and newborns in a non-polluted area of rural Rasht, Iran, we examined specimens of maternal blood, cord blood and colostrum (86×3=258) and specimens from 85 sets of mothers and newborns in a polluted area of Tehran, Iran (85×3=255) for lead levels using atomic absorption spectrophotometry (AAS) and analyzed the results by t-test, SPSS, and linear regression.
Results: The mean blood lead concentrations of mothers, cord blood of newborns and colostrum were 7.6±4.1, 5.9±3 and 4.2±2.5 μg/dl, respectively, in the non-polluted area and 9.1±8.4, 6.5±5.2 and 5.8±5.5 μg/dl, respectively, in the polluted area. The mean weights of the newborns in non-polluted and polluted areas were 3.2±0.5 kg and 3.2±4.5 kg, respectively.
Conclusions: Our data revealed an association between mean concentrations in blood lead of mothers and newborns and between mean concentrations of colostrum lead and newborn blood lead in both areas (p=0.01). There was no association between mean blood lead concentration of mothers with the weight of their newborns (p=0.89).
Volume 66, Issue 7 (10-2008)
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: Lead poisoning could be associated with
gastrointestinal renal, hematologic complications and neurologic deficit.
Case report: The patient was an opium addict, forty
one years old male, to hospital admitted with gastrointestinal signs,
constipation, abdominal pain, severe weakness of upper and lower limbs without
any sensory impairment and with anemia, leukocytosis, and slightly increased
liver function tests. Serum level of lead was more than 200µg/dl.
After treatment with dimercaprol (BAL),
CaNa2EDTA
for two five days sessions that followed with oral succimer for three days,
signs and symptoms relieved, all laboratory tests became normal and blood level
of lead reduced but the patient was discharged with quadriplegia. There was no
fecal or urinary incontinence.
Conclusions: Because of irreversibility and severity of lead related neuronal injury,
we should suspect to lead poisoning in each patient with neuronal involvement
and concurrent GI and hematologic signs.
Volume 70, Issue 1 (4-2012)
Background: Accidental ingestion of poisons in children is an important health problem all over the world. Over 90% of poisonings occur in household settings, and 40% happen during childhood. Recognition of the current etiologies of poisonings may be helpful in adoption of strategies for their prevention and prophylactic therapy.
Methods: In this cross-sectional study, the medical records of children aged 12 years or younger were collected from the 17th of Shahrivar Hospital in Rasht, Iran in 2010. The study was performed in collaboration with the Adverse drug reaction (ADR) Committee of Guilan University of Medical Sciences.
Results: Out of 3299 pediatric admissions, 4.27% were identified as accidental poisoning. 86.5% of children were below the age of five and the majority was in 1-5 year age group. Admission rates were higher during the spring season. The most common toxicities occurred by ingestion of drugs (56.73%) and kerosene (9.92%). Chlorine bleach (8.51%), rodenticides (5.67%), opium (4.25%) and mushrooms (3.54%) were other causes, respectively. No deaths had been recorded.
Conclusion: Informing parents about hazardous materials, especially kerosene, and medications which need to be kept out of reach of children seems to be helpful in reducing occurrences of poisonings and their subsequent complications.
Volume 76, Issue 7 (10-2018)
Methods: In this descriptive study, which was conducted from March 2016 to February 2017 in Loghman Hakim Hospital in Tehran, ninety patients were evaluated using convenient sampling method for lead and thyroid hormones levels. The levels of lead and thyroid hormones were evaluated using standard laboratory method, in thirty male patients with lead poisoning, thirty male patients with opioid addiction referring to addiction treatment center and thirty healthy male referring to a blood donation center who were matched for age. Thyroid function parameters in patients with lead toxicity were compared with those of control groups.
Results: The lead level in the lead toxicity group was 57.5±23.5 µg/dl, in the first control group with opium addiction 7.8±3.8 µg/dl and in the healthy male referring to a blood donation center, 5.9±9 µg/dl. Thyroid stimulating hormone (TSH) was significantly lower in patients with lead poisoning (0.2±0.01 Milli-International Units Per Liter (mIU/L) than in the patients with opioid addiction (2.4±1/05 mIU/L) and healthy male referring to a blood donation center (2.3±0.01 mIU/L) (P= 0.04), and thyroxine hormone (T4) was significantly higher in patients with lead poisoning (17.8±2.6 µg/dl) than in the patients with opioid addiction (8.8±1/9 µg/dl) and healthy male referring to a blood donation center (7.4±3.5 µg/dl) (P= 0.02).
Conclusion: Lead toxicity has an effect on thyroid function and it reduces thyroid stimulating hormone and increases thyroxin levels. Clinicians should be aware of the potential hazardous effects of lead on the thyroid and mechanisms through which lead causes these effects on thyroid function need to be elucidated.
Volume 77, Issue 5 (8-2019)
Case Presentation: The patient was a 77 years old woman, Aryan race, who was known a case of severe and progressive rheumatoid arthritis. She previously was treated by multiple drugs such as salicylates, gold, corticosteroids, because of unresponsiveness to these drugs, physician prescribed methotrexate once a day, but patient misunderstands and use three times per day for days. Patient with this history referred to a poisoning emergency. In a physical exam, she had oral and throat erythema and swelling of mucosa. In the funduscopy of eyes, bottom of the eyes was normal and conjunctival eyes were prurient she had multiple petechiae at the upper part of chest and base of neck and shoulders and arms with no swelling around petechiae. The lesion had no itching. She had no other sign besides laboratory analysis showed a high level of creatinine, leukopenia, decreased the level of platelets, patient with high suspicious of methotrexate poisoning underwent to granulocyte-macrophage colony-stimulating factor (GM-CSF) and folic acid treatment. After treatment all of her signs recovered and laboratory tests became normal.
Conclusion: At the time of taking methotrexate by the patient, even with appointment of a specialist physician, with any skin signs such as maculopapular rash without itching, we should consider poisoning with methotrexate, and think appropriately about it. This suggests that methotrexate can cause side effects even at low doses.
Volume 77, Issue 7 (10-2019)
Methods: In a descriptive, randomized/ cross-sectional study in the poisoning ward of Imam Reza Hospital in Mashhad from October 2013 to April 2015, all patients who referred to the emergency department because of their methadone toxicity or symptoms, had an ECG with 12 leads taken from them, at the time of the arrival. QT dispersion was calculated manually in comparison to other parameters. Also their blood sample were taken to the lab in order to measure different electrolytes (Mg, K, Ca). To ensure the accuracy of study, patient’s urine samples were taken and tested for methadone. There was no intervention in this study. The control group was also not considered QT scattering and dispersion was compared with normal reference in this study.
Results: In this study, 100 patients were studied, 65 of them males (65%) and 35 females (35%). Mean age of subjects entering the study was 33.87±14.5. The average dose of methadone in these cases was 35.5±35.7 mg. However, their usual dose was 1.11±4.85 mg prior to overdoses, and the average duration of use mentioned in patients who had a history of usage was 5.1 months, but 90% of the subjects did not mention any history. The average measured potassium was 3.99±0.5 meq/l, calcium was 8.94±0.5 meq/l, and magnesium was 1.98±0.26 mg/dl. Average measured oxygen saturation at the time of admission was 94.43±5.6%. Mean QT dispersion was 0.041±0.018 millisecond.
Conclusion: In our study, no significant correlation was found between QT dispersion and methadone poisoning.
Volume 78, Issue 8 (11-2020)
Methods: This cross-sectional study was performed on all patients with opioid poisoning admitted to the ICU, Imam Reza Hospital, Mashhad, Iran, from the beginning of April 2016 to March 2017 (Persian Calendar). For all poisoned patients enrolled in the study, the four mortality predicting tools were filled daily in the first three days of hospitalization and then every other day until discharge from the ICU or patient's death.
|
Results: Overall, 57 patients were evaluated of whom 72% (41 patients) were male. The mean age was 49.9±19.8 (median 53, range 18-94) years. The mean length of stay in the ICU was 13.5±17.5 (median 7, range: 75-75) days. The mortality rate was 17.5% (10 patients). The scores of SOFA, SAPS II, APACHE II, and APACHE IV were significantly higher in deceased patients than in discharged ones. The highest diagnostic accuracy (area under the curve) for all four predicting tools was observed in the second week of hospitalization. On the other hand, SAPS II (74%) on the first day, APACHE-II (76%) on the second day, APACHE-II (82%) on the third day, SOFA (77%) on day 4-5, and SAPS II (82%) on day 6-7 had the highest diagnostic accuracy.
Conclusion: In the present study scores of all four mortality predicting tools at admission were significantly associated with mortality. The accuracy of SAPS II, APACHE IV, and APACHE II are appropriate for estimating prognosis, especially after the second week of admission. |
Volume 80, Issue 1 (4-2022)
Methods: This case-control study was performed on 100 patients with clinical evidence of lead poisoning who were referred to Loghman-e-Hakim hospital in Tehran from April to December 2018. Also, another 100 participants with the matched sex and age, a history of opium use, and exposure to lead or non-work-related metals, and with normal lead levels, were considered as a control group. Demographic information was collected by a trained researcher by reviewing hospital records or interviewing participants. To monitor lead levels in the control group, 5 ml of venous blood was collected from the antecubital vein at 7 to 8 am in sterile tubes containing EDTA as an anticoagulant. Serum lead levels were assessed by GBC Avanta atomic absorption spectrophotometer. Values in the two groups were compared. SPSS version 16 (SPSS Inc. Chicago, Il, The USA) was used for data analysis. A P-value below 0.05 was considered statistically significant.
Results: The mean level of serum lead in case and control groups were 63.0±12.4 μg/dL and 6.0±2.1 μg/dL, respectively with a statistically significant difference (p<0.001). However, Alkaline phosphatase (ALKp), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes were significantly higher in cases compared to controls (p<0.001). The thyroid-stimulating hormone in patients with lead poisoning (0.3±0.04 MIU/L) was significantly lower than those in the control group (2.5±1.23) (P=0.04).
|
Conclusion: Lead poisoning could potentially damage liver function and elevate liver enzymes. Moreover, it can also affect the levels of TSH and levothyroxine. Understanding the exact mechanisms might help to control The hepatotoxic effects of lead in patients. Also, knowing the pattern of elevated liver enzymes and thyroid hormones changes might help discriminate lead poisoning with other differential diagnoses.
|
| Page 1 from 1 |
Related Websites
Site Keywords
Cardiology, Anatomy, Biology, Epidemiology, Immunology, Neuroscience, Physical therapy, Physiology, Dermatology, Endocrinology and metabolicSite Statistics
- Registered users: 7694 users
- Online users: 1 users
- Guest users: 230 users
- All visits: 14871701 visits
- Visits in 24 Hours: 9013 visits
- Total articles: 11156 articles
- Published articles: 4901 articles
© 2024 , Tehran University of Medical Sciences, CC BY-NC 4.0
Designed & Developed by : Yektaweb