2024-03-29T11:05:23+03:30 http://ijt.arakmu.ac.ir/browse.php?mag_id=24&slc_lang=en&sid=1
24-276 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Methadone Overdose and Its Complications in Patients Admitted to ‎the Toxicology Emergency Ward of Baharloo Hospital of Tehran in ‎‎2011-2012‎ Behnam Behnoush Fakhredin Taghadosinejad Babak Salahshour salahshour.babak@yahoo.com ‎ Vahid ‎ Yousefinejad Background: To date, studies on methadone overdose in adults have not been ‎reported in Iran. Hence, this study was performed to determine the frequency of ‎methadone overdose and its associated complications in Baharloo Hospital of Tehran ‎between August 2011 and August 2012.‎ Methods: This cross-sectional study was done on 390 cases. All patients with ‎methadone overdoses and positive urine screen test for methadone were included in this ‎case study through census method. Demographic data and overdose complications, ‎such as loss of consciousness, respiratory complications, arrhythmia, hemodynamic ‎disturbances, and QTC interval, were recorded in the questionnaire. Data were analyzed ‎by SPSS software and Kolmogorov Smirnov, t-test, and Chi-square tests were used for ‎data analysis.‎ Results: Overall, 84.1% of the samples were male and the mean age of the samples ‎was 35.53±11.25 years (range: 15-84 years). Mean of the methadone dose used in ‎current admissions was 96.13±52.34 mg. Concomitant drug abuse and concomitant ‎uses of medications were seen in 25.9% and 36.9% of the patients, respectively. ‎Respiratory depression, pulmonary edema, pneumonia, aspiration, and arrhythmia were ‎seen in 87.9%, 26.2%, 3.3%, 7.4%, and 15.4% of the patients, respectively. ‎ There were significant differences between concomitant medications, duration of ‎methadone use, and QTc interval prolongation and arrhythmia (P<0.05).‎ Conclusion: Based on the findings of the present study, initial screening of ECG ‎changes and QT interval prolongation as well as arrhythmias should be considered in ‎patients on methadone therapy and concurrent drug abuse and co-administration of ‎medications that lead to QT prolongation should be avoided in them. ‎ Arrhythmia Complications Methadone Overdose Qtc Interval.‎ 2014 1 01 932 939 http://ijt.arakmu.ac.ir/article-1-276-en.pdf
24-277 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Comparison of Deferoxamine, Activated Charcoal, and Vitamin C in ‎Changing the Serum Level of Fe in Iron Overloaded Rats Reza Ghafari Jaber Gharehdaghi Hassan‎ Solhi‎ solhi.h@arak.ac.ir Background: Iron is an essential mineral for normal cellular physiology but its ‎overload can lead to cell injury. For many years, deferoxamine injection has been used ‎as an iron chelator for treatment of iron overload. The aim of this study is to compare ‎oral deferoxamine, activated charcoal, and vitamin C, as an absorbent factor of Fe, in ‎changing the serum level of iron in iron overload rats. ‎ Methods: In this experimental study, all groups were administered 150 mg iron dextran ‎orally by gavage. After eight hours, rats in the first group received oral deferoxamine ‎while those in the second and third groups received oral activated charcoal 1 mg/kg and ‎oral vitamin C 150 mg, respectively. Then, serum levels of iron ware measured in all ‎rats.‎ Results: The mean serum level of iron in rats that received oral deferoxamine was ‎‎258.11±10.49 µg/dl, whereas mean levels of iron in charcoal and vitamin C groups were ‎‎380.88±11.21 µg/dl and 401.22±13.28 µg/dl, respectively. None of the measurements ‎were within safety limits of serum iron.‎ Conclusion: It seems that oral deferoxamine per se may not help physicians in the ‎management of cases presented with iron toxicity. Activated charcoal did not reduce ‎serum iron significantly in this study and further investigations may be warranted to ‎assess the potential clinical utility of its mixture with oral deferoxamine as an adjunct in ‎the clinical management of iron ingestions. ‎ Ascorbic Acid Charcoal Deferoxamine Iron Poisoning Rats.‎ 2014 1 01 940 943 http://ijt.arakmu.ac.ir/article-1-277-en.pdf
24-270 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 The Effect of Rebadioside A on Attenuation of Oxidative Stress in ‎Kidney of Mice under Acetaminophen Toxicity Seyed Ali Hashemi Abdolamir ‎ Allameh allameha@modares.ac.ir Bahram Daraei Kamran Moradi Peynevandi Ramin Pashazadeh‎ Background: Acetaminophen (APAP) overdose causes renal and hepatic injury. It is ‎also believed that oxidative stress has a pivotal role in APAP-induced renal injury. ‎Therefore, protective effects of different antioxidants have been examined in APAP-‎induced renal and hepatic toxicity models. Stevia rebadiana is a plant with a high ‎degree of natural antioxidant activity in its leaf extract. The aim of this study was to ‎investigate the possible protective effects of rebadioside A one of the main components ‎of stevia extract, on APAP-induced oxidative stress in kidney of mice. ‎ Methods: Oxidative stress was induced in kidney of BALB/c mice by the intraperitoneal ‎‎(i.p.) administration of a single dose of 300 mg/kg APAP. Some of these mice also ‎received rebadioside A (700 mg/kg) (i.p.) 30 minutes after APAP injection. Two and six ‎hours after APAP injection, all mice were sacrificed and malondialdehyde (MDA), ‎glutathione (GSH), free APAP, and glutathione conjugated of APAP (APAP-GSH) were ‎determined in the kidney tissue.‎ Results: GSH depletion and MDA levels significantly (P<0.05) increased in mice treated ‎with either APAP or APAP plus Rebadioside A, respectively in 2 and 6 hours intervals ‎after APAP administration. Significantly (P<0.05) higher levels of free APAP and ‎APAP-GSH levels detected in kidney of mice administrated with APAP plus rebadioside ‎A compared to APAP treated ones.‎ Conclusion: Rebadioside A may be a potential compound in alleviation of APAP-‎induced oxidative stress in kidney of mice after APAP overdoses. ‎ Acetaminophen Oxidative Stress Rebadioside A.‎ 2014 1 01 944 951 http://ijt.arakmu.ac.ir/article-1-270-en.pdf
24-268 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Electrocardiographic Manifestations of Benzodiazepine Toxicity Nahid Kazemzadeh Saeed Mohammadi drsm1980@gmail.com Mohammadali Emamhadi Abdollah Amirfarhangi Hossein Sanaei-Zadeh Background: The aim of this study was to evaluate and compare the clinical and ‎electrocardiographic (ECG) manifestations of benzodiazepines (BZs).‎ Methods: In this retrospective study, all BZ-poisoned patients hospitalized at Loghman ‎Hakim Hospital between September 2010 and March 2011 were evaluated. Patients’ ‎information including age, sex, time elapsed between the ingestion and presentation, ‎and type of the BZ used were extracted from the patients' charts and recorded. ECGs ‎on presentation to the emergency department (ED) were evaluated and parameters ‎such as PR interval, QRS duration, corrected QT, amplitude of S wave in lead I, height ‎of R wave and R/S ratio in the lead aVR were also measured and recorded.‎ Results: Oxazepam, chlordiazepoxide, lorazepam, alprazolam, diazepam, and ‎clonazepam were ingested by 9 (3%), 13 (4.4%), 29 (9.9%), 105 (35.8%), 65 (22.2%), ‎and 72 (24.6%) patients, respectively. Mean PR interval was reported to be 0.16 ± 0.03 ‎sec and PR interval of greater than 200 msec was detected in 12 (4.5%) patients. Mean ‎QRS duration was 0.07 ± 0.01sec and QRS≥120 msec was observed in 7 (2.6%) ‎cases. ‎ Conclusion: Diazepam is the only BZ that does not cause QRS widening and ‎oxazepam is the only one not causing PR prolongation. It can be concluded that if a ‎patient refers with a decreased level of consciousness and accompanying signs of BZ ‎toxicity, QRS widening in ECG rules out diazepam, whereas PR prolongation rules out ‎oxazepam toxicity.‎ Benzodiazepines Electrocardiogram Manifestations Poisoning.‎ 2014 1 01 952 955 http://ijt.arakmu.ac.ir/article-1-268-en.pdf
24-278 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Assessment of Toxic Metals Concentration using Pearl Oyster, ‎Pinctada radiate, as Bioindicator on the Coast of Persian Gulf, Iran‎ Asma Mohammad Karami Alireza Riyahi Bakhtiari riahi@modares.ac.ir ‎ Ali Kazemi Kheirabadi Kheirabadi Background: Persian Gulf is a semi-closed environment which is affected by pollution ‎from heavy metals. Entrance of heavy metals to the water column and binding to ‎sediment particles can affect the benthic organisms that can accumulate these ‎materials in their body. Noticing this ability, mussels are considered as bio-monitoring ‎agents.‎ Methods: The pearl oyster, Pinctada radiate, and sediment samples were collected ‎from Lengeh Port and Qeshm Island. For measuring heavy metals, 0.5g of soft tissue ‎and 1g of shell and sediment were digested by HNO3 (69%) and hot block digester. The ‎prepared samples were evaluated for Cd, Cu, and Zn using a flame AAS Model 67OG ‎while for Pb a graphite furnace AAS was used.‎ Results: Higher metal accumulations were observed in soft tissues. Positive ‎correlations between Cd, Pb, Zn, and Cu concentrations in sediments and soft tissues ‎of oyster were observed. The use of soft tissue of P. radiata as an indicator showed the ‎highest accumulations of Cd (9.76±0.59) and Zn (3142.60±477.10) in Lengeh Port, but ‎there were no significant differences in Cu and Pb concentrations between the two ‎stations.‎ Conclusion: The higher concentrations of heavy metals in P. radiata’ soft tissue in ‎comparison to shell suggested this material as a better heavy metals indicator than ‎shell. Also, the correlation between heavy metals concentration in soft tissue and ‎sediment improve this idea that soft tissue of Pinctada radiata can be considered as a ‎biomonitoring agent for toxic metals pollutions. Hence, using this bioindicator showed ‎Lengeh Port as more polluted station than Qeshm Island.‎ Bioindicator Heavy Metals Persian Gulf Pinctada Radiata Shell Soft ‎Tissue.‎ 2014 1 01 956 961 http://ijt.arakmu.ac.ir/article-1-278-en.pdf
24-279 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Methicillin Resistant Staphylococcus Aureus in Ventilator Associated ‎Pneumonia in Toxicological Intensive Care Unit Alireza Salimi Sepideh ‎ Kamalbeik‎ Arezou Mahdavinejad ‎ Shahram‎ Sabeti ‎ Haleh‎ Talaie talaie@sbmu.ac.ir Background: Methicillin resistant Staphylococus Aureus (MRSA) is a cause of ‎nosocomial infections at intensive care unit (ICU), which imposes a high mortality and ‎morbidity on the health care systems.‎ The objective of this study was to evaluate the role of MRSA in patients with clinically ‎suspected ventilator associated pneumonia (VAP) in toxicological ICU admitted ‎patients.Methods: This cross-sectional study was performed over a period of six months from ‎August 2009 to February 2010. A total of 84 patients with clinically suspected VAP were ‎selected from all 381 ICU admitted patients under mechanical ventilation for more than ‎‎48 hours. MRSA Screen Agar was used to detect resistance in Staph aureus ‎specimens. MRSA was determined as the main outcome.‎ Results: MRSA was the cause in 54% of Staph aureus infected VAPs. Although ‎MRSA infection was not significantly associated with age, gender, cause of poisoning, ‎chronic disease, paraclinical findings, length of hospital stay, and antibiotic prescription ‎‎(P>0.05 for all comparisons), it was reported higher in those who expired than those ‎who survived (66.7% vs. 31.9%, P<0.012)‎.Conclusion: In the main referral toxicological ICU in Tehran, in more than 1 of 3 ‎clinically suspected VAP cases, MRSA was seen which was associated with the poorer ‎outcome, higher inpatient mortality.‎ Intensive Care Unit Methicillin Resistance Pneumonia Staphylococus ‎Aureus Ventilator.‎ 2014 1 01 962 966 http://ijt.arakmu.ac.ir/article-1-279-en.pdf
24-269 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Determination of the Antimicrobial Effects of Hydro-Alcoholic Extract ‎of Cannabis Sativa on Multiple Drug Resistant Bacteria Isolated from ‎Nosocomial Infections Hossein Sarmadyan Hassan Solhi ‎ Tahereh Hajimir Negin Najarian-Araghi Ehsanollah Ghaznavi-Rad e.ghaznavirad@arakmu.ac.ir Background: The science of identification and employment of medicinal plants dates ‎back to the early days of man on earth. Cannabis (hashish) is the most common illegal ‎substance used in the United States and was subjected to extensive research as a ‎powerful local disinfecting agent for mouth cavity and skin and an anti-tubercular agent ‎in 1950.‎ Methods: Clinical strains were isolated from hospitalized patients in Vali-e-Asr Hospital ‎of Arak. The hydro-alcoholic extract of cannabis (5 g) was prepared following liquid-‎liquid method and drying in 45˚C. The antimicrobial properties of the extract were ‎determined through disk diffusion and determination of MIC (Minimum Inhibitory ‎Concentration).‎ Results: First, the sensitivity of bacteria was detected based on disk diffusion method ‎and the zone of inhibition was obtained for MRSA (12 mm), S.aureus 25923 (14 mm), E. ‎coli ESBL+: (10 mm), and Klebsiella pneumoniae (7 mm). Disk diffusion for ‎Pseudomonas and Acinetobacter demonstrated no inhibitory zones. Through Broth ‎dilution method, MIC of cannabis extract on the bacteria was determined: E.coli 25922: ‎‎50µg/ml, E.coli ESBL+:100 µg/ml, S.aureus 25923:25 µg/ml, MRSA: 50 µg/ml, ‎Pseudomona aeroginosaESBL+> 100 µg/ml, Pseudomonas: 100 µg/ml, Klebsiella ‎pneumoniae: 100 µg/ml, and Acinetobacter baumannii> 1000.‎ Conclusion: The maximum anti-microbial effect of the hydro-alcoholic extract of ‎cannabis was seen for gram positive cocci, especially S. aureus, whereas non-‎fermentative gram negatives presented resistance to the extract. This extract had ‎intermediate effect on Enterobacteriacae family. Cannabis components extracted ‎through chemical analysis can perhaps be effective in treatment of nosocomial ‎infections.‎ Antibiotic resistance Cannabis Nosocomial Infections.‎ 2014 1 01 967 972 http://ijt.arakmu.ac.ir/article-1-269-en.pdf
24-280 2024-03-29 10.1002
Iranian Journal of Toxicology IJT 2008-2967 2251-9459 10.61186/ijt 2014 7 23 Toxicological Investigation of Acute Carbon Monoxide Poisoning in ‎Four Occupants of a Fuming Sport Utility Vehicle ‎ Martin Nnoli mnnoli@yahoo.com Nwidu Lucky Lebgbosi ‎ Innocent Ijezie Chukwuonye Collins Ogbonna Nwabuko Background: This toxicological investigation involves a report on the death of four ‎occupants of a sport utility vehicle on one of the major busy Federal roads of Nigeria ‎where they were held for up to three hours in a traffic jam while the car was steaming.‎ Methods: Autopsy was executed using the standard procedure and toxicological ‎analysis was done using simple spectrophotometric method to establish the level of ‎carboxyhaemoglobin (HbCO) in peripheral blood in the four occupants. ‎ Results: The autopsy report indicated generalized cyanosis, sub-conjuctival ‎hemorrhages, marked laryngo-trachea edema with severe hyperemia with frothy fluid ‎discharges characteristic of carbon monoxide poisoning. Toxicological report of the level ‎of HbCO in part per million (ppm) in the peripheral blood of the four occupants was A= ‎‎650 ppm B= 500 ppm C= 480 ppm, and D= 495 ppm against the maximum permissible ‎level of 50 ppm.‎ Conclusion: The sudden death of the four occupants was due to excessive inhalation ‎of the carbon monoxide gas from the exhaust fumes leaking into the cabin of the car. ‎The poor road network, numerous potholes, and traffic jam in most of roads in Nigeria ‎could have exacerbated a leaky exhaust of the smoky second hand SUV car leading to ‎the acute carbon monoxide poisoning. ‎ Acute Poisoning Autopsy Carbon Monoxide Toxicological Studies.‎ 2014 1 01 973 976 http://ijt.arakmu.ac.ir/article-1-280-en.pdf