Background: The herbicide 2, 4-dichlorophenoxyacetic acid (2, 4-D) can cause moderate to lethal poisoning. Although urine alkalization has been recommended as the main treatment, hemodialysis (HD) may be more effective in severe cases.

Case: On 24^th June 2014, a 53- year-old man ingested a high amount of 40% 2, 4-D. He suffered from mouth and epigastric burning sensation, vomiting and nausea. He was treated, in Emam Reza’s Hospital of Mashhad University Of Medical Sciences, Mashhad , Iran,  with maintenance daily fluid infusion plus 10 meq/L NaHCO3. Up to 9 hours after exposure, he became progressively stuporous. He developed diarrhea and hypotension, BP=100/60, unresponsive to volume replacement therapy. He received regular hemodialysis (HD) with bicarbonate for three hours. At the end of HD, his blood pressure rose to 110/70 and the level of consciousness began to improve. Four hours later, he was fully conscious with stable blood pressure (130/80 mmHg).

Conclusion: HD may be an effective, safe and fast method for 2, 4-D high dose intoxication induced coma.

Background: Hair dye poisoning, with main toxic component paraphenylene diamine, is a medical emergency. It is on increasing trend in developing countries due to wide availability and low cost of hair dyes. It carries a high mortality and does not have any specific antidote.

Case Report:  Twenty three years old patient presented with breathelessness along with difficulty in speaking for one hour after consuming hair dye. He developed cervicofacial edema followed by rhabdomyolysis, myoglobinuria and acute kidney injury, classical of hair dye poisoning. Laboratory investigations revealed blood urea of 100 mg/dl and serum creatinine of 3.8 mg/dl. The serum creatinine phosphokinase (CPK) levels were 1230 U/L and urine myoglobin was positive. He was treated conservatively for acute kidney injury and discharged in stable condition.

Conclusion: Early diagnosis and treatment of poisoning due to hair dyes leads to improved prognosis, so widespread awareness is needed about this emerging form of poisoning.

Background: Medicinal plants have potential to affect therapeutically procedures. In this study, the therapeutical effects of psyllium on a patient with highly increased level of uric acid, creatinine, and urea have been studied.

Case Report: The case was a 50-yr-old woman affected by diabetes mellitus. Her blood biochemical analyses, showed an increased levels of uric acid (9.70±0.30mg/dL), urea (93.00± 3.60mg/dL) and creatinine (2.30±0.20 mg/dL). She was taken allopurinol (100 mg /daily) followed by consumption of 5 gr/daily from psyllium seeds which continued for two consecutive weeks. Then, the levels of uric acid, urea and creatinine were reached the normal value so that their measured levels were 5.60±0.26; 34.00±1.73 and 1.10±0.10 mg/dL, respectively. Psyllium together with allopurinol could also reduce cholesterol and triglyceride levels in this patient.

Conclusion: We can conclude that psyllium along with allopurinol can synergistically decrease the increased levels of uric acid, creatinine, and urea.