Showing 8 results for Poisoning.
Seyed Mahdi Mortazavi, Yahya Haaji, Ahmad Khonche, Hamidreza Jamilian,
Volume 6, Issue 17 (7-2012)
Abstract
Background: Poisoning is a serious health problem in the world. In the intentional type, the person may attempt suicide by self-poisoning or may be poisoned by others in a criminal act. The present study was designed to investigate the causes and the frequency of poisoning cases referring to Loqman Hospital, Tehran, Iran, during summer 2010.
Methods: In this descriptive-analytical study, age, gender, educational level, daily sleep duration, history of physical illness, and type of substance used for poisoning were analyzed by SPSS software.
Results: Of the 200 poisoned patients, 51% were male and 49% female. 60% of the patients were single. The patients’mean of age was 26.82 years. Minimum age was 14 years and maximum age was 77 years. Most of the patients were graduated from high school and 95.5% of them were living in large cities. Their parents were alive in most cases (92.2%) and 70.5% of them were the first to third child of their family. The person in charge of them was their parents in most cases. The mean daily sleep duration was 7 hours and 72% of the subjects did not have any physical illnesss. Also, 42% of the patients had history of cigarette smoking. Overall, 57% of the patients were poisoned by antidepressant drugs, 31% by narcotic compounds, and remaining 12% by unknown substances.
Conclusion: Most poisoned cases by antidepressant drugs can be explained by a various of reasons such as availability of the drugs. The findings of this study necessitate more vigilance from physicians in prescribing drugs and community in educating people about drugs.
Morteza Rahbar Taromsar, Ali Reza Badsar, Choubineh Mah Manzar, Morteza Fallah Karkan,
Volume 6, Issue 17 (7-2012)
Abstract
Background:Naltrexone is a competitive opioid receptor antagonist blocking the euphoric effects of exogenous opioids. When used concomitantly with opioids, naltrexone causes severe withdrawal symptoms.The main aim of the study is to determine the symptomatology and outcome of patients who consumed naltrexone in conjunction with an opioid substance.
Methods:This cross-sectional study was performed on the patients hospitalized with history of naltrexone usage coincided with opioid substances at Razi Hospital, Rasht, Iran. The collected data were demographic information, abuse information, clinical signs and symptoms, laboratory findings, and therapeutic measures taken. Data analysis was performed by descriptive tests using SPSS software version 16.
Results: The mean age of the patients was 33.7±10.2. The majority of the cases were male (95.6%) and urban (96.7%). The main cause of withdrawal symptoms in 91.1% of the patients was inappropriate naltrexone usage.The main poisoning agent in 80% of the cases was consumed naltrexone alone. The route of consumption in 90.1% of the cases was oral and in 9.9% the cases was IV injection. The major clinical features were nausea, vomiting, and agitation.The main therapeutic measures were supportive intravenous fluids (94.8%) and opioid administration in the form of methadone. The mean hospitalization period was 21.8±18 hours.
Conclusion: Severity, clinical course, and outcome of opioid withdrawal by accidental or intentional naltrexone abuse varies greatly among patients and is unpredictable. Common findings upon presentation were gastrointestinal symptoms and agitation and the main therapeutic measures for these patients were support with intravenous fluids and anti-nausea drugs administration as plasil and opioid administration as methadone.
Fakhreddin Taghaddosi-Nejad, Meysamie Alipash, Shahin Shadnia, Mahmoud Ghazi Khansari, Hossein Hassanian, Arash Okazi,
Volume 6, Issue 18 (10-2012)
Abstract
Background: Fatalities from acetaminophen poisoning are common, but they are preventable by timely treatment with N-acetyl cysteine (NAC). In many medical centers, NAC is prescribed in keeping with the ingested dose of the drug as revealed through medical history. It seems to significantly differ from the real indications of NAC administration based on plasma level of acetaminophen. Overtreatment increases adverse drug reactions and it is time- consuming and costly.
Methods: Acetaminophen plasma level was checked by HPLC method in 170 admitted patients who had history of acute ingestion of more than 7.5 g acetaminophen within 4 to 24 hours prior to hospital admission. Indications for NAC prescription according to patient’s history and adaptation from acetaminophen plasma level in Romack-Mathew nomogram were matched. Data were analyzed by SPSS software version 16.0.
Results: Mean age of the patients was 21.8±6.05 years. In 75.8% of the patients, poisoning had occurred after suicidal attempts. Acetaminophen plasma level was between less than 2 and 265 μg/ml (18.7±28.88, mean± SD). Only in 18 (10.6%) cases, overtreatment had been performed. Multiple logistic regression analysis showed that the number of suicidal attempts, number of ingested pills, and time of referral had positive relationships with acetaminophen plasma level.
Conclusion: If NAC is prescribed only based on patient's medical history, overtreatment may take place.
Ghafar Ali Mahmudi, Khatereh Anbari, Zia Obeidavi,
Volume 7, Issue 22 (9-2013)
Abstract
Background: Poisoning is considered an important public health issue. Considering the high prevalence of poisonings and the diversity of their ensuing symptoms, this study aimed to investigate the epidemiology of the clinical symptoms of poisoning in children admitted to Shahid Madani and Ta'min Ejtema'i hospitals of Khorramabad in 2011.
Methods: In this cross-sectional study, the data was collected from the records of the children hospitalized with a diagnosis of poisoning in the referral hospitals of Khorramabad in 2011. Collected data was statistically analyzed using SPSS software.
Results: Of the 230 hospitalized patients whose age ranged from 30 days to 11 years (with a mean age of 3.1 years ± 2.4), 117 (50.9%) were male and 113 (49.1%) were female. Neurological (43.5%) and gastrointestinal (21.3%) symptoms ranked as the most common clinical symptoms of poisonings. At P<0.01 level of significance, drug abuse (42%) was identified as the most prevalent cause of neurological symptoms, and hydro-carbonic poisonings (40.81%) stood as the most frequent causes of gastrointestinal symptoms.
Conclusions: Neurological complications are viewed as one of the main threats to pediatric health and the high incidence of such complications in the sample of poisoned children in this study suggests that the issue of pediatric poisoning needs to be taken into serious consideration. Furthermore, high priority needs to be accorded to the careful training of the personnel of healthcare centers and the correct treatment of the poisonings which result in neurological complications.
Nahid Kazemzadeh, Saeed Mohammadi, Mohammadali Emamhadi, Abdollah Amirfarhangi, Hossein Sanaei-Zadeh,
Volume 7, Issue 23 (1-2014)
Abstract
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.
Hossein Hassanian-Moghadam, Mohammad Reza Zarei, Vahid Eslami, Ali Zandieh, Gohar Fakhfouri, Marjan Rasouli, Patricia Khashayar, Mohammad Reza Rasouli,
Volume 8, Issue 25 (6-2014)
Abstract
Background: There is no clear data on the adherence of emergency medical services (EMS) paramedics and hospital staff rather than those working in poisoning centers to the guidelines for managing acutely poisoned patients in developing countries.
Methods: During a 6-month period, all EMS-managed poisoned patients along with those initially managed in a non-poisoning center before being referred to a poisoning hospital in Tehran, Iran, were instructed. Then the indications for administrating the activated charcoal (AC) as well as performing gastric lavage (GL) and tracheal intubation were studied and compared to the recommended guidelines.
Results: A total of 3347 cases, including 1859 males (55.6%), were evaluated. There were significant differences between expected and performed endotracheal intubations in both EMS and other medical centers (P-value = 0.002 and 0.001, respectively) as well as the administration of GL and AC in other medical centers (P-values= 0.003 and 0.03, respectively).
Conclusion: More extensive educational programs should be established to improve the preliminary management of poisoned patients performed by EMS paramedics and staff of hospitals other than poisoning centers.
Ali Arjmand Shabestari, Zahra Purfarzad, Mojtaba Ghorbani,
Volume 8, Issue 26 (9-2014)
Abstract
Background: Poisoning is one of the important reasons for children’s admission to hospital. Knowledge of epidemiology of poisoning in each region plays an important role in planning prevention, care, and treatment of patients. This study was conducted to determine the characteristics of acute poisoning epidemiology in children attending pediatric wards of Amirkabir Hospital in Arak in a five-year period (March 2008 to March 2012).
Methods: This descriptive cross-sectional study was conducted on 224 children admitted for poisoning. Data were retrospectively collected from patients’ files and analyzed using SPSS 16 software.
Results: Of the total population, 54.9% were boys and the rest were girls. Mean age of children was 3.54±2.99 years, and the most common age range was 1-3 years (50.9%). The highest rate of children’s admission due to poisoning was in the winter (30.8%). The most common causes of poisoning included drugs (65.2%), kerosene (7.1%), and food poisoning (5.4%). The most common poisoning drugs, included benzodiazepines (21.9%), gastrointestinal drugs (19.9%), opioid analgesics (15.1%). The most prevalent drugs were methadone, metoclopramide, and clonazepam. At admission, the most common presenting symptoms were neurological (51.3%), and gastrointestinal symptoms (38.4%).
Conclusion: High prevalence of poisoning with groups of drugs mentioned could indicate community-wide excessive use of these drugs, as well as negligence of families in keeping them out of children’s reach. Therefore, raising knowledge and awareness about variety of poisoning and how to prevent them, through holding workshops, national media, schools, and health centers can be a valuable step toward upkeep of children’s health.
Mohammad Shokrzadeh , Masoud Poorhosein, Nafiseh Nasri Nasrabadi, Farzaneh Veisi, , Zohreh Kooshki,
Volume 8, Issue 27 (1-2015)
Abstract
Background: Carbon monoxide is an odorless, colorless and poisonous gas. Since there is currently no information on the prevalence of carbon monoxide poisoning in Mazandaran, this study aimed to investigate the prevalence of carbon monoxide poisoning and compare its prevalence with other poisonings recorded in Mazandaran Department of Forensic Medicine, from 2009 to 2011.
Methods: This is a descriptive-analytical study, in which the information was received from Mazandaran Department of Forensic Medicine.
Results: Among the 2446 human deaths in 2009, 2010, 2011, 237 deaths were due to poisoning and 27 (11.4%) were due to carbon monoxide poisoning, which ranked third after narcotic and Aluminum phosphide intoxication. Poisoning in males was 1.7 times more than females. Co was the most common cause of deaths among people aged 21 to 30 years.
Conclusion: Considering the fact that in most cases of poisoning deaths caused by CO (silent killer) come by quietly and in a hidden manner, CO actually makes any defense and escape impossible for the person and despite seeing the shadow of death, that person will inevitably surrender and will be defeated. Therefore, it is necessary to educate and inform the public through media and educational institutions about the risks and sources of CO poisoning.
