Nastaran eizadi-mood

Isfahan University of Medical Sciences · Clinical Toxicology

Methanol poisoning can occur through consumption of methanol-containing alcohols, especially in areas where production, distribution, sale and consumption of alcohol is lawfully prohibited. Due to its toxic potency, determination of methanol in alcoholic solutions is important. The aim of the present study was to develop a rapid, simple and inexpen...

Background Central venous catheters (CVCs) are used widely in emergency centers, which may be associated with complications. There is a paucity of literature focusing on CVC complications, specifically in the poisoning emergency centers. In this study, we determined the frequency of CVC complications in patients with acute poisoning. Materials and...

Introduction Methadone maintenance treatment (MMT) is a popular method of treating opioid use disorder. However, the majority of drug-using males experience sexual dysfunction. Objectives This systematic review and meta-analysis examined the possible impact of MMT on sexual dysfunction in drug-using males. Methods Cochrane, Web of Science, ProQue...

Background The objective is to summarize evidence from systematic reviews, scoping reviews, and meta-analyses evaluating the effects of any format of Internet-based, mobile-, or telephone-based intervention as a technology-based intervention in suicide prevention. Materials and Methods This is an umbrella review, that followed Preferred Reporting...

Background: Poisoning with Organophosphates (OP) and/or Pyrethroids (PYR) pesticides is common. We present a rare case of OP+PYR poisoned patient who suffered from Atrial Fibrillation (AF) at the beginning of treatment by a low dose of atropine and reviewed the literature. Case Presentation: A 50-year-old man had ingested about 5-10 ml of a mixture...

The pattern of poisoning varies in different societies. In this study, we investigated the clinical-epidemiological features and outcomes of poisoned patients based on the substances involved, whether pharmaceutical or non- pharmaceutical toxins. This cross-sectional study involved a retrospective chart review of all poisoned patients who presented...

Background This study aimed to investigate the impact of child abuse and substance desire on adolescent suicide. Methods This cross-sectional analytical study was conducted on all adolescents aged 12 to 19 who attempted suicide in 2018 at Khorshid Hospital, Isfahan, Iran. A checklist of the patients’ demographic information, toxicological data, an...

Objective Methanol poisoning can occur either intentionally through the consumption of methanol-containing products or accidentally through ingestion, resulting in visual impairment. We assessed the long-term visual sequelae in patients with methanol poisoning. Methods This prospective cohort study was conducted at referral centers, Khorshid and A...

Objective: Poisoning is one of the most common methods of suicide in developing countries. We assessed the frequency of impaired hematological indices in patients with acute poisoning. Methods: The present study was a cross-sectional retrospective. Using the census sampling method, all patients who had attempted suicide by poisoning and were admitt...

Background: Today, methanol intoxication is increasing. Identifying mortality predictors has a significant correlation with poisoning progress. This meta-analysis study aimed to identify and evaluate mortality predictors for methanol poisoning. Methods: In this study, we searched electronic databases for case-control and cohort studies related to m...

Objective This study aimed to assess the severity of poisoning, various scoring systems, including Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II), Simplified Acute Physiology Score (SAPS II), Modified APACHE II, and poisoning severity score (PSS) were used. In this study, we compared...

Objective Aluminum phosphide (ALP) and zinc phosphide (ZnP) are toxic agrochemical pesticides, which are commonly used as an agent of self-harm in developing countries. Because of high toxicity of phosphides, we evaluated toxico-epidemiology ALP and ZnP poisoning in with respect to outcome. Methods We performed a cross-sectional study with retrosp...

Gastrointestinal (GI) manifestations of lead poisoning include abdominal pain, constipation, and diarrhea. Depending on the severity of a symptom, surgical consultation is required. The present study aimed to make a comparison between the mean blood lead levels of patients hospitalized for lead toxicity and the various Gl symptoms. A retrospective...

Paraquat (PQ) is a commercially important and effective herbicide in the world. Nevertheless, it has higher toxicity causing acute organ damage and different complications, mainly in the lungs and kidneys. Ferulic acid (FA), 4-hydroxy-3-methoxycinnamic acid imposes multiple pharmacological impacts. No protective effect of FA on PQ poisoning-caused...

methadone poisoning

Background: There is no dedicated specific intensive care unit (ICU) for poisoning cases due to the small number of poisoned patients in some poisoning centers and patients may hospitalized in the general ICU. In this study, we compared the outcome of hospitalization in poisoning and general ICU, in matched patients to demographical and toxico-cli...

Background: Beta-blockers carry a high risk of potentially causing fatal poisoning if overdosed. We aimed to assess the clinical and epidemiological characteristics of patients with beta-blocker poisoning. Methods: Patients were categorized based on the type of drug poisoning into propranolol, other beta-blockers, and the combination of beta-blo...

Background Several studies worldwide have investigated household product poisoning. We conducted a toxico-clinical study on the two-year prevalence of poisoning with household products. Methods This cross-sectional study was performed in Khorshid Hospital, the main referral center for poisoning cases in Isfahan, affiliated to Isfahan University of...

Paraquat skin contact occurs less frequently and is rarely fatal. This article reports a case of a 45-year-old man who presented with dysphagia, respiratory distress and grade two, and third skin burns focusing on the upper body after accidental exposure to paraquat. He was admitted to the hospital 6 days after the first contact. The urine sodium d...

Objective: Tricyclic antidepressants poisoning (TCA) is associated with cardiovascular complications, electrocardiographic abnormalities, and central nervous system toxicity. This study aimed to compare the clinical manifestations of poisoned patients with tricyclic antidepressants alone or with benzodiazepine (BZD) intoxication according to the d...

Background: Complications or death risk factors is necessary for better monitoring and treatment. The aim of this study was to define the relative risk of toxico-clinical parameters with regard to poisoning severity and outcomes in patients with acute poisoning. Materials and methods: This cross-sectional study entailed of patients with acute po...

Background: Paraquat (PQ) poisoning is a serious public health concern, especially in developing countries, due to its easy access and lack of awareness of potential harms. No effective treatment has been reported yet. Conventional hemodialysis (HD) is still used in many centers for excreting PQ or reducing acute kidney injury, but there is no con...

Background Paraquat is a non-selective herbicide that causes severe tissue damage in various organs including the liver and kidney. The aim of this study was to determine the trend of the liver and kidney injury in patients with paraquat poisoning. Methods This retrospective cross-sectional study was performed at the Khorshid Hospital referral poi...

The ingestion of pesticides for suicide commitment purposes is common in developing countries. We present a case of suicide with ingestion of mixed pesticides. The autopsy findings showed the presence of diazinon, chlorpyrifos, trifluralin, fenpropathrin, pyriproxyfen, and cypermethrin in his body. Clinicians managing poisoning cases need to be awa...

Background: Patients with acute poisoning sometimes require hospitalization in the Intensive Care Unit (ICU). The correct admission of these patients has resulted to lower mortality. This study compared the characteristics of adult patients with acute poisoning who were admitted to the poisoning ward and the ICU. We also determined the relevant out...

Background: Lead poisoning was on the rise in recent years. There exists a lack of easy access to some of the main chelator drugs in developing countries. Thus, this study aimed to explore the comparative effects of Succimer and D-Penicillamine on acute lead poisoning patients from 2013 to 2018. Methods: This descriptive study was conducted in the...

Objective: In this study, we evaluated the predictive factors for the occurrence of metabolic acidosis in patients with multi-drug poisoning, including antidepressants (Ad)/antipsychotics (Ap). Methods: This cross-sectional study was carried out in the referral poisoning center, Khorshid University Hospital, affiliated with Isfahan University of...

Comparison of Correlation between Naloxone Administered by Emergency Medical Services and Hospital Poisoning Emergency Service in Patients with Opioid Poisoning

Background: Alcohol consumption leads to a significant number of deaths, mostly in men, worldwide. Considering the effect of ethanol toxicity on the heart, we studied various Electrocardiographic (ECG) changes in patients with acute ethanol poisoning. Methods: A cross-sectional study was performed on patients admitted to Khorshid Hospital (affiliat...

Although the predominant treatment for snakebite is the antivenom, other treatments are also considered. We studied the effects of single or multiple-doses of anti-inflammatory drugs on local, systemic and laboratory findings of the snakebite victims. In this cross-sectional study, 101 patients (90 male: 89.1%) with snakebite envenomation who were...

Background: Digoxin is extensively prescribed for cardiac diseases, so its chronic or acute toxicity commonly occur. Although digoxin specific antibodies (anti-digoxin Fab) are recommended to be used in patients with cardiac symptoms of digoxin toxicity, there is ongoing controversy about the effectiveness and dose of anti-digoxin Fab. Because our...

Objective: Opioids poisoning is of the most important cause of mortality. The objective of the study was to compare the demographic factors, clinical manifestations, and outcomes of the most common opioids involved in drug overdose presenting to the Emergency Department. Methods: This cross-sectional study was conducted from October 2016 to Marc...

Background: Digoxin is extensively prescribed for cardiac diseases, so its chronic or acute toxicity commonly occur. Although digoxin specific antibodies (anti-digoxin Fab) are recommended to be used in patients with cardiac symptoms of digoxin toxicity, there is ongoing controversy about the effectiveness and dose of anti-digoxin Fab. Because our...

Objective: To evaluating the efficacy of fresh frozen plasma (FFP) in comparison with conventional regimen in the treatment of organophosphate (OP) poisoning. Methods: PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following key words "organophosphate" and "poisoning or toxicity", "(atro...

Objective: We aimed to find the toxicoepidemiological indicators of tramadol poisoning in children and also the relationship of these indicators (such as demographic characteristics, and referral time) with the final therapeutic outcome. Methods: In this cross-sectional study with retrospective data collection, we included the records for all th...

Background: Many studies have focused on the relationship between naloxone and seizure in tramadol poisoning but the results are in conflict. We performed a meta-analysis study to see whether naloxone prevents or increase the risk of seizure in tramadol poisoning. Methods: Bibliographic literature searches were conducted in the ISI Web of Scienc...

Background: In view of the high prevalence of poisoning with antipsychotics, antidepressants, and benzodiazepines, the aim of this study was to compare the cardiovascular complications of poisoning with antipsychotic and antidepressant drugs with or without benzodiazepines. Methods: In this case-control study, 120 patients poisoned with psychiatri...

Background Paraquat (PQ) poisoning is a serious public health problem in many countries. In spite of different treatments, the mortality is still high. We performed a meta-analysis to see whether hemoperfusion (HP) in combination with other treatments reduces the mortality more than HP alone in patients with PQ poisoning. Materials and Methods We...

Atropine is a drug of choice for muscarinic effects in organophosphate (OP) poisoning. Allergic reaction to atropine is rare. Here, we report a case of a 17-year-old male who was admitted with clinical manifestations of acute OP poisoning. After intravenous atropine injection, cutaneous signs of hypersensitivity including erythema and urticarial we...

Background There have been studies on the outcome of acute intoxication with antidepressants or antipsychotics. We performed outcome prediction analysis in acute poisoning patients with antidepressants/antipsychotics with or without combination with other drugs. Materials and Methods A cross-sectional study was performed in Khorshid (PBUH) Univers...

Objective The trend of methadone toxicity in children and adolescents seems to be increasing in Iran since it is used as a legal measure of the treatment for opioids addiction in methadone maintenance therapy clinics. In the present study, we describe the clinical and demographical characteristics of acute methadone toxicity in a cohort of pediatri...

Background: Endotracheal intubation is one of the most common interventions in the intensive care unit to provide a reliable airway for patients. We investigated the causes of endotracheal reintubation in cases with poisoning admitted to the intensive care unit. Methods: In this case-control study, 43 patients required endotracheal reintubation (ca...

Gastric intestinal decontamination (GID) remains an important issue in the management of acute poisoning.[1] Its effectiveness is dependent on the nature, form, amount of ingested toxin, and time from ingestion to admission.[2,3] Reported adverse effects of orogastric lavage include injury to the esophagus and stomach, rupture of the stomach, inadv...

Proposed Management Protocol for Acute Aluminum Phosphide Poisoning

Background: Poisoning is one of the serious underlying causes of loss of consciousness. Due to the relative lack of preserving factors of respiratory tract, risk of aspiration pneumonia would be increased. We evaluated factors associated with aspiration pneumonia in patients admitted with acute drug intoxication. Methods: A retrospective cohort ra...

Objective Suicide is a social health problem worldwide. Anemia has been associated with depression. Since it remains debated whether anemia is associated with suicide independently of depression, we evaluate this probable association in women who attempted suicide through acute poisoning. Methods The study design was cross-sectional and performed...

Dear Editor, Paraquat (PQ, 1,1′-dimethyl-4,4′-bipyridinium dichloride) is one of the most toxic pesticides available here in the Middle East. Clinical manifestations and outcomes of acute PQ poisoning depend on the volume of PQ ingested orally. Ingestion of as little as 5 mL of the 20% weight/volume PQ solution is sufficient to cause death in more...

Background: Opioid use makes the largest contribution to drug abuse mortality, while it is increasing in the world, especially in Iran. Objectives: The current study aimed at obtain the typical features of corpses under methadone maintenance treatment (MMT) and opium intoxication in Isfahan, Iran. Patients and Methods: The current cross sectional s...

Background: Poisoning with organophosphate (OP) compounds is common and causes many complications, including seizure. The purpose of this study was to investigate the predictor factors of seizure in patients with organophosphate poisoning. Methods: This study was performed on patients with organophosphate poisoning hospitalized from 2007 to 2015 i...

Objective Bispectral index (BIS) is one of the several methods used to monitor the depth of anesthesia. Poisoning with ingestion of different drugs is one of the most common poisonings that have different clinical signs from drowsiness to coma. This study was performed to compare the BIS index number in poisoned patients with multi drugs ingestion...

Background: Methadone is a common medication used for pain relief and addiction treatment. We evaluated clinical, demographic, and forensics findings in deceased cases of acute methadone poisoning. Methods: An 11-year chart review study was done on deceased cases diagnosed with methadone poisoning admitted to a referral emergency ward affiliated to...

Background: Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine (NAC) on the survival time, hemodynamics, and cardiac biochemical parameters at various time intervals in some cases of AlP poisoning. Methods: This research was a case–control study to evaluate 63 AlP poisoned pat...

Objective: Methadone poisoning is common in our society, mainly in drug addicts. One of its lethal complications is pulmonary edema. Therefore, we evaluated the prevalence of pulmonary edema in the deceased cases with methadone poisoning and its possible relationship with some medical variables. Methods: In this cross-sectional study which was d...

Background: Methadone toxicity is rising not only in those who are under maintenance methadone therapy (MMT) treatment but also in those who face accidentally to drugs, which result in increased morbidity and mortality. Naloxone is used for the treatment of methadone poisoning. The aim of this study was to evaluate the effect of oral naltrexone on...

Background: Midazolam is commonly and safely used in poisoning management and intensive care for the control of agitated poisoned patients. Despite the introduction of newer and safer antidepressants, tricyclic antidepressants (TCAs) are still prescribed and used in many countries due to their cost-effectiveness. Severe morbidity and mortality ass...

Background: Determining the depth of anesthesia or loss of consciousness in poisoned patients admitted to hospitals is one of the most important issues in determining the necessity to tracheal intubation. This study aimed to investigate the relationship between the scores of Bispectral index (BIS) and Glasgow coma scale (GCS) in poisoned patients w...

Methamphetamine is the second most widely abused drug worldwide. We performed a study on the treatment outcome of acute methamphetamine intoxication in a referral tertiary care University hospital in Iran. In this hospital-based, retrospective study which was carried out from 2012 to 2013, medical records of all patients aged 18 to 65 years who wer...

Amlodipine overdose can be life-threatening when manifesting as noncardiogenic pulmonary edema. Treatment remains challenging. We describe a case of noncardiogenic pulmonary edema without refractory hypotension and bradycardia after ingestion of 500 milligram amlodipine with suicidal intent. Mechanical ventilation, dexamethasone, atrovent HFA (ipra...

We aimed to investigate the frequency of seizure after acute carbamazepine poisoning and the important risk factors related to the outcomes of therapy. In this two-year cross-sectional study conducted in a University Hospital in Iran, 114 patients with acute carbamazepine poisoning were divided into two groups of with seizure (n = 8) and without se...

Background. Psychiatric consultation is necessary for all patients with intentional poisoning and its reliability depends on the proper function of patients' memory performance. This study aimed to determine the possible memory impairment following acute TCAs' poisoning. Materials and Methods. In this cross-sectional study, patients with acute TCAs...

Background. Poisoning with tricyclic antidepressants (TCAs) is still a major concern for emergency physicians and intensivists. Concomitant ingestion of other psychoactive drugs especially benzodiazepines with TCAs may make this clinical situation more complex. This study aimed to compare the arterial blood gas (ABG) values and the outcome of treat...

In some opinions, opium consumption has traditionally been considered to be a means to lower blood lipids and to put off heart diseases. In this study, the relationship between opium consumption and risk factors of coronary artery diseases, hemodynamic factors and cardiac related functions before and after surgery was evaluated. In a cross-sectiona...

There is a high tendency among specialists to treat the addicts with naltrexone; withdrawal symptoms are frequent after taking naltrexone along with opioids. This study investigated the frequency of agitation due to inappropriate use of naltrexone in addicts. This was a cross-sectional study, conducted in Noor and Aliasghar hospitals in Isfahan cit...

Introduction. This study was conducted to evaluate and document the frequency and causes of agitation, the symptoms accompanying this condition in intoxications, relationship between agitation score on admission and different variables, and the outcome of therapy in a tertiary care referral poisoning center in Iran. Methods. In this prospective obs...

BACKGROUND: Some opioid-poisoned patients do not respond appropriately to naloxone; consequently, intubation is required. Although various measures have been used to evaluate the level of consciousness of poisoned patients, no study has assessed the role of the bispectral index (BIS) to ascertain the depth of anesthesia in opioid-poisoned patients...

Background: Postoperative cognitive dysfunction, especially delirium commonly occurs after cardiac surgery. Clinical evidences suggest an increase in delirium in opium abusers after Coronary Artery Bypass Graft (CABG) surgery. In this study, the prevalence of delirium in addict (opium user) and nonaddict patients after CABG were compared. Methods:...

Introduction This study was designed to compare the effects of intranasal (IN) and intravenous (IV) administration of naloxone in patients who had overdosed on opioids. Material and methods This randomized clinical trial study was conducted in the Department of Poisoning Emergencies at Noor and Ali Asghar (PBUH) University Hospital. One hundred op...

Tramadol poisoning has increased in recent years. Seizure is one of the side-effects of tramadol toxicity. There is a controversy about possible preventive effect of naloxone in tramadol poisoning induced seizure. Therefore, this study was performed to compare seizure incidence in tramadol poisoning patients who received and did not receive naloxon...

Background: Acute poisoning is one of the most threatening health problems around the world. The purpose of this study was to evaluate the prevalence of intentional and unintentional poisoning in vulnerable groups in order to assist in planning and implementation of preventive measures. Methods: This cross-sectional study included 786 patients in...