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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Journal of Emergency Practice and Trauma
- نوع مقاله: Journal Article
- کلمات کلیدی: children,Emergency Medicine,Unusual poisoning
- چکیده:
- چکیده انگلیسی: The Clinical Toxicology Center in Imam Reza hospital in Mashhad is the referral center of poisonings in the East of Iran and many cases of poisoned children are referred to this center and some cases are admitted.In this letter we report some specific, strange and unusual poisonings in children admitted in our center.
- انتشار مقاله: 10-04-1398
- نویسندگان: Mohammad Hossein Kamaloddini,Anahita Alizadeh Ghamsari,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Emergency Practice and Trauma
- نوع مقاله: Journal Article
- کلمات کلیدی: Tramadol,Hypoxic ischemic encephalopathy,Antiepileptic,Status epilepticus
- چکیده:
- چکیده انگلیسی: Objective: Tramadol is a synthetic analgesic with two mechanisms. The opioid and non-opioid mechanisms are responsible for tramadol side effects. Non-opioid side effects of tramadol are due to the reuptake inhibitions of serotonin and norepinephrine. Some of the side effects include anaphylactoid reactions, CNS depression, hypoglycemia, hypotension, respiratory depression, seizures, and serotonin syndrome. Seizure may happen in therapeutic doses. If the frequency of tramadol seizures increases, ischemic brain injury and hypoxic-ischemic encephalopathy can be induced.
Case Report: We report a young man with a history of tramadol abuse that was admitted with status epilepticus in Imam Reza hospital in Mashhad, Iran. Due to his altered mental status, he was intubated and antiepileptic agents were prescribed. He was transferred to ICU. After regaining consciousness, he was extubated and with the prescription of rehabilitation support he was discharged.
Conclusion: Tramadol is a synthetic analgesic agent with less potential for dependence. It is important to mention that the overdose of this drug is common. This drug has two mechanisms. This paper reports a case that developed generalized tonic clonic seizures due to tramadol and hypoxic ischemic encephalopathy. With adequate treatment and supportive care, patient’s mental status improves and he/she can be discharged.- انتشار مقاله: 01-07-1398
- نویسندگان: Zahra Ataee,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: occupational exposure,lead poisoning,Biochemical markers,Hematologic Tests
- چکیده:
- چکیده انگلیسی: Background: Lead is a toxic element which causes acute, subacute or chronic poisoning through environmental and occupational exposure. The aim of this study was to investigate clinical and laboratory abnormalities of chronic lead poisoning among workers of a car battery industry.
Methods: Questionnaires and forms were designed and used to record demographic data, past medical histories and clinical manifestations of lead poisoning. Blood samples were taken to determine biochemical (using Auto Analyzer; Model BT3000) and hematologic (using Cell Counter Sysmex; Model KX21N) parameters. An atomic absorption spectrometer (Perkin-Elmer, Model 3030, USA) was used to determine lead concentration in blood and urine by heated graphite atomization technique.
Results: A total of 112 men mean age 28.78±5.17 years, who worked in a car battery industry were recruited in the present study. The most common signs/symptoms of lead poisoning included increased excitability 41.9%, arthralgia 41.0%, fatigue 40.1%, dental grey discoloration 44.6%, lead line 24.1%, increased deep tendon reflexes (DTR) 22.3%, and decreased DTR (18.7%). Blood lead concentration (BLC) was 398.95 µg/L±177.40, which was significantly correlated with duration of work (P=0.044) but not with the clinical manifestations of lead poisoning. However, BLC was significantly correlated with urine lead concentration (83.67 µg/L±49.78; r2=0.711; P<0.001), mean corpuscular hemoglobin (r=-0.280; P=0.011), mean corpuscular hemoglobin concentration (r=-0.304; P=0.006) and fasting blood sugar or FBS (r=-0.258; P=0.010). Conclusion: Neuropsychiatric and skeletal findings were common manifestations of chronic occupational lead poisoning. BLC was significantly correlated with duration of work, urine lead concentration, two hemoglobin indices and FBS.- انتشار مقاله: 09-09-1392
- نویسندگان: Mahdi Balali-Mood,Sina Kianoush,Seyed Reza Mousavi,Mohammad Taghi Shakeri,Bita Dadpour,Valiollah Moradi,Mahmoud Sadeghi
- مشاهده
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: Clinical toxicology,Multidisciplinary,Programmed conferences
- چکیده:
- چکیده انگلیسی: Medical management, is a team work and the nature of clinical toxicology is multidisciplinary. Internal organs problems following intoxications are included in field of internal medicine; similar problems in poisoned children brings pediatric medicine into the arena. The emergency nature of many acute intoxications, the legal problems of poisoned patients, respiratory assist in unconscious cases or need to sedate sever agitation in some intoxicated patients on the contrary, require the expertise of emergency medicine, forensic medicine, and anesthesiology, respectively.
Multidisciplinary nature of clinical toxicology is a valuable point; so that, incorporating various medical specialties, gives great power to clinical toxicology groups. On the other hand, this diversity in specialties leads to a variety of viewpoints on dealing with poisoned patients.
The key point sessions have been held in Mashhad CTD for the past 18 months and considering the wide range of topics, the need to continue these sessions in the coming years is quietly felt.- انتشار مقاله: 14-07-1398
- نویسندگان: Zahra Ataee,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Education,Internal medicine,Residency
- چکیده:
- چکیده انگلیسی: Background: Internal Medicine (IM) is one of the main medical specialties. In this paper, the features of the Iranian IM residency training program, duties and salary were evaluated and compared with some countries.
Methods: Using the Iranian Ministry of Health and Medical Education (IMHME) directive, the features of educational curriculum, compulsory working hours, duties and salary were extracted and compared with some countries whose full details were available.
Results: The annual capacity of IM residency admission in Iran is about 280 residents in 34 countrywide medical universities. The training curriculum of IM is designed uniformly for all universities by IMHME and is consisted of a 4-year training of gastroenterology, endocrinology, nephrology, pulmonary, hematology and rheumatology plus cardiology, neurology, intensive care, emergency medicine, radiology and dermatology in hospital departments and continuity clinics. Residency training period in Iran is similar to Turkey and Canada and is shorter than most European countries. Average weekly working hours for IM residents is 84 hours in Iran, which is higher than Turkey European countries, Canada and the USA. Two to eight years of medical service in underserved areas have been assigned for Iranian graduates of IM residency before receiving certification for working in larger cities.
Conclusion: Residency training in each country is affected by different factors such as economic status, work force, national health priorities and available facilities. Training of residents with more knowledge and skills that did not bear remarkable job burnout during their training period is a challenging goal for medical education policymakers- انتشار مقاله: 18-03-1396
- نویسندگان: Seyed Mostafa Monzavi,Bita Dadpour,Kianoush Shahraki,Maryam Nemati
- مشاهده
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: Poisoning,Aluminum phosphide,Emergency,case report,Evidence- Based Medicine,Educational Round
- چکیده:
- چکیده انگلیسی: Evidence- Based Medicine (EBM) aims to bring the best available evidence into clinical practice. Different clinical methods of education such as in-patient rounds, follow up rounds, out-patients rounds, group sessions, grand rounds, lectures, and journal clubs could be held by EBM approach. The current text presents two interrelated case reports; a case report of EBM decision making in an emergency condition which incorporates a case report of surviving an Aluminum Phosphide poisoned patient by placing Intra Aortic Balloon Pump.
- انتشار مقاله: 19-11-1391
- نویسندگان: Bita Dadpour,Omid Mehrpour,Zohreh Oghabian,Vahid Reza Dabbagh Kakhki
- مشاهده
- جایگاه : پژوهشی
- مجله: Avicenna Journal of Phytomedicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Poisoning,Clinical trial,Organophosphorus pesticides,HESA-A
- چکیده:
- چکیده انگلیسی: Objective: Organophosphorus compounds (OPs) are common causes of poisonings. Atropine and oximes are pharmacological antidotes of OPs. However, because of their adverse effects and insufficient performance, several other compounds have been evaluated as adjuvant therapy. HESA-A is a herbal-marine drug that contains material from Carum carvi (Persian cumin), Penaeus latisculatus (king prawn), and Apium graveolens (celery) with anti-inflammatory and antioxidants properties, which has shown useful effects as adjuvant therapy on some diseases. We have evaluated the effect of HESA-A on 69 moderate to severe acute OPs poisoned patients (44 HESA-A treated and 25 controls) as an adjuvant drug.
Materials and Methods: Two randomized age and sex matched groups of OPs poisoned patients were treated in Medical Toxicology Center of Imam Reza hospital, Mashhad, by conventional therapy with or without HESA-A (50 mg/kg/day orally). The evaluation criteria were total administrated doses of atropine and pralidoxime, intensive care unit (ICU) admission rate, mechanical respiration need, number of hospitalization days and mortality.
Results: There were no significant differences between the morbidity and mortality rate criteria of the two groups; moreover, we did not observe significant adverse effects for HESA-A.
Conclusion: HESA-A did not reduce morbidity and mortality of OPs poisoning and did not induce any major side effect in the patients.- انتشار مقاله: 26-11-1397
- نویسندگان: Seyed Reza Mousavi,Mohammad Moshiri,Emadodin Darchini-Maragheh,Seyed Khosro Ghasempouri,Bita Dadpour,Faezeh Sardar Antighechi,Mahdi Balali-Mood
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Acute liver failure,Liver Function Tests,Icterus,Tribulus terrestris
- چکیده:
- چکیده انگلیسی: Background: Plants have been used for the treatment of a wide range of conditions since ancient times but some have side effects and toxic effects that limit their use. Tribulus terrestris is traditionally used for lowering blood pressure, inhibiting kidney stone formation and inducing weight loss. In this case study, we present an Iranian woman who suffered from liver failure after using this plant.
Case presentation: A 31-year-old Iranian woman was admitted to Emam-Reza hospital due to epigastric pain radiating to back and shoulders, and weakness, Malas,neusia and icterus. Upon admission,, her vital signs were normal. She had been consuming Tribulus terrestris as an herbal tea , several times a day for 2-3 months, in order to lose weight. Upon physical examination, the patient had generalized icterus and laboratory tests showed elevated transaminases, PT, and INR. Various causes of hepatic failure, such as viral hepatitis and autoimmune hepatitis, were ruled out and the only probable diagnosis was toxin-induced liver failure.
Conclusion: Herbal plants may have some beneficial medical effects but they can also cause toxicity. Consistent use and high dose of Tribulus terrestris may cause hepatic failure and death.- انتشار مقاله: 21-07-1396
- نویسندگان: Zahra Ataee,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Poisoning,Spatial analysis,Spatial Autocorrelation
- چکیده:
- چکیده انگلیسی: Background: Geospatial distribution analysis is a highly useful tool, especially in the field of health research and health economics. We aimed to study the geospatial distribution of poisoned patients and the risk factors in Mashhad, Iran.
Methods: This was a retrospective cross-sectional study of patients treated at the Medical Toxicology Center, Imam Reza Hospital, Mashhad, Iran, which is the only referral center in northeast of Iran, in 2013. Negative binomial and Poisson approach via generalized linear mixed models were performed to investigate the association between socio-demographic characteristics with the number of reported cases of poisoning.
Results: A total of 5064 poisoned patients (52% females) were included. Most of the poisoned patients were within the age group of 20-29 years old (41.4%). Pharmaceutical agents were the most common cause of poisonings (64.6%). The local test of spatial autocorrelation (Moran’s I) confirms that the poisoning had cluster pattern in Mashhad. Number of poisoning events were found to be associated with population density (RR= 1.00011; 95% CI 1.0001-1.00013), and the frequency of people with less than high school education (RR=1.49; 95% CI 1.32-1.68).
Conclusion: The geospatial factors may have impact on the number of acute poisoning events in a city. Some parts of a city may exhibit spatial clustering in poisoning events. Once clusters are found, interventions can be focused to specific geographic locations and would be helpful for healthcare policymakers to focus on prevention programs.- انتشار مقاله: 14-02-1398
- نویسندگان: Mohammad Taghi Shakeri,Seyed Ehsan Saffari,Bita Dadpour,Hossein Aghajani,Ali Hadianfar,Reza Afshari
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Acetaminophen,rhabdomyolysis,Kidney Injury
- چکیده:
- چکیده انگلیسی: Background: Rhabdomyolysis is a clinical syndrome that results in releasing myoglobin content from damaged muscle cells into circulation and often causes acute kidney injury (1). Different mechanisms are considered to be responsible in rhabdomyolysis and renal failure. However, free radical generation is the most important mechanism resulting in kidney injury. Thus, the effect of various antioxidants has been investigated. Acetaminophen, with antioxidant ability in therapeutic dose, has shown a considerable protective effect on kidney after muscle injury. The investigations have shown that acetaminophen enhances renal function, decreases renal damage and reduces oxidant injury. The aim of this review was to summarize proven evidences for etiology to renal injury and abilities of acetaminophen in reducing it.
Methods: Articles published from 2010 to 2017 in PubMed and Google Scholar were covered in this review. The articles investigating the role of free radical in renal injury following Rhabdomylosis were searched using the keywords Rhabdomyolysis, kidney and oxidative stress. The keywords used to find articles regarding antioxidant ability of acetaminophen were antioxidant and acetaminophen.
Conclusion: With assessment of evidences form antioxidant capacity of acetaminophen and mechanism of renal failure in Rhabdomyolysis, this drug can be useful for prevention and treatment of kidney injury especially following rhabdomyolysis.- انتشار مقاله: 26-09-1397
- نویسندگان: Marjan Emzhik,Pouran Makhdoumi,Nasrin Milani,Bita Dadpour
- مشاهده