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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Epidemiology,Survey,Amatoxin,Mushroom poisoning
- چکیده:
- چکیده انگلیسی: Background:Besides their nutritional value, mushrooms have shown beneficial effects on human body organs; thus, people are interested in consumption of mushrooms regardless of their safety. In this report, we present patients with suspected mushroom poisoning, who were admitted to the Medical Toxicology Department of Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Method:Seventeen mushroom-poisoned patients were admitted to our department from April 2012 to May 2015. Following the evaluation of the vital signs, biochemical analysis was done and in parallel, treatment was initiated based on the laboratory tests results and clinical manifestations. Results:In this period, 17 mushroom-poisoned individuals (11 males (64.7%) and 6 females (35.3%) with mean age of 28.26±18.05 years old) were referred to our department. Subjects presenting the signs of intoxication within 6 hours post-ingestion comprised 58.8% of our patients. The rate of mortality was zero but 3 patients presented with some levels of unconsciousness. Only one patient had augmented levels of AST with no evidence of hepatic failure. Coagulopathy as reflected by increased INR was observed in 2 patients. Regarding the season in which the poisoning occurred, the majority of cases happened in spring and autumn. Conclusion:Similar to other reports on mushroom-poisoned patients, we observed gastrointestinal disturbances as the major symptom. Since the majority of mushroom poisoning cases occur following the ingestion of accidentally picked mushrooms, risk communication practices should be improved to increase the public awareness of mushrooms toxic effects.
- انتشار مقاله: 19-11-1396
- نویسندگان: Samaneh Silakhori,Bita Dadpour,Mona Najaf Najafi
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی:
- انتشار مقاله: 04-06-1396
- نویسندگان: Parvaneh Layegh,Zakieh Ghorbanpour,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Psychotropic drugs,Concomitant Drug Use,Opioid,MMT
- چکیده:
- چکیده انگلیسی: Background: Methadone maintenance therapy (MMT) is considered as an efficient and effective treatment in management of high risk opioids addiction; although, concomitant use of other drugs may interfere with treatment course and outcome in MMT cases. This study aimed at evaluating patterns of drug use along with methadone based on self reported and urine analysis data in two MMT clinics.
Methods: 135 patients on MMT recruited for this cross-sectional study which was conducted from March to September 2014. Data were obtained of MMT clinic of Imam Reza (p) hospital, Mashhad, Iran. After completing a written informed consent, a questionnaire including demographic information, duration of MMT, methadone dose, concomitant medication and other related information was fulfilled. Data were analyzed by SPSS software version 16.
Results: Mean (SD) age of patients was 42.8 (12.2). All patients were taking medication along with methadone. The most prevalent drug classes were antidepressants (32%) and benzodiazepines (BNZD) (25%). The next three drug groups were analgesics, GI and cardiovascular drugs respectively. Antidepressant and benzodiazepine use was more prevalent in patients who were on MMT for at least 7 months compared with shorter courses. Antidepressant use was more common in patients on maximum dose of 30 mg/day methadone while BNZD use was more frequent in patients on doses higher than 30 mg/d.
Conclusion: Psychiatric drug use is common in opioid addicted cases. BNZD and antidepressant drugs were two most consumed drugs in cases on MMT based on our study. Psychiatric drug consumption was more common in patients on higher length of methadone use. Dosage of methadone may affect kind of concomitant drug use. Physicians should be aware of interactions between psychiatric medications and opioids.- انتشار مقاله: 02-11-1395
- نویسندگان: Marjan Emzhik,Danial Zarif,Shahrad Tajoddini,Amir Baniasad,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Poisoning,Myocardial Infarction,ARSENIC
- چکیده:
- چکیده انگلیسی: Background: Arsenic toxicity as a result of consumption of hair removal agent has been rarely seen in last few years in comparison with the past.
Case Presentation: In this case report, we presented a middle age woman referred to medical toxicology department due to epigastric pain and diarrhea following ingestion of hair removal agent. Urinary test for arsenic was positive. ECG changes and elevated cardiac Troponin levels were compatible with acute MI. Loss of consciousness and respiratory distress developed over next days and despite chelating therapy and other symptomatic treatments she deceased after 5 days of admission.
Discussion: Current case is a rare presentation of oral arsenic toxicity. A mild diarrhea, epigastric pain, ECG changes which were compatible with acute MI and hypotension were the main manifestations once admission.
Conclusion: Arsenic may still exist in depilating agents. Physicians should be aware of clinical manifestations of acute arsenic toxicity and chelating therapy should be initiated as soon as possible.- انتشار مقاله: 02-09-1395
- نویسندگان: Shahrad Tajoddini,Alireza Esmaeili,Fatemeh Hoseini,Bita Dadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Poisoning,Carbon Monoxide,Brain,magnetic resonance imaging
- چکیده:
- چکیده انگلیسی: Background: Carbon monoxide (CO) poisoning may lead to hypoxic/anoxic injury and eventually ischemic encephalopathy. Magnetic resonance imaging (MRI) has a well-recognized role in assessment of the severity of brain damage caused by CO poisoning. In this study, we aimed to present and analyze the structural abnormalities in the brain MRI and especially in diffusion weighted MRI (DWI) images in a series of patients with acute CO poisoning.
Methods: This cross-sectional observational study was performed on patients with moderate to severe CO poisoning admitted to Mashhad Medical Toxicology Center of Imam Reza Hospital, Mashhad, Iran, during autumn and winter 2013. After stabilization, patients underwent brain MRI. T1 weighted, T2 weighted and FLAIR images in sagittal, axial and coronal sections, and DWI in axial sections were performed for each patient.
Results: Eighteen patients (77.8% men) were enrolled in this study with median age of 29.5 years. Eleven patients (61.1%) had abnormal MRI signals and in 7 cases no abnormality or nonspecific abnormalities were detected. The most common involved region in brain MRI was white matter (38.9%) followed by globus pallidus (33.3%). Patients with signal abnormality in brain MRI had significantly longer duration of exposure to CO compared to those without signal changes (10.6 ± 6.2 h vs. 3.4 ± 2.8 h, P = 0.011). Nine patients had restricted diffusion in DWI. Patients with restricted diffusion in DWI had also longer duration of exposure to CO compared to patients with normal DWI (12.1 ± 5.5 h vs. 3.5 ± 2.9 h, P = 0.001).
Conclusion: The white matter and globus pallidus were the most common affected regions in brain following acute CO poisoning. Signal abnormalities and restricted diffusion in MRI were correlated with duration of exposure to CO but not with the carboxyhemoglobin levels.- انتشار مقاله: 25-03-1393
- نویسندگان: Yasmin Davoudi,Bita Dadpour,Reza Afshari,Naser Hasaniyeh,Nassim Matin,Mahboobeh Rahimi-Doab
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Snakebite,Prognostic factor,Thrombocytopenia,Therapeutic response,Initial control
- چکیده:
- چکیده انگلیسی: Background: The goal of antivenom administration for snake-bitten patients is to achieve therapeutic response (initial control), which means reversal of the venom-induced effects through neutralizing the venom. The aim of this study was to identify snakebite prognostic factors of weak therapeutic response prior to antivenom administration.
Methods: This was a retrospective study of patients with viperidae snakebite envenomation who were admitted to Mashhad Toxicology Centre during 2007-2011. Demographic features, clinical manifestations and snakebite severity score (SSS) were collected prior to antivenom administration. Total number of antivenom vials administered to achieve therapeutic response and duration of hospitalization were also recorded. Potential factors in snakebite prognosis were analyzed by comparing in two groups of achieving therapeutic response with less than 5 vials and over 5 to calculate odds ratio.
Results: Total of 108 patients (male/female: 85/23) with mean (SD) age of 34.5 (17.0) were studied. The most common manifestations included fang marks (100%), pain (100%), ecchymosis (89%), swelling (83%), blister formation (48%) and thrombocytopenia (25%). In univariate analysis, thrombocytopenia (P=0.01), spontaneous bleeding (P=0.02), coagulopathic disturbances (P=0.007), swelling (P=0.003), progressive swelling (P=0.005), ecchymosis (P=0.05) and respiratory distress (P= 0.05) were significantly correlated to weak therapeutic response. Swelling and spontaneous bleeding were the strongest snakebite prognostic factors, as respectively they put the patients at 12.4 and 10.4 fold risks for difficult achievement of therapeutic response.
Conclusions: In snakebite, some clinical manifestations in the first hours of admission and prior to antivenom administration are associated with weak therapeutic response. Identifying these prognostic factors, can assist health care providers to better estimate the patient’s needs and predict the final consequences.- انتشار مقاله: 18-06-1391
- نویسندگان: Bita Dadpour,Azam Shafahi,Seyed Mostafa Monzavi,Abbas Zavar,Reza Afshari,Ali Reza Khoshdel
- مشاهده