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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Poisoning,Aluminum phosphide
- چکیده:
- چکیده انگلیسی: Dear Editor; I wish to thank the authors for their careful comment (1), on our short report entitled “Aluminum Phosphide Poisoning: A Case Series in North Iran” (2). Unfortunately, as we were excited to display the findings of our series, some facts were missed from the methods of the article. The results presented in our series was collected from eight patients with definitive aluminum phosphide (AlP) poisoning diagnosed by taking history from the patients (or relatives) and clinical presentations (nausea and vomiting, metabolic acidosis, liver damage, etc.). Also, for some cases, the container of the rice tablet was brought by the patient or relatives. In Iranian pesticide market, two chemical products are sold under the name of rice tablet (3): a) the common form that contains AlP and is highly toxic, b) herbal-based product with garlic odor which contains no AlP. The herbal-based product is produced from garlic extract, sodium chloride, talc and starch, and so it is generally non-toxic for humans (4). Because these two forms are similar in their appearance, it is difficult to differentiate them for a patient with the history of rice tablet ingestion (3). Nevertheless, looking at the poison container brought by patients or their relatives in addition to clinical presentations of patients and also the odor of the tablet would be substantially helpful in this regard. Moreover, the herbal-based rice tablet is a relatively newer product in Iran (3,4); and thus poisoning with this toxic agent during the period of our study (2011 to 2012) was less probable. It is a good recommendation to evaluate and verify patients with history of rice tablet ingestion by application of silver nitrate breath test (1,3); however, this test is not available in all medical toxicology settings in the country.
- انتشار مقاله: 03-02-1393
- نویسندگان: Mohammad Karami,Mohammad Karami,Mohammad Karami
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Poisoning,Aluminum phosphide,Phosphine
- چکیده:
- چکیده انگلیسی: Background: Aluminum phosphide (AlP) poisoning is one of the most life threatening emergencies. In this study, demographic characteristics, clinical profiles and outcomes of a series of patients presented with AlP poisoning in north Iran are described.
Methods: The study was a retrospective descriptive medical chart review of AlP poisoned patients who were admitted to internal ward of Imam Khomeini hospital, Sari, Iran, from July 1st 2011 to July 1st 2012. Collected data included gender, age, intention of poisoning, amount of AlP ingested, clinical manifestations at admission, therapeutic interventions, laboratory tests and outcome.
Results: During the one-year period, 8 patients which were all men with mean (SD) age of 40.5 (22.5) years were admitted with AlP (rice tablet) poisoning. The most common signs and symptoms at admission were nausea and vomiting (100%), metabolic acidosis (100%) and hemodynamic instability (87.5%). All cases were poisoned as a result of suicidal attempt leading to 5 (62.5.6%) deaths. Compared with the patients who survived, those who died had taken higher doses of AlP, developed hepatic dysfunction in higher rates and had severer metabolic acidosis. All patients were admitted to intensive care unit and received gastric washing with sodium bicarbonate, followed by activated charcoal therapy and intravenous calcium gluconate for decontamination purposes. The median (IQR) of length of hospital stay was 2 (1-4) days.
Conclusion: AlP is a low-cost highly-toxic rodenticide. It is easily available and used as a toxic compound for suicide in the Asia region. There has been no effective antidote available for treatment of AlP poisoned patients; thus, symptomatic management should be taken into consideration as soon as possible.
- انتشار مقاله: 01-03-1392
- نویسندگان: Anahita Nosrati,Mohammad Karami,Majid Esmaeilnia
- مشاهده