ABSTRACT
Poisoning is a frequent cause of referral to medical emergencies and a major health problem around the world, especially in developing countries. We aimed to review the epidemiology and pattern of adult poisoning in Iran in order to facilitate the early diagnosis and management of poisoning. The pattern of poisoning is different in various parts of Iran. Pharmaceutical compounds were the most common cause of poisoning in most parts of Iran. Pesticide-related toxicities were more common in northern agricultural regions, whereas bites and stings were seen more commonly in southern Iran. Carbon monoxide poisoning was common in cities with many motor vehicles such as Tehran and in colder climates such as in northern and western regions due to inadequately vented gas appliances such as stoves and heaters. Majoon Birjandi [containing cannabis] is a unique substance used in eastern Iran. Poisoning by opioids, tramadol, and pesticides [organophosphate and aluminum phosphide] has remained a common hazard in Iran. Poisoning-associated morbidity and mortality rates vary by region and have changed over time due to the introduction of new drugs and chemicals. Early diagnosis and proper treatment may be lifesaving; thus, understanding the general pattern of poisoning in different regions is important
ABSTRACT
Aluminium phosphide [AlP] is used to protect stored grains from rodents. It produces phosphine gas [PH[3]], a mitochondrial poison thought to cause toxicity by blocking the cytochrome c oxidase enzyme and inhibiting oxidative phosphorylation, which results in cell death. AlP poisoning has a high mortality rate among humans due to the rapid onset of cardiogenic shock and metabolic acidosis, despite aggressive treatment. We report a 21-yearold male who was referred to the Afzalipour Hospital, Kerman, Iran, in 2015 after having intentionally ingested a 3 g AlP tablet. He was successfully treated with crystalloid fluids, vasopressors, sodium bicarbonate, digoxin, glucagon and antioxidant agents and was discharged from the hospital six days after admission in good clinical condition. For the treatment of AlP poisoning, the combination of glucagon and digoxin with antioxidant agents should be considered. However, evaluation of further cases is necessary to optimise treatment protocols
ABSTRACT
Aluminum phosphide [AlP] as 3 g tablet is widely used in Iran to protect stored food grains from pests. Hyperglycemia following its ingestion has been already reported in the recent years but severe hypoglycemia is uncommon. Here, we report a 19 year old male who attempted suicide with one tablet of AlP and demonstrated severe hypoglycemia. Despite restoration of blood glucose concentration to normal, he failed to respond to supportive treatment and died. The possible mechanisms leading to severe hypoglycemia are discussed. Though severe hypoglycemia is rare following AlP poisoning, physicians managing such patients should be aware of it.
ABSTRACT
The aim of this study was investigating the characteristic and outcome of self-immolation cases admitted to the Burn Centre of Birjand, Iran over an eight year period. This study is a retrospective review of case notes for patients with self-Immolation and admitted to our referral burn centre in the last 8 years [January 2003-January 2011]. A performa was designed to collect the data such as: demographic information, length of hospital stay, extent of the burn injuries as%TBSA [Total Body Surface Area] and final outcome. Data was analyzed by SPSS software. Between 2003 and 2011, 188 self-immolation cases admitted. The mean age was 26.97 +/- 12.6 years. Female to male ratio was 1.7:1. Housewives represented the largest group [43.1%] and kerosene was the most frequent agent used [74.6%]. There was significant different between mortality and TBSA and low educational level [P=0.0001]. There was a significant fluctuation time trend in the incidence [per 100,000 population] of self-immolation from 2003 [4.64, CI 95%: 4.62-4.65] to 2008 [5.2, CI 95%: 5.19-5.21]. Mortality rate was 64%. The survival rates at three weeks survival for patients who self-immolated was 24 percent [CI 95%: 17-31]. The mean and median survival times were 6 days [CI 95%: 4.8-7.2] and 17.5 days [CI 95%: 13.3-21.6], respectively. Our study has shown a lower incidence of self-immolation [5.3%] in the South Khorasan region, when compared with other parts of Iran, as well as a relatively low mortality rate. We have also reported self-immolation in pregnant women which has rarely been reported in medical literature