ABSTRACT
Background: Paraquat poisoning has been a health concern in many developing countries. Management of it is not standardized and varies from center to center. This study is aimed at devising an available evidence-based comprehensive protocol for parquat poisoning management in Isfahan, Iran, to reduce unnecessary variations in practice. Materials and Methods: A narrative search in electronic databases was performed. Several peer-reviewed articles, guidelines, and textbooks were reviewed and practical details were extracted from 1967 till now. The simple, available and wide-ranged descriptive protocol was developed. Then, it was finally discussed with expert physicians specialized to be optimized for the diagnostic tools and treatments used in this setting by supplementing other specific considerations. Results: The final version of the protocol was designed in six steps. The algorithm consists of a planned are based on the severity of the toxicity. It comprised of supportive treatments based on Resuscitation, Gastrointestinal decontamination, Elimination enhancement, and other treatment options for PQ lung injury. Conclusion: Paraquat poisoning is a clinical toxicologic emergency, which needs to be diagnosed and treated in an organized manner, although its mortality rate is great.
ABSTRACT
ABSTRACT OBJECTIVE: The aim of this study was to evaluate possible interactions among Angiotensin-I converting enzyme genotype, insertion/deletion polymorphism and atherosclerosis of vein grafts in Iranian patients, and characterize their clinical and demographic profile. METHODS: In this cross-sectional study, patients who underwent coronary artery bypass graft surgery more than five years ago, were included for angiographic analysis. Atherosclerosis was determined by quantitative angiography and adjusted Gensini score. The gene angiotensin converting enzyme I/D polymorphism was detected by polymerase chain reaction. RESULTS: A total of 102 patients participated in this study. Eighty-four patients were male. The frequency distribution of DD, ID and II polymorphism were 23.6%, 62.7% and 13.7% respectively. There were no differences among genotypic groups in age, sex, number of risk factors, number of vein grafts and months since bypass surgery. According to adjusted Gensini score [0.18±0.12 (II) vs. 0.11±0.09 (ID) and 0.1±0.09 (DD) P=0.021] the II genotype was associated with severity of vein graft atherosclerosis. CONCLUSION: Although there are conflicting results about gene angiotensin converting enzyme I/D polymorphism and the degree of venous bypass graft degeneration, this study suggests an association between ACE genotype II and atherosclerosis of saphenous vein grafts, however, large samples considering clinical, demographic and ethnic profile are necessary to confirm these results.