Investigation Paraquat Poisoning in Southwest of Iran - from Sign to Mortality and Morbidity.

Introduction: Paraquat is the most important herbicide of bi-prides class which is used widely in agriculture part but in many countries such as Iran, this herbicide use for suicide. This study was conducted with the aim to investigating Paraquat poisoning in Khuzestan province of Iran. Material and methods: This study is a retrospective and statistic investigation in which 159 files of toxicity cases were investigated during 2004 to 2015. The patients were contacted to inquire into their health, after completing a questionnaire, the data was gathered and analyzed using SPSS software. Result: Of 159 patients studied for paraquate poisoning, 65 patients (40.9%) were female and 94 patients (59.1%) were male and 138 cases (86.8%) of patients were 15-29 years and 150 patients (66%) were single. rate of poisoning due to suicide was 96.9%. First signs in this patients was Nausea and Vomiting, Mouth and throat ulcers, Mouth and throat erythema and Mouth and throat Irritation. 113 patients (71.1%) were treated by specialized medicines without antibiotics. 73 patients (45.9%) developed acidosis during hospitalization, and 13 patients (8.2%) experienced alkalosis. Sixty-three cases (39.6%) died. Conclusions: The current study showed that paraquet is one of the deadliest poisons in Khozestan province which is used frequently for suicide. Considering the high importance of this substance in agriculture, it cannot be replaced by other toxins. Furthermore, this study showed that drug therapy has not continued after discharge of survived patients.

Applications of cardiotoxicity in breast cancer: a meta-analysis.

INTRODUCTION: Breast cancer is the most common type of cancer in women. Many antineoplastic agents used to treat breast cancer have potentially cardiotoxic effects and may lead to chemotherapy induced cardiomyopathy and heart failure. We conducted a meta-analysis to clarify the applications of cardiotoxicity in breast cancer. EVIDENCE ACQUISITION: A published literature search was performed through PubMed, Cochrane Library, Medline, and Science Citation Index Expanded databases for articles published in English. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using random or fixed effects models. Heterogeneity was assessed using χ2 and I2 statistics. We performed a formal meta-analysis using summary measures from these studies. EVIDENCE SYNTHESIS: In total, 9 published studies were included in the final analysis. The combined analysis revealed that there was non-significant regardless of the statistical ejection fraction (OR=0.98, 95% CI: 0.63-1.54, P=0.96) and left ventricular ejection fraction (OR=1.04; 95% CI: 0.69-1.56, P=0.85) decline method used. Additionally, the pooled OR was 0.99 (95% CI: 0.79-1.28) for the trastuzumab plus lapatinib combination, and 1.00 (95% CI: 0.88-1.13) for the trastuzumab plus pertuzumab combination. CONCLUSIONS: In this meta-analysis, there was evidence indicated that there was not a significant decrease on LVEF and EF in patients who received trastuzumab plus lapatinib and trastuzumab plus pertuzumab combination. Our study suggests that the combination of two anti-HER2 agents does not significantly increase the risk for adverse compared with anti-HER2 monotherapy in patients with adequate cardiac function prior to start of therapy.

Evaluation of Hospitalized Intractable Epileptic Children with SPECT Scan in Ahvaz, South West of Iran.

INTRODUCTION: Seizures are the most frequent neurologic disorder seen in childhood. Epilepsy is a group of disorders that includes an abnormally increased susceptibility to seizures. AIM: To examine the effectiveness of SPECT (Single Photon Emission Computerized Tomography) in detecting seizure foci in 21 Iranian children who had medically refractory epilepsy. MATERIALS AND METHODS: Children between 2 to 15 years of age with uncontrolled seizures were investigated using SPECT scan as a standardized protocol. RESULTS: In 16 cases (76.2%), likely seizure foci were evident, as were seen in the form of decreased regional blood flow, while in 5 cases (23.8%), SPECT scan results were normal. Left temporal lobe was the most common area which had decreased regional blood flow. CONCLUSION: SPECT scan can potentially be used to investigate children with uncontrolled seizures.

The Success Rate of Pediatric In-Hospital Cardiopulmonary Resuscitation in Ahvaz Training Hospitals.

Research Objective. This study determined the outcome of cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest and factors influencing it in two training hospitals in Ahvaz. Method. Patients hospitalized in the pediatric wards and exposed to CPR during hospital stay were included in the study (September 2013 to May 2014). The primary outcome of CPR was assumed to be the return of spontaneous circulation (ROSC) and the secondary outcome was assumed to be survival to discharge. The neurological outcome of survivors was assessed using the Pediatric Cerebral Performance Category (PCPC) method. Results. Of the 279 study participants, 138 patients (49.4%) showed ROSC, 81 patients (29%) survived for 24 hours after the CPR, and 33 patients (11.8%) survived to discharge. Of the surviving patients, 16 (48.5%) had favorable neurological outcome. The resuscitation during holidays resulted in fewer ROSC. Multivariate analysis showed that longer CPR duration, CPR by junior residents, growth deficiency, and prearrest vasoactive drug infusion were associated with decreased survival to discharge (p < 0.05). Infants and patients with respiratory disease had higher survival rates. Conclusion. The rate of successful CPR in our study was lower than rates reported by developed countries. However, factors influencing the outcome of CPR were similar. These results reflect the necessity of paying more attention to pediatric CPR training, postresuscitation conditions, and expansion of intensive care facilities.

Study of laboratory profile in patients with aluminium phosphide poisoning in the southwest of Iran from 2010 to 2015.

Introduction: Aluminium phosphide or rice tablet is one of the most common pesticides around the world. The substance releases phosphine gas in the presence of water, steam or stomach acid which can lead to poisoning. Phosphine poisoning is more about suicide the number of which is increasing day by day. Two-thirds of patients lose their lives. The aim of this study was to evaluate the data on the clinical epidemiology and laboratory changes in patients poisoned with rice tablets. Material and methods: A total of 23 patients poisoned by aluminium phosphide who referred to Ahvaz Razi hospital within the period of 2010-2015 were studied. The data were analyzed using descriptive statistics and statistical tests. Results: The mean age of the patients was 27.2 ±7.3 years and 60.9% of the patients were male. 8.7% of the patients had hyponatremia and 21.7% of the patients had hypokalemia. In the majority of cases the amount of sodium and potassium was normal. 91% of patients had acidosis and serum bicarbonate was reduced in the majority of cases. The average interval between poisoning and admission was 1.48 ±0.76 hours. Conclusions: The pattern to change the electrolytes and other laboratory factors could be a good marker of the severity of the poisoning and the clinical conditions of the patient, which requires more specific research to prove the process.

Relationship between high-sensitivity C-reactive protein serum levels and the severity of coronary artery stenosis in patients with coronary artery disease.

BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) inflammatory biomarker is one of the best informative markers of prognosis of coronary artery disease (CAD) that has been studied. Some studies have found that hs-CRP has a direct correlation with CAD. The aim of this study was to determine the relationship between serum levels of hs-CRP and the severity of coronary artery stenosis in patients with stable and unstable angina. METHODS: In a cross-sectional study, 150 patients undergoing coronary angiography in Golestan Hospital Ahvaz, Iran in 2012, were studied in three groups of stable angina (n = 50), unstable angina (n = 50), and normal coronary angiography (n = 50). Hs-CRP levels were measured in patients before angiography by enzyme-linked immunosorbent assay method, were compared between the three groups and its correlation with the degree of stenosis was evaluated. RESULTS: The mean levels of hs-CRP in the stable angina group, unstable angina group and the group with normal coronary angiography were 2.46 ± 1.79, 4.84 ± 3.38, and 2.95 ± 2.57 mg/L, respectively. The results show that the mean levels of hs-CRP in patients with unstable angina was significantly higher compared to patients with stable angina (P < 0.050) and patients with normal coronary angiography (P < 0.001). However, a statistical difference between the mean CRP levels in patients with stable angina and patients with normal angiography results was not seen (P > 0.050). A significant relationship between arterial stenosis points and hs-CRP levels in patients with stable angina was not seen (P = 0.985). CONCLUSION: The findings suggest that it seems hs-CRP level in patients with unstable angina were significantly higher than those in patients with stable angina and patients with normal coronary angiography. It also appears that the level of hs-CRP in patients with unstable angina is associated with the severity of coronary stenosis. Given the finding of consistent results, the use of hs-CRP as a prognostic factor in these patients may be useful.

Cardiac Surgery Anesthesia And Systemic Inflammatory Response.

Cardiac surgery is associated with the development of a systemic inflammatory response. Inflammation represents the response of the body to tissue injury and in normal circumstances is a controlled humoral and cellular response that will lead to control of infection and wound healing. In some instances this response may become exaggerated, ultimately leading to additional tissue injury and the development of organ dysfunction. In this paper we discuss about relationships between cardiac surgery anesthesia and systemic inflammatory response.