Search

Aim: Early radiologic evaluations including noncontrast computed tomographic (CT) scan of the brain have been reported to be useful in the diagnosis and management of the intoxicated patients. Changes in the brain CT scan of the acute opium overdose patients have little been studied to date. This study aimed to evaluate changes of the brain CT scans in the acute opium overdose patients. Methods: In this retrospective study, medical records of all acute opium overdose patients hospitalized in Loghman-Hakim Poison Hospital in Tehran, Iran, between September 2009 and September 2010 were identified. Those who had undergone noncontrast brain CT within the first 24 hours of hospital presentation were included. Patients with any underlying disease, head trauma, underlying central nervous system disease, epilepsy, and multidrug ingestion were excluded. The patients' demographic information, vital signs, and laboratory data at presentation were extracted and recorded. The data were analyzed using SPSS software version 17 (SPSS, Chicago, IL). Results: A total of 71 patients were included. Fifty-eight patients (80.5%) survived, and 10 (13.8%) died. Fourteen cases (19.7%) had abnormal CT findings including 8 cases of generalized cerebral edema and 6 cases of infarction/ischemia. There were no statistically significant differences between the patients with and without abnormal CT scan findings with respect to age, sex, systolic and/or diastolic blood pressures, pulse rate, respiratory rate, occurrence of seizures, pH, Pco(2), HCO(3)(-), blood sodium level, and blood glucose level (all P values were > .05). However, a statistically significant difference was found between these patients in terms of outcome (P = .007). Conclusion: Abnormal brain CT findings are detected in about 20% of the acute opium overdose patients who are ill enough to warrant performance of the brain CT scan and associate with a poor prognosis in this group of the patients. [ABSTRACT FROM AUTHOR]

In the patients with medication poisoning, diagnosis and treatment may be complicated due to the decreased level of consciousness or lack of the patient cooperation. In this review, we tried to assess the role of ultrasonography in detection of the ingested medication in the stomach of the patients with suspected medication poisoning. Of the studies performed in this regard, only one managed to determine the extended phenytoin capsules in the stomach of a poisoned patient. In actual acute poisoning -- even in the hands of an experienced ultrasonographer -- detection of the medications in the patients' stomach seems to be difficult due to the presence of the food or lack of the water in their stomach. Also, after dissolution of the tablets or capsules or their passage from the pylorus, they can not further been visualized by ultrasound. We, therefore, conclude that ultrasonography is not an appropriate tool for diagnosis of the medication ingestion in acute poisoning. [ABSTRACT FROM AUTHOR]

The article describes the case of a 70-year-old male patient who was bitten by a centipede, Scolopendra spp. which was treated with lidocaine, pentazocine, hydrocortisone, chlorpheniramine, hand elevation and tetanus prophylaxis.

A letter to the editor is presented in response to the article "Lipid Emulsion Improves Glasgow Coma Scale and Decreases Blood Glucose Level in the Setting of Acute Non-Local Anesthetic Drug Positioning-A Randomized Controlled Trial," by E. Taftachi and colleagues in the 2012 issue.

This article describes a case study of shoulder dislocation in a tramadol-intoxicated patient complaining of pain and stiffness of the shoulder after a seizure.