Search

Inhibition of cholinesterase (ChE) activity has been long considered as the main diagnostic method of organophosphate (OP) and carbamate pesticides poisoning; however, it has been shown that ChE activity may also be altered due to exposure to other non‐organophosphorus toxicants and variety of different medical conditions. Hence, to avoid misdiagnosis, we aimed to systematically review available documents to look for additional biomarkers of OP and carbamate poisoning. The electronic databases in addition to Google scholar were searched for eligible articles on March 2022 using "organophosphate," "carbamate," and "biomarker" including all their similar terms. After collecting the relevant documents, the data were extracted and described qualitatively. In total, data of 66 articles from 51 human and 15 animal studies were extracted. Findings demonstrated that enzymes such as β‐glucuronidase, neuropathy target esterase, amylase, and lipase, in addition to hematological indicators such as CBC, CRP, lactate dehydrogenase, and CPK have high sensitivity and accuracy in the diagnosis of OP poisoning. Findings suggest that using various markers for diagnosis of OP intoxication is helpful for appropriate management, and early identifying the patients at risk of death. The suggested biomarkers also help to avoid misdiagnosis of OP poisoning with other similar conditions. [ABSTRACT FROM AUTHOR]

Introduction: Substance abuse has been recognized as a national problem in Iran, in which poisoning with pharmaceutical drugs, opioids and alcohols is common. Due to the lack of a comprehensive information system related to Substance abuse, it is challenging to manage the treatment and follow-up of patients caused by drug abuse poisoning. The purpose of this research was to develop a registry system for substance abuse poisoning in - Urmia University of Medical Sciences. Material and Methods: This research is a practical development study that was done in 4 phases. In the first phase, minimum data set (MDS) of the system were determined. In the second phase, the registration system was designed. The third phase includes the implementation of the system, and finally, the system was evaluated by QUIS questionnaire. Results: A total of 58 data elements in 6 classes were recognized as essential for this system from the point of view of experts. The system was implemented on the ASP.NET platform using C# language and SQL Server database in the poisoning department of Taleghani Hospital in Urmia. The evaluation of usability of the system showed score obtained in the 6 main categories were in set of terms of the system 8.52, screen 8.36, ability to learn 8.8, general functionality 8.04, user interface 7.98, and the general interaction is 7.73 respectively. Conclusion: Considering the capabilities of the system for registering poisonings caused by drug abuse, it seems necessary to implement this system in the form of a national network, in order to make the necessary interventions to control drug abuse while using resources efficiently [ABSTRACT FROM AUTHOR]

Background: Hemodialysis is one of the most common extracorporeal procedures that is used for treatment in some intoxicated patients. Therefore, epidemiology and prognostic factors in hemodialysis intoxicated patients were evaluated. Methods: In this cross-sectional study, all hospitalized patients, who underwent hemodialysis admitted to the poisoning center at Taleghani Hospital, Urmia, Iran, from 2016-2020 were evaluated. The demographic data, clinical and some laboratory findings in survivor and non-survivor group were studied retrospectively and evaluated in relation to outcome of the patients. Then, the data were analyzed by descriptive and analytical statistics using SPSS v 16. Results: In this study, 200 (158 males, 42 females) patients were evaluated. The mortality rate was 31.5% (79% males, 21% females). Toxic Alcohol (methanol, ethylene glycol) 86 (43%) and paraquat 58 (29%) were the main causes of poisoning among the patients treated with hemodialysis. Loss of consciousness 82 (41%) and Gastrointestinal discomforts (nausea, vomiting, and epigastric pain) 68 (34%) were the most signs and symptoms in patients. Statistically significant relationships (p value < 0.05) were found between the acute renal failure and causes of poisoning. Finally, 137 patients (68.5%) were discharged with full recovery and 63 cases (31.5%) were died. Conclusion: Because extracorporeal therapies such as hemodialysis are one of the main procedures in the treatment of poisoning and there are limited studies on the prevalence of hemodialysis in poisoned patients, this study was carried out to evaluate hemodialysis in intoxicated patients whose data can be used more widely in the future. However, more studies are required to explore the prevalence of hemodialysis in poisoned patients. [ABSTRACT FROM AUTHOR]

Background: Acute organophosphate poisoning (AOPP) is related to several clinical complications that may be fatal. The aim of this study was to evaluate the effects of demographic, clinical and laboratory findings on AOPP outcome. Methods: In this retrospective cross-sectional study, medical records of all patients with AOPP admitted to Imam Reza Hospital, Mashhad, Iran, were reviewed from January 2016 to December 2017. Demographic data, clinical presentations, erythrocyte cholinesterase (RBC-ChE) and serum cholinesterase (S-ChE) activities were studied and evaluated in relation to clinical outcome of the patients. Results: A total of 64 patients (37 male, 27 female) were evaluated from whom 6 patients (9.4%) died. Statistically significant relationships were found between the outcome of the patients and RBC-ChE activity (p =0.008), intratracheal intubation (p=0.003), and abnormal blood pressure (p =0.009). Despite the lower mean S-ChE levels in the deceased patients and loss of consciousness in 42.2% (n=27) of patients, there was no statistically significant correlations between these factors and patients' outcome (p =0.147, p =0.075, respectively). Conclusion: RBC-ChE activity, need for intratracheal intubation, and abnormal blood pressure on admission were important predictive factors in the clinical outcome of AOPP. Although S-ChE activity, level of consciousness, white blood cell count and blood glucose level on admission provide useful information, these data had no prognostic value in patients with AOPP. [ABSTRACT FROM AUTHOR]

Purpose: Paraquat is a contact herbicide which is highly toxic to human. Deliberate self-poisoning with paraquat continues to be a major public health concern in many developing countries. This study aimed to evaluate the data on cases of acute paraquat poisoning and to compare different variables between survivors and non-survivors., Methods: In this cross sectional study, medical records of all paraquat intoxicated patients were reviewed at Taleghani hospital of Urmia, Iran, from 2007 to 2013, retrospectively. Demographics, clinical features and laboratory findings were evaluated. The variables compared between survivors and non-survivors were the amount of paraquat ingested, occurrence of vomiting after ingestion, time and place of hospital admission, length of hospital stay, leukocytosis, serum creatinine level and the outcomes., Results: A total of 41 patients were evaluated. The mean ± standard deviation of patients' age were 31.6±16.9 years. The Length of hospital stay was 5.75±4.6 days. Most poisonings occurred in spring and summer. The in-hospital fatality rate was 46.3%. Statistically significant associations were found between the outcome of patients and the amount ingested (P=0.001), vomiting (P=0.004), early need to intensive cares (P=0.009), leukocytosis (P=0.001), serum creatinine levels (P=0.001), manifestations of acute hepatic (P<0.001) and respiratory failure (P=0.007)., Conclusion: Ingestion of more than 30 ml, prompt vomiting, early need to intensive cares, leukocytosis, and multi-organ failures are major determinants for fatal outcome of paraquat poisoning. It may be useful to educate health professionals and the general population about the serious consequences of exposure to paraquat.

Objective: As chief prescribers, physicians could have a key role in rational drug use. Core prescribing indicators of all physicians have been evaluated in the Islamic Republic of Iran for several years, but no study has assessed the effects of academic status of doctors on their prescribing behaviors. We aimed to compare prescribing indicators of two groups of academic and non-academic specialist physicians working in Urmia, Iran., Methods: In this cross-sectional study, prescribing indicators of the total number of 37 academic and 104 non-academic specialist physicians in six medical specialties (infectious diseases, psychiatry, otorhinolaryngology, gynecology, pediatrics and general surgery) were studied during 2012 using Rx-analyzer, a dedicated computer application. A set of five quality indicators was used based on the World Health Organization and International Network for Rational Use of Drugs recommendations., Findings: Totally, 709,771 medications in 269,660 prescriptions were studied. For academic and non-academic specialist physicians, the average number of medications per prescription was 2.26 and 2.65, respectively. Similarly, patients' encounters with injectable pharmaceuticals were 17.37% and 26.76%, respectively. The corresponding figures for antimicrobial agents were 33.12% and 45.46%, respectively. The average costs of every prescription were 6.53 and 3.30 United States Dollar for academic and non-academic specialist physicians, respectively. All the above-mentioned differences were statistically significant., Conclusion: Better prescribing patterns were observed in academic specialist physicians. However, they prescribed medications that were more expensive, while the reason was not investigated in this study. Further studies may reveal the exact causes of these differences.