Oral Poisoning Research Articles

Cyanide Medical Countermeasure Development: Assessing the Efficacy of Intramuscular Sodium Tetrathionate for the Treatment of Acute, Severe Cyanide Toxicity in Swine (Sus scrofa).

Given its availability and lethality, cyanide has potential for weaponization and thus has the attention of several governmental agencies. In large scale exposure scenarios, an effective countermeasure that can be administered quickly and in low volume intramuscularly may prove valuable because IV medications may have limited practical applications in these situations. Sodium tetrathionate, a potential cyanide antidote, is a compound that provides sulfur to rhodanese, the enzyme that detoxifies cyanide endogenously. Additionally, sodium tetrathionate has been reported to directly react with cyanide and is effective when administered intramuscularly. In this study, we assess the efficacy of sodium tetrathionate, when administered intramuscularly for the treatment of acute, oral cyanide poisoning in swine. We conducted a prospective trial approved by the 59th Medical Wing Institutional Animal Care and Use Committee comparing intramuscular sodium tetrathionate (n=6) to no treatment control (n=4) in animals (Sus scrofa) exposed to a lethal dose of oral potassium cyanide. Survival at 120 minutes was the primary outcome. Lactate, a cyanide toxicity biomarker, was measured. At the study end, all animals were euthanized in compliance with the Animal Welfare Act and the American Association for Accreditation of Laboratory Animal Care. Survival between groups was summarized using a Kaplan-Meier survival curve after comparing survival by log-rank, Mantel-Cox analysis. The Mann-Whitney U test was used for comparison of other variables between groups. At baseline animals were similar. There was 100% survival in the treatment group and 0% survival in the control group (P=0.0011). Serum lactate significantly increased in the control group (control: 5±0.9 vs. treatment: 2.1 ± 0.5 mmol/L at 20 minutes). Sodium tetrathionate (intramuscular) significantly improved survival in a large, swine model of acute, oral cyanide poisoning. Future studies will be directed at further assessing sodium tetrathionate as a potential medical countermeasure for cyanide poisoning.

A case of oral chloropicrin poisoning

Chloropicrin is a commonly used pesticide in agricultural production. The clinical manifestations of oral poisoning patients are complex, and the lesions involve multiple organs. At present, the specific pathogenic mechanism of such poisoning is not clear, and the treatment experience is insufficient, so there are certain difficulties in clinical diagnosis, treatment and treatment. In this paper, the data of a patient with oral chloropicrin poisoning treated in Yidu Central Hospital of Weifang City in April 2023 were summarized. The patient was admitted to our hospital for treatment in time, and his condition improved after Hemopurification, methylene blue reduction, organ support, infection prevention as well as other symptomatic support. Oral chlorophenol can cause lung damage, skin and mucous membrane damage, and may have certain effects on the nervous system and kidney. Early intervention, especially blood purification, is effective.

CURRENT STATUS OF THE LEGAL FRAMEWORK IN THE PLANT PROTECTION AND ECOLOGY AND HYGIENE MONITORING DOMAIN IN UKRAINE

Presently chemical plant protection products are an inseparable part of agriculture. They have not only their main purpose of plant assistance, but they also have the potential risk of negative impact on biocenosis species (birds, bees, soil microflora, algae, etc.) and the human body and its health respectively. The purpose of our study was to aggregate data on the existing legal framework of plant protection products in Ukraine and assess their ecology and hygiene monitoring. For analysis of the plant chemical protection, we used as the basic documents the regulatory framework of domestic legislation in toxicological and hygiene, ecology assessment, and ecology and hygiene monitoring domains. Currently, many laws and legal acts regulate the use of pesticides by state and private agricultural farms in Ukraine. This number of documents covers not only pre-registration studies of pesticides but also their post-registration monitoring in the environment. The key entities that control potential negative risks of these products through the regulations are the State Emergency Service, Ministry of Environmental Protection, Ministry of Health, Ministry of Housing and Communal Services, Ministry of Agriculture Policy, State Agency of Water Resources, State Committee of Land Resources, State Agency of the Forest Resources. However, the impact of xenobiotics on non-target species of the ecosystem is currently quite underestimated. The decline in biodiversity directly depends on the condition of the environment and the negative impact on it. Instances of acute oral, inhalation, or dermal poisoning of birds, bees, and aquatic invertebrates with pesticides are quite common and among the factors that affect public health. That is why ecology and hygiene monitoring is essential in line with the assessment of the risks of the inappropriate release of pesticides. These should be treated as a critical component of managing environmental sustainability and safety for public health. The implementation of global approaches to monitoring and controlling the post- registration impact of pesticides on the ecology and hygiene in Ukraine can also take into account the far-reaching consequences of their negative impact, accumulation, and environmental pollution. As a result, this will help to avoid adverse impacts on animal, insect, and bird populations, as well as human health.

Prognostic value of plasma diquat concentration in patients with acute oral diquat poisoning: a retrospective study.

Diquat poisoning is an important public health and social security agency. This study aimed to develop a prognostic model and evaluate the prognostic value of plasma diquat concentration in patients with acute oral diquat poisoning, focusing on how its impact changes over time after poisoning. This was a retrospective cohort study using electronic healthcare reports from the Second Hospital of Hebei Medical University. The study sample included 80 patients with acute oral Diquat poisoning who were admitted to the hospital between January 2019 and May 2022. Time-to-event analyses were performed to assess the risk of all-cause mortality (30 days and 90 days), controlling for demographics, comorbidities, vital signs, and other laboratory measurements. The prognostic value of plasma DQ concentration on admission was assessed by computing the area under a time-dependent receiver operating characteristic curve (ROC). Among the 80 patients, 29 (36.25%) patients died, and 51 (63.75%) patients survived in the hospital. Non-survivors had a median survival time (IQR) of 1.3(1.0) days and the longest survival time of 4.5 days after DQ poisoning. Compared with non-survivors, survivors had significantly lower amounts of ingestion, plasma DQ concentration on admission, lungs injury within 24 h after admission, liver injury within 24 h after admission, kidney injury within 24 h after admission, and CNS injury within 36 h after admission, higher APACHE II score and PSS within 24 h after admission (all p < 0.05). Plasma Diquat concentration at admission (HR = Exp (0.032-0.059 × ln (t))) and PSS within 24 h after admission (HR: 4.470, 95%CI: 1.604 ~ 12.452, p = 0.004) were independent prognostic factors in the time-dependent Cox regression model. Plasma DQ concentration at admission and PSS within 24 h after admission are independent prognostic factors for the in-hospital case fatality rate in patients with acute oral DQ poisoning. The prognostic value of plasma DQ concentration decreased with time.

Choice of poisoning agent and self-reported reasons for attempted suicide - A retrospective study

Suicide, a tragic loss of life, is a complex and multifaceted phenomenon, presenting a significant challenge to public health efforts globally. The prevalence of suicide, particularly due to pesticide self-poisoning in rural areas of low and middle-income countries, underscores its significant impact. Despite efforts to understand suicide, little is known about the diverse range of poisoning agents used and the socioenvironmental factors surrounding their selection. To study sociodemographic profile, choice of poisoning agent, and self-reported reasons for attempted suicide.This was a retrospective observational study. All the case records of patients admitted for attempted suicide by oral poisoning in a tertiary care hospital were accessed and assessed in detail regarding sociodemographic profile, choice of oral poisoning agent, and self-reported reasons for attempted suicide. The present study, comprising 146 cases of attempted suicide, revealed a predominant age group of 18-27 years, with a male majority and a high illiteracy rate. The agricultural sector, low socioeconomic status, and unmarried status were prevalent among the participants. Herbicides were the most commonly used poisoning agents, followed by insecticides. Immediate precipitants for suicide attempts were family quarrels.The findings of the current study align with previous research, indicating a vulnerable demographic of young, unmarried males from low socioeconomic backgrounds. The predominance of agricultural sector involvement underscores the accessibility of pesticides as suicide agents. Family conflict was cited to be the immediate precipitant for suicide attempt. Thus, addressing underlying sociodemographic stressors and regulating pesticide availability could mitigate suicide risk. Moreover, interventions targeting psychosocial support and coping strategies are crucial for preventing suicide attempts.This study presents insights into the choice of poisoning agents and self-reported motives in suicide attempts, shedding light on the underlying sociodemographic factors and immediate precipitants driving these behaviours.

Cullin-3 proteins be a novel biomarkers and therapeutic targets for hyperchloremia induced by oral poisoning

Oral poisoning can trigger diverse physiological reactions, determined by the toxic substance involved. One such consequence is hyperchloremia, characterized by an elevated level of chloride in the blood and leads to kidney damage and impairing chloride ion regulation. Here, we conducted a comprehensive genome-wide analysis to investigate genes or proteins linked to hyperchloremia. Our analysis included functional enrichment, protein–protein interactions, gene expression, exploration of molecular pathways, and the identification of potential shared genetic factors contributing to the development of hyperchloremia. Functional enrichment analysis revealed that oral poisoning owing hyperchloremia is associated with 4 proteins e.g. Kelch-like protein 3, Serine/threonine-protein kinase WNK4, Serine/threonine-protein kinase WNK1 and Cullin-3. The protein–protein interaction network revealed Cullin-3 as an exceptional protein, displaying a maximum connection of 18 nodes. Insufficient data from transcriptomic analysis indicates that there are lack of information having direct associations between these proteins and human-related functions to oral poisoning, hyperchloremia, or metabolic acidosis. The metabolic pathway of Cullin-3 protein revealed that the derivative is Sulfonamide which play role in, increasing urine output, and metabolic acidosis resulted in hypertension. Based on molecular docking results analysis it found that Cullin-3 proteins has the lowest binding energies score and being suitable proteins. Moreover, no major variations were observed in unbound Cullin-3 and all three peptide bound complexes shows that all systems remain compact during 50 ns simulations. The results of our study revealed Cullin-3 proteins be a strong foundation for the development of potential drug targets or biomarker for future studies.

Intestinal Lavage in the Complex Treatment for Corrosive Poisoning

BACKGROUND. The high incidence of various complications and the persistent mortality remain relevant to the search for new approaches in the treatment of victims with poisoning by corrosive substances. OBJECTIVE. To increase the effectiveness of the therapeutic complex in case of corrosive poisoning by adding intestinal lavage. MATERIAL AND METHODS. We examined 73 patients (34.3 % of women and 65.7 % of men) with acute oral poisoning by acetic acid (35.6 % of the total number of patients) and alkali — NaOH (64.4 %) aged from 27 to 65 years (43 (33.0; 56.0) years). Endoscopic examination before the start of treatment in all the patients revealed 2–3rd degree chemical burns of the mucous membrane of the mouth, pharynx, esophagus and stomach. The treatment of 38 patients (study group) included intestinal lavage using an enteral solution in a volume of 4.5 liters in the first 6 hours after taking the poison. The comparison group consisted of 35 patients who received standard therapy. The groups were identical in age, sex, type and severity of poisoning. RESULTS. Patients who received intestinal lavage showed a clear positive dynamics of the process of cleansing the affected areas of the mucous membrane of the esophagus and stomach from necrotic masses and the appearance of granulations already on the 5th day. In the comparison group, by this time there were no signs of healing of local defects in the mucous membrane of the esophagus and stomach. CONCLUSION. The inclusion of intestinal lavage in the treatment complex helps reduce the regeneration time of the mucous membrane of the gastrointestinal tract in case of damage and inflammation caused by poisoning by corrosive substances, a decrease in the incidence of extraintestinal complications, in particular pneumonia (by 17.1 %), which is reflected in a decrease in mortality (by 5.7%) and a decrease in the duration of hospitalization by 2.1 times.

Acute oral poisoning due to pretilachlor herbicide – a rare case report from Nepal

Introduction: Acute oral intoxication of pretilachlor, a synthetic chloroacetanilide herbicide, can present similar clinical manifestations of organophosphorus toxicity in humans. Case presentation: A 15-year-old male was admitted after suicidal ingestion of pretilachlor poison, with decreased consciousness and blood-mixed vomiting. Discussion: Pretilachlor is a colorless and odorless liquid that can cause neurotoxicity and carcinogenicity due to its prolonged exposure. The effects of acute oral exposure are mild and may differ from chronic exposure. Individuals exposed to chloroacetanilides may not show symptoms or experience vomiting and neurological issues. Clinical manifestations such as vomiting, excessive lacrimation, bowel and bladder incontinence, bradycardia, and hypotension can be observed in both organophosphate poisoning and pretilachlor poisoning, making accurate diagnosis challenging, particularly in resource-limited settings like ours. There is no specific antidote for pretilachlor poisoning. Treatment focuses on symptomatic care and monitoring the patient’s hemodynamics as per standard protocol. Conclusion: This case underscores the need for prompt stabilization, vigilant monitoring, and supportive care to ensure timely recovery in pretilachlor poisoning cases despite similarities with organophosphate poisoning. It emphasizes the importance of educating and raising awareness among physicians about potential mimickers like organophosphates.

Demographics and Clinical Characteristics Assessment of Severe Acute Toxic Ingestions in Pediatric Patients: A Single-Center Study in Jilin Province of China.

This study aimed to describe the demographic and clinical characteristics of severe acute toxic ingestions in children in Jilin Province and provide a reference for seeking effective measures to prevent poisoning accidents. The clinical data of patients diagnosed with acute toxic ingestions and who presented with severe life-threatening symptoms or organ dysfunction at the Pediatric Intensive Care Unit of the First Hospital of Jilin University were retrospectively analyzed. Patients with incomplete clinical medical records, unclear toxic substance, and loss to follow-up within 6 months of discharge are excluded. We sorted out these children's demographic characteristics, types of poisoning, clinical manifestations, treatment process, and follow-up, etc. This study enrolled 141 cases with no significant differences in sex and region; adolescents accounted for 44.68%. The most common poisons were pesticides and insecticides for rural areas and internal medication for urban areas. With poisoning details as a grouping variable, there was no statistical difference between sex groupings (χ2 = 6.018, P = 0.198) and no difference between region groups (χ2 = 3.775, P = 0.289). However, there were statistical differences between age groups (χ2 = 28.22, P = 0.001). In this research, patients younger than 6 years are mainly unintentionally poisoned, whereas the suicide rate of the urban group (P < 0.05), adolescents (P < 0.01), and girls (P < 0.01) has increased significantly; moreover, the suicide group is more likely to take more overdose medication or pesticides and insecticides (P < 0.01). In addition, there was a statistical difference between suicide and length of intensive care unit stay (r = 0.268, P < 0.01). A total of 90.78% of the patients were successfully discharged after comprehensive treatment. Children aged younger than 12 years had good psychological and intellectual development during the follow-up period, whereas adolescents diagnosed with depression often required long-term psychological and medication intervention. This study identified poisoning details in different ages, regions, and sex of acute severe oral poisoning in children from Jilin Province. The results presentation of different prevention priorities should vary among children of different ages and emphasize adolescent suicide being a reality in Jilin Province. There is an urgent need for further culture-specific research in this area.

Retrospective Evaluation of Poisoning Cases Followed Up in Pediatric Intensive Care Unit-A 12-Year Experience in a Single Center.

Poisonings constitute an important part of preventable morbidity and mortality in pediatric intensive care units (PICUs) and hospitalizations. However, information on poisoning requiring intensive care is limited. This study aimed epidemiological evaluation of poisoning cases treated in the PICU in a single center. The records of 504 patients admitted to the PICU due to acute poisoning between 2010 and 2022 were retrospectively reviewed. Data were evaluated using descriptive methods and the χ2 test, and statistical differences with P value <0.05 were considered significant. The age range of the patients ranged from 1 month to 216 months (18 years), and the rate of girls was 53.2% (n = 268), whereas the rate of boys was 46.8% (n = 236). The mean age was 4.4 ± 4.3 years for boys, 6.7 ± 5.8 years for girls, and 5.6 ± 5.3 years for all patients. It was determined that 79.6% of the cases were poisoned by accident and 20.4% by suicide. A total of 76.7% of the patients who were poisoned for suicide were girls and 23.3% were boys. The mean age of these patients was 14.3 ± 3.0 years. On the other hand, 47.1% of the children who were accidentally poisoned were girls and 52.9% were boys, and the mean age of these children was 3.4 ± 2.9 years. Although 79.9% of poisonings occurred at home, the causative agent was oral poisoning in 97.4% of the cases. Approximately two thirds (69.2%) of the cases were drug-related, whereas 30.8% were related to nondrug substances. In drug-related poisonings, central nervous system drugs (35.8%) were the most common agent, followed by analgesic/antipyretic (20.9%) agents, whereas among the nonpharmaceutical factors, insecticides (agricultural pesticides, rat poison, pesticides, etc) were the most common, followed by poisonous herbs (beetleweed, widow's weed, cannabis, etc). The mean admission time of the patients to the hospital was 6.3 ± 8.4 hours, and the mean length of stay in the intensive care unit was 1.6 ± 1.3 days. In the 12 years of our study, only 3 patients died due to poisoning, and our mortality rate was 0.5%. Four patients (0.7%) were referred to the Alcohol and Drug Addicts Treatment and Research Center. In this study, in which we retrospectively analyzed the profiles of poisoning cases hospitalized in the PICU for 12 years, we determined that poisonous weeds were the major factor in accidental poisonings, and suicidal poisonings were above the expected rates even at the young age group such as 8-12 years old. These results show the importance of determining the poisoning profile of the health care service area.

A clinical case of acute methadone poisoning in an infant child

Introduction. The article considers a case of a favorable outcome of severe acute oral methadone poisoning complicated by the development of acute respiratory failure and toxic hypoxic encephalopathy.&#x0D; Clinical observation. A clinical case of acute oral (through breast milk) methadone poisoning of severe degree in a child of 9 months and 6 days with the development of toxicohypoxic encephalopathy is presented. The narcotic substance entered the body once, after breastfeeding from mother to child. Acute poisoning in the child was manifested by respiratory insufficiency with impaired consciousness (did not respond to pain stimuli, short-term apnea was noted, saturation of arterial blood with oxygen (SpO2) was 62%).&#x0D; Intensive therapy included infusion, antidote, detoxification therapy, correction of acid-base state disorders, water-electrolyte balance, hypoxic disorders.&#x0D; Conclusion. Methadone-induced respiratory failure is characterized by dose dependence and the possibility of relief after administration of naloxone.&#x0D; In our clinical case, a specific antidote was used at the prehospital and hospital stages and an activator of metabolic cellular processes – riboxin in combination with B vitamins: thiamine chloride (vitamin B1) and pyridoxine hydrochloride (vitamin B6).&#x0D; In conclusion, it should be noted that the relevance of acute methadone poisoning in childhood remains high. Taking into account the mechanisms of the toxic effect of methadone, it is possible to formulate the directions of intensive therapy: maintenance of life support systems, rational antidote therapy, the fight against hypoxia and its consequences.

Retrospective Analysis of Death Cases of Oral Diphenidol Hydrochloride Poisoning.

To explore the characteristics of postmortem examination, chemical examination and scene investigation of deaths caused by oral diphenidol hydrochloride poisoning, and so as to provide a reference for proper settlement and prevention of such deaths. The data of 22 deaths caused by oral diphenidol hydrochloride poisoning in a city from January 2018 to August 2020 were collected, including case details, scene investigations, autopsies, chemical examinations and digital evidence. Thirty-one cases of deaths caused by oral diphenidol hydrochloride poisoning reported in previous literature were also collected. In the 53 oral diphenidol hydrochloride poisoning death cases, 50 cases were suicide, 2 cases were accidental, while 1 case was undetermined. Fifty-two cases were found in the medical records or crime scene investigation reports with doses ranging from 775 mg to 12 500 mg, and 23 deceased were detected with postmortem blood concentrations ranging from 2.71 mg/L to 83.1 mg/L. Clinical symptoms were recorded in 6 patients, including conscious disturbance and convulsion. Among the 45 cases which were performed with external examination, 23 cases autopsied. Most of the deceased of oral diphenidol hydrochloride poisoning were suicide. No significant correlation was found between dose and blood concentration through the retrospective analysis of cases.

Case report: occupational acute poisoning caused by the accidental release of lambda-cyhalothrin

Lambda-cyhalothrin is a new-generation pyrethroid II insecticide that is neurotoxic. Most domestic and international reported cases are of oral poisoning, whereas few cases of inhalation and skin absorption poisoning have been reported. Here, we report the case of a 46-year-old man who was poisoned via dermal absorption and inhalation due to the rupture and leakage of the lambda-cyhalothrin pipeline. The patient developed a skin burning sensation, eyeball pain, and upper-limb tremor after exposure. After admission, the patient developed cough, sputum expectoration, chest tightness, and other symptoms. Lung computerized tomography indicated double pneumonia and the patient's electroencephalogram result was abnormal; the patient's condition improved after treatment.

A single post-exposure oxime RS194B treatment rapidly reactivates acetylcholinesterase and reverses acute symptoms in macaques exposed to diethylphosphorothioate parathion and chlorpyrifos insecticides.

Millions of individuals globally suffer from inadvertent, occupational or self-harm exposures from organophosphate (OP) insecticides, significantly impacting human health. Similar to nerve agents, insecticides are neurotoxins that target and inhibit acetylcholinesterase (AChE) in central and peripheral synapses in the cholinergic nervous system. Post-exposure therapeutic countermeasures generally include administration of atropine with an oxime to reactivate the OP-inhibited AChE. However, animal model studies and recent clinical trials using insecticide-poisoned individuals have shown minimal clinical benefits of the currently approved oximes and their efficacy as antidotes has been debated. Currently used oximes either reactivate poorly, do not readily cross the blood-brain barrier (BBB), or are rapidly cleared from the circulation and must be repeatedly administered. Zwitterionic oximes of unbranched and simplified structure, for example RS194B, have been developed that efficiently cross the BBB resulting in reactivation of OP-inhibited AChE and dramatic reversal of severe clinical symptoms in mice and macaques exposed to OP insecticides or nerve agents. Thus, a single IM injection of RS194B has been shown to rapidly restore blood AChE and butyrylcholinesterase (BChE) activity, reverse cholinergic symptoms, and prevent death in macaques following lethal inhaled sarin and paraoxon exposure. The present macaque studies extend these findings and assess the ability of post-exposure RS194B treatment to counteract oral poisoning by highly toxic diethylphosphorothioate insecticides such as parathion and chlorpyrifos. These OPs require conversion by P450 in the liver of the inactive thions to the active toxic oxon forms, and once again demonstrated RS194B efficacy to reactivate and alleviate clinical symptoms within 60 mins of a single IM administration. Furthermore, when delivered orally, the Tmax of RS194B at 1-2h was in the same range as those administered IM but were maintained in the circulation for longer periods greatly facilitating the use of RS194B as a non-invasive treatment, especially in isolated rural settings.

Use of Antibiotics in Poisonous Ingestions of Corrosives and Organophosphates: A Retrospective Cohort Study.

The use of antibiotics following oral poisoning by corrosives and organophosphates is controversial. We assessed the clinical outcomes of using antibiotics in acute poisonous ingestion involving corrosives or organophosphates by conducting a retrospective cohort study of patients presenting to the emergency department following ingestion of corrosives or organophosphates who received either antibiotics or supportive care. The endpoints included clinical stability, length of stay (LOS), and mortality. Of 95 patients, 40 received antibiotics and 55 received supportive care. The median age was 2.1 and 2.7 years, respectively (p = 0.053). Bacterial growth was shown in only 2 of 28 cultures (both were respiratory), but with hospital-acquired organisms as it was shown ≥4 days post-admission. Clinical stability rates were 60% and 89.1% in the antibiotic and supportive care groups, respectively (p < 0.001). Median LOS was 3 vs. 0 days (p < 0.001), and no mortality was recorded. NG/G-tube placement was the only factor associated with clinical failure (OR, 20.97; 95% CI, 2.36-186.13). Antibiotic use was not associated with higher chances of clinical stability, which may suggest that their use was unnecessary. Clinicians are encouraged to use antibiotics wisely, and only in the presence of a clear indication of an infection. This study provides a basis for future prospective studies to confirm its findings.

Avicenna's clinical toxicology approach and beneficial materia medica against oral poisoning.

Considering the rich background of Persian Medicine in the use of materia medica for the treatment of diseases, the huge burden of oral poisonings in the world, and the urgent need to find scientific solutions, the purpose of this study was to determine Avicenna's approach toward clinical toxicology and his proposed treatments for oral poisonings. In Al-Qanun Fi Al-Tibb, Avicenna addressed the materia medica for the treatments of oral poisonings after explaining the ingestion of different toxins and also elucidating the clinical toxicology approach toward poisoned patients. These materia medica were from different classes including emetics, purgatives, enemas, diaphoretics, antidiarrheals, inhaled drugs, sternutators, anticoagulants, antiepileptics, antitussives, diuretics, cooling drugs, stimulants, cardiotonic drugs, and heating oils. By applying different therapies, Avicenna endeavored to attain main goals in clinical toxicology that are comparable with modern medicine. They included removing the toxins from the body, decreasing the severity of the deleterious effects of toxins on the body, and counteracting the effects of toxins inside the body. Aside from introducing different therapeutic agents that played an important role in the treatment of oral poisonings, he emphasized the ameliorating effects of nutritive foods and beverages. Further research using other Persian medical resources is recommended to elucidate the applicable approaches and treatments for different poisonings.

Investigating the Efficacy of Sucralfate in the Treatment of Oral Paraquat Poisoning: A Randomized Double-Blind Clinical Trial

Background: There is a high prevalence of intentional paraquat poisoning especially for suicide reported from many part of the world, with its negative effects on the lungs, kidneys, heart, and digestive system. This study was planned, aimed at investigating the efficacy of sucralfate in the treatment of oral paraquat poisoning with respect to its clinical outcomes. Methods: A randomized double-blind clinical trial was conducted on 70 patients, suffering from oral paraquat poisoning. These patients were divided into two groups of 35 each. Subsequently, gastric lavage was performed for each patient in the control and treatment groups with 5g sucralfate mixed in tap water in the treatment group, but with tap water alone in the controls. The patients’ hemodynamic and laboratory parameters were evaluated and recorded, on admission and the hospital discharge dates. In addition, the patients’ final clinical outcome, including survival or death was also recorded. Results: The results of the present study revealed that the patients’ hemodynamic parameters, coagulation factors, renal and liver laboratory findings did not differ significantly between the two groups (P&gt;0.05). Moreover, 45.7% and 31.4% of the patients died in the control and treatment groups, respectively (P&gt;0.05). Conclusions: The sucralfate administration did not have a significant effect on the patients’ hemodynamic and laboratory parameters. The survival of patients in the treatment group was slightly higher than those in the control group. Also the patients in the treatment group had less pulmonary and renal complications in the long-term than those in the control group.

Emergency management of oral corrosive poisoning based on case study

Poisoning is one of the reasons for which Emergency Medical Teams are called. They range from mild and asymptomatic incidents to those complicated by shock and Sudden Cardiac Arrest. The causes of poisoning may be related to accidental contact with a potentially poisonous substance, but also to deliberate use or exposure to poison for suicidal purposes. Some of these events are classified as situations subject to the assessment of forensic specialists. Rescue procedures in case of poisoning depend on the type of poison, the course of poisoning and the clinical signs presented by the patient. Medical Emergency Procedures should always be based on the pursuit of circulatory and respiratory stability of the patient. Pre-hospital management is aimed at limiting further absorption of the poison and, if possible, implementing causal treatment through the supply of antidotes. In the absence of a specific antagonist, the patient should be treated symptomatically.

Study of profile, pattern and outcomes of oral poisoning cases admitted in emergency department of Janakpur provincial hospital, Nepal

Study of profile, pattern and outcomes of oral poisoning cases admitted in emergency department of Janakpur provincial hospital, Nepal

Clinical features of 86 cases of acute diquat poisoning

To explore the clinical features of acute diquat (DQ) poisoning, and further improve the awareness of acute DQ poisoning. A retrospective analysis was performed on the clinical data of patients with acute DQ poisoning diagnosed in the emergency department of the Second Hospital of Hebei Medical University from January 1, 2019 to December 31, 2021. The clinical data included age, gender, exposure routes, presence of pesticides (drugs) mixture poisoning, dosage of poison, the time from taking poisoning to admitting in the emergency department, clinical manifestations, laboratory data, treatment, hospital days, prognosis and survival days. The number of cases who firstly complained of acute DQ poisoning in the past three years were 19 cases in 2019, 28 cases in 2020, and 51 cases in 2021. A total of 12 patients were excluded due to being diagnosed paraquat (PQ) poisoning by toxicology detection. Finally, 86 cases of acute DQ poisoning were included, including 80 cases of oral DQ poisoning, 1 case of intramuscular injection, 1 case of binocular contact and 4 cases of dermal exposure. In 80 cases of oral DQ poisoning, there were 70 cases of diquat poisoning alone (42 cases survived, 28 cases died) and 10 cases of pesticide mixture poisoning (6 cases survived, 4 cases died). The time from oral poisoning to admitting in the emergency department was 0.5-96.0 hours, with an average of (8.6±5.8) hours. The time of intramuscular injection poisoning to admitting in the emergency department was 3 hours. The time of dermal exposure to admitting in the emergency department was relatively long, with an average of 66.1 hours. The time from oral simple DQ poisoning to death was 12.0-108.0 hours, and the time from oral mixed DQ poisoning to death was 24.0-576.0 hours. A total of 70 patients with oral diquat poisoning alone presented various degrees of multiple organ injuries. All patients presented gastrointestinal symptoms such as nausea and vomiting. Renal injury and central nervous system injury were the most significant and closely related to the prognosis. Acute oral DQ poisoning can cause to multiple organ injuries, and the clinical manifestations are related to the dose of the poison. In severe cases, acute renal failure and refractory circulatory failure occur within 24 hours after poisoning, and severe central nervous system injury with disturbance of consciousness as the primary manifestation occurs within 36 hours, followed by multiple organ failure until death.