Rice Tablet Research Articles

The Protective Effect of Ethanolic Extract of Olive Leaf on Aluminum Phosphide-Induced Cardiac Toxicity in Rats

Background: The purpose of this study is to evaluate a treatment for aluminum phosphide (ALP) poisoning, which is known as “rice tablet”. Methods: In the present study, the impact of different doses of ethanolic extract of olive leaves (100, 200, and 400 mg/kg) on ALP (120 mg/kg)-induced cardiotoxicity was evaluated in anesthetized-gastrotomized adult male Wistar rats. Thirty-five rats were randomly assigned into five groups (n=7) as follows: control (AC) and treatment groups [ALP+Olea100 (AO100), ALP+Olea 200 (AO200), and ALP+Olea 400 (AO400)]. Physiological data including blood pressure, heart rate, electrocardiogram (ECG), as well as oxidative stress markers were measured in heart tissues. Results: ALP-intoxication led to perturbed normal ECG and increased oxidative stress. Administration of olive leaf extract at various concentrations, however, mitigated bradycardia after 90 minutes, following ALP-intoxication (in AO200), hypotension (in AO100), and cardiac conduction disturbances (decreased QTC in the AO200 30 (P<0.05), 60 (P<0.001), and 90 (P<0.05) minutes after intoxication) and decreased PR 60 (P<0.05) and 90 minutes (P<0.01) after intoxication. This was compared with baseline as well as detrimental changes in cardiac electrophysiology [mitigated ST-segment elevation in AO200 and depressed T-wave in the AO200 (P<0.05) and AO400 (P<0.01) groups 90 minutes after intoxication] Conclusion: Based on these authentic results, it seems that olive leaf extracts can be useful in reducing the severity of symptoms in ALP-poisoned individuals and could be utilized in a poisoning emergency.

Evaluation of the Protective Effects of Lugol's Solution in Rats Poisoned with Aluminum Phosphide (Rice Tablets).

Aluminum phosphide (AlP) is the main component of rice tablets (a pesticide), which produces phosphine gas (PH3) when exposed to stomach acid. The most important symptoms of PH3 toxicity include, lethargy, tachycardia, hypotension, and cardiac shock. It was shown that Iodine can chemically react with PH3, and the purpose of this study is to investigate the protective effects of Lugol solution in poisoning with rice tablets. Five doses (12, 15, 21, 23, and 25mg/kg) of AlP were selected, for calculating its lethal dose (LD50). Then, the rats were divided into 4 groups: AlP, Lugol, AlP + Lugol, and Almond oil (as a control). After 4h, the blood pressure and electrocardiogram (ECG) were recorded, and blood samples were obtained for biochemical tests, then liver, lung, kidney, heart, and brain tissues were removed for histopathological examination. The results of the blood pressure showed no significant changes (P > 0.05). In ECG, the PR interval showed a significant decrease in the AlP + Lugol group (P < 0.05). In biochemical tests, LDH, Ca2+, Creatinine, ALP, Mg2+, and K+ represented significant decreases in AlP + Lugol compared to the AlP group (P < 0.05). Also, the administration of Lugol's solution to AlP-poisoned rats resulted in a significant decrease in malondialdehyde levels and a significant increase in catalase activity (P < 0.05). Histopathological evaluation indicates that Lugol improves changes in the lungs, kidneys, brain, and heart. Our results showed that the Lugol solution could reduce tissue damage and oxidative stress in AlP-poisoned rats. We assume that the positive effects of Lugol on pulmonary and cardiac tissues are due to its ability to react directly with PH3.

Assessment of Knowledge regarding Aluminum Phosphide (Rice Tablet) Uses and Hazards among Women at Assiut District Villages

Assessment of Knowledge regarding Aluminum Phosphide (Rice Tablet) Uses and Hazards among Women at Assiut District Villages

The therapeutic effect of a novel parenteral formulation of dihydroxyacetone in aluminum phosphide-intoxicated patients

Background and objectivesAluminum phosphide (AlP), known as “rice tablet,” is widely used as an effective pesticide. However, AlP poisoning is a common cause of mortality in many countries, such as Iran. Unfortunately, there is no specific antidote for AlP toxicity to date. AlP releases phosphine gas when it is exposed to moisture or acid. Phosphine is a potent mitochondrial toxin that could significantly inhibit cellular energy metabolism. AlP poisoning is an emergency condition that needs instant and effective intervention. Dihydroxyacetone (DHA) is a simple saccharide used for several pharmacological as well as cosmetic purposes. Previously, we found that DHA could significantly prevent mitochondrial impairment induced by toxic agents such as cyanide and phosphine in various in vitro and in vivo experimental models. MethodsHospitalized patients (n = 111) were evaluated for eligibility criteria. Among these patients, n = 35 cases were excluded due to incomplete data (n = 11) and suspicion of poisoning with poisons other than AlP (n = 24). Meanwhile, n = 76 cases with confirmed AlP poisoning were included in the study. AlP-poisoned patients who did not receive DHA (n = 18) were used as the control group.Patients (n = 58) received at least one dose of DHA (500 ml of 5 % DHA solution w/v, i.v.) as an adjuvant therapy in addition to the routine treatment of AlP poisoning. Arterial blood gas (ABG), blood pH, bicarbonate levels, and other vital signs and biochemical measurements were monitored. Moreover, the mortality rate and hospitalization time were evaluated in DHA-treated and AlP-poisoned patients without DHA administration. Several biomarkers were assessed before (upon hospitalization) and after DHA treatment. The routine tests for AlP-poisoned patients in this study were the measurement of electrolytes (K+ and Na+), WBC, RBC, hemoglobin, INR, carbonate (HCO3), blood pH, PaCO2, and PaO2 and SGPT, SGOT, BUN, Cr. ResultsUpon patients' admission, significant decreases in blood pH (acidosis), blood PaO2, and HCO3 levels were the hallmarks of AlP poisoning. It was found that DHA significantly alleviated biomarkers of AlP poisoning and tremendously enhanced patients’ survival rate (65.52 % in DHA-treated vs 33.34 % in the control group) compared to patients treated based on hospital routine AlP poisoning protocols (no DHA). No significant adverse effects were evident in DHA-treated patients in the current study. Interpretation and conclusionsThese data suggest that parenteral DHA is a novel and effective antidote against AlP poisoning to be used as an adjuvant in addition to routine supportive treatment. Trial registrationIR.SUMS.REC.1394.102.

Assessment of the Effect of Neem Extract (Azadirachta indica) on Aluminium Phosphide Induced Toxicity in Adult Wistar Rat

Aluminum phosphide (ALP), also known as rice tablet, is a well-known fumigant used in grain storage facilities. It is a greenish-gray tablet with a rotten fish or garlic odour. Rice tablets contain ALP, urea, and ammonium carbamate, which produce phosphine gas (PH3) when exposed to water, steam, and gastric acid. This research was carried out to investigate the effect of neem extract on aluminum phosphide-induced toxicity in the liver of albino Wistar rats and also to evaluate the effect of neem leaf extract on hematological parameters in aluminum phosphide-induced toxicity in adult wistar rat .Thirty (30) adult male Wistar rats were grouped into five (5) groups (A-E). Group A served as the control group, Group B received aluminum phosphide only, Group C received aluminum phosphide and 200 mg neem extract and Group D received aluminum phosphide and 400mg neem extract Group E neem extract only. Hematoxylin and Eosin staining technique was used to study the histological morphology of the liver. Hematological investigations were also carried out. From the result obtained, white blood cells neutrophils, hemoglobin and red blood cells were reduced while platelet and lymphocyte were increased. Result shows that the group which took a higher dose of neem extract had less damage to the liver cell compared to those that took a lesser dose and aluminium phosphide alone respectively. Hence, it can be inferred that neem extract does not completely ameliorate hepatotoxicity of aluminium phosphide.

Treatment of critical aluminum phosphide (rice tablet) poisoning with high-dose insulin: a case report

BackgroundAluminum phosphide (rice tablet) is a highly efficient agent for preserving grains against rodents and insects. It accounts for a large number of poisoning cases. Aluminum phosphide poisoning has a high mortality rate of about 90%, and to date, no antidote is available. It releases phosphine gas after exposure to moisture, and this reaction is catalyzed by the acidity of the stomach. Phosphine is then absorbed throughout the respiratory or gastrointestinal tracts and causes toxicity through inhibition of cytochrome c oxidase and formation of highly reactive free radicals. Treatment of patients with aluminum phosphide poisoning is supportive, including mechanical ventilation and vasopressors. The usage of infusion of glucose-insulin-potassium in rice tablet poisoning has been suggested, after its positive beneficial cardiac inotropic effects in patients with beta-blocker and calcium channel blocker poisoning.Case presentationWe report the case of a 30-year-old Iranian woman with critical aluminum phosphide poisoning, presented with hypotension and other signs of shock and severe metabolic acidosis, successfully treated with high-dose regular insulin and hypertonic dextrose and discharged from hospital in good condition. In contrast to our previous experiences, in which nearly all patients with critical aluminum phosphide poisoning died, this patient was saved with glucose-insulin-potassium.ConclusionAluminum phosphide poisoning has a high mortality rate, and to date, no antidote is available. Administration of high-dose intravenous regular insulin and dextrose is suggested as a potential life-saving treatment for patients with critical aluminum phosphide poisoning.

The Rate of Suicide and its Reasons in Children Under the Age of 18 Years

Background: The type of suicide is determined by various factors, such as accessibility to drugs, economic problems, and psychological disorders.This study aimed to assess the rate of suicide and its reasons in children &lt;18 years. Methods: This was a cross-sectional study carried out on 350 autopsy bodies less than 18 years of age in Tehran Forensic Medicine Center in 2010-2020 who had struggled with suicide. Data were analyzed using SPSS software v. 18. Results: Mean±SD age of children was 16.36±1.76 years. The most common method in children less than 15 years and over 15 years was hanging (n=36) and poisoning with chemical substances (n=139), respectively (P&lt;0.001). The most common method of suicide was poisoning with chemical substances (n=147, 42%). The most common method of suicide in girls and boys was poisoning with chemical substances (n=81) and hanging (n=75), respectively. The highest number of children who struggled were residents in the outskirt of Tehran (n=113, 32.5%). The suicide rate in people with depressive disorder and tentative injury was 10% (n=35) and 18.6% (n=65). In 13 patients, vitreous humor alcohol was positive (Mean±SD alcohol: 60.61±43.03 mg/dl). The most common toxin observed in toxicology was rice tablet or aluminum phosphide (n=90, 25.7%). Regarding drug toxicity in toxicology, 52.6% (n=86) was not positive. Opium was found in 7.4% of cases (n=26). Conclusion: The suicide rate has been on the rise during the past ten years through hanging and poisoning with chemical substances, such as aluminum phosphide, opium, and tricyclic antidepressants, especially in the outskirts.

The Rate of Suicide and its Reasons in Children Under the Age of 18 Years

Background: The type of suicide is determined by various factors, such as accessibility to drugs, economic problems, and psychological disorders.This study aimed to assess the rate of suicide and its reasons in children &lt;18 years. Methods: This was a cross-sectional study carried out on 350 autopsy bodies less than 18 years of age in Tehran Forensic Medicine Center in 2010-2020 who had struggled with suicide. Data were analyzed using SPSS software v. 18. Results: Mean±SD age of children was 16.36±1.76 years. The most common method in children less than 15 years and over 15 years was hanging (n=36) and poisoning with chemical substances (n=139), respectively (P&lt;0.001). The most common method of suicide was poisoning with chemical substances (n=147, 42%). The most common method of suicide in girls and boys was poisoning with chemical substances (n=81) and hanging (n=75), respectively. The highest number of children who struggled were residents in the outskirt of Tehran (n=113, 32.5%). The suicide rate in people with depressive disorder and tentative injury was 10% (n=35) and 18.6% (n=65). In 13 patients, vitreous humor alcohol was positive (Mean±SD alcohol: 60.61±43.03 mg/dl). The most common toxin observed in toxicology was rice tablet or aluminum phosphide (n=90, 25.7%). Regarding drug toxicity in toxicology, 52.6% (n=86) was not positive. Opium was found in 7.4% of cases (n=26). Conclusion: The suicide rate has been on the rise during the past ten years through hanging and poisoning with chemical substances, such as aluminum phosphide, opium, and tricyclic antidepressants, especially in the outskirts.

Prognostic Factors of In-Hospital Mortality in Adult Patients With Aluminum Phosphide (ALP) Poisoning in Southern Iran (2014-2018)

Background: The suicide with aluminum phosphide, known as rice tablet, has increased significantly. This study aimed to investigate the epidemiology of Aluminum Phosphide (ALP) poisoning and determine the in-hospital mortality prognostic factors in adult people referring to ALP poisoning to one of the main poisoning centers in southern Iran. Methods: This retrospective cross-sectional study (March 21, 2014, to March 21, 2018) was conducted on all adult patients (&gt;16 years) with ALP poisoning who were referred to Ali-Asghar Hospital (affiliated with Shiraz University of Medical Sciences). All data were extracted from the patients’ medical files. The patients were categorized into two groups of survived and non-survived. Univariate and multivariate logistic regression analyses were conducted to determine prognostic factors for in-hospital mortality, and Odds Ratios (ORs) were reported. Results: Totally, 97 patients were enrolled in this study. The patients’ Mean±SD age was 29.3±12.2 years. Both study groups (survived and non-survived) were matched in most demographic and poisoning characteristics. Nausea (62.9%) and vomiting (49.5%) were the most symptoms at the time of admission. Castor oil (66%), N-acetyl cysteine (56.7%), and magnesium sulfate (52.6%) were the most frequent treatment in these patients. The multivariate analysis showed that age (OR=1.12, 95%CI: 1.03-1.22), body temperature (OR=0.02, 95%CI: 0.01-0.48), resistant acidosis (OR=77.10, 95%CI: 5.05-1176.86), and taking sodium bicarbonate (OR=12.35, 95%CI: 1.25-122.10) were the prognostic factors of in-hospital mortality. Conclusion: The in-hospital mortality rate in patients with ALP poisoning was 29.9%. Age, illiteracy, body temperature, resistant acidosis, and taking sodium bicarbonate were the prognostic factors of in-hospital mortality in these patients.

Prognostic Factors Of In-Hospital Mortality In Adult Patients With Aluminum Phosphide (ALP) Poisoning In Southern Iran (2014-2018):

Introduction: The suicide with aluminum phosphide (ALP) which is known as rice tablet has increased significantly. This study aimed to investigate the epidemiology of ALP poisoning and determining the in-hospital mortality prognostic factors in adult people referring due to ALP poisoning to one of the main poisoning center in southern Iran. Methods: This retrospective cross-sectional study (21/March/2014 to 21/March/2018) was conducted on all adult patients (> 16 years) with ALP poisoning, who were referred to Ali-Asghar Hospital (affiliated by Shiraz University of Medical Sciences). All data were extracted from the patients' medical files. The patients were categorized as two groups of survived and non-survived. Univariate and multivariate logistic regression analysis were applied to determine prognostic factors for in-hospital mortality, and odds ratios (ORs) were reported. Results: Totally, 97 patients were enrolled. The mean±SD of age was 29.3±12.2. Both groups were the same in most of demographic and poisoning characteristics. Nausea (62.9%) and vomiting (49.5%) were the most symptoms at the time of admission. Castor oil (66%), N-Acetyl Cysteine (56.7%), and magnesium sulfate (52.6%) were the most frequent treatment in these patients. The multivariate analysis showed that age (OR=1.12, 95%CI; 1.03-1.22), be illiterate (OR=39.95, 95%CI=0.85-11887.59), temperature (OR=0.02, 95%CI=0.01-0.48), resistant acidosis (OR=77.10, 95%CI; 5.05-1176.86), and taking sodium bicarbonate (OR=12.35, 95%CI; 1.25-122.10) were the prognostic factors of in-hospital mortality. Conclusion: The in-hospital mortality rate in patients with ALP poisoning was 29.9%. Age, be illiterate, body temperature, resistant acidosis, and taking sodium bicarbonate were the prognostic factors of in-hospital mortality in these patients.

Fatalities Due to Poisoning with Aluminum Phosphide (Rice Pill) and Methadone

Acute poisoning is commonly seen with pharmaceutical substance or pesticides. Understanding pattern of acute poisoning due to different agents can enable better emergency management. The aim of this study is to present and evaluate the fatality-related data of acute poisoning due to aluminum phosphide (rice pills) and methadone. This descriptive-analytical study was performed on patients Shahid Rahimi Hospital due to poisoning with rice tablets (aluminum phosphide) and methadone from 2015-2020. The data collection tool was a questionnaire using with demographic data, type and dose of poison and clinical presentation, duration of hospitalization was obtained and statistically analyzed. Out of 19 238 patients with poisoning referred to this center, 412 people referred to the hospital due to rice pill poisoning, of which 56 (13.59%) died and among 2157 patients due to methadone poisoning, 22 of them (1.09%) died. In both the groups, rice pill and methadone, there were more male patients 53.57 and 81.81%, respectively. In aluminum phosphide poisoning, the greatest population was in the age group (15-35). However, no specific age group was seen in methadone poisoning. The duration of hospitalization and the time of referral to the emergency department to the death of the patient was significantly correlated with mortality in both the groups. The prevalence of intentional rice kill poising was greatest, effecting young population, we recommend that health care awareness program and training should be provided in this regard. Furthermore, psychiatric care should be made easily available in the region.

The Treatment Results in Patients with Aluminum Phosphide Toxicity Admitted to Razi Hospital in Ahvaz

Introduction: Aluminum phosphide (ALP), locally known as "Rice Tablet", is a cheap and powerful pesticide used frequently to protect cereals. Cases of ALP toxicity have grown dramatically in recent decades by using it for suicide purposes. Treatment of ALP toxicity is largely supported by various remedies as there is no specific antidote. This study deals with the epidemiology of ALP toxicity in Khuzestan (Iran) and assesses the clinical and paraclinical manifestations, as well as the results of various treatments during the last 12 years. The study further examines the next suicidal intentions and subsequent complications of poisoning with ALP. Methodology: The records of all patients with ALP toxicity admitted to Razi Hospital in Ahvaz from 2006 to 2017 were reviewed within a retrospective study. Epidemiological and demographic information, clinical and paraclinical manifestations, and the results of various treatments were extracted. Data on the subsequent complications and the next suicidal intentions in those who have survived a suicide attempt were gathered and analyzed. Results: Of the 48 patients studied, 50% were male and the mean age was 29.33±10.45. Most of the toxicities were orally and with the intention of suicide in Ahvaz and Andimeshk. A total of 71.42% of the dead have been carried to this center. The majority of cases were reported from urban areas and in August and during summer. The most prevalent clinical signs were loss of consciousness, nausea, and vomiting. There were some differences in the experimental and EKG results. A meaningful correlation was observed between the administration and/or consumption of ranitidine, NAC, and intravenous sodium bicarbonate with treatment outcomes. Only one case of reattempt to suicide has been reported, and hematuria, ascites, and pleural effusion were widely visible in survivors. Conclusion: On-call counseling may decrease the rate of mortality in dispatching patients. Clinical and paraclinical manifestations can be useful in the diagnosis or prognosis. Patients' follow-up, actions to enhance public awareness, restrictions on the distribution of ALP, and availability of alternative substances can be helpful to diminish cases of ALP toxicity and/or death. Keywords: Aluminum phosphide (ALP), Rice tablets, Poisoning, Khuzestan

Cardiovascular Conditions in Patients With Aluminum Phosphide Poisoning

Background: Aluminum Phosphide (AlP) is a well-known rodenticide and insecticide, used as a fumigant to control pests and rodents in grain-storage facilities. Its intoxication presents a medical emergency that requires early rigorous management. This study aimed to investigate cardiac function by Electrocardiogram (ECG) changes in patients with AlP intoxication. We also explored the potential relationship between low bicarbonate and cardiac function. Methods: This cross-sectional study investigated 42 patients in the age range of 17-47 years, with a history of orally-administered AlP poisoning, known as “rice tablet”, admitted to the toxicology ward of Imam Reza Hospital from March 2019 to March 2021. The study patients’ demographic data were collected by trained interviewers, using pretested questionnaires. Systolic and diastolic blood pressure, as well as blood samples, were measured 12 hours from admission. Echocardiography was performed during the first 12 hours and on the fifth-day post-admission. All statistical analysis was performed using R 3.6.1. The significance level was set at 0.05 for all statistical tests. Results: In total, 48.78% of patients presented normal bicarbonate levels, and 24.39% and 26.83% had moderate and severe acidity, respectively. Moderately and severely decreased Left Ventricular Ejection Fraction (LVEF) was observed among 21 (51.2%) and 10 (24.4%) patients, respectively. Furthermore, mild Right Ventricular (RV) function was observed among 11 (26.8%) patients. A statistically significant association was observed between bicarbonate level and RV function (P&lt;0.001) and LVEF (P&lt;0.001). Besides, 19.5% of the explored patients expired. The proportion of expired patients was significantly higher in patients with mild RV function, compared to the other patients (P&lt;0.001). Conclusion: Acute AlP intoxication is a worldwide serious problem. Severe metabolic acidosis and ECG abnormalities are associated with poor outcomes in this respect. Thus, conducting early ECG and echocardiography could be desirable instruments to predict prognosis. There is no antidote for AlP poisoning; thus, the replacement of a safer agent for in-store grain protection is strongly suggested.

Kompleksna i retka prezentacija trovanja pirinčanom tabletom - prikaz slučaja

Aluminum phosphide, known as "rice tablet" (RT), is a common cause of suicide in adult women in Iran, with a high rate of lethal outcome. We report a patient with RT toxicity, with a complex syndrome of hepatic failure, renal failure, Brugada electrocardiography (ECG) patterns, and pleuropericardial effusion. The patient received conventional management with fluid therapy, gastric washing, activated charcoal followed by intra-aortic balloon pump insertion, inotropic drugs support, and mechanical ventilation. The unique features of our case are related to a combination of multiorgan failure with Brugada atypical ECG patterns and pleuropericardial effusion. Among the aforementioned complications, pleuropericardial effusion, ascites, and Brugada syndrome are exceedingly rare events. The patient was treated with high-dose inotropic drugs and intra-aortic balloon pump insertion. Despite tremendous management of metabolic acidosis, all efforts failed, and the patient died with sudden cardiac arrest.

Total Gastric Necrosis as a Presentation of Aluminum Phosphide Poisoning: A Case Report

Background: Rice pill poisoning is among the most frequent causes of death among prisoners. Despite advances in the treatment of this poisoning, its mortality rate remains high. The symptoms of Aluminum Phosphide (AlP) poisoning are varied and progressive. One of the essential foundations of diagnosis is based on the history of swallowing the pill by the patient or their companions.&#x0D; Case report: A 20-year-old woman with generalized abdominal pain and a diagnosis of peritonitis was operated. The operative finding was total gastric necrosis. After the operation, the patient's husband claimed that she had consumed some rice pills, intending to commit suicide. Despite all efforts, she remained in persistent septic shock and multi-organ failure and passed away after surgery.&#x0D; Conclusion: Total gastric necrosis could be among the lethal complications of rice tablet (AlP) poisoning.

Clinical Symptoms and Para-Clinical Findings among the Deceased Patients Due to Aluminum Phosphide Poisoning in Ardabil, Iran, From 2009 To 2017

Introduction: Aluminum phosphide or rice tablet is one of the most common pesticides and insecticides used in agriculture to protect crops, cereals, and rice. Recently, this substance has been increasingly used as a method for committing suicide among people in society. This study aimed to evaluate the clinical symptoms and para-clinical findings of deceased patients due to Aluminum phosphide poisoning in Ardabil province, Iran. Materials and Methods: This descriptive cross-sectional study was conducted on 97 hospitalized patients who died due to Aluminum phosphide poisoning in Ardabil province, Iran, from 2009 to 2017. The data were collected using a checklist and then analyzed in SPSS software (version 19) through descriptive and analytical statistics Results: The mean age of all patients was 34.3±15.8 years, and the majority of the cases (77.3%) were female. The most important symptoms were nausea and vomiting in males (92%) and females (100%). Moreover, the patients had a mean recovery time of 5.89 h. Of all the deceased patients, 22 and 75 cases took two and one tablets, respectively. Furthermore, 92.7% of the patients had taken the rice tablets orally. The amount of Glasgow Coma Scale (P=0.001), systolic blood pressure (P=0.001), PH (P=0.001), heart rate (P=0.001), respiratory rate (P=0.001), bicarbonate (P=0.001) and white blood cell (P=0.009) in died patients in more than 24 hour significantly difference with died patients in less than 24 hour. The females obtained a significantly lower systolic blood pressure (P=0.01) and lower pH (p=0.045), but the higher partial pressure of oxygen (P=0.01), compared to males. Conclusion: The results of this study showed that the frequency of deaths due to rice pill poisoning was much higher in males than females; moreover, this value was higher in middle-aged groups, compared to other age groups.

Epidemiology of Acute Poisoning in Mazandaran Province, Iran

Background: Poisoning is a critical medical emergency worldwide. The present study aimed to determine the characteristics and treatment outcomes of patients admitted to the poisoning department.Methods: This cross-sectional descriptive study was conducted from March 2015 to September 2016 (for 18 months). We explored the epidemiology of poisoned patients hospitalized at Razi and Imam hospitals in Mazandaran Province, Iran. The obtained results were described as the frequency of poisoning, percentages, confidence intervals (95% CI), and mean values. The standard deviation scores were also presented for quantitative variables. The Student t-test and Chi-squared test were used for data analysis.Results: The prevalence rate of poisoning equaled 4.98% of the total hospitalized patients. Of 71192 of the investigated cases, 3544 patients were hospitalized for acute poisoning. In terms of poisoning type, 65.2% belonged to drug toxicity, (95% CI) (64.7-77.2); 6.7% were related to methadone; 5.7% to an agricultural pesticide; 4.15% to aluminum phosphide (rice tablets); 2.2% to rat poison paste, and the remaining cases were caused by other poisons. There was a gender-wise significant difference in the poisoning method (P&lt;0.001). The mortality rate in this study was calculated as 1.71% of all cases. The most frequent causes of death were aluminum phosphide (33.33%) and narcotics (16.16%) poisonings. Conclusion: Acute poisoning is a fundamental health problem in Mazandaran Province, i.e., located in the north of Iran. Pharmaceutical medications, opioid agents, and aluminum phosphide were the main means of poisoning in the investigated adult patients. Most cases of poisoning occurred in the young-adult groups. Aluminum phosphide and organophosphate agents consumption generated the most critical states and were the main causes of death. It is suggested that aluminum phosphate be recalled from the market, as appropriate training must be provided for its proper use.

Cardioprotective activity of ethanolic extract of Echinophora cinerea against aluminum phosphide poisoning in rats.

Rice tablet, also known as aluminum phosphide (ALP), is a nonorganic material used as an insecticide and rodenticide in the storage and transportation of grains. Phosphine gas, released from the chemical material, in contact with humidity and weak acid, can induce poisoning and death. This study was conducted to investigate the effect of ethanol extract of Echinophora cinerea leaves on ALP poisoning in heart in rats. In this study, factors such as blood pressure, heart rate, electrocardiography, and biochemical biomarkers of oxidative stress of cardiac tissue were evaluated. The use of Echinophora extract at a dose of 200mg per/kg primarily improved bradycardia, hypotension, and cardiac conduction. Echinophora extract at a dose of 400mg could protect body against oxidative stress. It seems that Echinophora extract has significant clinical positive effects that can be employed in treatment protocols of acute poisoning associated with ALP. PRACTICAL APPLICATIONS: Administration of the Echinophora cinerea extract can improve bradycardia, hypotension, and conduction disturbances of the heart caused by poisoning with rice tablet. E.cinerea extract also can increase the levels of antioxidant enzymes and protect the body against oxidative damage caused by poisoning with rice tablet. Therefore, Echinophora extract has significant clinical positive effects that can be used in treatment protocols of acute poisoning associated with aluminum phosphide.

Can rutin ameliorate aluminum phosphide-induced acute cardiac toxicity in adult albino rats?

Current management of rice tablet or aluminium phosphide (AlP) poisoning has remained mostly supportive despite of its fatal outcome and unfortunately no antidote is found yet, therefore, there is a need to search for a treatment that can adequately protect against its toxicity. To the best of our knowledge, there are no studies until now concerning the cardioprotective effect of rutin against AlP cardiac toxicity in rats. For this purpose, this study was carried out to investigate the possible protective effect of rutin against AlP induced cardiotoxicity in rats. Forty male albino rats were randomly divided into four groups. Group I: normal control group was served as untreated rats and received distilled water orally through a gastric tube. Group II: Rutin treated group received a dose of 100 mg/kg rutin dissolved in distilled water and given orally through a gastric tube. Group III: AlP intoxicated rats received AlP oral single sub-lethal dose (2 mg/Kg body weight) dissolved in distilled water and given through a gastric tube. Group IV: AlP intoxicated rats + Rutin treated one hour after receiving AlP in doses as mentioned above. After that we tested the following parameters: ECG changes including HR and ST-segment elevation, serum level of TNF-α, IL-6 and H-FABP (pg/ml), antioxidant and Oxidant parameters in cardiac tissue as GSH, SOD, and MDA, apoptotic factor caspase-3 and histopathological examination of cardiac tissue was also included. The results showed that treatment with rutin caused a significant decrease in heart rate and ST segment elevation, a significant decrease in activity of TNF-α and IL-6 and levels of H-FABP also a significant decrease in the activity of SOD with decreased levels of MDA and caspase-3 level and a significant increase in the level of GSH compared to (AlP) intoxicated group, also histopathological changes induced by AlP improved after treatment with rutin. It is concluded that AlP intoxication caused ECG, biochemical and histopathological changes which were potentially improved with rutin. Â

Preparation of a probiotic rice tablet: Sensory evaluation and antioxidant activity during gastrointestinal digestion

Broken rice produced during rice processing had a poor taste, thus was not accepted by consumers. Milling and fermentation could make broken rice applicable material for food use. In this study, indica rice flour was used as raw material to prepare fermented rice tablets with probiotic effects. A starter composed of Brettanomyces custersii ZSM-001 and Lactobacillus plantarum ZSM-002 were used, and the sensory properties of the resulting tablet was similar to the tablet prepared with commercial starters. Compounds affecting sensory properties, e.g. sugars, organic acids, and volatiles were analyzed, with an obvious change in volatiles after fermentation. The cell density change of Lactobacillus plantarum ZSM-002 during in vitro gastrointestinal (GI) digestion was studied, which was still higher than the minimum for probiotics to exert probiotic effect. The antioxidant activities of rice tablets during GI digestion were analyzed, with the tablet fermented with Brettanomyces custersii ZSM-001 and Lactobacillus plantarum ZSM-002 showing the highest activity. This study reported the feasibility of preparing a probiotic rice tablet with good sensory properties using indica rice flour, which may enrich fermented rice products and increase the usage of broken rice in the food industry.