Human & experimental toxicology
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Two cases of acute valproic acid poisoning with central nervous system depression and raised ammonia level without hepatotoxicity were reported. They were treated successfully with the use of the antidotes: L-carnitine and other supportive measures. Clinical manifestation and progress was described, and discussion is focused on the use of L-carnitine in valproic acid-induced hyperammonemia, from its mechanism to the clinical experiences in the literature. Based on the favorable response of our two cases and the literature review, we recommend the administration of intravenous L-carnitine in patients of valproic acid overdose with hyperammonemia or valproic acid-induced hyperammonemic encephalopathy and hepatotoxicity at a dose of 50 mg/kg every 8 h for the first initial 24 h with further individual assessment.
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There have been no case reports on aluminum phosphide-induced pancreatitis in the literature available. In this report, we present the case of a young man who developed acute pancreatitis and probably acute myocarditis following ingestion of aluminum phosphide pellets in the absence of the usual risk factors and after exclusion of other possible causes of pancreatitis. In the absence of re-challenge, we put forth the probable causative association of pancreatitis with aluminum phosphide or phosphine gas, its active pesticidal component.
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To characterize the poisoning cases admitted to the Loghman-Hakim Hospital Poison Center (a teaching reference hospital of poisoning) in Tehran, Iran. All admitted acutely poisoned patients from January to December 2003 were evaluated retrospectively. Information of socio-demographic characteristics, agents and cause of poisoning, and the mortality rate were collected from medical records of the hospital. ⋯ The mortality rate was 1.3% (318 patients). Death was mostly occurred by opioids (41.54%), followed by drugs (28%) and pesticides especially OPs (12%). The prevention and treatment of poisoning due to opioids, pesticides specially OPs and sedative-hypnotics drugs should merit high priority in the health care of the indigenous population of Tehran.
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The objective of this study is to analyze exposures concerning analgesics that were reported to Dokuz Eylul University Drug and Poison Information Center (DPIC) and admitted to the Department of Emergency Medicine in Dokuz Eylul University Hospital (EMDEU) between 1993 and 2004. Demographics of the patients, characteristics of analgesic exposures, performed treatment attempts and outcome of the poisoned patients were recorded on standard data forms and were then entered into a computerized database program. Statistical analysis was performed by using the chi-square test. ⋯ Paracetamol ingestion was the most common cause of analgesic exposures reported to our DPIC. Most of the analgesic exposures reported to DPIC were asymptomatic or mild. DPICs have an important role for the referral of analgesic exposures without unnecessary gastrointestinal decontamination procedures.
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Organophosphate poisoning (OPP) occurs frequently and accounts for a large number of intoxication cases treated in intensive care units (ICU). Poisoning by these agents is a serious public health problem. Among pesticides, OPs are the main cause of poisoning and death in Loghman-Hakim Poison Center of Tehran, Iran. ⋯ One-third of the subjects needing intensive care die within the hospitalization period. SAPS II scores calculated within the first 24 hours were recognized as good prognostic indicator among patients with acute OPP that required ICU admission. It is concluded that SAPS II score above 11 within the first 24 hours is a predictor of poor outcome in patients with acute OPP requiring ICU admission.