Background:: Acute poisoning is a major cause of preventable morbidity and mortality. In India, plant poisoning accounts for 6-15% of poisoning cases, with yellow oleander (Thevetia peruviana) among the most common toxic plants. Despite its clinical importance, evidence regarding severity assessment and prognostic factors remains limited. The Poisoning Severity Score (PSS) is an internationally accepted tool for grading poisoning severity, but it has rarely been evaluated for Yellow Oleander Poisoning (YOP) in India. Methods: This prospective observational study assessed a modified Poisoning Severity Score in patients with YOP and evaluated its association with clinical outcomes. The modified PSS was recorded at admission, and patients were classified into grades 0-4 based on the most severe clinical signs and symptoms. Patients were followed until discharge or death.Results: YOP accounted for 8.68% of all poisoning cases during the study period, with a case fatality proportion of 5.7%. Among 53 patients, the mean age was 30 years, and 64.2% were female. Most poisonings were intentional (88.7%), and ingestion of crushed seeds was the commonest mode of exposure (49.0%). Moderate poisoning (PSS Grade 2) was observed in 49.1% of patients. PSS grade showed significant associations with age, quantity of poison ingested, serum potassium level, duration of hospitalisation, and clinical outcome (all p<0.05). Overall, 88.7% of patients recovered, whereas all deaths occurred among patients with higher PSS grades.Conclusion: The modified PSS is a useful tool for early assessment of severity and prognostication in Yellow Oleander Poisoning, supporting timely risk stratification and appropriate clinical management.
Background: Monosodium glutamate (MSG) ranks among the most widely utilized food additives. Reports on its safety are conflicting, with some studies claiming safety and others noting deleterious health effects. The study objective was to evaluate whether MSG induces testicular toxicity and to determine if Lepidium meyenii has an ameliorative effect.Methods: A total of forty adult male albino rats were randomly assigned to four equal groups: Group I (control), Group II (maca), Group III (MSG), and Group IV (MSG plus maca). All treatments were administered orally for six weeks. Blood samples were collected for hormonal and biochemical analyses. Testicular tissues were prepared and stained with H&E, trichrome, and caspase-3. Monosodium glutamate produced deleterious effects on rats’ testes as confirmed by a significant decrease in testosterone hormone (P < 0.01) and significantly disturbed oxidative stress indicators (TAC and MDA).Results: Histologically, in the MSG group, widening of the spaces between seminiferous tubules, with apparent disorganization, was evident. Excessive collagen deposition was observed in trichrome-stained sections. Additionally, few interstitial Leydig cells, destruction of most germinal epithelium, and elevated caspase-3 immunostaining. Maca administration evidently improved the degenerative changes.Conclusion: Monosodium glutamate induced significant degenerative changes, oxidative stress, and pronounced hormonal disturbance. Lepidium meyenii effectively attenuated hormonal, biochemical, and most histopathological alterations against MSG-induced testicular toxicity at the specific duration and dose investigated.
Introduction: Herbicidal compounds are one of the common types of poisonings used for Deliberate Self Harm in Developing countries, associated with high morbidity and mortality with multisystem toxicity The rare manifestations involve Cardiovascular and Neurological system.Case Report: In 2025, a 30-year-old male presented to emergency department at Lata Mangeshkar hospital, India, one hour after ingestion of 150 ml of 41% glyphosate (Glycel) with vomiting, tachycardia (140/min), hypotension and hypoxia. Within hours, he developed metabolic acidosis, type 1 respiratory failure, refractory hypotension requiring noradrenaline, left ventricular dysfunction (EF 35%), and neurological signs (horizontal/vertical nystagmus, diplopia). Management included gastric lavage, mechanical ventilation, Inotropic support (Noradrenaline, Dobutamine), N-Acetylcysteine and Antibiotics for aspiration pneumonia. MRI Brain was normal. By day 6, cardiac, neurological and respiratory parameters gradually normalized; the patient was extubated and discharged without sequelae after psychiatric evaluation.Discussion: The severe multisystem toxicity observed in this case, particularly the transient cardiomyopathy and neurological deficits, is primarily driven by the surfactants in commercial glyphosate formulations rather than the glyphosate moiety itself. These surfactants likely induce cellular damage through mitochondrial dysfunction and the uncoupling of oxidative phosphorylation. The reversibility of these manifestations suggests a transient toxic-metabolic process rather than permanent structural injury, emphasizing the critical role of surfactant-induced cardiotoxicity and neurotoxicity.Conclusion: This case highlights rare cardiovascular and reversible neurotoxic effects of glyphosate poisoning which is mainly due to mechanism of uncoupling of oxidative phosphorylation. The most common clinical symptoms are gastrointestinal like erosions and gastrointestinal hemorrhages. Increased risk of mortality is seen patients developing acute kidney injury, pulmonary edema and hyperkalemia. This case report underscores the efficacy of aggressive supportive care in achieving favorable outcomes despite absence of an antidote.
Introduction: During the COVID-19 pandemic, drug repurposing attempts increased due to limited therapeutic options in the setting of a high morbidity illness. Drug repurposing may also be utilized by those looking for alternative treatment modalities when faced with new medical illnesses. This case report demonstrates the danger of ivermectin use outside of its typical indications.Case Report: A 69-year-old female presented to a hospital in Milwaukee, Wisconsin, United States of America with altered mental status. She was difficult to awake from sleep by her family. She had a recent diagnosis of metastatic breast cancer. Her initial evaluation including cerebral imaging and infectious assessment did not reveal an etiology for her encephalopathy. She was admitted to the hospital, and during her continued neurologic evaluation she made a gradual recovery. It was revealed by the patient and her family that she had been taking daily ivermectin as an attempted cancer treatment.Discussion: Ivermectin is used as a deworming agent in veterinary medicine. Ivermectin potentiates gamma-aminobutyric acid (GABA)-gated currents. This explains its clinical effects of central nervous system depression. Treatment of ivermectin toxicity involves symptomatic and supportive care with gastrointestinal decontamination with activated charcoal if the ingestion occurs within 1 to 2 hours.Conclusion: The undifferentiated encephalopathic patient often requires a broad laboratory and imaging evaluation. As in this case, taking a thorough history of present illness revealed ivermectin associated neurotoxicity as her final diagnosis. Emergency clinicians must be vigilant of this possible diagnosis especially with increasing attempts at drug repurposing.
Background: Elevated serum chromium levels are occasionally detected during clinical evaluation; however, their relationship with clinical toxicity remains uncertain. Potential confounders, including complementary and alternative medicine (CAM) use and underlying comorbidities, may influence the interpretation of elevated chromium concentrations. Hence, we aim to evaluate the association between serum chromium levels and clinical manifestations in these patients.Methods: We performed a retrospective analysis of 22 patients with elevated serum chromium levels (>10 µg/L) at a tertiary care hospital in South India from January to December 2015. Clinical records were reviewed for symptoms associated with chromium toxicity and possible confounders. Correlation analyses were used to examine links between chromium concentrations and clinical findings.Results: Only 2 of 22 patients (9.1%) exhibited symptoms considered attributable to chromium exposure. Mean serum chromium concentrations were similar in symptomatic and asymptomatic patients (40.45 µg/L vs. 35.16 µg/L; p = 0.83). Stratified analyses demonstrated no serum concentration–response relationship between chromium levels and symptom prevalence. CAM use was reported in 36.4% of patients and was associated with significantly higher chromium concentrations than in non-users (53.40 ± 34.55 µg/L vs. 25.50 ± 25.68 µg/L; p = 0.0185). Comorbidities were present in 50.0% of patients and may have contributed to clinical manifestations independently of chromium exposure.Conclusion: No significant association was observed between elevated serum chromium levels and clinical toxicity in this cohort. Clinical interpretation should therefore rely on comprehensive assessment rather than serum chromium concentrations alone.
Introduction: Hydrogen cyanamide (Dormex), a widely used plant growth regulator, poses significant toxic hazards, particularly in low-resource agricultural regions. The ease accessibility of agricultural chemicals facilitates impulsive self-poisoning. Case report: We report a case of 16-year-old female who intentionally ingested Dormex in a suicidal attempt. She was initially misdiagnosed as having organophosphate poisoning. The patient developed severe complications, including metabolic acidosis, disseminated intravascular coagulation (DIC), acute fulminant hepatitis, cerebral edema, and multi-organ failure. Aggressive supportive management was initiated, including N-acetylcysteine infusion, fresh frozen plasma, and mechanical ventilation. Her condition gradually improved, and she ultimately made a full recovery. Discussion: This case report adds to the sparse literature on intentional self-poisoning with hydrogen cyanamide related to occupational context, offering critical insight into its clinical presentation, and multisystem complications. It documents a rare complication of DIC and rapid clinical deterioration following ingestion, yet survival with prompt supportive management.Conclusion: This case highlights the high toxicity associated with hydrogen cyanamide ingestion and emphasizes the importance of early and accurate diagnosis, in addition to the aggressive supportive management. It also calls attention to the urgent need for regulatory measures, public health education, and safe storage practices in agricultural communities to prevent accidental or intentional exposures.
Introduction: Venomous snakes are of significant medical importance and are categorized into two groups: highly medically important snakes and lesser medically important snakes. In Sri Lanka, seven species of terrestrial snakes are classified as highly medically important. Accurate identification of these snakes can be challenging because several nonvenomous species closely resemble them in appearance. This case report describes two such snakebite incidents in Sri Lanka, highlighting the difficulties in snake identification and the potential clinical implications of misidentification.Case Report: Two patients presented with nonvenomous snakebites. A 14-year-old schoolgirl was admitted Emergency Treatment Unit at Teaching Hospital Ratnapura, Sri Lanka in 2020 due to a python bite to her left 4th toe. A 44-year-old female was transferred from a local hospital for further management of a suspected krait bite, which was later identified as a common wolf snake. The patient was bitten on the left 3rd finger. Neither patient developed envenoming features and was discharged on day 2 of the snakebite.Discussion: Even though nonvenomous snakebites do not cause envenoming effects, they are important. Juvenile pythons closely resemble adult Russell’s vipers, whereas wolf snakes mimic kraits. Antivenoms are indicated for bites by Russell’s vipers and kraits. Therefore, the correct identification of the snake is essential when managing these patients.Conclusion: Some nonvenomous snakes mimic medically important snakes through morphological similarity, particularly in colour variation. Therefore, characteristic features should be used to identify these snakes.
Introduction: Altered levels of consciousness in emergency settings, particularly in the presence of a reported history of alcohol consumption, may lead to misdiagnosis and delayed detection of life-threatening intracranial conditions such as cerebral hemorrhage. This case report aims to highlight the diagnostic challenge of intracerebral hemorrhage presenting with features suggestive of alcohol intoxication and to emphasize the importance of avoiding diagnostic anchoring based on companion reported history.Case Report: This case report describes a 38-year-old male who was admitted to the poisoning department of Imam Reza Hospital, in 2025 with a decreased level of consciousness and suspected alcohol intoxication. Initial clinical assessments and laboratory investigations were performed. Owing to persistent neurological impairment, brain computed tomography was subsequently obtained.Discussion: Clinical assessment was initially confounded by reported alcohol use; however, neuroimaging confirmed a significant intracerebral hemorrhage. Retrospective evaluation revealed a neglected history of minor trauma, illustrating the critical importance of excluding structural brain injuries in patients with altered consciousness, regardless of reported intoxication.Conclusion: This case underscores the necessity of prioritizing objective clinical assessment and comprehensive neurological examination over third-party history in patients with altered mental status. Early consideration of structural brain injury and timely neuroimaging are crucial to preventing diagnostic delay and reducing adverse clinical and medicolegal outcomes.
Background: The presence of pharmaceutical contaminants such as Penicillin G in aquatic environments poses significant ecological and health risks. This study aimed to synthesize carboxyl-functionalized multi-walled carbon nanotubes (MWCNT-COOH) and evaluate their efficiency in removing Penicillin G from aqueous solutions through adsorption.Methods: This experimental study was conducted at the Toxicology and Pharmacology, Faculty of Pharmacy, Mazandaran University of Medical Sciences. MWCNT-COOH was synthesized via a diazonium-based surface modification and characterized using FTIR and SEM. Batch adsorption experiments were carried out to investigate the effects of pH, contact time, initial concentration, adsorbent dosage, and temperature. Adsorption data were fitted to Langmuir, Freundlich, and Temkin isotherms, and kinetics were assessed using pseudo-first-order and pseudo-second-order models.Results: The synthesized MWCNT-COOH showed efficient adsorption performance, with maximum removal observed at pH 8 and equilibrium achieved within 80 minutes. The Langmuir model best described the isotherm data, with a maximum monolayer adsorption capacity of 118.17 mg/g. Kinetic analysis revealed that the process followed a pseudo-second-order model, indicating chemisorption. Adsorption efficiency decreased with increasing temperature, suggesting an exothermic mechanism.Conclusion: MWCNT-COOH prepared via surface functionalization showed excellent potential as an adsorbent for Penicillin G removal. The findings support the use of functionalized carbon nanomaterials for the treatment of antibiotic-contaminated water.
Background: The widespread use of plastics has led to an increased environmental presence of microplastics, with potential adverse effects. This study was conducted to assess the effects of polyethylene terephthalate (PET) microplastics on reproductive hormones and Interleukin-1β in chronically-exposed female albino rats.Methods: Forty female albino rats were selected for the study. Polyethylene terephthalate pellets were obtained, crushed, dissolved in water, and passed through a 5µm sieve to obtain particles with a size of ≤ 5µm which were used for the study. Twelve rats were used for a pilot study, while the remaining twenty-eight rats were randomly assigned into four experimental groups (n = 7). The PET treatment was administered orally using gavage tubes for 90-days. 40mg/kg, 80mg/kg, and 120mg/kg PET-microplastics were given to rats in groups 2, 3, and 4, respectively, while group 1 received only food and water (negative control). After the duration of treatments, blood samples were collected for analysis of estradiol, progesterone, prolactin, and IL-1β levels using ELISA methods. Statistical analysis was computed using GraphPad Prism Software. Differences were considered significant at P ≤ 0.05. Results: The mean levels of estradiol, progesterone, and IL-1β in the PET-treated rats were significantly higher than the levels in the control group (p < 0.0001). However, the mean levels of prolactin in PET-treated groups were not significantly different from those in the control rats (p = 0.2157).Conclusion: These findings suggest that chronic PET-microplastic exposure may induce inflammatory responses and endocrine disruption in the animal model, as evidenced by alterations in hormone levels and IL-1β concentration, highlighting potential health risks that may be associated with prolonged PET microplastic exposure.
Background: Childhood poisoning poses serious health risks and complications. Numerous studies have highlighted differing rates of pediatric poisoning. This study investigates the prevalence, causes, and contributing factors of poisoning among children during the period from 2022 to 2024.Methods: This cross-sectional study involved 483 children aged 1–18 years diagnosed with poisoning in Amir Kabir Hospital in Arak between March 2022 and March 2024. Data were retrospectively gathered from patient medical records during the specified period. Information on demographic details, seasonality, type of exposure (intentional or accidental), and general categories of poisoning agents was collected and analyzed using SPSS version 26. Results: The mean age was 7.78 ± 5.75 years. Girls were significantly older than boys (8.79 ± 5.82 vs. 6.62 ± 5.45 years; P = 0.0001). Poisoning peaked in winter (30.6%). Mean hospital stay was 1.72 ± 1.06 days. Pharmaceutical poisoning was the most common cause (43.1%). Neurological symptoms were the most frequent presentation (49.9%). Accidental poisoning accounted for 76.4% of cases, with significant gender differences (accidental: 51.8% in boys; intentional: 71.1% in girls; P < 0.01).Conclusion: Pharmaceutical agents represented the leading cause of pediatric poisoning in this study. These findings underscore the importance of enhancing medication safety measures, enforcing stricter controls on drug accessibility, and implementing targeted prevention strategies, particularly for younger children and adolescents.
Background: Deliberate self-harm (DSH) represents a largely under-recognized public health crisis in low- and middle-income countries, particularly affecting young adults. Despite its significant contribution to morbidity, mortality, and long-term psychological and socioeconomic consequences, it continues to receive insufficient attention in public health agendas. We aim to describe the socio-demographic and clinical characteristics of patients who presented with DSH to a secondary care hospital in South India.Methods: This retrospective study was conducted using electronic medical records of patients presenting with DSH to the Emergency Department of a secondary care hospital in South India between 2019 and 2024. Data on sociodemographic characteristics, methods of self-harm, clinical features, and referral outcomes were extracted and analyzed. Descriptive statistics were used to summarize the findings.Results: Of 61,797 Emergency Department visits over five years, 179 (0.29%) were due to DSH. The mean (SD) age was 31.8 (14.1) years, with a slight female predominance (50.8%); most patients were aged 15–30 years (58.7%). Toxic ingestion was the predominant method, with agrochemicals forming the largest group (31.8%), followed by medication overdose (15.1%) and corrosive ingestion (11.2%); hanging accounted for 17.9% of cases. Most patients were referred to tertiary centres (64.8%), while 22.3% were admitted locally. Emergency department mortality was 1.7%.Conclusion: DSH remains a substantial public health burden in India, especially among young adults. The high proportion of impulsive, high-lethality attempts highlights the urgent need to strengthen emergency mental health services, pesticide regulation, and preventive strategies at the secondary care level.
Background: Narcotic addiction poses a significant threat to individuals, families, and communities in Afghanistan, particularly in Lashkargah City, Helmand Province. This study examines the effectiveness of government-led initiatives in preventing narcotics use.Methods: A mixed-methods approach was employed. Behavioral observation reports and structured questionnaires from 70 addicts were supplemented with data from the Helmand Directorate of Public Health and a 100-bed rehabilitation facility. Quantitative data were analyzed using IBM SPSS, while qualitative findings strengthened the interpretation of results.Results: The findings indicate that the primary causes of drug addiction in the area include peer pressure (85.2%) and the high accessibility of drugs (85%). Participants also reported several major consequences of addiction, such as social stigma (55.6%), economic strain (61.1%), and social isolation (70.4%). Additionally, 94.4% of respondents emphasized the importance of government-led and community-based initiatives, including awareness campaigns, rehabilitation services, and public participation. Moreover, 83.3% of respondents recognized educational institutions as key actors in prevention, noting that school-based awareness programs and prevention education can significantly reduce drug use among youth.Conclusion: The study concludes that peer pressure and easy access to drugs are primary drivers of addiction in Lashkargah. It also highlights the critical contribution of government bodies, educational institutions, and community efforts as part of multi-sectoral approaches to narcotics prevention. Effective mitigation of drug use requires coordinated action and continued collaboration across these sectors.
Background: Although glyphosate-based herbicides are generally considered to have low acute toxicity to humans, commercially available formulations may contain multiple active ingredients and co-formulants that produce atypical clinical manifestations.Case Presentation: A 53-year-old woman with a history of panic disorder and kleptomania was found collapsed at home by her family just before incarceration. On arrival, she had marked bilateral mydriasis (8 mm), impaired consciousness (Glasgow Coma Scale: E1V1M1), QTc prolongation (633 ms), metabolic acidosis, and elevated lactate. Stimulant intoxication was initially considered because of mydriasis and a positive urine amphetamine screen; however, she lacked hypertension, tachycardia, diaphoresis, and agitation, and QT prolongation was not interpreted as evidence of adrenergic stimulation. Detailed history-taking and UPLC-HRMS toxicological analysis revealed ingestion of a commercial herbicide containing glyphosate isopropylamine salt, flumioxazin, and MCPA, with MCPA detected in serum. She improved with conservative treatment and was discharged on hospital day 8.Discussion: This case illustrates atypical toxicosis caused by a multi-ingredient herbicide. The presentation did not fulfill a classic sympathomimetic toxidrome; instead, mydriasis, impaired consciousness, QT prolongation, and ileus required broad differential diagnosis. Component-specific assessment suggested that glyphosate-surfactant exposure, MCPA toxicity, and uncertain co-formulant effects together contributed to the clinical picture. Quantitative pupillometry and confirmatory toxicological analysis helped avoid diagnostic anchoring.Conclusion: Commercial herbicide poisoning should not automatically be interpreted as single-agent glyphosate poisoning. Separating key clinical problems from formulation-specific toxicities may improve emergency diagnosis and management.
Background: Aluminum phosphide (AlP) is a highly toxic pesticide widely used in agricultural settings. Due to its low cost and lack of regulatory control, it has become a common cause of poisoning in Egypt, often with fatal outcomes. Early identification of prognostic markers using routine laboratory investigations may aid in improving patient outcomes.Methods: This prospective cohort study was conducted at the Poison Control Center of Zagazig University Hospitals from January to June 2021. A total of 42 patients with confirmed AlP poisoning were enrolled. Routine laboratory parameters, including total leukocyte count (TLC), liver enzymes (AST, ALT), renal function markers (creatinine, BUN), and serum electrolytes (Na⁺, K⁺), were collected within 24 hours of admission. Patients were followed until discharge or in-hospital death. Survivors and non-survivors were compared to identify significant predictors.Results: Serum sodium levels were significantly higher in non-survivors (P = 0.04). Potassium levels were lower overall but did not differ significantly between groups. The Total leukocyte count showed an increasing trend in non-survivors, although this trend was not statistically significant. Liver enzymes and renal function markers showed mild elevations in some cases but were not significantly associated with mortality.Conclusion: In this prospective cohort of acute AlP poisoning, elevated serum sodium was significantly associated with in-hospital mortality, as ROC analysis for serum sodium yielded an AUC of 0.67 (0.5-0.83), while total leukocyte count showed a non-significant upward trend. These findings suggest that routine markers may offer early prognostic insight but require further validation.
Background: Poisoning is a major global health challenge and often requires intensive care due to high morbidity and mortality. We evaluate epidemiological trends, clinical features, and outcomes of adults admitted to the ICU with toxic exposures or substance misuse over 20 years.Methods: We conducted a retrospective review at Aga Khan University Hospital, Karachi, including adults (≥18 years) admitted to the medical ICU between 2002 and 2022. Statistical analyses (Chi-square, Fisher’s exact, Mann-Whitney U, and logistic regression) assessed associations and predictors of mortality.Results: Among 115 patients, most were young adults (18–30 years, 47%) and male (71.3%). Organophosphorus (OP) compounds were the most common (39.1%), followed by household bleach and paraquat (24.3%). Median ICU stay was 5 days, and hospital stay was 9 days. ICU mortality was 18.3%, with 81.7% surviving to discharge. Gastric lavage was performed in 23.5%, and antidotes in 65.2%, with slightly higher survival among recipients (66% vs. 61.9%). OP poisoning was linked to central nervous and cardiovascular complications, while methanol poisoning was strongly associated with acute kidney injury. Non-survivors had shorter ICU stays, more renal complications, higher vasopressor use (90.5%), and increased need for renal replacement therapy (52.4%). Logistic regression identified longer hospital stay (OR = 1.124, p = 0.044) and vasopressor use (OR = 0.029, 95% CI: 0.005–0.176) as significant mortality predictors.Conclusion: Poisoning-related ICU admissions mainly affected young males, with OP compounds and methanol as leading toxins. Methanol poisoning and vasopressor requirement were strongly associated with mortality. Early recognition and aggressive management are essential for improving outcomes.
Background: This study investigated the relationship between environmental particulate matter and electrocardiographic parameters, SpO2, creatine kinase-MB, and cardiac troponin in cardiovascular patients with COVID-19.Methods: This cross-sectional analytical study obtained information about the concentration of environmental particulate matter (PM10, PM2.5) from March 20, 2020, to March 20, 2023, from the Abadan Environmental Department. Clinical and laboratory information of cardiovascular patients with COVID-19 who were hospitalized at Ayatollah Taleghani Hospital in Abadan during this period was collected. The relationship between environmental particulate matter and SpO2, ECG parameters, troponin, and creatine kinase MB in these patients was investigated.Results: 58.5% of patients were female, with a mean age of 63.03 ± 15.21. The mean ejection fraction (EF) was 30.41 ± 22.69, and the mean peripheral capillary oxygen saturation (SpO2) was 87.56 ± 11.28, which were lower than normal. The study of the association of environmental particulate matter with clinical and laboratory diagnostic factors in cardiovascular patients with COVID-19 showed that the association between disease progression and troponin T with PM2.5 was significant, and no significant association with environmental particulate matter was observed in other factors. Also, mean PM2.5 was significantly higher on days when patients died, and it was significantly higher in patients with positive troponin T.Conclusion: These findings suggest that exposure to higher levels of PM2.5 may be associated with an increased mortality risk compared to recovery. However, further studies controlling for confounding variables must confirm the causal relationship.
Background: Paraquat ingestion is associated with multi-organ failure and high mortality. The lack of management guidelines and an appropriate antidote is concerning. This report discusses the successful treatment and management of four patients at our tertiary hospital using a novel combination protocol.Methods: We treated four patients with paraquat ingestion who presented to our center with a novel combination protocol, which included administration of intravenous Methylprednisolone, N-acetylcysteine, Cyclophosphamide, oral Vitamin C and Vitamin E, and an antifibrotic agent. We followed up with these patients in the hospital, monitoring their clinical outcome.Results: The ingested volume of paraquat ranged from 10 ml to 50 ml of 24% paraquat. Three patients had paraquat tongue with corrosive injury. We noted a serial rise in creatinine levels in all patients, which returned to baseline on follow-up. Three patients had ground-glass opacifications on a high-resolution Chest computerized tomography scan. At follow-up, we noted normal renal and liver function, with no delayed effects or complications in these patients.Conclusion: A combination therapy with immunosuppression, high-dose antioxidants, and antifibrotics has demonstrated potential in treating paraquat (PQ) poisoning, preventing progressive pulmonary fibrosis, and improving survival. This protocol has shown progress in PQ poisoning management and has laid the groundwork for future research.
Background: Gentamicin is a commonly used antibiotic in neonatal intensive care units with known renal and auditory toxic effects. Several studies have aimed to reduce these adverse effects, which are mainly related to dosage and infusion rate. Reducing the frequency of gentamicin injections may save time, money, and human resources. This study aimed to compare the toxic effects of gentamicin administered once daily versus twice daily in neonates. Methods: All neonates hospitalized in the NICU who met eligibility criteria and were receiving gentamicin therapy were recruited using a non-random, target-based sampling method. Participants were randomly assigned to two groups: group A received gentamicin once daily, and group B twice daily. Therapeutic efficacy, nephrotoxicity, ototoxicity, and mortality rates were compared between the groups based on clinical evaluation, laboratory data, and audiometric tests. Serum urea and creatinine levels were assessed to evaluate nephrotoxicity, while otoacoustic emissions (OAE) and automated auditory brainstem response (AABR) tests were used to assess ototoxicity.Results: Therapeutic effectiveness and nephrotoxicity were similar between the groups. Audiometric tests were normal in group A, whereas 6 patients in group B showed abnormal OAE and AABR results, which was statistically significant (P=0.012). No neonatal deaths occurred in either group.Conclusion: Once-daily gentamicin administration results in fewer audiological side effects compared to twice-daily dosing, highlighting its importance in reducing toxicity and conserving resources.
Background: Heavy metals toxicities have been implicated in many biochemical, physiological, and hematological changes, some leading to the development of many organ pathologies. Miners, and even non-miners living in mining areas, are constantly exposed to these toxicities and therefore, possible sufferers of organ failures. Some mechanisms involved in the development of these changes are already elucidated, while some are not. Methods: This review brings together many findings on the effects of these heavy metals on both occupationally and environmentally exposed individuals, and attempts to suggest some modes of action of these metals in bringing about the adverse effects. Published articles on the effects of heavy metals and priority heavy metals were randomly sourced from the internet using search terms like “toxicity of priority heavy metals”, “effects of heavy metals on miners”, biochemical changes in liver, kidney, heart of heavy metal miners”, “hematological changes in occupationally and non-occupationally exposed lead miners”, “priority heavy metals in ethno-medicinal plants. Also, unpublished work and personal experiences were used but not referenced.Results: The results showed wide adverse effects of heavy metals on internal organs, especially the kidney, liver, and heart, of both occupationally and environmentally exposed subjects.Conclusion: Artisanal system of mining in developing and underdeveloped countries can be a major culprit in the development of these organ pathologies. Therefore, government regulation and legislation will be a saving grace to the miners and other occupants of mining areas.
