Characteristic features of patients hospitalized with Narcotic poisoning in Yazd, Iran (original) (raw)
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Introduction: Poisoning is a major health problem worldwide and one of the most common reasons for visiting emergency departments (EDs). The object of this study was to determine the epidemiological characteristics of poisoned patients referred to emergency department of Bandar Abbas Shahid-Mohammadi hospital in 2011-2012. Methods: In a cross-sectional study between March 2011 and February 2012 all the paitents admitted through ED for further evaluation and treatment were investigated. Data were gathered from direct interviewing and patient's medical files by using a checklist and analyzed by SPSS version 16 using descriptive statistical tests, Chi-Square and t-test. Results: Poisonings comprised 3.6% of emergency department patients. During the study period, 493 patients with drug or chemical exposure were admitted. Of them, 52.1% were male and 47.9% were female. 75.7% were between the ages of 14-29 years. Benzodiazepines (23.1%) followed by Tramadol (20.1%) were the most common cause of poisonings. Intentional poisonings constituted the majority of cases (67%). The mean age of suicidal cases was lower (23.3 vs 30.3). The majority of patients were single (52.9%), unemployed (58.4%) and living in urban centers (75.3%). 26% of patients had a diagnosed psychiatric disease, 13% had previous suicidal self-poisoning and 32.3% were addicted. 2.2% of patients were died during hospital stay. Conclusion: In this study, poisonings most commonly occur as intentional and mostly by pharmaceutical agents. The prevalence was higher in younger individuals than other groups. According to these findings, the authorities have to prevent its further occurance by screening of psychiatric diseases in poisoning cases and early treatment of them, as well as limiting easy availability of drugs.
IOSR Journals , 2019
Background: Poisoning is a global public health problem largely underexplored in North east India. This study describes the mode (suicidal, accidental, homicidal) and type of poisoning; relation to age, sex, occupation; outcome of different type of poisons and requirement of ventilatory support in different type of poisonings. MATERIALS AND METHODS This observational study was conducted in Department of Medicine of GUWAHATI NEUROLOGICAL RESEARCH INSTITUTE, NORTH GUWAHATI over a period of one year. A total of 234 patients were enrolled in the study after obtaining informed consent. RESULTS Poisoning was more common among males (62.39%). Maximum number of patients were in the age group 18-30 years (58.55%) and consumption was found to be more prevalent in rural population (79.49%). Most of the patients were farmers and students. Most common types of poisoning were organophosphate (n=92, 39.32%), snake bite (n=41, 17.52%) followed by alcohol (n=31, 13.24%). Out of 234 patients, 220 (94.02%) improved while 14(5.98%) expired. Mortality was highest in organophosphate poisoning. Requirement of ventilatory support was most commonly associated with alcohol intoxication (32.26%) followed by organophosphate poisoning (20.65%). CONCLUSION Poisoning was more common in young males. Pesticides and snake bite were major causes of poisoning. Complications though rare were potentially preventable by community education and awareness on timely attention to seek medical care, and avoidance of harmful first aid practices. Training of peripheral health center personnel to manage cases of poisoning, to provide ventilatory support and escalation in public awareness about the importance of problem should be done.
Background and objectives: Drug poisoning is a serious global health problem that sometimes requires hospitalization and intensive care. This study investigates clinical and demographic profile of acute poisoning cases admitted to the intensive care unit (ICU) of 5 Azar hospital in Gorgan, Iran. Methods: This cross-sectional descriptive study was carried out on 440 acute drug poisoning cases (224 men and 190 women) who had been admitted to the ICU of the hospital from March 2008 to March 2018. Data were collected with a checklist and using the census method. The collected data were analyzed using SPSS (version 16) and the Chi-square test. Results: Of 440 cases, 54.1% were male and 43.7% were aged 20-29 years. Suicide attempt by selfpoisoning was the most important type of poisoning (70.8%). Benzodiazepines (38.9%) and narcotic drugs (18.6%) overdose was the most common cause of acute poisoning. The majority of incidents (72.7%) were caused by a single drug. The average length of stay in the ICU was 4.21 ± 3.45 days. Acute poisoning-related mortality rate was 4.1%, which was primarily due to the use of narcotic drugs. Conclusion: Benzodiazepines and narcotics are the primary agents involved in acute poisoning requiring critical care. Moreover, methadone-based narcotics are the main cause of drug poisoningrelated mortality.
General Approach to Poisoned Patient
Poisoning in the Modern World - New Tricks for an Old Dog?, 2019
Poisoning is a serious worldwide public health problem. Based on the World Health Organization data in 2012, almost 190,000 people died worldwide and the number of deaths due to poisoning in 2008 exceeded the number of deaths due to motor vehicular crashes; also, poisoning death rate nearly tripled worldwide. The number of patients presenting to the emergency departments with overdose had been increased both intentionally and accidentally. All the previous facts make toxicology an important field in emergency medicine. According to the American Association of Poison Control Centers (AAPCC) in the United States, over 2.1 million human exposure calls are reported in 2016. Management of intoxicated patients has a unique approach because of the challenge in diagnosis and treatment of overdose cases. This chapter focuses on general approaches for intoxicated patients and initial management and on how the history and physical examinations could help physicians to have a clue about the drugs that have been abused. Patients are most commonly poisoned via oral ingestion, but other routes could also cause intoxication including inhalation, insufflation, cutaneous and mucous membrane exposure, and injection.
Health in Emergencies & Disasters Quarterly (HDQ), 2023
Background: Unintentional poisoning is a critical type of poisoning by which people injure themselves with no intention. Such a condition occurs accidentally, occupationally, or through abusive manners. The present study aims to examine the one-year frequency and causes of unintentional poisoning in patients treated by the prehospital emergency center in Qaemshahr City, Iran, in 2016. Materials and Methods: This is a cross-sectional descriptive study of 259 patients with unintentional poisoning. The variables were extracted and then registered in the questionnaires. The data were analyzed by the SPSS software. Results: In this study, 83.8% of the patients were male and 16.2% were female. Most toxicity cases (89.1%) were unintentional as a result of drug abuse in the forms of tramadol abuse (42.8%), narcotic drugs (26.6%), and alcohol (19.7%), ranking 1 to 3, respectively. A total of 48.2% of the unintentional poisoning cases were caused by medicinal factors and other cases (51.8%) were due to non-medicinal agents. Benzodiazepines and cardiovascular drugs were the most common drugs causing a medicinal overdose. Gastrointestinal poisoning was the most prevalent way of toxicity (77.6%) and the rate of death was 4%. Conclusion: The results of the present study and similar research show that unintentional poisoning includes large populations of toxicity cases that occur mainly by drug abuse, such as tramadol and narcotic drugs. This study can be considered a pattern to conduct more research in the relevant fields.
INTENSIVE CARE MANAGEMENT OF POISONING
Poison is a substance capable of producing damage or dysfunction in the body by its chemical activity. Poisoning can be accidental or intentional. In many parts of the developing countries pesticide poisoning, insecticidal poisoning, drug over dose, and cosmetics poisoning, causes more deaths than infectious diseases. To study the pattern of poisoning cases admitted in Medical Intensive Care Unit of selected Hospital, to list the type of poisons consumed, observe the symptoms, antidotes used in these cases and to prepare guidelines for the management of the same. The study was conducted for a period of 9 months. The ethical committee clearance was obtained from Institutional Review Board of Hospital. Data of all patients admitted to MICU for the treatment of poisoning was collected from their case sheets. The data was analyzed for demographic profile of patients, patterns of specific drug and antidote use. During the period of study, 55 patients were enrolled. Guidelines for the management of poisons that we came across in our study were made for the reference of the clinicians. In conclusion it can be said that identification of pattern of poisoning cases and antidotes used helps in making guidelines for the management of the same.
Journal of Clinical and Experimental Investigations
The purpose of this study was to investigate the demographic and etiologic features of acute poisoning cases, the toxic substances which cause the poisonings and their properties, laboratory findings and clinical features retrospectively and to show what could be the precautions to be taken. Patients and Methods: Total of 483 patients, who were admitted to emergency department with drug poisoning within 3 years and whose information was available were taken into this retrospective study. The patients' age, sex, date of admission to hospital, duration of hospitalization in emergency department and intensive care unit, clinical outcomes, agents and amounts of drugs taken, applied antidote and extracorporeal treatments, laboratory values of cases were examined. Results: 179 (37,1%) of the cases were followed up for an average of 3,21 ± 4,5 days in the intensive care unit and 304 (62,9%) patients were followed up for an average of 2,1 ± 2 days in the observation unit of the emergency department. When the lipophilicity of poisoning drugs were examined, in 191 (39.5%) patients only lipophilic, in 100 (20.7%) patients lipophilic and additional substance, in 83 (17.2%) patients only hydrophilic and in 109 (22.6%) patients hydrophilic drug and additional substance was found. Extracorporeal treatment was applied to 14 patients. Our mortality rate was found 0.62%. Conclusion: Early intervention in poisonings is life-saving. Supportive therapies, antidotes and extracorporal techniques may reduce mortality, but toxicological guidelines may be needed to guide clinicians in more extensive studies.
Scientific reports, 2024
The pattern of poisoning varies in different societies. In this study, we investigated the clinicalepidemiological features and outcomes of poisoned patients based on the substances involved, whether pharmaceutical or non-pharmaceutical toxins. This cross-sectional study involved a retrospective chart review of all poisoned patients who presented to the poisoning emergency hospital in the center of Iran between January 2015 and December 2019. We collected data on socio-demographics, the nature of the poisoning, and the outcomes. Backward stepwise binary regression analysis was conducted to predict the mortality. Throughout the study period, 5777 patients with acute poisoning met the inclusion criteria. Of these, 3524 cases (61%) were attributed to pharmaceutical, and 2253 cases (39%) were due to non-pharmaceutical poisoning. The majority of pharmaceutical poisonings (82.9%) were intentional, whereas non-pharmaceutical poisonings accounted for 46.2% of intentional exposures (P < 0.001). Patients with non-pharmaceutical poisoning were predominantly men, older in age, and had a history of addiction compared to those with pharmaceutical poisoning (P < 0.001). In binary logistic regression analysis, patients poisoned by nonpharmaceutical substances had a significantly higher risk of mortality [Odds ratio, 3.14; (95% CI 1.39-7.10); P = 0.006] compared to those poisoned by pharmaceutical substances (P < 0.001). The pattern of poisoning differs in terms of age and gender when comparing pharmaceutical to non-pharmaceutical poisoning. Patients poisoned by non-pharmaceutical may have a worse outcome compared to those poisoned by pharmaceutical substances.
Poisoning cause analysis among patients hospitalized in an emergency department
2019
Consequences of using psychoactive substances are always negative. They cause not only physical and mental dependence, but also huge damage in the body in case of poisoning. The toxicity of these substances varies and depends on the type of chemical compound. The effects can be difficult to predict and often can pose a direct threat to life and health. The objective of this study was to analyse the causes and consequences of poisoning with psychoactive substances among patients hospitalized in the Emergency Department of Stefan Kardynał Wyszyński Province Specialist Hospital in Lublin within the period of one year (01.01.2016-31.12.2016). Our own study results showed that men and people living in urban areas were the patients most frequently admitted to the Emergency Department due to poisoning. Alcohol was the most common psychoactive substance used by the patients in the study group. Poisoning with anti-epileptic, sedative-hypnotic and psychotropic medications predominated among women, whereas alcohol and narcotics and psychodysleptic medications were the most frequent cause of poisoning among men.
Asian Journal of Pharmaceutical and Clinical Research, 2020
Objective: Poisoning with suicidal intention is a serious health issue among adults. Poisoning, as an emergency, is more common in India due to the easy availability of poisons, increased use of chemicals in industrial and domestic purposes. The objective of the study is to evaluate the nature of poisoning cases and the drug utilization pattern of poisoning cases. Results: Among 127 total patients, 113 cases were suicidal. Systemic poisons (47.24%) were more consumed in our study, among which benzodiazepines (16.54%) being the most common sub-class ingested. Of the 862 medications prescribed, normal saline (38.97%) was the most commonly infused intravenous fluid. Gastric lavage (38.1%) has been the most frequently used general measures. Injection pantoprazole (50.6%) was the commonly prescribed anti-ulcer drug. The most commonly used analgesic (47.83%) was paracetamol, antimicrobial agent was cefotaxime (25%), Vitamin and minerals were Vitamin B complex (68%), steroid was hydrocortisone (76%), and antidote was atropine (37.5%). Conclusion: The magnitude of poisoning was high for suicidal purposes, in the young age group and in females. Intravenous fluids and general measures were the mainstay of the management of poisoned cases. Educational programs with an emphasis on preventive measures for toxic exposures are necessary to create awareness and to construct preventive strategies. Suggestions like poisoning centers in tertiary care hospitals will also help decrease morbidity and mortality.