Background and Objectives-Poisoning due to drugs and chemicals is influenced to a large extent by the population’s socioeconomic and cultural status. The purpose of our study was to determine and present the pattern of Poisoning with drugs and chemicals in 2 Poisoning referral centers in Gilan province, northern Iran, and to analyze medical and social parameters involved. Methods-This retrospective cross-sectional study was performed on 1215 cases of Poisoning (with drugs and chemicals) who were hospitalized in 2 Poisoning referral centers, namely, Razi and 17-Shahrivar Hospitals in Rasht during a three-year period. Chi-square and a values were considered for the statistical analysis. Results-Five-hundred and twenty-six of the Poisoning cases (25%) were children and 1625 cases (75%) were adults. Poisoning was most common in the 15-64 years age group and in women. In order of frequency, the three most common causes of Poisoning in adults were organophosphorous compounds, rat-killers, tranquilizers and anticonvulsants, and in children they were kerosene oil, detergents, and metoclopramide. The fatality rate was 1-4%. A significant statistical relationship (p<0.05) was noted between the type of poison and patient’s age, sex, occupation, residence (village/city), cause of Poisoning (intentional/ accidental) and season in which the Poisoning occurred. Conclusion-It was seen that women between 15-64 years of age were more prone to suicidal Poisoning with organophosphorous compounds in spring and summer and children of 1-4 years of age were more susceptible to accidental Poisoning with kerosene oil and its derivatives in the spring. The fatality rate of this study was higher as compared to other cities in Iran and other industrialized countries. It is thus recommended that more preventive measures be taught to the general population.

Background: Acute drug Poisoning remains an important public health problem and represents the second most frequent accidental disease in children. In this study, we identified epidemiological and clinical features of children admitted for acute drug Poisoning and related factors associated with suicidal Poisoning.Methods: We conducted a retrospective study in the Department of Pediatrics, the Military Hospital, Tunis, over a period of 8 years (2008-2014). Children aged less than 16 yr and admitted for acute drug Poisoning were included. Cases of drug addiction were excluded. Two groups were compared: accidental Poisoning / suicidal Poisoning.Results: We collected 150 cases. The ratio male / female was 1: 1.2. The mean age was 4.3 yr. Poisoning was due to one drug in 82% of cases. Children were asymptomatic in 39% of cases, had digestive and neurologic symptoms respectively in 30% and 20% of cases, respectively. Psychotropics came in the first place (20%) followed by paracetamol (16%). Two groups were identified: accidental Poisoning (74 %) and suicidal Poisoning (26%). Four factors were significantly associated with suicidal Poisoning: age ³8 yr (P<0.001, OR=16.25, 95% IC: [6.44-40.95]), female gender (P=0.011, OR=5.4, 95% IC: [2.09-13.91]), multiple drug intake (P <0.001, OR=9.42, 95% IC: [3.05-29.03]) and use of psychotropics (P=0.003, OR=4.81, 95%IC: [2.06-11.26]).Conclusion: Two groups had to be distinguished: accidental and suicidal drug Poisoning. The identification of their characteristics and their predisposing factors is necessary in order to take appropriate preventive actions.

Background: Following pulmonary aspiration of gastric contents, a variety of conditions occurs ranging from the acute inflammatory response (aspiration pneumonitis) to an infectious process (aspiration pneumonia). They cause due to the failure of protecting mechanism of airway patency following Poisoning toxicity.Methods: Patients with acute drug Poisoning for assessment of aspiration-induced lung injury evaluated during the twelfth months.Results: 410 participants followed the study. Of those, 249 (61 %) were male and 161 (39%) female. They ranged between 17-55 years. The mode was 25-39 years with frequency of 38%. The mean±SD of age was 32.3±14.5 (Female 34% and Male 27% respectively). The mean age ±SD of females was lower than males (27.3±12.4 vs.34.4±14.4 years old). An episode of vomiting was recorded positive in 62% (254) of patients. They were recorded by self-reported or witnessed by someone else within the first hours of Poisoning. The chest radiograph abnormality was observed mostly in both lungs (45%, 185). They consisted of multifocal patchy infiltrates in lungs 44% (178), diffuse bilateral infiltration 35% (144), and bilateral perihilar consolidation 18% (72) and lobular consolidation 4% (16) mainly in both lung fields (45%, 185). Aspiration related pulmonary complications attributed to pneumonitis 43.5% (178) including ARDS 35% (144), pneumonia 18% (72), and lung abscess 4% (16). There was a significant relationship with vomiting (P=0.04).Conclusion: Aspiration pulmonary abnormalities were the commonest lung manifestation of drug toxicities. Chest x-ray abnormalities associated with vomiting presentation are clues to finding pulmonary complications of acute drug toxicity.

Objective: In this study, we evaluated the predictive factors for the occurrence of metabolic acidosis in patients with multi‑, drug Poisoning, including antidepressants (Ad)/antipsychotics (Ap). Methods: This cross‑, sectional study was carried out in the referral Poisoning center, Khorshid University Hospital, affiliated with Isfahan University of Medical Sciences. All patients with multi‑, drug ingestion, including Ad/Ap, were included in the study. Patients were divided into two groups with and without metabolic acidosis. Demographic factors, time from ingestion to admission, clinical manifestations, length of hospital stay, and outcome were compared in two groups. Binary logistic regression was used to identify factors associated with the risk of metabolic acidosis occurrence. Findings: Among the 206 evaluated patients, 45 patients (21. 8%) had metabolic acidosis whom the majority were female (73. 3%) with intentional purposes (77. 8%). 31. 1% of the patients with metabolic acidosis had tachycardia on admission (P = 0. 03). Among all variables, time from ingestion to admission (P = 0. 02) and lengths of hospital stay (P = 0. 002) were significantly different between patients with and without metabolic acidosis. Tachycardia on admission (adjusted odds ratio [OR], 2. 24,95% confidence interval [CI]: 1. 05–, 4. 76,P = 0. 036) and time from ingestion to admission (adjusted OR, 1. 06,95% CI: 1. 00–, 1. 13,P = 0. 04) were also the predictive factors in occurrence of metabolic acidosis. Most of the patients survived without any complications (94. 6%), of whom 72. 3% had no previous underlying somatic diseases (P = 0. 05). Conclusion: Admission tachycardia and the time elapsed from ingestion to admission may be considered important factors for predicting metabolic acidosis in multi‑, drug Poisoning, including Ad/Ap.

Dear Editor/s:I found one article on the website of IJMTFM, which had studied the consequences of aspiration of gastric contents in acute Poisoning patients (1). It was informative. Unfortunately, there are some errors in that article, which I would like to bring to your kind attention.The errors are with regard to citing of references in the discussion section of that article (1). In the first paragraph of the discussion section, the reference cited for the sentence, "Adnet and Baud demonstrated that the risk of aspiration increases with the degree of impairment in consciousness by the Glasgow Coma Scale measurement (8)." does not match.