Toxicity Mechanism of Dangerous Scorpion Stings in Iran.

Background: Considering the importance of scorpions and recognizing the mechanisms of toxicity caused by their medically important species in Iran and adopting the best therapeutic approach based on these mechanisms, this study was performed by reviewing the clinical manifestations of scorpion stings. Methods: The research was conducted by searching for articles and researches in related websites (PubMed, EMBASE, Scopus, Web of Science and CINAHL) and using domestic and international authoritative journals using the keywords of scorpion, clinical manifestations, in a review method. Finally, 104 qualified sources were selected and after reviewing and criticizing these studies, the author's point of view was presented. Results: Clinical manifestations of Scorpion sting toxicity vary due to the existence of two toxic classes of neurotoxins and cytotoxins or hemotoxins in these arthropods in Iran. The number and distribution of species with neurotoxic venom are higher than the scorpions with cytotoxic venom and are reported throughout Iran. Scorpions with cytotoxic venom are mostly widespread in south and southwest of Iran. Conclusion: Treatment and prevention of scorpion stings in Iran and neighboring countries in the Middle East should be planned based on the mechanism of toxicity and the presence of toxic classes with neurotoxic or cytotoxic venoms.

Toxic reaction of a 3-year-old boy due to Hornet multiple stings in Kerman-Iran province: A case report.

A three-year-old boy was attacked by a group of hornets and the head, arms, back and buttocks of the child were targeted to various stings. The child was first taken to a rural clinic and then to a hospital in Baft city. At arrival to rural clinic, the child was conscious and approximately 30 hyperpigmented, painful and itchy papular lesions was seen on his body. Head and neck weren't erythematous and edematous. However gradually, the face, lips, eyelids, and neck became swollen. The child became restless and itchy in the sting sites. Stress induced hyperglycemia occurred. Despite supportive treatments, the clinical conditions get worse and progressed. He referred to the pediatric ward of Afzalipour hospital in Kerman and admitted to intensive care unit (ICU). The child was ill and oliguric. The treatment was started including: hydration with normal saline and diuretic agent (furosemide), insulin, corticosteroid, dopamine and calcium. But a systemic toxic reaction occurred during the hospitalization. Hemolysis, hematuria, anemia, thrombocytopenia and rhabdomyolysis, myoglobinuria, acute renal failure, hepatic injury, epistaxis and respiratory distress was happened. In order to urine alkalinization, sodium bicarbonate was added to his treatments. Also, plasmapheresis was performed. Then according to acute tubular necrosis (ATN) (due to intravascular hemolysis and rhabdomyolysis), pleural effusion and respiratory distress, intermittent hemodialysis was started one day in between. After five intermittent hemodialysis sessions and nineteen days after hospitalization, the patient was discharged in relatively good general condition.

Opium as a risk factor for upper gastrointestinal cancers: a population-based case-control study in Iran.

BACKGROUND: Gastrointestinal cancers, including esophageal, gastric, liver and pancreatic are relatively common in Iran. Furthermore, consumption of opium and its derivatives (O&D) are considerable. This study, aimed to examine the association between consumption of O&D and the incidence of upper gastrointestinal (UGI) cancers. METHODS: In a matched case-control study in Kerman (located in southeast of Iran), 142 patients with UGI cancers and 284 healthy people (matched in terms of age, sex and residence (urban/rural)) were recruited. Variables (using O&D, smoking, alcohol use and diet) were collected using a structured questionnaire. Conditional logistic regression models were used to assess the above mentioned association. RESULTS: Opium use was associated with an increased risk of UGI cancers with an adjusted OR 4.0 (95% CI=2.2-7.0). A very strong dose-response relation was observed between consumption of O&D and the incidence of UGI cancers. (Three consumption levels-none, low and high; OR=18.7; 95% CI=5.5-63.3). This dose-response relationship was also strong even in patients with gastric cancers (OR=9.2; 95% CI=2.5-33.7). CONCLUSION: The results of this study showed that opium consumption can be a strong risk factor for UGI cancers in Iran.