Potential Association Between Latent Toxoplasma gondii Infection and Suicide Attempts: A Case-Control Registry-Based Study.

Toxoplasma gondii is a ubiquitous parasitic protozoan that may be an important cause of neurological and psychiatric diseases. The purpose of this case-control registry-based study was to evaluate the prevalence of T. gondii infection and related risk factors among subjects who attempted suicide by drug use and a control group at the Iranian National Registry Center for Toxoplasmosis in Mazandaran Province, northern Iran. Baseline data were collected from participants using a questionnaire, and a blood sample was taken from each individual. The plasma was prepared for serological analysis, whereas the buffy coat was used for molecular analysis. Out of 282 individuals (147 cases with suicide attempters [SA] and 135 controls), 42.9% of patients and 16.3% of control subjects were positive for anti-Toxoplasma immunoglobin G (IgG), but all participants were negative for T. gondii DNA and anti-Toxoplasma immunoglobin M. Based on multiple logistic regressions, IgG seropositivity in SA in the age group of 20-30 years was 3.22 times higher than that in the control group (p < 0.001). These findings suggest that latent T. gondii infection among SA is significantly higher than that in healthy individuals, indicating a potential association between latent toxoplasmosis and SA at least in the studied area. Further research is needed to shed light on the potential association between T. gondii and suicide among different populations and areas of the world.

Management of organophosphorus poisoning and the role of magnesium sulfate: A scoping review of literature.

Organophosphorus agents are easily absorbed via respiratory, gastrointestinal, and dermal routes, and inhibit the acetylcholine transferase enzyme (AChE), which is responsible for the majority of toxicity caused by organophosphates in the body. A comprehensive search was conducted across three prominent databases, namely Google Scholar, PubMed, and Science Direct, to identify relevant articles published. The search focused on the keywords "MgSO4" or "magnesium sulfate" in conjunction with "organophosphate" or "organophosphate poisoning." Inhibition of AChE results in the accumulation of acetylcholine (ACh) in synapses and stimulation of cholinergic receptors. Considering that several studies have shown the use of magnesium sulfate (MgSO4) in inhibiting the release of ACh in the central and peripheral sympathetic and parasympathetic synapses, this study was conducted to review the role of MgSO4 in the treatment of OP. The intravenous administration of MgSO4 exhibits favorable tolerability and clinical efficacy in alleviating cardiac toxicity associated with OP exposure.

Massive intracerebral hemorrhage following methamphetamine poisoning in a man: A case report.

INTRODUCTION AND IMPORTANCE: Methamphetamine (MAP) is a highly addictive stimulant known to have detrimental effects on the brain and various physiological systems, including an elevation in heart rate and blood pressure. Additionally, MAP use has been linked to the development of intracerebral hemorrhage (ICH), a serious and potentially fatal condition that is notably prevalent among young individuals. CASE PRESENTATION: We present the case of a 42-year-old man who suffered a massive ICH due to hypertension resulting from MAP poisoning. The patient presented with symptoms of nausea, vomiting, and blurred vision for around two hours following the accidental inhalation of MAP. However, his condition was significantly improved through the implementation of neurosurgical intervention. CLINICAL DISCUSSION: In recent years, the misuse of MAP among young adults has raised concerns about its association with ICH. ICH is a type of stroke where a blood vessel in the brain ruptures due to high blood pressure, causing bleeding. This medical emergency can lead to various symptoms, such as severe headaches, loss of consciousness, and paralysis. ICH is indeed a serious and life-threatening condition that necessitates prompt medical attention. It can also lead to long-term adverse effects for the individual affected. CONCLUSIONS: The association with ICH and MAP abuse among young adults is a substantial public health issue. To gain a comprehensive understanding of the mechanisms underlying MAP abuse-induced elevation of ICH risk, further exploration is necessary.

Epidemiological Aspects of Opioid Poisoning in Northern Iran: A Registry-Based Clinical Study.

Opioids are a class of drugs that are commonly used to manage pain due to their analgesic and sedative effects. However, the high consumption of opioids in the community has led to an increase in the incidence of overdoses and poisonings caused by various types of these drugs, whether intentional or unintentional. Therefore, comprehending the epidemiological features of patients experiencing opioid poisoning is crucial. We decided to investigate various epidemiological aspects of patients with opioid poisoning in the Mazandaran province, located in northern Iran, during the period of 2020 to 2021. The present investigation was conducted as a descriptive cross-sectional study, wherein we collected data on patients registered in the Mazandaran Registry Center of Opioid Poisoning (MRCOP) who had a history of using any kind of opioid. We collected information on various parameters, including patient demographics, the type of opioid consumed, the mode of consumption, and clinical outcomes. A total of 240 patients were initially registered at the registry center. However, 17 cases were excluded with personal consent, and eventually, a total of 223 patients were included in the investigation. The majority of the patients 70.9% (n = 158) were male, and the average age was 34.4 ± 16.55 years. The most common cause of poisoning reported in our study was intentional, which was mainly due to a suicide attempt. Furthermore, the most prevalent type of opioid consumed was methadone. The most frequently observed symptoms of poisoning among the patients were drowsiness, a decreased level of consciousness, and reduced arterial oxygen saturation levels. Based on the results of our study, several factors were found to be significant in methadone poisoning, including addiction, age, gender, suicide attempt, and a history of psychiatric disorder. These findings highlight the need for public education and awareness campaigns on the risks associated with opioid use, particularly methadone.

Potential diagnostic application of a novel deep learning- based approach for COVID-19.

COVID-19 is a highly communicable respiratory illness caused by the novel coronavirus SARS-CoV-2, which has had a significant impact on global public health and the economy. Detecting COVID-19 patients during a pandemic with limited medical facilities can be challenging, resulting in errors and further complications. Therefore, this study aims to develop deep learning models to facilitate automated diagnosis of COVID-19 from CT scan records of patients. The study also introduced COVID-MAH-CT, a new dataset that contains 4442 CT scan images from 133 COVID-19 patients, as well as 133 CT scan 3D volumes. We proposed and evaluated six different transfer learning models for slide-level analysis that are responsible for detecting COVID-19 in multi-slice spiral CT. Additionally, multi-head attention squeeze and excitation residual (MASERes) neural network, a novel 3D deep model was developed for patient-level analysis, which analyzes all the CT slides of a given patient as a whole and can accurately diagnose COVID-19. The codes and dataset developed in this study are available at https://github.com/alrzsdgh/COVID . The proposed transfer learning models for slide-level analysis were able to detect COVID-19 CT slides with an accuracy of more than 99%, while MASERes was able to detect COVID-19 patients from 3D CT volumes with an accuracy of 100%. These achievements demonstrate that the proposed models in this study can be useful for automatically detecting COVID-19 in both slide-level and patient-level from patients' CT scan records, and can be applied for real-world utilization, particularly in diagnosing COVID-19 cases in areas with limited medical facilities.

Accidental vitamin D3 overdose in a young man.

Vitamin D3 (VD3) is a fat-soluble vitamin that can accumulate in the body and lead to toxicity by increasing 25(OH) D levels when consumed in large amounts. Maintaining 25(OH) D levels greater than 30 ng/mL is crucial for overall health due to the significant role of vitamin D in the body. The most common causes of VD3 intoxication are manufacturing errors or self-administration. Currently, there is no definitive data on the dose and duration of VD3 consumption that leads to toxicity. The maximum daily doses of VD3 that can be tolerated without causing adverse effects are not established. The maximum recommended amount for long-term supplementation is 2,000 units per day. Vitamin D3 toxicity (VDT) can present in various scenarios, ranging from asymptomatic to gastrointestinal, and in severe cases with neuropsychiatric and life-threatening symptoms. We report the case of a 29-year-old man who presented with symptoms of VDT following an accidental overdose of VD3 over 2 weeks.

Fatal peritonitis due to gastric perforation in a male heroin addict: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Perforation of hollow organs, such as the stomach, within the abdomen can lead to the development of acute abdomen, a critical and potentially life-threatening condition. It is important to note that there is currently insufficient information available regarding the specific effects of heroin, an illegal substance commonly abused, in causing this particular complication. CASE PRESENTATION: We present the case of a 32-year-old male who is addicted to heroin and was admitted to an addiction rehabilitation center with the aim of overcoming his addiction. After a few days of admission, the patient developed symptoms of abdominal pain, anorexia, and subsequent neurological manifestations, such as drowsiness, confusion, and a decreased level of consciousness. Tragically, the patient suffered a cardiorespiratory arrest upon arrival at the emergency room and despite efforts to resuscitate him, he unfortunately passed away. CLINICAL DISCUSSION: During the autopsy of the aforementioned case, an observation was made of a perforation in the stomach, which ultimately led to the cause of death being identified as peritonitis. Acute peritonitis is recognized as one of the potential causes of acute abdomen, often resulting from the rupture of hollow organs within the abdominal region. It is characterized by inflammation of the serous membrane that lines the abdominal cavity. CONCLUSIONS: Indeed, conducting original and coherent studies to investigate the potential effects of heroin on gastric perforation could prove to be highly valuable in facilitating the timely diagnosis and treatment of this fatal complication.

The clinico-epidemiological, diagnostic and therapeutic aspects of methanol poisoning: A five-year retrospective study, northern Iran.

INTRODUCTION: Methanol poisoning (MP) is a serious health issue that has become more prevalent in recent years and has resulted in numerous deaths. Early detection and timely treatment are critical for preventing fatalities and reducing the incidence of neurological complications. PATIENTS AND METHODS: This study was designed as a retrospective investigation with the purpose of analyzing the clinico-epidemiological, diagnostic, and therapeutic aspects of patients who were admitted to two training hospitals in northern Iran due to MP. The selection of samples for this study was based on a pre-defined checklist. Following the completion of the treatment period in the hospital, the patients were categorized into three groups based on their clinical outcome. All relevant variables for each group were recorded and reported separately, using the SciPy library in the Python programming language. RESULTS: The majority of the patients (88.12%) were male (P=0.012), the average age was 41.46, and mostly (82.18%) lived in urban regions (P=0.025). The primary clinical complaint reported was visual disorders, accounting for 75.25% of the cases, followed by nervous, gastrointestinal, respiratory, and chest pain accordingly. The average hospitalization length for the patients was 5.065 days. Out of the 101 patients, 65 (64.36%) were discharged without any complications, 17 (16.83%) were discharged with complications, and unfortunately, 19 (18.81%) were died. CONCLUSION: A decreased level of consciousness and severe metabolic acidosis are commonly associated with unfavorable outcomes in MP. The use of systemic corticosteroids as a treatment method has a significant association with reducing mortality rates.

Nasal Leishmaniasis Misdiagnosed With Intranasal Polyp in a Patient Candidate for Rhinoplasty.

Mucosal leishmaniasis (ML) is a chronic and rare form of leishmaniasis that causes malignant lesions in the mucosa of the nasal, pharyngeal, and laryngeal regions. We describe a 29-year-old woman who had been suffering from an intranasal polyp for 3 years. The polyp recurred annually after surgical removal, and was diagnosed as nasal leishmaniasis.

Respiratory and intestinal trichobezoar in a female: An unusual case report and literature review.

Trichobezoars are hairballs in the gastrointestinal tract that usually develop due to the consumption of hair after pulling it. However, some rare case reports suggest that trichobezoar can also occur in the respiratory system. In this context, we present an unusual case of a 25-year-old woman who experienced dyspnea, productive cough, and leukocytosis. The patient was found to have a trichobezoar in her respiratory tract, accompanied by the presence of hair in her digestive tract.

Massive dermal ulcerative lesions due to brown recluse spider bite: a rare case report and review of literature.

A brown recluse spider (BRS) bite is challenging to confirm, but may be clinically diagnosed by considering the location, the season of the year, and the clinical manifestations. Here, the case of a 26-year-old male who presented after an insect bite with a skin lesion, bruising, severe swelling, and diffuse blisters on the right lower extremity after three days, is described. Following clinical examination, patient history assessment, and consideration of other relevant factors, the patient received a differential diagnosis of necrotizing fasciitis caused by BRS bite. Although spider bite poisoning is rare, proper diagnosis and management are important because, in some cases, the outcomes may be devastating.

Tramadol poisoning and its management and complications: a scoping review.

Tramadol (TR) is an opioid agonist (µ-opioid receptors) that also affects the noradrenergic and serotonergic systems. TR is a synthetic analgesic substance with opioid agonist properties that has been approved for pain management by affecting the central nervous system. Objective: The primary objective of this scoping review was to determine the poisoning consequences of TR and its associated symptom management techniques, as well as its effect on opioid and non-opioid receptors, metabolism, and complications on various organ systems. Discussion: Typically, acute overdose of TR is not considered life threatening, and most fatalities are attributed to polysubstance overdose. TR can cause drowsiness, headaches, seizures, respiratory depression, low heart rate, coma, and even death. Additionally, the prolonged use of TR can lead to addiction, with withdrawal resulting in both common and atypical symptoms. Conclusions: Therefore, it is recommended that patients with TR poisoning receive close monitoring of their cardiovascular system, along with a comprehensive management plan for their levels of consciousness and respiratory function.

Fatal outcome due to aluminum phosphide poisoning in an old man with a psychiatric disorder as a latent post-COVID-19 challenge: A case report.

Aluminum phosphide is a metal phosphide widely implemented as a pesticide. In the country of Iran, it is recognized by the colloquial name of rice pill. Any trace of accidental or intentional ingestion of aluminum phosphidecan result in severe hemodynamic disorders and metabolic acidosis, ultimately leading to the patient's mortality. In this report, we document the unfortunate demise of an 85-year-old man who lived in isolation, having lost his wife to COVID-19. The patient consumed aluminum phosphide tablets and, despite resuscitation efforts, inevitably succumbed to the toxic effects.

Severe metabolic acidosis due to massive metformin overdose in a man: a case report.

Metformin-associated lactic acidosis is an extremely unusual but potentially life-threatening condition. This condition is typically observed in individuals who are suicidal or have type II diabetes mellitus (DM) and have taken an overdose of metformin. In this case, we present the instance of a 43-year-old man who had type II DM and was addicted to oral opium. Following a suicide attempt with an overdose of metformin, he experienced symptoms such as nausea, vomiting, weakness and lactic acidosis. However, prompt and effective treatment was administered, including hemodialysis and adequate hemodynamic resuscitation, leading to a successful outcome.

Massive dermal ulcerative lesions because of brown recluse spider bite: a rare case report and review of literature.

A brown recluse spider (BRS) bite is challenging to confirm, but can be clinically diagnosed by considering the location, the season of the year and the clinical manifestations. We described a 26-year-old male who presented after a BRS bite with a skin lesion, bruising, severe swelling and diffuse blisters on the right lower extremity after 3 days. This case should be considered in the differential diagnosis of necrotizing fasciitis. Although spider bite poisoning is rare, proper diagnosis and management are important because, in some cases, it can have devastating outcomes.

Ruptured pulmonary hydatid cyst and lophomoniasis comorbidity in a young man: a rare case.

Hydatidosis is a parasitic and zoonotic infection caused by the larval stage of Echinococcus granulosus. Cysts of this parasite involve almost all the organs of the human body, especially the liver and lungs. Asymptomatic cases may develop into symptomatic pulmonary hydatidosis due to the rupture of hydatid cysts. Lophomonas, as causative agents of pulmonary lophomoniasis, is an emerging protozoan that mostly infects the lower respiratory airways. Clinical symptoms of these two diseases can mostly be overlapped. Herein, we describe the rare case of comorbidity of a ruptured cystic echinococcosis and lophomoniasis in a 38-year-old male farmer with a history of opium addiction from northern Iran.

Compartment syndrome following snakebite in a boy: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Snake bites represent a significant public health issue worldwide, as venomous snake bites can result in lethal consequences if not treated promptly, including both local and systemic effects. The local symptoms of a snake bite commonly include tissue necrosis, edema, and compartment syndrome (CS). While CS is a rare complication following a snake bite, it may be more pronounced in children who typically have lower total dilution volume. Currently, the administration of anti-snake venom and prompt fasciotomy are the only specific treatments available for CS. CASE PRESENTATION: The present report details a case of CS of the right upper extremity in a three-year-old boy who suffered a snake bite on his right hand and was brought to the emergency department of a hospital in northern Iran after a lapse of 14 h. CLINICAL DISCUSSION: Snakebites frequently occur in the extremities, with about two thirds of them happening in the upper extremities. The skin of the dorsum is extremely thin, there is essentially little subcutaneous fat tissue, and there are numerous superficial veins in this area, particularly the hand. CONCLUSIONS: Following snake bites, the use of proximal tourniquets should be avoided, and the public's awareness of this need should be encouraged through health education. The prognosis for recovery following fasciotomy and the significance of follow-up and rehabilitation should also be explained to patients.

Viral contamination of acrylic resin removable denture bases in patients with COVID-19: A cross-sectional study.

STATEMENT OF PROBLEM: Salivary gland ducts are one of the primary targets of severe acute respiratory syndrome coronavirus 2. Moreover, saliva contains minor and major salivary gland secretions and a combination of nasopharyngeal and lung secretions. The acrylic resin bases of complete or partial removable dentures have pores and provide a favorable environment for the growth of microorganisms. PURPOSE: The purpose of this cross-sectional study was to investigate the presence of viral contamination of acrylic resin removable denture bases in patients with coronavirus disease 2019 (COVID-19). MATERIAL AND METHODS: The acrylic resin denture bases (partial and complete) of 29 patients with COVID-19 who underwent treatment in the Infectious Diseases Department of Razi Hospital in Ghaemshahr, Mazandaran, Iran, were evaluated. Samples were collected from the intaglio surface of the prostheses by direct swabbing and coding and were evaluated in a laboratory for the presence or absence of coronavirus. The relationship between hospital polymerase chain reaction (PCR) and denture PCR and the relationship between denture type and denture PCR were evaluated with the Fisher exact test (α=.05). RESULTS: Twenty-nine patients, age range 55 to 85 years, 18 women, 3 with partial dentures and 26 with complete dentures, were evaluated. The hospital PCR test was positive in 28 patients, while the denture PCR test was positive in 4 patients. No significant relationship was observed between the results of hospital PCR and denture PCR in patients with COVID-19 (P=.138). All 4 patients who tested positive for denture PCR had complete dentures. No significant relationship was found between denture type and denture PCR test results in patients with COVID-19 (P>999). CONCLUSIONS: Despite the microporous structure of the acrylic resin base, no statistically significant viral contamination was observed.

The prevalence of substance use among drivers with traffic injuries in Mazandaran Province, Northern Iran.

Background: Motor vehicle accidents (MVAs) are one of the main causes of mortality in developing countries. Although the association between alcohol and the risk of MVA has been known for a long time, only a few studies have been conducted on driving following substance consumption in a short period of time. This is while narcotic and stimulant use seems to be a threat to traffic safety and a serious health concern for substance users. In this study, we investigated the prevalence of substance use (narcotics and stimulants) in drivers with traffic injuries admitted to the orthopedic ward of Imam Khomeini Hospital between October 2020 and June 2021. Methods: The current research is a cross-sectional, descriptive-analytical study. The statistical population consisted of 77 patients admitted to the orthopedic ward of a training hospital (Imam Khomeini) in Mazandaran Province, northern Iran. The Shapiro-Wilk test was used to determine the quantitative variables. The sampling method is random and consecutive. The method of data collection was through questionnaire tools. The software used was SPSS 26 with an independent t-test, Mann-Whitney U test, Chi-square or Fisher's exact test. Results: In this study, the frequency of substance use was 18.18%. The prevalence of opioid usage was 35.7% and for stimulants it was 64.28%. There was no case of concomitant use of opioids and stimulants. In the opioid group, 60% of patients used opium, 20% methadone, and 20% tramadol. In the stimulant and alcohol groups, 12.12% utilized methamphetamine and 88.88% drank alcohol. The average age of consumers was 39 years, which was significantly higher in the opioid group (P = 0.040). The education level of substance users was remarkably lower (P < 0.05) and, occupationally, there was no statistically significant difference between groups of substance users (P = 0.290). Considerably, the unemployed population consumed more substances (P = 0.001). Multiple fractures (P < 0.05) and surgical treatment (P = 0.012) were more common in the user group. Conclusion: Users of stimulants and alcohol were younger than opioid users, according to our results. There is an association between drug use and the incidence of traffic accidents, as well as lower educational levels, masculinity, fracture type, and patient complication type.

Methamphetamine poisoning due to body packer swallowing in a prisoner.

Individuals who introduce illicit substances such as opioids and amphetamines into the gastrointestinal tract by swallowing or inserting them into the rectum are known as body packers. We describe a prisoner who developed severe poisoning symptoms after swallowing amphetamine packets and was promptly removed by laparotomy.