Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
01
Indoor Air Quality and Severity of COVID-19: Where Communicable and Non-communicable Preventive Measures Meet
1
2
EN
Reza
Afshari
Division of Occupational and Environmental Health, School of population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
afsharireza@yahoo.com
10.22038/apjmt.2020.15312
Indoor Air Quality,Corona,COVID-19
https://apjmt.mums.ac.ir/article_15312.html
https://apjmt.mums.ac.ir/article_15312_c8be8fd6f2fa7a69583b7840b3c1c9ba.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Oxidative DNA Damage and Pro-inflammatory Response In Chronic Exposure To Cement Dust
3
10
EN
Lara
Taiye
Obaji-Ogar
Department of Medical Laboratory Science,University of Calabar, Nigeria
laraariye71@yahoo.com
Augusta
Chinyere
Nsonwu-Anyanwu
https://orcid.org/0000-0003-1141-5992
University of Calabar, Nigeria
austadechic@yahoo.com
Friday
Acho
Odum
Department of Medical Laboratory Science, University of Calabar, Nigeria
destinedgodwins@gmail.com
10.22038/apjmt.2020.15313
<strong>Background:</strong> Inflammatory cell activation, oxidative stress and oxidative DNA damage have been associated with exposure to cement dust. Biomarkers of oxidative stress, oxidative DNA damage, inflammation and heavy metals were estimated in cement loaders.<br /> <strong>Methods</strong>: Ninety men (45 cement loaders and 45 controls) were recruited into this comparative cross-sectional study. Total antioxidant capacity (TAC), total plasma peroxides (TPP), malondialdehyde (MDA), reduced glutathione (GSH), nitric oxide (NO) and uric acid (UA) were estimated by colorimetry, arsenic (As), chromium (Cr) and cadmium (Cd) by atomic absorption spectrophotometry and tumor necrosis factor alpha (TNF-α), 8-hydroxy-2-deoxyguanosine (8-OHdG) by enzyme linked immunosorbent assay. <br /> <strong>Results</strong>: Cement loaders had increased lipid peroxidation (MDA, TPP, OSI), inflammation (TNF-ɑ) and heavy metals (As, Cr) and lower antioxidants (UA, TAC, GSH) compared to controls (p<0.05). Increasing duration of exposure to cement dust was associated with higher lipid peroxidation, Cd, TNF-α and oxidative DNA damage (8-OHdG) (p<0.05). Negative correlation was observed between TAC and duration of exposure (r=-0.375, p=0.011) and positive correlations between TPP and duration of exposure (r=0.614, p=0.000), TNF-α and 8-OHdG (r=0.492, p=0.001) in cement loaders. <br /> <strong>Conclusion: </strong>Chronic exposure to cement dust is associated with depletion of antioxidants, increased lipid peroxidation, oxidative stress, inflammation and oxidative DNA damage. These may be implicated in the development of chronic lung conditions.
cement,Heavy metals,Inflammation Oxidative Stress
https://apjmt.mums.ac.ir/article_15313.html
https://apjmt.mums.ac.ir/article_15313_4c78440dfb269187c5d7a86b30a8af22.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Lead Exposure Effect on Peripheral Blood Parameters among People around Bus Terminal in Yogyakarta
11
16
EN
Sani
Rachman
Soleman
0000-0002-2815-818X
Department of Public Health, Faculty of Medicine, Islamic University of Indonesia, Indonesia
sani.rachman@uii.ac.id
Shafira
Alifiana
Andini
Professional Medical Doctor Program, Suroto General Hospital, Faculty of Medicine, Universitas Islam Indonesia, Indonesia
alifianashafira@gmail.com
Linda
Rosita
Department of Clinical Pathology, Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia
linda.rosita@uii.ac.id
10.22038/apjmt.2020.15314
<strong>Background: </strong>Lead is a dangerous substance that can impact the blood components. Lead toxicity can cause imbalance in the homeostasis process of blood peripheral. The aim of this study is to search impact of lead exposure on peripheral blood parameter alterations among people around bus terminals in Yogyakarta.<br /> <strong>Methods: </strong>This study is a cross sectional research design with convenience sampling method. According to calculation of sample size, 72 respondents had fulfilled the inclusion criteria. The independent variable was lead exposure and dependent variables were peripheral blood parameters including leucocytes, erythrocytes, hemoglobin, and platelets. Lead exposure was measured by atomic absorption spectrophotometer (AAS) and peripheral blood parameters were measured by automatic hematology analyzer. Those variables were analyzed by linear regression.<br /> <strong>Results: </strong>Based on Independent T Test was found aged > 40 yo correlated with leukocyte (P =0.029), male workers correlated with leukocyte, erythrocyte, hemoglobin, and platelet (P =0.025,0.006, 0.000, and 0.031, respectively), smoking 1 packed per week associated with hemoglobin (P =0.006) and settlement 500 meter around terminal associated with leukocyte, erythrocyte, hemoglobin and platelet (P =0.025, 0.006, 0.000, and 0.031, respectively). Linear regression can predict level of leukocyte (β=0.32; CI 95= -0.207 to 0.643, P =0.006), erythrocyte (β=0.3; CI 95=-0.269 to 0.29; P =0.009), hemoglobin (β=0.33; CI 95=0.042 to 0.211; P =0.004), and platelet (β=0.25; CI 95=-0.548 to 0.73; P =0.029).<br /> <strong>Conclusion: </strong>Age > 40 years old associated with leukocyte; male gender associated with leukocyte, erythrocyte, hemoglobin, and platelet level, respectively; smoking 1 packed per week correlated with hemoglobin level; settlement 500 m around terminal associated with level leukocyte, erythrocyte, hemoglobin, and platelet level, respectively. Finally, level of lead can predict positively leukocyte, erythrocyte, hemoglobin, and platelet level respectively.
Bus Terminal,Lead exposure,Peripheral Blood Parameters
https://apjmt.mums.ac.ir/article_15314.html
https://apjmt.mums.ac.ir/article_15314_981263311dafafc5e512e5dbe18b2d58.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Hydrocarbon Associated Toxicities: a Case Series and Review of Literature
17
20
EN
Ishan
Lamba
0000-0002-8748-8517
Assistant Professor, Dr DY Patil Medical College, India
drishanlamba@yahoo.com
Dhiraj
Jadhav
0000-0001-5119-4368
Assistant Professor, Dr DY Patil Medical College,
Sant Tukaram Nagar
Pimpri, India
jdhiraj2010@yahoo.com
10.22038/apjmt.2020.15315
Background: Hydrocarbon associated toxicity (HAT) is an emerging threat related to wide scale industrialization and easy access to hydrocarbon-containing chemical compounds. Hydrocarbons have a unique toxicological profile and the principles of managing related toxidromes are considerably different from other toxins.<br /> Case reports: Here, we present a case series and in-depth review of the existing literature to show the risks associated with these seemingly harmless chemicals, and the approved guidelines for treating exposed patients. In all three cases, the hydrocarbon was a diluent for a pesticide. The amount of pesticide ingested was nontoxic, while the hydrocarbons caused a dose-independent physical toxicity to the lungs.<br /> Discussion: Hydrocarbon associated toxicities often go unnoticed because of their usage as diluents for various other toxic chemicals. Their treatment usually differs from other toxins that may have been consumed with them, albeit in insignificant quantities.<br /> Conclusion: Recognition of a hydrocarbon diluent in a consumed toxin marks the first step in the correct treatment. Correct labeling of chemical solutions containing hydrocarbons would go a long way in identifying these toxins.
Hydrocarbon Toxicity,Kerosene,Pesticide,Toluene,Turpentine
https://apjmt.mums.ac.ir/article_15315.html
https://apjmt.mums.ac.ir/article_15315_0898411f496077f378db4a3ded4ee485.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Uric Acid Lowering Effects of Psyllium Seeds on a Hyperuricemic Patient: A Case Report and Review of Literature
21
24
EN
Alireza
Ebadollahi-Natanzi
0000-0002-0749-3309
Assistant Professor of Toxicology & Pharmacology, Medicinal plants Department, Imam Khomeini Higher Education Center, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran.
alireza_ebad@yahoo.com
Gholamreza
Arabrahmatipour
0000-0002-0766-2395
Laboratory Sciences Expert, Farabi Hospital Laboratory, Tehran University of Medical Sciences, Tehran, Iran
arab.mplants@gmail.com
10.22038/apjmt.2020.16319
<em>Background: </em>Psyllium seeds, produced from <em>Plantago ovata </em>Forsk, are an herbal treatment generally used as a laxative. They also reportedly have lowering effects on some metabolic parameters such as blood glucose, lipids and uric acid. In this paper, we report the effect of this herbal medicine in reducing serum uric acid levels, without major adverse effects, in a hyperuricemic patient.<br /> <em>Case report</em>: A 51-year-old patient with a history of hyperuricemia (10.5 mg/dL in a recent measurement) gave consent to undergo a 40-day treatment using psyllium seeds with dosage of 83.3 mg/kg. Treatment was given in two 20-day courses: During the first course, the seeds were given daily and during the second course, the same dosage was given every other day. Serum uric acid levels decreased to 8.1 mg/dL and 6.8 mg/dL on the 20<sup>th</sup> and 40<sup>th</sup> days, respectively. No major adverse effects were observed, such as skin rashes, digestive disorders, muscular pain, allergic manifestations, abnormalities in liver and kidney function tests, and abnormalities in blood parameters.<br /> <em>Conclusion</em>: Psyllium seeds may be effective in reducing serum uric acid levels in hyperuricemia patients, and major adverse effects are not expected to occur. These data can be used for further research and designing clinical trials.
Hyperuricemia,Psyllium,Uric acid,Xanthine Oxidase
https://apjmt.mums.ac.ir/article_16319.html
https://apjmt.mums.ac.ir/article_16319_3f6345bcd0aa0b3cfbb873e4f404e4a4.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Severe Calcium Channel Blocker Overdose and Successful Management: a Case Report and Literature Review
25
28
EN
Hong Khai
Lau
0000-0003-1244-4613
Department of Emergency Medicine, Sengkang General Hospial & Singapore General Hospital, Singapor
lhongkhai@gmail.com
Kenneth
Boon Kiat Tan
Department of Emergency Medicine, Singapore General Hospital, Singapre
kenneth.tan.b.k@singhealth.com.sg
Ponampalam
R
Department of Emergency Medicine, Singapore General Hospital, Singapore
ponampalam@singhealth.com.sg
10.22038/apjmt.2020.15317
<em>Background</em>: Calcium channel blocker (CCB) toxicity is one of the most lethal and common drug overdoses encountered in the emergency department (ED). The toxicity of these drugs results from blockade of L-type calcium channels in smooth cells, myocardial cells, and beta cells of the pancreas. Severe toxicity can result in bradycardia, hypotension, hyperglycemia, metabolic acidosis, shock, cardiac arrest and death. According to the American Association of Poison Control Centers’ National Poison Data System’s annual report in 2015, cardiovascular medications were the fourth most common adult poisoning exposure and second most common cause of adult poisoning fatality in the USA. CCBs are responsible for a substantial portion of the mortality associated with cardiovascular medication overdose cases. Understanding the emergent management of CCB toxicity is essential. Treatment of patients with CCB overdose remains challenging especially in those with refractory hypotension and end organ dysfunction.<br /> <em>Case Presentation</em>: A 45-year-old male with massive amlodipine overdose presented to ED with syncope and severe hypotension. Intensive medical therapy (fluid resuscitation, inotropes, calcium gluconate, and hyperinsulinemia euglycemia therapy [HIET]) was initiated in the ED and continued in the Intensive Care Unit (ICU), and resulted in the patient’s total recovery, without any major complications. Fortunately, ECMO implantation (extracorporeal membrane oxygenation) was not required in this patient.<br /> <em>Conclusion</em>: Urgent administration of fluids, calcium, vasopressors, and HIET therapy seem to be the most well validated initial approaches to CCBs overdose treatment. Our successful management strategy should serve as a good learning experience as well as a recommendation for managing such patients.
Amlodipine,Calcium Channel Blockers Overdose,Emergency Department
https://apjmt.mums.ac.ir/article_15317.html
https://apjmt.mums.ac.ir/article_15317_1b18c7c4459533644170fd8d05252819.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Methadone Toxicity with Electrocardiographic Sodium Channel Blockade Changes in a Pediatric Patient Post-cardiopulmonary Arrest: a Case Report
29
32
EN
Gene
Yong-Kwang
Ong
0000-0002-9879-0594
KK Women's and Children's Hospital, Singapore
geneong@yahoo.com
10.22038/apjmt.2020.15316
Background: Cardiopulmonary arrest in the pediatric population due to methadone toxicity is not commonly reported. Severe methadone toxicity often involves respiratory depression with reports of orthostatic hypotension, due to vasodilation, and QTc prolongation.<br /> Case presentation: A pair of toddler siblings presented in cardiopulmonary arrest due to methadone ingestion. They were successfully resuscitated with no significant neurobehavioral deficits despite a suspected prolonged “downtime.” After return of spontaneous circulation, the older sibling, a four-year old male, had electrocardiographs (ECGs) that were suggestive of sodium channel blockade. These changes were reversed following bicarbonate therapy. The two-year old child’s ECGs did not show such changes.<br /> Discussion: There is no prior clinical literature on sodium channel blockade in methadone toxicity. The older sibling’s ECG findings and response to bicarbonate therapy appeared to be consistent with sodium channel blockade. There have been preclinical data that suggest methadone cardiotoxicity may involve cardiac sodium channels. Pharmacogenetic variations could also explain how these effects may selectively manifest.<br /> Conclusion: Physicians should be aware of the possible toxicologic causes of cardiopulmonary arrest in the pediatric population. Pharmacogenetic variations may contribute to different clinical manifestations in methadone cardiotoxicity.
Electrocardiography,Heart Arrest,Pediatrics,toxicology
https://apjmt.mums.ac.ir/article_15316.html
https://apjmt.mums.ac.ir/article_15316_9aceddb870f6c181f1d952a743e9089a.pdf
Mashhad University of Medical Sciences
Asia Pacific Journal of Medical Toxicology
2322-2611
2322-4320
9
1
2020
03
20
Hepatic Failure in a Young Woman Following Ingestion of Tribulus Terrestris
33
34
EN
Zahra
Ataee
0000_0000_0000_0000
Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
ataeez@mums.ac.ir
Bita
Dadpour
0000-0001-6004-0344
Bita Dadpour, MD. Assistant Professor, Toxicology Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
dadpourb@mums.ac.ir
10.22038/apjmt.2020.15318
Background: Plants have been used for the treatment of a wide range of conditions since ancient times but some have side effects and toxic effects that limit their use. <em>Tribulus terrestris</em> is traditionally used for lowering blood pressure, inhibiting kidney stone formation and inducing weight loss. In this case study, we present an Iranian woman who suffered from liver failure after using this plant.<br /> Case presentation: A 31-year-old Iranian woman was admitted to Emam-Reza hospital due to epigastric pain radiating to back and shoulders, and weakness, Malas,neusia and icterus. Upon admission,, her vital signs were normal. She had been consuming Tribulus terrestris as an herbal tea , several times a day for 2-3 months, in order to lose weight. Upon physical examination, the patient had generalized icterus and laboratory tests showed elevated transaminases, PT, and INR. Various causes of hepatic failure, such as viral hepatitis and autoimmune hepatitis, were ruled out and the only probable diagnosis was toxin-induced liver failure.<br /> Conclusion: Herbal plants may have some beneficial medical effects but they can also cause toxicity. Consistent use and high dose of Tribulus terrestris may cause hepatic failure and death.
Acute Liver Failure,Icterus,Liver Function Tests,Tribulus terrestris
https://apjmt.mums.ac.ir/article_15318.html
https://apjmt.mums.ac.ir/article_15318_4b06e797463c17e43102cac907868730.pdf