Asia Pacific Journal of Medical Toxicology
Volume:5 Issue: 4, Autumn 2016

Datura stramonium is a poisonous and common flowering plant that is a member of the Solanacae family. Datura poisonings are a rare occurrence in the 21st century, making toxicological information on this plant sparse. Historical information on Datura provides useful information on the clinical symptoms and characteristics of poisonings. This review looks at the state of knowledge on Datura’s chemical properties and clinical characteristics in the 18th and 19th century.
A literature review was conducted, and an online database search identified 197 articles. Ultimately 42 articles met the search criteria and were included for review.
Medical literature on Datura focused predominantly on clinical poisonings, medical treatments, and identifying its chemical properties. Clinical poisonings included cases of accidental and intentional poisonings, and provided information on the age of patients, their symptoms, and treatments. Datura was also used to treat a variety of conditions, including asthma, inflammatory diseases, epileptic seizures, and hallucinations. Chemical experimentation on Datura commonly looked at isolating alkaloids and assaying their concentrations in various plant organs.
Historical literature on Datura shows that cases of poisoning were a common occurrence. These historical sources provide useful information on Datura poisoning’s clinical findings, and preliminary uses of Datura in medical treatments. Early chemical exploration of Datura also set the groundwork for future research.

Organophosphates are pesticides that are used widely in agriculture and industry. Because of the ease of access and abundant use of these pesticides, many cases of intentional and accidental poisoning of these compounds are reported. The aim of this comprehensive study was to evaluate the symptoms and treatment of patients referred to Razi hospital as the main center for poisoning in the South west of Iran.
In this study, patients with Organophosphate poisoning referred to Razi hospital during the years 2006 to 2012 was included. The information collected from their records includes reference data, demographic data, clinical manifestations and treatment options.
Of all 173 cases, 46.2% were male. The average age of cases was 24.31 years and most of them were from rural areas. 86% of patients had deliberately consumed a toxic substance. The first clinical symptoms of more than half of the patients were nausea and vomiting. 72.8% of patients needed antidote; a combination of atropine and pralidoxim was administered in 70% of cases. 16.2% required intubation and 80% admitted to ICU. In 52% of cases a specified pesticide was found and 4% of the cases deceased.
Organophosphate poisoning in most cases occurred deliberately as a suicidal attempt. It was more common in rural areas. Need for admission to intensive care unit was more common in cases under the age of twenty. Treatment of patients with both antidote atropine and pralidoxime was a very suitable therapeutic model.

Every day, people with addiction cause heavy economic and cultural damage to society. In some circumstances, opioids are used as a tool for suicide, which is often seen in youth. The aim of this study was to investigate the clinical signs of toxicity associated with opium in patients referred to Ardabil city hospital.
This is a cross-sectional study that has been done on opium toxicity patients referred to Ardabil Sabalan hospital from 2014-15. Patients’ information such as individual characteristics (age, gender, living location, job and marital status), drug type, poisoning cause, poisoning season, history of physical and mental illness, and clinical symptoms were obtained from patients and then analyzed using statistical methods in SPSS.16 software.
180 hospitalized patients were entered in the study. 75 persons (42%) used Tramadol, the most commonly used drug in opium intoxication. Most patients (80.6%) were male and in the age group 20-30 years (37.8%). 155 patients (86.1%) lived in this city, and the most patients (55 cases, 35.5%) had a primary education level. 39% of cases were seen in spring, the most common season for referring intoxications. Of all patients, 160 (88.9%) consciously took the drug (by choice).
Results showed that poisoning by Tramadol was the most common form of opium intoxication in patients. Opium intoxication can be prevented by decreasing the arbitrary use of drugs and also increasing the awareness level of personnel about care of these patients, and raising awareness to all people in society about opium and drug toxicity.

Poisoning in children is a world-wide problem and one of the most important reasons for children’s hospital admission. Incidence of toxicity based on cultural and economic characteristics vary in different communities.
All children with proven opioid toxicity who admitted to children emergency ward of Imam Reza hospital of Mashhad through June 2014 to June 2015 were included the study. Age, sex, weight, parent’s educational level and job, causes and kinds of ingested opioid, addiction in family, clinical manifestations, laboratory findings, changes in QT corrected (QTC), and mortality rate were recorded. Finally, all data were analyzed with SPSS.
In this study, 126 opioid-intoxicated children were recruited. No significant age difference was seen between genders (P value = 0.24). Parent's educational levels in most cases were low. Addiction to opium was also common among fathers (68.3%). Methadone was the most common agent causing opioid poisoning (52.4%), followed by opium (43.7%). The cause of poisoning was accidental in 58% of patients. The common signs and symptoms were drowsiness (77.8%), miotic pupil (69 %), decreased levels of O2 saturation (67.5%), Bradypnea (37.3%), apnea (27.8%) and convulsions (8.7%). Venous blood gases (VBG) in most cases (69.8%) was abnormal, leukocytosis (26.2%), hyperglycemia (11.1%), hyponatremia (9.5%), hypernatremia (5.6%), increases in distance of QT in Electrocardiography (2.4%) were seen.
Opioid poisonings are severe and life-threatening in children. Methadone was the most common cause of poisoning in more than the half of cases (52.4%). Poisonings were due to low parental knowledge about methadone poisoning and careless storage of methadone at their home.

Metals such as iron, zinc, and copper are critical and necessary for the survival of all living organisms, whereas xenobiotic metals such as lead, cadmium, mercury, and arsenic have no known biologic role. Any metals in high doses can have toxic effects. The aim of this work was to evaluate the hematological changes induced by lead as a toxic metal and characterize the potential efficacy of Deferasirox in removing lead from bodies of male rats.
Lead was given to rats at two doses of 40 (low dose of drinking lead) and 80 mg/kg (high dose of drinking lead). After 60 days of lead administration, chelation therapy was carried out for two weeks and then clinical, biochemical and haematological parameters were compared with the lead-free control group.
The results showed a decrease in iron level, hematocrit, red blood cells count, hemoglobin concentration, mean cellular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration, after lead administration. Chelation therapy with Deferasirox (DFX) significantly reduced blood lead level, and iron concentrations returned to normal levels simultaneously.
Deferasirox significantly reduced blood lead level along with normalizing iron. The symptoms of toxicity were also reduced and iron deficiency anemia following lead administration was obviated.

Arsenic toxicity as a result of consumption of hair removal agent has been rarely seen in last few years in comparison with the past.
In this case report, we presented a middle age woman referred to medical toxicology department due to epigastric pain and diarrhea following ingestion of hair removal agent. Urinary test for arsenic was positive. ECG changes and elevated cardiac Troponin levels were compatible with acute MI. Loss of consciousness and respiratory distress developed over next days and despite chelating therapy and other symptomatic treatments she deceased after 5 days of admission.
Current case is a rare presentation of oral arsenic toxicity. A mild diarrhea, epigastric pain, ECG changes which were compatible with acute MI and hypotension were the main manifestations once admission.
Arsenic may still exist in depilating agents. Physicians should be aware of clinical manifestations of acute arsenic toxicity and chelating therapy should be initiated as soon as possible.