International Journal of Medical Toxicology and Forensic Medicine

Background: Toxocariasis is a zoontic helminthes infection, occurring in human by the accidental ingestion of embryonated eggs of Toxocara canis (TC) and less frequently, Toxocara catis (TCC). Children are on the front line of encounter group. Clinical features may mimic respiratory symptoms as; asthma–like symptoms plus producing bronchial airway hyper-reactivity. The aim of this study was to determine seroprevalence of TC infection among children’s outpatient with the wheezing symptom among urban public of Tehran.

Method: All of the children with current wheezing symptom that was coming in the chest clinic, sequentially enrolled as sample population. Diagnosis of known diseases associated with the wheezing was made possible. Anti TC Ig G antibodies in serum were measured based upon the recommendation commercial kit.

Results: A total 89 children meet the study criteria. Mean age was 9.7±3.8 SD years, ranged 2-15 years. Boy/girl ratio was 1.2. Seropositive for TC antibody was 16%. TC infection was noticeable in boys subgroup 53%.

Conclusion: Seroconvertion of TC infection was meaningful among children, 2-15 years in Tehran. School-aged group had been higher rated infection than other groups. Toxocariasis among children of target population was associated with eosinophilia and allergic reaction.

Background: Prehospital treatment following acute pesticide poisoning is not optimal and mortality following such poisoning is high in Bangladesh.

Method: It was a prospective study in which pattern of pre-hospital treatment received and outcome of pesticide poisoned patient were studied at one adult medical unit of Dhaka Medical College Hospital from October 2005 to June 2006.

Results: The number of cases of pesticide poisoning were 60 (1.98%) of 3030 admitted patients. The mean age was 24.7±8.8 years. Most of them (40, 66.7%) were male. The incidence of poisoning was high among students (11, 18.3%) and housewives (10, 16.7%). The most common cause of poisoning was intentional (55, 91.7%). Familial disharmony was underlying cause in 27 (45%) patients. More than half of the patients (41, 68.3%) purchased the poison self. 25 (41.7%) patients got first contact with physician within 30 minutes of poisoning. In majority cases (45, 75%) first contact health care provider was government hospital. Only 22 (36.7%) patients received first aid before arrival to present hospital. Among them, 19 (31.7%) patients received induced vomiting by ingestion of tamarind water or lemon water or soap water or putting finger or other substances (cow dung, human excreta etc.) in mouth and 3 (15%) patients received home remedy like milk, raw egg etc. The overall mortality was 16.7%.

Conclusion: Measures should be taken to increase the awareness among general population regarding the first aid following pesticide poisoning.

Background: The Aspergillus fumigatus (AF) has been found the most common etiologic agent in allergic aspergillosis. In addition, AF is responsible for 90% of human infections. Increasing the air pollution in urban area causes the increase in asthma rates. Significant cutaneous sensitization occurs in asthmatic population with AF. In these patients, susceptibility of diseases increases. The aims of this study were to identify frequency of specific IgG antibodies and sensitization to Aspergillus antigens through skin prick-test reactivity (SPT) among adults with allergic asthma and to diagnose atopic phenotype subset.

Method: 201 chronic asthmatic patients were applied in order to instructions based on the increased level of immunoglobulin E antibodies concentrations in allergy, having criteria of the  study and specific immunoglobulin G antibodies against AF in serum and SPT reactivity with aspergillus antigen. Thereafter, atopic phenotype was diagnosed.

Results: 42 (21%) subjects had positive skin reactivity to aspergillus antigens, also specific AF IgG antibodies was observed in 122 (61%).  36 (30%) of positive aspergillus skin prick test was found among those who were positive specific AF IgG antibodies of allergic asthma (P=0.001), 81 (40%) subjects of all allergic asthma patients were atopic. 19 (24%) of the atopic subsets had positive aspergillus skin prick test  and  specific AF IgG antibodies was seen in 41 (50%)  of atopic subjects. In addition, significant differences in aspergillus skin prick test was observed between atopic with nonatopic subgroups (P=0.01).

Conclusion: Our finding indicated that significant frequency of specific IgG antibodies seroconvertion against AF in serum and immediate SPT sensitization to AF antigen were detected among chronic bronchial asthma with allergic and also, atopic phenotype subsets.

Background: Acute poisoning by drugs and chemical agents is a medical emergency and carries a high morbidity and mortality rate. The epidemiology of acute poisoning varies between countries and different regions.

Method: In this one year retrospective study, we reviewed the epidemiology of patients with acute poisoning (intentionally or unintentionally) who died during hospitalization at Loghman Hakim hospital, Tehran, Iran.

Results: Of the 280 cases of completed suicide by self-poisoning 69 (24.6%) cases were female and 211(75.4%) cases were male, between 15-78 years old with mean±SD of 39±17.5. Most of them were conscious (69.6%) on admission to Emergency Department (ED). Past history of any self- harm were positive in 82 (29.3) cases of subjects. Multiple drug toxicity and opioid poisoning were the most common causes of acute poisoning death in 27.5% and 27.1% respectively.

Conclusion: Differences based on age category, sex, the types of toxic agents involved and the outcomes of the poisoning death incidents were noted. Future interventions should take these differences into account.

Background: Physicians seldom encounter chest x-ray of adult patients diagnosed with dextrocardia.

Case presentation: Here, we present the case of a 21-year-old woman who referred to the hospital with the clinical diagnosis of dextrocardia but, she has pulmonary hypoplasia and this rare disease in adults may be a component of scimitar syndrome and scimitar sign is not pathognomonic to define the syndrome. MR angiography was done, but finally the diagnosis was hypoplasia of right upper lobe and aplasia of middle lobe.

Conclusion: As lung hypoplasia is rare in adults, some cases are misdiagnosed as dextrocardia on chest x-ray.

Background: Physicians frequently encounter chest-x ray reports of pleural effusion in patients. Thoracocentesis is the second step to diagnosis, but if there isn’t any effusion actually, thoracocentesis may lead to complication.

Case Report: A 47-year-old man with a history of dyspnea and dry cough and posteroanterior (PA) chest x-ray (and right lateral decubitus) report of pleural effusion referred for thoracocentesis, but vesicular sounds at over the lungs were normal. Spiral lung CT scan revealed localized eventration of diaphragm.

Conclusion: Localized eventration of right diaphragm may cause the appearance of pleural effusion in PA and also right lateral decubitus chest x-ray.