Background Human growth hormone (HGH) is a categorized as a performance-enhancing substance. HGH has been abused by athletes for doping purposes. Case presentation We present a first lethal case of HGH acute toxicity. A young-agitated-athlete with a history of somatropin for the past 2-year, who had hallucinations referred to the emergency department reporting to have abused of 300 mg subcutaneous injections of HGH. He was tachycardic with mild hypertension. Lab data revealed hypernatremia (157 mEq/L), hyperkalemia (5.3 mEq/L), high LDH (1448 U/L), and CPK (2620 U/L), in favor of rhabdomyolysis. Routine drug screening tests were negative for all substances. He was intubated due to low O2 saturation and progressive loss of consciousness. After several episodes of hyperthermia, hypertension, and possibly pulmonary embolism, he died subsequent to somatropin overdose. Conclusions Complications of HGH misuse can be life-threatening and athletes should be warned of its deleterious effects.
Background and Aim: Each year, millions of older people experience falling which can cause serious injuries such as broken bones, head injuries, or even death. Since Diabetes Mellitus can disrupt the balance system and increase falling, and given that fear of falling and balance confidence are critical fall-related psychological concerns that can be the risk factors of falls in the diabetic elderly, this study aimed to compare fear of falling and balance confidence of diabetic and non-diabetic older adults in Iran. Methods: Participants were 63 diabetic older patients and 59 non-diabetic peers aged 60 years and over. Data were collected using the Persian versions of falling efficacy scale-international and activities-specific balance confidence-short form questionnaires. In addition, modified Romberg and timed up and go tests were performed to assess subjective balance performance. Results: The scores of falling efficacy scale-international questionnaire and timed up and go test were significantly higher in diabetic group while the scores of activities-specific balance confidence-short form questionnaire were lower (p<0.001). No significant differences were observed in the modified Romberg test scores between two groups. Conclusion: Fear of falling and low balance confidence are more common in diabetic older adults compared to non-diabetic peers. They have poor performance in timed up and go test and have more falls during the last 12 months. Keywords: Type 2 diabetes mellitus; aging; fear of falling; balance confidence
Objective: The data on the changes in the prevalence of obesity and overweight could help policy makers to make better plans for improving the health status of people; hence, the aim of his study is to evaluate the prevalence and incidence of overweight, obesity and abdominal obesity in Ahvaz during five years. Materials and Methods: Cohort study was the method of choice in this survey, conducted on 605 people aged over 20 years who were selected among the people covered by health centers in Ahvaz. The participants weight, height, and waist circumferences were measured two times in 2009 and 2014. The incidence and prevalence of obesity, abdominal obesity and overweight were evaluated. The SPSS 22 statistical software was used to analyze the data, and paired T-test to compare the level of changes. The significant level for P-value < 0.05. Results: Among 605 people aged over 20 years, the prevalence of overweight, obesity and abdominal obesity in 2009 and 2014 were respectively: overweight (40% and 38.50%), obesity (26.90% and 27.10%), and abdominal obesity (26.80% and 33. 90%).This prevalence increased from 11.70% to 14.90% in men and from 39.90% to 50.50% in women. The incidence of overweight, obesity and abdominal obesity were respectively 102.50, 22.50 and 76.5 per 1000 person’s year in Ahvaz people. Conclusion: The findings of our study showed that the prevalence of overweight, obesity and abdominal obesity in adult population in Ahvaz is high. Also, the prevalence of obesity and abdominal obesity in women is higher than men; therefore special attention must be paid to this issue in women. Also the age groups 35-64 years are higher risk.
Introduction Diabetic ketoacidosis (DKA) is a complication of diabetes presenting with high anion gap metabolic acidosis. Methanol poisoning, on the other hand, is a toxicology emergency which presents with the same feature. We present a case of methanol poisoning who presented with DKA. Case presentation A 28-year-old male was referred to us with blurred vision and loss of consciousness three days after ingestion of 1.5 L of an unknown mixture of bootleg alcoholic beverage. He had history of insulin-dependent diabetes and had neglected his insulin shots on the day prior to hospital admission due to progressive loss of consciousness. Vital signs were normal and venous blood gas analysis showed severe metabolic acidosis and a methanol level of 10.2 mg/dL. After eight hours of hemodialysis, he remained unresponsive. Diabetic ketoacidosis was suspected due to positive urine ketone and blood sugar of 411 mg/dL. Insulin infusion was initiated which was followed by full awakening and extubation. He was discharged completely symptom-free after 4 weeks. Conclusions Diabetic ketoacidosis and methanol poisoning can happen simultaneously in a diabetic patient. Given the analogous high anion gap metabolic acidosis, physicians should pay particular attention to examination of the diabetic patients. Meticulous evaluation for both conditions is highly recommended.
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