Due to the importance of using cost-effective methods for therapeutic purposes, the function of probiotics as safe microorganisms and the study of their relevant functional mechanisms have recently been in the spotlight. Finding the mechanisms of attachment and stability and their beneficial effects on the immune system can be useful in identifying and increasing the therapeutic effects of probiotics. In this review, the functional mechanisms of probiotics were comprehensively investigated. Relevant articles were searched in scientific sources, documents, and databases, including PubMed, NCBI, Bactibace, OptiBac, and Bagel4. The most important functional mechanisms of probiotics and their effects on strengthening the epithelial barrier, competitive inhibition of pathogenic microorganisms, production of antimicrobials, binding and interaction with the host, and regulatory effects on the immune system were discussed.In this regard, the attachment of probiotics to the epithelium is very important because the prerequisite for their proper functioning is to establish a proper connection to the epithelium. Therefore, more attention should be paid to the binding effect of probiotics, including sortase A, a significant factor involved in the expression of sortase-dependent proteins (SDP), on their surface as mediators of intestinal epithelial cell binding. In general, by investigating the functional mechanisms of probiotics, it was concluded that the mechanism by which probiotics regulate the immune system and adhesion capacity can directly and indirectly have preventive and therapeutic effects on a wide range of diseases. However, further study of these mechanisms requires extensive research on various aspects.

Wound infections due to snake bites such as cellulitis and necrotizing fasciitis, although not common, are seen in snake bites and if left untreated can cause serious complications.

Although acute kidney injury (AKI) is a very rare complication of tramadol (TR) poisoning, overdose use in recent years should be considered. We present a 21‐year‐old man with metabolic acidosis, seizures, elevated serum creatine phosphokinase (CPK), creatinine, and rhabdomyolysis due to tramadol poisoning.

Acute methanol poisoning may be associated with a variety of symptoms, such as abdominal pain, blurred vision, loss of consciousness, and acute pancreatitis. We present a 37‐year‐old man with acute pancreatitis due to methanol poisoning during the COVID‐19 pandemic.

Immunocompromised patients, especially those hospitalized, are at higher risk for infection with opportunistic pathogens such as Stenotrophomonas maltophilia (S. maltophilia) which is a multidrug-resistant gram-negative bacillus and can cause a challenge in the management of patients with concomitant COVID-19 and S. maltophilia pneumonia. A 71-year-old man with Hodgkin's lymphoma presented with severe respiratory symptoms of COVID-19 and was intubated upon admission and the initial standard treatment for COVID-19 was started for him. The patient subsequently developed superimposed bacterial pneumonia with S. maltophilia. According to that, the patient's intubation tube was removed and a tracheostomy was performed for him. Also, antibiotic treatment was replaced with Colistin and Co-trimoxazole drugs. Finally, after 31 days of hospitalization in the ICU and the aappropriate drug treatment, he was discharged with reduced symptoms and partial recovery. It should be noted that the occurrence of co-infection with multidrug-resistant pathogens such as S. maltophilia requires proper management to select appropriate treatment methods and drugs so that in addition to proper effectiveness, it does not lead to side effects and complications associated with COVID-19 disease.

Background Zinc phosphide (ZnP) is a dark gray crystalline compound used as a rodenticide against rodents such as mice. ZnP poisoning may be accidental or suicidal. The aim of this study was to investigate the clinical manifestations and treatment management of hospitalized patients with ZnP poisoning in Mazandaran Province, northern Iran. Methods Between 2013 and 2017, a cross-sectional study was performed on hospitalized patients with ZnP poisoning who were referred to two training hospitals in Mazandaran Province, northern Iran. Results A total of 127 patients participated in this trial, including 71 (55.9%) men and 56 (44.1%) women. The patients’ average (standard deviation) age was 25.5 (±16.82) years, and it took 2.18 (±2.23) hours to refer them to the hospital. There were 42 (33%) cases with less than one package, 9 (7%) cases with several packages, and 76 (60%) cases with no particular usage. Conclusions This study has shown that ZnP poisoning may be asymptomatic initially or with mild clinical symptoms that may gradually worsen. Therefore, hospitalization and obtaining a history and a careful physical examination should be considered.

Snake bite is a common and very important issue threatening health worldwide. Patients who develop hemorrhagic or non-hemorrhagic blisters following snakebite, in addition to anti-venom, need broad-spectrum antibiotics and sometimes emergency surgical procedures and hospitalization to prevent serious complications such as necrotizing fasciitis, compartment syndrome.

Propranolol, a β-blocker (BB), is one of the drugs that can be misused for suicide. The clinical manifestations of overdose can range from asymptomatic to neurological symptoms such as seizures and loss of consciousness, cardiac shock, and even death. Herein, we describe 2 cases that were referred to our hospital’s emergency department in northern Iran: The first case was a 37-year-old woman who suffered from a decreased level of consciousness, bradycardia, and hypotension after ingesting 4 g of propranolol tablets. In the second case, a 32-year-old woman was admitted with complete cardiac arrest and a suspected history of ingesting 4.8 g of propranolol pills a few hours before admission. Therefore, the time interval between pill intake and treatment initiation seems to be one of the most important factors in prognosis, in addition to the number and dosage of pills ingested.