Background: Methanol is a highly toxic compound. Severe metabolic acidosis, intense neurological and visual affection are the hallmark of toxicity. Despite maximal supportive care, the mortality rate is yet high. Objectives: This study aimed to determine the predictors of poor outcomes in acute methanol poisoning. Methods: In this retrospective study, forty acute methanol poisoned patients were recruited. Data of four years (2017 to 2020) was obtained from Tanta university Poison Control Center (TUPCC) archive. Data of patients' outcomes were recorded in addition to demographic data, clinical examination, and laboratory investigations results. Results: Out of the 40 enrolled patients, 17 patients had poor outcomes, either death or visual affection, and the remaining 23 patients had completely recovered. A significantly prolonged time elapsed between methanol ingestion and admission in the poor outcome group compared to good outcome one. Likely, the mean GCS, arterial ph, and HCO3 levels were significantly lower in the poor outcome group. Additionally, the poor outcome group noticed a significant increase in total leucocytic count, RBS, ALT, AST, serum creatinine, blood urea, PT, and anion gap. Conclusions: Our study shows that delayed hospital admission and on admission GCS were identified as potential predictive factors of poor outcome in acute methanol poisoning.
Background: Burns continue to be a medical, psychological and economic problem in developed and developing countries. Burns in Egypt represent a major problem as compared with heart diseases, malignancy and road accidents. Objectives: Accordingly, this work was conducted to study the medico legal aspects of burned cases and the magnitude of burn problem in Burn Unit in Tanta University Hospital. Study design: This study was cross sectional, conducted over six months where (160) burned cases admitted to Burn Unit in Tanta University hospital from the start of March 2013 to the end of August 2013. All the patients were included except old burn injuries. Patients were interviewed, clinically examined and investigated, and then data were collected in a specially designed sheet for every patient. Results: One hundred and sixty cases admitted to Burn Unit in Tanta University Hospital during a period of six months from the start of March 2013 to the end of August 2013. The highest percentage of patients was among the age group less than 10 years (38.125%). The majority of the studied cases were distributed among males (58.1%) in rural areas (61.9%). Burns at home constituted (84.4%) of burns. Concerning the agent causing burn, flame constituted (51.9%) followed by scald (37.5%), chemical (6.3%) and electrical burns (4.4%). Most flame burns were due to explosion of gas cylinder. Most burns were of second degree (49.37%), distributed all over the body (43.8%) and involved 15-30% total body surface area (TBSA) (40%). Accidental burns accounted for 95% of all cases followed by suicidal and homicidal cases (3.1 and 1.9% respectively). All suicidal cases were females, caused by flame and distributed all over the body with involvement of more than 60% TBSA. While homicidal cases were males in urban areas. Respiratory complications were the commonest cause of death (38.9%). It could be concluded that intensive educational programs concerning burn dangers, proper prevention, safety measures and regular servicing of gas appliances must be followed. Psychological autopsy is needed in suicidal cases.
Background: Tricyclic antidepressants (TCAs) toxicity continues to be a major problem and an important cause of morbidity and mortality from poisoning all over the world. Aim of the study: to compare the effectiveness of poison severity score (PSS), acute physiology and chronic health evaluation (APACHE II) score and rapid emergency medicine score (REMS) for prediction of the need for intensive care unit (ICU) admission and mechanical ventilation (MV) in cases with acute TCAs toxicity. Methods: This retrospective observational study was conducted on 109 TCAs poisoned cases who were admitted to Tanta University Poison Control Center during the period from the first of January 2017 to the end of December 2020. Three scoring systems (PSS, APACHE II and REMS) were calculated for all cases at admission. Discrimination was evaluated using receiver operating characteristics curve and calculating the area under the curve (AUC). Results: The results of this study revealed that twenty-five cases needed to be admitted to ICU and 8 cases needed MV. The median of the three scores was significantly higher in cases that needed both ICU admission and MV. Although the APACHE II score has the best AUC value for prediction of ICU admission and MV (0.956 and 0.943 respectively), there was no statistically significant difference between the three scores. The AUC value of REMS comes next (0.931 and 0.925 respectively). Conclusion: REMS is rapid and simple score that can be easily assessed in emergency situations, it is recommended to be used for outcome prediction in TCAs poisoning.
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