ABSTRACT:The present study aimed at verifying the impact of a Moroccan strategy against scorpion stings and specifically at identifying the epidemiological features of patients envenomed or just stung by scorpions. It included 11,907 patients from El Kelaa des Sraghna Province, Morocco, who were evaluated over five years (2001)(2002)(2003)(2004)(2005). Most stings occurred during the hot period and mainly at night. The average incidence was 3.2 per 1,000 inhabitants; patients ≤15 years accounted for 34%, and the envenomation rate was 12%. Average lethality rate was 0.7%. Our work evaluated the efficacy of the adopted strategy based on indicators of follow-up, morbidity and lethality due to scorpion sting and envenomation.
The present study aimed at verifying the impact of a Moroccan strategy against scorpion stings and, specifically, at identifying the epidemiological features of the patients envenomed or just stung by scorpions. The investigation included 4089 patients from a province of Morocco which were evaluated over three years (2001, 2002 and 2003). Most stings occurred during the hot period and mainly at night (between 6:00 p.m. and 12:00 p.m.). The average incidence was 2.8‰, the average age of the patients was 26.7±18.2 years, and the envenomation rate was 6.7%. Mortality rate was 0.05‰, and average lethality rate was 0.7%. Analysis of variance showed that young age, symptoms at admission, and long time elapsed between sting and admission were correlated with poor outcome. Comparison among data of the three years revealed an increasing number of reported cases and decreasing morbidity and mortality
ABSTRACT:The present study aims to elucidate the risk factors involved in deaths caused by scorpion envenomation. A retrospective study was carried out in the province of Kelâa des Sraghna from 2003 to 2004. The hospital charts of scorpion envenomation cases treated in the Essalama Hospital in Kelâa des Sraghna were exhaustively analyzed. Our study contains 31 cases of death among 470 hospitalization cases. Most stings had occurred during the hot period peaking in July and August (54.6%). Moreover, the scorpion stings occurred at night in 60.1% of the cases, between 6:00 pm and 6:00 am. In addition, all age groups were affected by envenomation, with a higher frequency in children aged less than 15 years (68.3%). The envenomation rate (class II + class III) was 70.9%. The statistical analysis of the data shows that being less than 15 years old, having been stung during the night and belonging to class III are risk factors that aggravate vital prognosis of hospitalized patients. Furthermore, clinical severity factors, elicited by relative risk analysis, are cardiovascular, respiratory and neurological vital distresses, with relative risks of 14.84, 11.92 and 48.33, respectively. The results of our study clearly displayed the severity and extent of the scorpion envenomation problem. Thus, great attention must be paid to this region of Morocco by the national health authorities.
Objective:
High concentrations of antituberculosis (anti-TB) drugs can be associated with many adverse drug reactions (ADRs). The objective of this study was to examine the plasma concentrations of rifampicin (RMP) and isoniazid (INH) in patients with and without ADRs.
Methods:
Concentration monitoring data of patients treated with anti-TB drugs were retrospectively analyzed from 2009 to 2011. RMP and INH plasma concentrations were measured 2 and 3 h after drug administration respectively using high-performance liquid chromatography.
Results:
A total of 54 out of 120 patients have experienced ADRs to anti-TB drugs. The median concentrations [interquartile range (IQR)] obtained in patients with and without ADRs were 6.7 mg/l (3.7–9.9) and 5.6 mg/l (2.9–8.6) (p = 0.56) for RMP and 4.3 mg/l (2.3–5.3) and 3.1 mg/l (1.7–4.8) (p = 0.04) for INH, respectively. Related median doses (IQR) were 8.7 mg/kg (8.0–10.0) and 8.6 mg/kg (6.5–9.9) (p = 0.42) for RMP and 4.8 mg/kg (4.3–5.0) and 4.0 mg/kg (2.8–5) (p < 0.01) for INH, respectively. Concentrations above the expected range in patients with and without ADRs were not reached for RMP, but were 76% and 65% for INH, respectively. Correlation between concentrations and doses has not been established for RMP or INH. In addition, high INH concentrations showed no association with sex, age, liver injury or renal or diabetes.
Conclusions:
High INH concentrations were common in patients with and without ADRs whereas RMP concentrations were low or within the normal range in most patients. Further studies are required to assess the association between high INH concentrations and the occurrence of ADRs.
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