Introduction: Rodenticides are considered a global challenge to public health. Two major compounds in this category include aluminum phosphide and zinc phosphide. However, simultaneous use of aluminum phosphide and zinc phosphide has not been reported in the literature. Case Presentation: We present the case of a 20-year-old female, who was poisoned with both a rice tablet and powdered rat poison. She was admitted to Shahid Beheshti hospital of Babol University of Medical Sciences, Babol, Iran in July 2016. Resuscitative and supportive measures were applied, including prophylactic intubation, gastric lavage with a bicarbonate solution, and intravenous administration of N-acetylcysteine (NAC), magnesium sulfate, calcium gluconate, and bicarbonate compounds. In case of a blood sugar level above 100 mg/dL, regular insulin was infused. After diagnosis of phosphine-induced cardiomyopathy, digitization with digoxin was prescribed for the patient. Conclusions: This case report presents the possible positive effects of digoxin, insulin, and antioxidant therapy on simultaneous poisoning with aluminum phosphide and zinc phosphide.
Introduction: Pulmonary mucormycosis is an uncommon, difficult-to-diagnose disease with currently no suitable treatments. It is associated with hematological malignancies, diabetes, and immunosuppression. Case presentation: We report a 16-year-old boy who developed pleural mucormycosis for unknown reasons. The patient presented to our hospital because of fever, chills, weakness, lethargy, loss of appetite, pleuritic chest pain, and shortness of breath. Histopathological testing ultimately diagnosed mucormycosis. Discussion: Pulmonary mucormycosis is a potentially fatal infection with a challenging clinical presentation that requires prompt diagnosis. Diagnosis of pleural mucormycosis was verified by histopathological analysis of pleural fluid and pleural tissue biopsy. Conclusion: This study emphasizes the relevance of histological examination in detecting mucormycosis, which will aid in early management by highlighting the difficulty of diagnosis.
Over the course of the Coronavirus disease 2019 (COVID-19) pandemic, numerous complications have been documented. In this report, we have detailed an unexpected complication of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that occurred in a 73-year-old female patient who was simultaneously afflicted with mucormycosis and another unanticipated problem. Due to the lack of recovery of the patient after receiving mucormycosis treatment and continued fever, cough and hemoptysis, bronchoscopy was performed for her. During bronchoscopy, we encountered a foreign body that was the cause of the patient's fever, cough, and hemoptysis. Rigid bronchoscopy was performed and a foreign body (2.7 x 1.2 cm) was removed from the left main bronchus. Although research has showed fewer cases of pediatric Foreign Body Aspiration (FBA) during lockdown periods, there is not enough evidence about FBA risk in elderly patients with comorbidities. Finally, in the treatment of cases of COVID-19 infections co-infected with opportunistic fungal and maybe even bacterial infections, we should not look at the patient through a tunnel vision and consider all possible scenarios for the patient.
Background This study aimed to determine the characteristics, vaccination status, and outcomes of confidence interval (COVID‐19) patients, admitted to a tertiary hospital in Iran during the predominant severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) Delta variant period. Methods This retrospective study assessed the medical records of all hospitalized COVID‐19 patients, who were admitted to a tertiary hospital from July 10 to September 15, 2021. Adjusted binary logistic regression analyses were conducted to determine factors associated with poor outcomes. Results More than 25% of hospitalized patients received at least one vaccine dose of SARS‐CoV‐2. The Sinopharm BIBP vaccine (China) was the most commonly received vaccine (73.3%). After adjusting for age and comorbidities, the adjusted odds ratio (AOR) for poor outcomes was significantly lower in hospitalized patients who received Remdesivir compared to those not receiving Remdesivir (AOR: 0.35; 95% confidence interval [CI]: 0.15, 0.78; p < .010). Besides, age ≥50 years (AOR: 2.51; 95% CI: 1.38, 4.59; p < .003), low educational level (AOR: 3.99; 95% CI: 1.17, 13.53; p < .027), work outside in the past year (AOR: 1.75; 95% CI: 1.02, 3.00; p < .041), and diabetes mellitus (AOR: 1.95; 95% CI: 1.66, 3.26; p = .011) were associated with more poor outcomes. Conclusion Based on the present results, the risk of mortality and the risk of poor outcomes were lower in patients who received Remdesivir compared to those not receiving Remdesivir. The number of vaccinated patients was smaller than the unvaccinated among hospitalized patients. It is important to emphasize that vaccination reduced the need for hospitalization and that only vaccinated patients with comorbidities required hospitalization.
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