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Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018. Objectives: This study aimed to address this issue from the public health perspective. The study further aimed at reporting the mortality and morbidity associated with mushroom poisoning and ascertaining the reasons behind the increase in the numbers of the affected persons. Methods: This report was based on the review of official reports and a field assessment in the areas affected by mushroom poisoning in the western part of Iran. Results: There were 1151 mushroom poisoning cases, out of which 1133 (98.4%) were hospitalized, and unfortunately, 18 (1.56%) died. Kermanshah province had the highest rate of mushroom poisoning casualties, out which seven people died. A total of 12 provinces were affected. Conclusions: Lack of knowledge of local people about the types of mushroom and their inability to differentiate between the toxic and non-toxic mushrooms, as well as lack of a swift and convenient immediate warning system has caused this incident of massive mushroom poisoning. However, planning and proper management can help to resolve these problems.

Introduction: Fluoxetine is used commonly as an antidepressant and celecoxib is widely used for pain relief and reducing inflammation in various chronic conditions. Both of them can cause liver injury, but it is a rare adverse reaction of their interactions. Here we report a case of liver injury possibly induced by fluoxetine and celecoxib in a female patient. Case Presentation: A 55-year-old woman who was given fluoxetine for three months and celecoxib for seven days was transferred to the Department of Emergency, the first affiliated hospital of Jilin University, Changchun, China, on March 2019, with icterus on the skin, dark brown urine and pain in the upper abdomen. Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels were elevated. According to follow-up examination, liver injury and cholecystitis were diagnosed. After discontinuing the two drugs and starting symptomatic treatment, her ALT and AST levels returned to normal. Conclusions: The mechanism of liver injury induced by fluoxetine and celecoxib remains unclear. Inhibitors and substrates of CYP2D6, CYP2C9, CYP3A4, and CYP2C19 might participate in this situation. The interaction between fluoxetine and celecoxib, as well as other inhibitors and substrates with similar metabolic pathways, are noteworthy

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of the Langerhans cells, which are part of the mononuclear phagocytic system. The disorder varies in terms of the extent of the disease, its natural course and patient outcomes. While skin rashes are a common presentation of neonatal LCH, other systems or organs may also be involved. Delays in the diagnosis of neonatal LCH may occur due to its non-specific presentation and a lack of awareness of the condition among doctors. We report a two-month-old male neonate who presented to the Chacha Nehru Bal Chikitsalya hospital, New Delhi, India, in 2016 after the onset of pulmonary symptoms. He had been noted to have a generalised rash which had progressively worsened from 15 days of age. Following a skin biopsy and chest imaging, he was diagnosed with multisystem LCH with risk organ involvement. There was a delayed response to combined chemotherapy with no major side-effects

Introduction : this report showed that clinically significant adductor muscle contraction can be possible even when the anterior and posterior branches of the obturator nerve are completely blocked. case presentation : a 66-year-old male patient visited GIL medical center, gachon university college of medicine, Incheon, south Korea during the year 2016. he underwent transurethral resection of the bladder (TURB) of a bladder tumor under spinal anesthesia and obturator nerve block (ONB). ONB was performed at the right-side inguinal crease by an ultrasound-guided block of the anterior and posterior branches. at the beginning of surgery, he exhibited grade iv obturator reflex; therefore, general anesthesia was applied and the surgery completed. after the effect of neuromuscular blockade had been completely reversed, we confirmed twitching of the pectineus muscle by ultrasound using a nerve stimulator (stimulation current 0.3 ma). main branches of the right obturator nerve were still completely blocked when we rechecked the previously blocked-site (stimulation current 2 ma). Conclusions : the described case cautions that investigators must be aware more than two branches may pass adjacent to interfascial layers at the inguinal crease level and that a missed obturator nerve branch might result in severe adductor muscle contraction. we report this observation and suggest the possibility of an anatomical variant that requires the need for nerve stimulation and ultrasound for obturator nerve block verification.

The research aimed at estimating the production function and the total cost function, as well as calculating the efficiency of resource use, technical, economic, price and cost efficiency. The research was based primarily on a simple random sample of 115 farmers in Baghdad governorate for the spring season 2016.The finding of the study reveal that the optimal size of production and the size of production that maximize profit reached about 98.6512, 112.8316 tons respectively. Technical, economic and price efficiencies were estimated at (61.8588, 61.8585, 90.479)% consequently, while cost efficiency was estimated at 0.66720, and the net farm income that achieved over all the sample less about 3726.9726 thousand dinars than that achieved at optimal size. The results of the resources efficiency criteria indicated that potato farmers were efficient in using resources (seeds, human labor) and were inefficient in using the irrigation resource. The research concluded that the quantity of seeds had the greatest impact on potato production and that there was waste in using the available resources, which led to the actual production being less than the optimum size of production. The research recommends that the related institutions should work to provide good quality potato seeds to cover the needs of local farmers, And from good sources in a timely manner and at the right price to increase the production and productivity of this important crop and reduce production costs. As well as the protection of the local producer by adopting price policies that grant best income of farmer

Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy. A urine sample was positive for tranylcypromine, amphetamine and methamphetamine using gas chromatography/mass spectrometry after derivatisation with heptafluorobutyric acid. As amphetamines were present in the urine sample, it was assumed that the tranylcypromine had been converted to amphetamines metabolically. As such, it is possible that the legitimate use of certain prescription drugs may complicate the interpretation of test results for illegal drugs