مجله دانشکده پزشکی اصفهان
پیاپی 718 (هفته دوم تیر 1402)

Scorpionism is one of the unpleasant topics for people. The Shush County has a suitable living environment for scorpions. This research was conducted to monitor scorpionism in Shush to provide documents to health system decision-makers.

In a cross-sectional study, all cases of scorpion stings were investigated who were referred to medical centers in Shush County in 2019. The data obtained from the amount of scorpion stings were classified according to gender, age groups, months of the year, type of region (urban or rural) and member exposed to scorpion stings and were analyzed using the Wilcoxon statistical test.

The scorpion sting rates among women (50.3%) were higher than among men (49.7%). The highest and lowest scorpion sting rates were observed in the age groups under 15 years (30.4%) and over 65 years (1.5%), and in September (23.6%) and April (6.9%), respectively. The scorpioism rates were higher in rural areas (79.7%) compared to urban areas (20.3%). Hands (43.2%) were more likely to be stung by scorpions than legs (32.2%) and trunks (24.6%). The Wilcoxon signed-rank test did not show significant differences between scorpionism rates related to gender, age groups, urban or rural type, and organs exposed to scorpion stings. But it showed a significant difference between the scorpionism rates among months.

The scorpionism trend gradually increased from April to September to reach its highest peak in September. Moreover, by increasing the age, scorpionism tends from its peak in the age group under 15 years, gradually achieving its minimum in the age group over 65.

Poisoning with super-warfarin, zinc phosphide (ZnP) and aluminum phosphide (ALP) are among the most common poisonings with rodenticides. The purpose of this study was to investigate the frequency of macroscopic and microscopic findings obtained from autopsy in the deceased due to poisoning with these rodenticide poisons.

This cross-sectional study was conducted in 2020 in Isfahan Forensic Medical Center and referral poisoning emergency center in Khorshid Hospital, Isfahan, Iran. The autopsy and pathological findings in the deceased cases due to phosphides and super warfarin poisoning from 21 March 2018 to 20 Feb 2021 were evaluated.

During the study period, 165 patients were hospitalized due to super warfarin and ZnP; and 105 patients with ALP poisoning. Death ‎due to super warfarin was not reported. One patient died due to ZnP poisoning who did not undergo autopsy. 37(35.2%) people died from ALP of which 33 cases underwent postmortem examination. 24 (72.7%) of the deceased were men. And the average age was 29.39 years. In the autopsy findings, pulmonary edema (69.6%) and pleural effusion (21.2%) were the most common findings in ALP poisoning. The pathological findings were liver degeneration, pulmonary edema, and pulmonary hemorrhage. There was a significant relationship between serum bicarbonate on admission and liver autopsy finding. Also time from ingestion to hospital admission was correlated with liver pathology finding.

Considering the prevalence of pulmonary edema and pleural effusion in deceased patients with ALP, guiding fluid therapy by controlling central venous pressure should be considered.

Nephrogenic adenomas in children, similar to adults, are rare benign lesions that often occur in patients with a history of previous surgery or chronic irritation of the urinary tract. These lesions often appear with hematuria and appear as polypoid or papillary lesions in cystoscopy and may have a differential diagnosis with malignant lesions. Most of the patients have a history of bladder augmentation, recurrent urinary tract infections, and urinary stones. So far, no case of nephrogenic adenoma has been reported in children following vesicostomy site prolapse.

Case Report: 

We report a case of nephrogenic adenoma in the bladder of a 2-year-old boy with a history of vesicostomy and vesicostomy prolapse and repeated surgery on the bladder. Vesicostomy was performed due to bilateral vesicoureteral reflux and posterior vesicoureteral valve. After performing two surgeries to correct the vesicostomy site, the vesicostomy was closed at the age of 18 months following resection of the posterior urethral valve, and in the follow-up ultrasound at the age of 2 years, a 2 cm mass was seen in the posterior wall of the bladder, and in the pathology report of the resected mass Nephrogenic adenoma is reported.

Prolapse of the vesicostomy and continuous irritation of the bladder mucosa can cause nephrogenic adenoma in the child's bladder.