Identifying the sources of mercury exposure in dental workers.

Dental professionals who handle dental amalgam are at risk of mercury exposure, though the prevalence and severity of elevated mercury levels from non-occupational sources are not well characterized. We report two dental workers who had elevated urinary mercury levels (37 and 25.6 mcg/L) during routine health screenings.

Emamectin Poisoning in Thailand: Clinical Characteristics and Outcomes.

Emamectin benzoate (Emamectin) is a broad-spectrum insecticide. Current data regarding emamectin poisoning in humans are very limited. We performed a 10-year retrospective cross-sectional study (2011-2020) using data from the Ramathibodi Poison Center database to examine the clinical characteristics and outcomes in patients exposed to emamectin.

Clinical features of seven patients poisoned with a tolfenpyrad-based insecticide in Thailand.

Introduction: Tolfenpyrad, a novel insecticide originating from Japan and first approved in 2002, has been marketed in numerous countries. Data on tolfenpyrad exposure in humans are limited. This study aimed to characterize the clinical features and outcomes of acute poisoning from tolfenpyrad-based insecticides in Thailand.

Poisoning from Ingestion of Fungus-Infected Cicada Nymphs: Characteristics and Clinical Outcomes of Patients in Thailand.

The current data regarding poisoning associated with ingestion of fungus-infected cicada nymphs are limited. We performed a retrospective cohort study of patients who ingested fungus-infected cicada nymphs and were referred to the Ramathibodi Poison Center for consultation from June 2010 to June 2022. Thirty-nine patients were included for analysis.

A 10-Year Retrospective Analysis of Medication Errors among Adult Patients: Characteristics and Outcomes.

Medication errors (MEs) are a global health problem. We conducted this study to clarify the clinical characteristics, outcomes, and factors associated with MEs that caused harm to adult patients (>15 years of age) who were managed in hospitals or healthcare facilities. We performed a 10-year retrospective study (2011-2020) by analyzing data from the Ramathibodi Poison Center (RPC) database (RPC Toxic Exposure Surveillance System).

Comparing Ultrasonography and Surface Landmark-Guided Lumbar Puncture in Patients with Obesity and Difficult Anatomy; a Randomized Controlled Trial.

Introduction: Previous studies have shown higher lumbar puncture (LP) success rates when using ultrasound guidance. This study aimed to compare the first-attempt success rate of ultrasound-guided LP with blind technique of needle insertion using the palpable spinal surface landmark in patients with obesity or a difficult anatomy.

Methods: This prospective randomized controlled study was performed at the emergency department of Ramathibodi Hospital, an academic tertiary university hospital, from August 2015 to July 2016.

A Retrospective Cohort Study of Cobra Envenomation: Clinical Characteristics, Treatments, and Outcomes.

This study investigated the clinical characteristics, treatments, and outcomes of envenomation involving cobra species in Thailand (, , and ). Data of patients who had been bitten by a cobra or inoculated via the eyes/skin in 2018-2021 were obtained from the Ramathibodi Poison Center. There were 1045 patients admitted during the 4-year study period (bite, n = 539; ocular/dermal inoculation, n = 506).

Clinical characteristics, treatment and outcomes of acute propanil poisoning in a 7-year retrospective cohort study.

The present study was a 7-year retrospective cohort study (2012-2018) of patients treated for acute propanil poisoning by ingestion, using data from Ramathibodi Poison Center, Thailand. The aim of this study was to describe the clinical characteristics, treatment, outcomes and factors associated with moderate to severe outcomes and death following acute exposure to propanil. The effect of administering multiple-dose activated charcoal (MDAC) on clinical outcomes was also evaluated.

The Impact of the Coronavirus Disease 2019 (Covid-19) Pandemic on the Use of Emergency Medical Services System in Bangkok, Thailand.

Background: Coronavirus disease 2019 (COVID-19) has widely affected the global public health system, especially the emergency medical service (EMS), which has been the first responders since 2020. However, this pandemic persists with still limited studies on its impact on EMS. This study aimed to compare the number of EMS patients and the operation periods of Bangkok EMS in Thailand between 2020 (severe COVID-19 pandemic) and 2019 (prepandemic).

Characteristics and Consequences of Medication Errors in Pediatric Patients Reported to Ramathibodi Poison Center: A 10-Year Retrospective Study.

Purpose: This study was performed to evaluate the clinical characteristics of, consequences of, and factors associated with medication errors (MEs) that cause harm to pediatric patients (<15 years of age) treated in the hospital setting.

Patients And Methods: We performed a 10-year retrospective study (January 2011-December 2020) by analyzing data from the Ramathibodi Poison Center. MEs were classified into categories A to I according to the severity of the outcome.

Situation of snakebite, antivenom market and access to antivenoms in ASEAN countries.

Introduction: Snakebite envenoming is a neglected tropical disease posing public health challenges globally. The Association of Southeast Asian Nations (ASEAN) countries are among the tropical regions with disproportionately high incidence of snakebite. Hence, this study aimed to review the situation of snakebite, antivenom market and access to antivenoms in ASEAN.

Malayan Pit Viper Envenomation and Treatment in Thailand.

Introduction: The Malayan pit viper (MPV; ) is a hematotoxic snake found in all regions of Thailand and many countries in Southeast Asia. Treatment of MPV envenomation varies among facilities due to their capabilities.

Materials And Methods: This study was a retrospective review of patients with MPV envenomation who were reported to the Ramathibodi Poison Center from 1 July 2016 to 30 June 2018.

Poisoning of Butanol-Containing Products: Clinical Characteristics and Outcomes.

Background: Butanol (butyl alcohol) is a chemical which occurs naturally in some foods and is used in the manufacture of other chemicals. Current data on butanol poisoning in humans are limited.

Objective: This study describes clinical characteristics and outcomes of patients exposed to products containing butanol.

Development of a Physiologically Based Pharmacokinetic Model of Mitragynine, Psychoactive Alkaloid in Kratom ( Korth.), In Rats and Humans.

Mitragynine is a major psychoactive alkaloid in leaves of kratom ( Korth.). To understand its disposition in organs, this study aimed to develop a physiologically based pharmacokinetic (PBPK) model that predicts mitragynine concentrations in plasma and organ of interests in rats and humans.

Rapid and Accurate Species-Specific PCR for the Identification of Lethal Box Jellyfish in Thailand.

Box jellyfish are extremely potent venom-producing marine organisms. While they have been found worldwide, the highest health burden has been anticipated to be the tropical Indo-Pacific of Southeast Asia (SEA). At least 12 Cubozoan species have now been documented in Thai waters, and many of them inflict acutely lethal strings, especially those under the order Chirodropida.

Toad Poisoning: Clinical Characteristics and Outcomes.

Objective: This study was performed to describe the clinical characteristics and outcomes of patients with toad poisoning in Thailand.

Methods: We carried out a retrospective study of patients with toad poisoning from the Ramathibodi Poison Center Toxic Exposure Surveillance System during a 5-year period (2012-2016).

Results: We studied 36 patients poisoned by toad toxin.

Myotoxic Mushroom Poisoning in Thailand: Clinical Characteristics and Outcomes.

Purpose: To describe the clinical characteristics and outcomes of myotoxic mushroom poisoning in Thailand.

Patients And Methods: We performed a retrospective cohort study of cases of myotoxic mushroom poisoning from the Ramathibodi Poison Center Toxic Exposure Surveillance System during a 5-year period (2012-2016).

Results: Forty-one cases were included.

A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017.

Interest in the Southeast Asian natural remedy kratom has increased in Western countries recently, along with increasing concern over its potential toxic effects. To describe and compare demographics, common co-exposure substances, clinical effects, treatments, and medical outcomes of kratom "abuse" exposures in the United States (US) and Thailand. This is a retrospective analysis of kratom "abuse" exposures, defined as use when attempting to gain a psychotropic effect, reported to the National Poison Data System (NPDS) in the US and the Ramathibodi Poison Center (RPC) in Thailand from 2010 to 2017.

A Surviving Child from Acute Liver Failure after an Ingestion of Cassia occidentalis Seeds.

Cassia occidentalis toxicity is thought to be uncommon; however, several cases have been described with acute hepatomyoencephalopathy with a high-mortality rate. We report a previously healthy, 2-year-old girl who developed acute liver failure after fresh seed ingestion. Without a specific antidote, we decided to implement supportive measures and medications including lactulose, sodium benzoate and N-acetylcysteine.

Acute Imidacloprid Poisoning in Thailand.

Introduction: Imidacloprid is the most commonly used neonicotinoid insecticide worldwide. Despite its reputation for safety, there is increasing evidence regarding its toxicity. This study characterized the clinical manifestations and outcomes of acute imidacloprid poisoning.

Poisoning of glutaraldehyde-containing products: clinical characteristics and outcomes.

Objective: This study describes the clinical characteristics, outcomes, and factors at presentation associated with death of cases poisoned by glutaraldehyde (GA)-containing products.

Methods: We performed a 5-year retrospective cohort study (July 2013-June 2018) using data from the Ramathibodi Poison Center.

Results: There were 244 cases included in this study.

Utility of Thrombin Time in Management of Patients with Green Pit Vipers Bite.

Objectives: GGreen pit vipers (GPV) envenomation causes consumptive coagulopathy mainly by thrombin-like enzymes. Fibrinogen levels are generally investigated to help evaluate systemic envenomation. However, tests of fibrinogen levels may not be available in every hospital.

Clinical Characteristics of Poisoning.

Background: is a tropical plant used as a herbal medicine in various parts of the world, including Thailand. In glucose-6-phosphate dehydrogenase (G6PD)-deficient patients, acute hemolysis has been reported following the ingestion of this plant. Methemoglobinemia was reported in the present study.

Complex regional pain syndrome following a centipede bite: a case report.

Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition associated with autonomic features. To date, the development of CRPS following centipede bite has not been reported. We report a case of CRPS likely secondary to a centipede bite.