The term "Non- ALCOHOLIC Steatohepatitis (NASH)" is applied when sonographic and pathologic view of liver shows ALCOHOLIC hepatitis changes without history of alcohol consumption. Radiologic findings can easily make the diagnosis and liver biopsy confirms the initial suspicion. It is showed that up to 43.5% of patients with asymptomatic abnormal liver transferases levels have some degrees of NASH, which suggest the importance of being familiar with the issue and how to approach and treat it. NASH is commonly accompanied with diabetes mellitus (especially type II), obesity and hyperlipidemia. These findings support the theory in which insulin resistance is the mainstay of NASH pathophysiology. The natural history of NASH is unclear but surely it is far better than ALCOHOLIC related liver disease. It is estimated that up to 8% of patients would meet cirrhosis, considering risk factors such as obesity and features found in biopsy specimen. Steatosis, polymorphonuclear lobular inflammation, ballooning degeneration, hyaline- Mallory bodies and cirrhosis are among different pathologies seen in biopsy. It is important to rule out other chronic liver diseases including drug induced liver disease, chronic viral hepatitis, and metabolic and autoimmune liver diseases to establish the diagnosis of NASH. There is no definite treatment for NASH. Therapeutic measures are categorized as reducing risk factors and using hepatocellular protective agents. The former includes weight reduction, treating hyperinsulinemia and diabetes, control of hypertriglyceridemia and leptin. Protective agents are anti-oxidants like vitamin E and/ or C, probucol, silymarin, ursodeoxycholic acid, reducing iron load, N-acetyl cystein, food supplements and cytokines. Increasing rate of NASH is reported among children and adolescences, which could be due to growing amount of obesity in these age groups.

Introduction: Methanol is a highly toxic substance and methanol poisoning results in severe health situations. Methanol poisoning occurs when it is consumed by various methods such as orally, by inhalation, and transdermally. Transdermal poisoning is rarely seen and causes severe health complications.Case Presentation: A 59-year-old male patient was admitted to the emergency room due to blurred vision and knee pain. He had wrapped alcohol soaked cotton around his knees because of pain, and left it for 10 hours at night. Onphysical examination the knees only exhibited redness. Upon fund uscopic examination, signs of poisoning were not seen, but a high anion gap metabolic acidosis was shown by arterial blood gas analysis. Hemodialysis was performed for severe acidosis and the patient was admitted to the ICU. The patient was treated and discharged from the ICU without sequelae.Conclusions: Methanol poisoning presents to the emergency department in our country with many different situations and with varying histories. In different parts of the world, transdermal INTOXICATION cases maybe more prevalent and they maybe overlooked, therefore, we aimed to present this case.

Brain injury associated with methanol toxicity can be ischemic, necrotic or hemorrhagic in nature. It most commonly affects the putamen area bilaterally; however, it can be seen in other locations. This report describes a 22-year-old intoxicated patient who developed an epidural hematoma following hemodialysis. Heparinization during hemodialysis may contribute to cerebral hemorrhagic complications in methanol poisoning. In addition, a history of head trauma may raise the incidence of post-hemodialysis hemorrhagic brain insults. Heparin-free dialysis or peritoneal dialysis can be a good option in these cases.

Although some Islamic jurists do not regard INTOXICATION as a defense to murder, Islamic Criminal Act, according to some Islamic jurists, provides that homicide while INTOXICATION does not involve retaliation (qisas) if (1) the drunk was in a state of automatism and (2) he did not make himself drunk in order to commit murder. While the Legislator has been subtle in reflecting this religious rule in some cases, but the Legislator was not precise in other cases including commission of crimes less serious than homicide and other crimes (Hodud and Ta'zirat) while INTOXICATION. Consequently the Legislator could not provide a comprehensive act fully consistent with Sharia (Islamic law).

Methanol is a clear liquid with high toxicity. Methanol INTOXICATION may result from accidental exposure, overconsumption of compounds containing methanol with suicidal intent, or following consumption of distilled and contaminated ALCOHOLIC beverages. This report describes a case of transdermal methanol INTOXICATION, which is a rare condition. A 58-year-old woman presented with nausea, vomiting, weakness, diplopia and dizziness. On neurological examination, she only had diplopia. On physical examination, a hyperemic lesion with clear borders was found over the right knee. The patient’ s recent medical history revealed that four days prior to the onset of symptoms, she had covered her knee with a methanol-soaked bandage in an attempt to alleviate her knee pain. She had a high osmolar gap as well as high anion-gap metabolic acidosis (HAGMA). Methanol INTOXICATION was suspected due to HAGMA and high osmolar gap. Serum methanol levels were subsequently measured and found to be 37. 9 mg/dL. The patient was treated with intravenous (IV) bicarbonate, IV ethyl alcohol and hemodialysis. She was discharged with no central nervous system or ophthalmologic sequelae. Methanol poisoning should be kept in mind in patients with diplopia and unexplained metabolic acidosis. Although most methanol INTOXICATION cases occur after oral ingestion, it should be considered that methanol poisoning may occur transdermally.

Background: Tramadol is an analgesic medication. High prevalence of tramadol abuse has beenfrequently reported. This study was aimed to evaluate the common and serious complications and deathcases due to tramadol INTOXICATION. Methods: A cross-sectional study was performed on 420 patients hospitalized in poisoning ward ofTehran Loghman Hospital for four months period. Patient’ s characteristics and medical complications wererecorded during hospitalization and subsequent visits. Results: Convulsion (31. 3%) and apnea (6. 2%) were the most serious side effects in patients using withtramadol INTOXICATION. The incidence of apnea was correlated with the drug doses (P<0/5%). However, theincidence of other complications was not significantly related with the drug dose. Conclusions: The high prevalence of tramadol abuse, and its high and dangerous complications in ourcountry that requires careful vigilance of physicians and pharmacists in prescribing and selling tramadol, andfamilies’ awareness about the arbitrary use of his youth.

This study has been performed on 42 patients with digoxin INTOXICATION during ten years. The patients had arrhythmia in ECG and on clinical examination. Tne digoxin level in these patients were higher than 2ng/ml with radioimmunoassay method. The results were compared with Chung's study that was carried out on 180 patients intoxicated with digitalis.The commonest arrhythmia in our and Chung's studies were ventricular arrhythmias(50% VS 57.75% P<0.05) and the most rare one was nodal arrhythmia (7% VS 4.76%). Atrioventricular(AV) blocks frequency was 16.66% VS 51.66% (P<0.05) and atrial arrhythmias 19.04% VS 20% (P<0.04) and sinus arrhythmias were 9.52% VS 15.55% (P<0.7) in comparision with Chung's studies.Digoxin INTOXICATION was three times more frequent in females than males. The highest frequency was obseved in 60 and over 60 years old (73.8%) and the commonest coexisting disease was corpulmonale.