The present study was conducted on paraquat poisoning cases, from January 2017to January 2018, a total of 9 patients of paraquat poisoning transferred to our referralToxicology center. Six of them survived. Paraquat is one of the most used herbicides, a non-selective, killing green plants on contact. It is very toxic for human. We usedimmunosuppressant and antioxidant drugs in most cases. In addition, many patientswere given gastrointestinal decontamination and activated charcoal at a local hospitalbefore transferring to our center. According to our treatments, early management andhemoperfusion after ingestion can increase the rate of survival.

Introduction: Parquet poisoning has been elaborated to be very common among developing countries, particularly in regions with agriculture economy. One of the most common presentations of paraquat poisoning is oropharyngeal burns. Herein, we report a patient from a dry and warm district in the geographic center of Iran where agriculture and, as a result, paraquat poisoning are not commonly reported. Case Presentation: A 25-year-old man presented to hospital subsequent to a suicide attempt by ingesting oral paraquat poison. He gradually developed odynophagia and trismus-like appearance that, after a psychiatric consultation, was misdiagnosed as a drug side effect in the form of dystonia. Upon further physical examination, oral ulcers on his tongue were revealed to be responsible for the symptom. Conclusion: Paraquat poisoning is very rare in regions with lower rates of agriculture activities. In any patient with poisoning, however, it is necessary to consider intraoral examination to rule out any other suspected diagnosis.

The herbicide paraquet (1, 1-dimethyl-4, 4-bipyridilium dichloride; PQ) is a highly toxic quaternary nitrogen herbicide. Many cases of PQ acute poisoning and death have been reported over the past few decades. The mechanisms of PQ toxicity have been reported to involve the generation of reactive oxygen species (ROS) in different organs. Several studies have suggested that the mechanism of PQ toxicity is associated with a redo cyclic reaction, which generates superoxide anion, singlet oxygen and other free radicals, leading to cellular NADPH depletion and lipid per oxidation of cell membranes. Then PQ poisoning is directed towards the use of antioxidants. There are several reports about oxidative stress in acute and chronic exposures to PQ. In this respect, there are several in vitro and in vivo but few clinical studies about mechanism underlying these effects. Bibliographic databases were searched for the years 1960-2013 and resulted in 378 articles. After elimination of duplicates or irrelevant papers, 70 papers were included and reviewed. Results indicated that the status of PQ toxicity and treating the toxic effects produced by PQ is presented. Nonetheless, it is reasonable for the scientific community to provide an expert review and evaluation of this herbicide and their toxic potential to produce disorders in brain, liver, kidney and lung in living organisms.