Assessment of chromium toxicity on pregnant mice and their fetal development

Chromium is a naturally occurring element, present in several valence states. Hexavalent chromium compounds [Cr VI] have been known to be more toxic than trivalent [Cr III] compounds. Exposure to chromium could be environmental due to its natural occurrence in rocks and soil as well as due to water, air and soil pollution resulting in high chromium concentrations in plants and food. On the other hand, industrial exposure could also occur as chromium enters into many industries leading to occupational hazards. The aim of the present work was to study the potential developmental toxicity of hexavalent chromium [potassium dichromate] in female mice exposed to chromium during gestation. The study was conducted on one hundred and twenty female mice which were mated with adult males. The day the vaginal plug was seen was considered day 0 of gestation. Mice were divided into four equal groups, each group consisted of thirty mice. Group I[controls], group II [treated with 10 ppm Cr VI], group III [treated with 25 ppm Cr VI], and group IV [treated with 50 ppm Cr VI]. All types of treatment were given via drinking water and started on day 6 through day 15 of gestation [period of organogenesis]. The parameters investigated in this study were maternal and fetal parameters. Maternal parameters included clinical signs of toxicity, food consumption. body weight, as well as absolute and relative organ weights. Fetal parameters included number of implantation sites, number of live and dead fetuses, number of resorptions [early and late], and fetal body weight. Gross external fetal examination, skeletal examination as well as visceral examination were done to detect any fetal malformations. The present study revealed that low concentration [10 ppm] of potassium dichromate [Cr VI] caused few signs of maternal and fetal toxicity while concentrations of 25 ppm and 50 ppm resulted in maternal and fetal toxicity, which was pronounced with the 50 ppm concentration. Maternal toxicity included general signs of toxicity [diminished activity, excessive salivation and hair loss], significant decrease in food consumption, in body weight and in absolute organ weights. Fetal toxicity included significant increase in number of dead fetuses. as well as early and late resorptions; significant decrease in fetal body weight i.e. growth retardation; and significant increase in fetal skeletal malformations in the form of cranial retardation, -absence of sacrum, shortening of long bones and absence of phalanges. No significant gross external fetal or visceral abnormalities were detected in any of the treated groups of mice compared to the control group

Assessment of severity and outcome of head injuries using a new serum marker [S-100 B protein]

Head injury is recognized as a major public health problem that is a frequent cause of death and disability in young people and makes a considerable demands on health services. The aim of the present study was to assess the severity and outcome of patients with head injuries using a new serum marker which is the level of S-100 B protein, in addition to the use of Glasgow Coma Scale [GCS], brain computed tomography [CT] findings and the Glasgow Outcome Scale [GOS]. The study was conducted on fifty patients with head injury [moderate and severe] who were admitted to the Critical Care Medicine Department [CCMD] at Alexandria Main University Hospital [AMUH] during the period from 1[st] March till the end of June 2004. Ten healthy adult individuals of both sexes were chosen and matched with patients of the present study as regards age and sex. They served as a control group when measuring S-100 B protein level. All patients were subjected to complete history taking with emphasis on causes of head injury, and clinical examination especially neurological examination using Glasgow Coma Scale [GCS]. Serum level of S-100 B protein was measured within six hours from the onset of head trauma, using ELISA technique. Radiological assessment included X-ray skull and computed tomography [CT] of the brain. The outcome of the patients was determined using the Glasgow Outcome Scale [GOS]. The present study revealed that the age of patients with head injuries ranged from 15-60 years with a mean age of 33.7+14.2 years. Male to female sex ratio was 5.25: 1. Road traffic accidents [RTAs] constituted the main cause of head injury [74.0%]. More than half the patients [58%] had open head injuries, while 42.0% had closed head injuries. Severe head injury [GCS=3-8] was encountered in 84.0% of patients, while moderate head injury [GCS=9-12] was evident in 16.0%. More than one quarter of the patients [26.0%] had skull fractures. Brain lesions demonstrated by CT scan was found in 86.0% of the patients while normal CT brain was reported in 14.0%. In patients with head injuries, S-100B protein level ranged from 0.7 to 4.5 mirco g/L with a mean level 1.8 +/- 1.5 mirco g/L, which was significantly higher than the mean serum level of the control group [0.1 +/- 0.02 mirco g/L]. A significant rise of serum S-100B protein level was related to severe head injuries assessed by GCS, posttraumatic amnesia [PTA] more than one week, absence of spontaneous ventilation, abnormal brain findings demonstrated by C T scan, and associated injuries especially thoracic trauma. More than half the patients showed poor outcome by GOS [60.0%], while those with good outcome [good recovery. and moderate disability] accounted for 40.0%. Serum S-100B protein level was significantly higher in patients with poor outcome than in those with good outcome using GOS. The study concluded that the admission level of S-100B protein is a useful early predictive marker in determination of the outcome [disability and mortality] after head injury

protective effect of silymarin on the suprarenal gland in chlorpyrifos intoxicated rats

Chlorpyrifos [CPF] is a widely used organophosphorous insecticide that induces toxic effects in man and animal through its inhibitory action on acetyl choline esterase enzyme. The present work aimed to evaluate the toxic effect of chlorpyrifos on the function and structure of the suprarenal gland and to investigate the possible protective effect of silymarin antioxidant against such toxicity. The study included twenty four adult male rats they were equally divided into four groups as follows: a control group [n=6] received the oral vehicle only [corn oil], a Silymarin group [n=6] received Silymarin in a dose of 6mg/kg b. w orally twice weekly for four weeks, the intoxicated group [n=6] received CPF 5mg/kg b. w, orally twice weekly for four weeks and the protection group [n=6] receivied silymarin orally 6mg/kg b. w. half an hour after chlorpyrifos, administration in a dose of 5mg/kg b. w. orally twice weekly for four weeks. By the end of the experiment, estimation of the following biochemical parameters was done: plasma choline esterase enzyme activity level, serum cholesterol, serum cortisol and serum testosterone. The suprarenal gland was examined by the light microscope using routine H and E stain and chromaffin stain reaction as well as by the Transmission Electron Microscope. The measured biochemical parameters showed significant variation in CPF group compared to the control. The chlorpyrifos intoxicated group revealed affection of the cells of the suprarenal cortex and medulla with variable degrees of degenerative changes. The protection group showed improvement of the levels of the biochemical parameters with partial restoration of the normal histological features of the suprarenal structure compared to the CPF intoxicated group. Accordingly, it was proved that silymarin is a reliable antioxidant that could protect against the toxic effect of chlorpyrifos on the suprarenal gland

Determination of sex from some pelvic measurements among Egyptians: a radiological study

The identity of the dead is an essential part of post-mortem examination. The establishment of the identity may be required upon mutilated and dismembered corpses and identification of sex in such medicolegal situations is frequently confronted with. The most useful bones for sex determination are pelvis and skull. In the pelvis, variables such as the subpubic angle [SPA], bicristal diameter [BCD], transverse diameter of the inlet [TDI], bituberal diameter [BTD], and Ischio-pubic Index [IPI] have been measured independently for sex verification. Little information is available on the concurrent measurement of these variables on the same pelvis for sex determination. The aim of the present study was to develop a method for determination of sex from pelvis among Egyptians using some radiological pelvic measurements. The study was carried out on one hundred plain X-ray of the pelvis [anteroposterior view] of healthy adults of both sexes [70 males and 30 females], aged from 25 to 65 years. These radiographs were done in the outpatient clinic of Diagnostic Radiology department at Alexandria Faculty of Medicine. The following measurements were used: subpubic angle [SPA], bicristal diameter [BCD], transverse diameter of the inlet [TDI], bituberal diameter [BTD], pubic length [PL], ischial length [IL], and ischio-pubic index [IPI]. Regression equation was developed using combination of these measurements for prediction of sex from the radiographs of the pelvis. The regression equation was then applied to a test sample [20 radiographs of pelvis] to establish the degree of accuracy in assigning sex. Based on age, cases of each sex were divided into two groups which were a young age group [25-45 years] and an old age group [45-65 years], and the same measurements were done and compared. The present study revealed that the mean values of all measurements except IL for females were significantly greater than that for males. These differences were statistically significant except in case of BCD. The SPA and BTD showed the most sexual dimorphism whereas the BCD showed the least according to the discriminating index. The overall percentage of accuracy of correct sex determination calculated from the developed equation was 97.0% whereas it was 98.57% in males and 93.33% in females. On application of the developed regression equation for the pelvis on the tested sample radiographs [n=20] blindly, the overall accuracy of correct sex determination was 98.0%. There was no significant difference between the young and old age groups of males as regards all measurements except with SPA and BCD. On the other hand, there was a significant difference between the young and old age groups of females as regards all measurements. It is concluded that the developed method for sex determination using radiographs of the pelvis is simple, reliable, applicable, and with a high degree of accuracy

Patterns of acute poisoning by drugs and substances abuse among addicts: a clinical and laboratory study

The drug dependency problem in Egypt and wordwide is currently one of the major issues of concern to the public as well as the professionals. This study was conducted on all addicts with acute poisoning by drugs and or substances abuse [n= 149]. They were admitted to Alexandria Poison Center [APC] and critical care unit [CCU] at Alexandria Main University Hospital [AMUH] during six months period from January to June 2003. In this study, all addicts were clinically examined. Routine investigations, arterial blood gases and acid base status were done with detection of drug or substance of abuse in urine by Axsym and gas chromatography / mass spectrometry [GC/MS] for negative urine samples. The study showed that 71.2% of addicts were encountered in the age group 20<40 years. adolescents accounted for 15.4% of the addicts. Males outnumbered females with a sex ratio of 17.5:1. The study revealed that the majority of addicts were smokers 95.3% single 71.8% and started drug/ substance abuse in the age group 10<30 years [87.2%]. 43.7% of addicts were of low and very low social class while 28.9% were commercial workers. The duration of addiction ranged from one to 10 years. In the present study cannabis was the first abused substance [24.2%]. Hypnotics whether of benzodiazepine [14.8] or barbiturates [10.7] accounted for 25.5%. Ethyl alcohol either alone or adulterated by methyl alcohol, opiods, constituted 21.5%, 9.4% and 19.5% respectively. Female addicts were more likely to abuse benzodiazepines [75.0%]. 26.2% of addicts presented with severe poisoning and were in need of critical care interventions. The study revealed that postive urine samples for benzodiazepines, oPiates, barbiturates and cannabis accunted for 100%, 96.6% 93.8% and 72.2%, respectively. The majority of addicts recovered completely [83.2%], deaths accounted for 3.4% of the total addicts. It is recommended that, Continuous health education and prevention programs concerning health hazards of drug and substance abuse among adolescents and young adults are highly indicated. In addition the Staff of poison centters and emergency departments, should be well trained to deal with diagnosis and management of overdose in addicts. Also screening immunoassay technique should be done on all urine samples of addicts and better to be confirmed using GC/MS, as the latter is more reliable in legal cases, where it can stand court defense

Assessment of the pattern and severity grading of acute poisoning in children admitted to Alexandria Poison Center

The present work aimed to study the pattern and severity grading of acute poisning among children. The study included all children less than 15 years [n=1072] who were admitted to Alexandria Poison Center [APC] at Alexandria Main University Hospital during six months period [Julyy - December 2000]. Children less than 5 years accounted for 62.8% of the total children where toddlers were the most vulnerable. Early adolescents 10 < 15 years constituted 26.1%, where grils significantly exceeded boys. Children with low and moderate socioeconomic levels represented 64.0% and 20.1% respectively. Accidental poisoning accounted for the majority of children [81.5%]; all of them were less than 5 years. Attempted suicide represented 17.9%, while overdose by addicting drugs constituted 0.6%, all were boys and 10 < 15 years. Non-drug poisoning represented 74.3%, while poisoning by drugs accounted for 17.5%. Carbon monoxide poisoning, animal poisons [snakes and scorpions] and plant poisoning constituted 6.7%, 1.2% and 0.3% respectively. Accordding to multicenter Study of Poisoning in Children [MSPC] score, the study revealed that children with score 0 [asymptomatic] represented 26.2%, those with scores 1 and 2 [mild and moderate] constituted 37.3% and 32.0% respectively, while scores 3 and 4 i.e. severe and very severe poisoning accounted for 3.9% and 0.7% respectively. It was noticed that the MSPC Severity Score goes hand in hand with Matthew and Lawson scale [M and L scale], where severe grades of coma by M and L scale i.e grades 3 and 4 have moderate, severe and very severe poisoning by MSPC Score

Acute poisoning by cholinesterase inhibitor insecticides: Effect on myocardial, hepatic and pancreatic functions in humans

The aim of the present work was to study patients with cholinesterase inhibitor insecticides intoxication as regards clinical manifestations, myocardial, hepatic and pancreatic affection with their laboratory investigations. The study was carried out on fifty consecutive patients with acute intoxication by ChEII admitted to Alexandria Poison Center and critical medicine department at Alexandria Main university hospital, Alexandria, Egypt. A control group of fifteen healthy subjects were randomly chosen. They were clinically free, not exposed to ChEII and of the same age group and sex as the patients. All patients were examined as regards; history and circumstantial evidence. Clinical examination and electrocardiogram [ECG] were done to all patients on admission. Also, laboratory investigation and determination of serum cholinesterase enzyme activity, serum glucose, trypsin, AST and ALT activity were carried out

Carbon monoxide poisoning: Role of brain diagnostic imaging [computed tomography and magnetic resonance imaging]

This study was conducted on thirty patients diagnosed as acute carbon monoxide [CO] poisoning who were admitted to Alexandria Poison Center, Alexandria, Egypt. They represented 4.4% of the total admission [n=9196] to the center during the year 2000. Their carboxyhemoglobin percentage [COHb%] level ranged from 15-42% with a mean of 27.38 +/- 7.73%. This level was significantly increased with deterioration of the level of consciousness, while insignificant relation was found between COHb% level and various clinical presentations, blood gases and acid-base status. Computerized tomography [CT] brain scan was done to all patients and revealed the following: Norma CT scan in 70.0% of patients, 26.7% had brain edema and one patient [3.3%] had internal capsular infarction, which delineated by magnetic resonance imaging [MRI] as bilateral lesions in the internal capsule and cerebellar peduncles. The vast majority of patients [96.7%] recovered completely, only one patient developed permanent sequelae manifested by paraparesis, dysarthria, and incoordination of movement

Is it antemortem or postmortem blood?

Bloodstains examination is required in many fields in medicolegal practice. This study was carried out to discriminate between antemortem [AM] andpostmortem [PM] bloodstains. The method used depended on the determination ofthe level of human myoglobin [by radioimmunoassay] as well as the levels ofadenosine triphosphate [ATP], xanthine and uracil [by HPLC] in thebloodstains. The study revealed a highly statistically significant elevationof myoglobin levels in PM than AM bloodstains. ATP was found in highconcentrations in all AM bloodstain samples and could not be detected in anyof the PM bloodstain ones. On the other hand, xanthine and uracil werepresent in considerable concentrations in all the PM bloodstain samples andwere not detected in any of the AM bloodstain ones. These results wereindependent of the age of the stain, the postmortem interval and the cause ofdeath. It was suggested that the determination of the above-mentionedparameters could help in the discrimination between antemortem and postmortembloodstains in medicolegal practice

Study of skull sutures as a tool for identification

The aim of the present work was to study the possibility of using the patternsof skull vault sutures as a tool for a positive personal identification. Itwas carried out on 100 human Egyptian skulls. They were photographed andexamined to determine the different patterns of skull vault sutures [coronal,sagittal and lambdoid sutures]. A method of describing these patterns on theectocranial surface of the skull was adopted and based on dividing each sutureinto subdivisions and describing the pattern found in each one. Skullradiographs [lateral and posteroanterior views] of 150 adult Egyptianindividuals of both sexes were also included in the study to determine thedifferent patterns of skull vault sutures recorded incidentally in routinediagnostic skull radiographs. The results showed that the suture patterns ofskull vaults were highly individualistic. Thus, no two skulls can ever havean identical suture patterns. This is of an utmost medicolegal importance inidentification, if only the suture patterns were recorded during life throughX-ray radiography for comparison

Carboxy hemoglobin and arterial blood gases levels in fire victims

The study was carried out on 40 burned patients admitted to the burn unit of Alexandria Main University Hospital. The mean age of patients was 27.98 +/- 20.27 years. The burn was accidental in 82.5% of patients and in 17.5% it was an attempt of suicide. The home was responsible for more than three quarters of burn accident [77.5%]. More than a quarter of patients with attempted suicide by burn [28.5%] showed a high% of body surface area burned [90- 100%]. A significant relation was observed between carboxyhemoglobin% and body surface area burned. Again blood carboxyhemoglobin level was high in patients with head and neck burns, neck burns and multiple burns. There was a slight decrease in the PaO2 and pH, and a significant decrease in the PaCO2 and bicarbonate levels. Thus, the possibility of high carboxyhemoglobin level and change in the acid- base status should be considered in fire victims especially those with smoke inhalation

Evaluation of the sensitivity of different methods for detection of seminal stains

identification of seminal stain by finding spermatozoa has long been regarded as the best and most certain means of detection. When the demonstration of complete spermatozoa was impossible, especially in persons having azoospermia as a result of disease or vasectomy, several methods have been sought for seminal fluid identification. The study showed that Florence test remained positive till five or six fold dilutions. On the other hand, Barberios and dithizone tests retained their positivity till 10-fold dilutions. As regards thin layer chromatography, the Rf value of fresh seminal stains was significantly higher than that of old seminal stains in undiluted specimen, but both could be identified till 1:64 dilution. A high creatine phosphokinase activity was reported with both fresh and old seminal stains, but it was significantly higher with fresh than with old stains till 1:16 dilutions. The activity of CK in fresh seminal stains remained high for less than a week [6 days]. This indicated that the presence of high CK activity might provide additional evidence for seminal fluid identification