Assessment of renal affection in opioid abusers admitted to Ain Shams university hospitals

Opioid abuse represents an often neglected risk factor for the development of wide spectrum of renal diseases. The aim of this study was to assess renal affection in opioid abusers. The current work was carried out on 25 adult opioid abusers admitted to Ain Shams University Hospitals in the period from April 2008 to October 2008, in addition to ten healthy adult individuals serving as controls. All subjects were subjected to sociodemographic study, full clinical evaluation and laboratory investigations that included assessment of serum creatinine, BUN, beta 2microglobulin [beta 2M] and CPK levels, screening for viral infections [HIV, HCV and HBV], detection of proteins in urine and urine screening for opioids. Results of this study revealed significant increase of both beta 2M and CPK serum levels in the studied opioid abusers compared to the control group with no significant difference between the two groups as regard serum creatinine and BUN. Proteinuria was detected in 40% of opioid abusers. Significant increase of infection was observed in opioid abusers including skin infection and viral infections. In conclusion, renal affection is a significant finding in opioid abusers. So, during treatment of opioid abusers it is recommended to assess beta 2M level and to test urine for proteinuria as they both are early and sensitive indicators of renal affection. Additionally, a campaign for awareness of the people about the complications of drug abuse should be carried out

Evaluation of honey protective effect on lead induced oxidative stress in rats

Lead toxicity is a worldwide health problem due to continuous exposure of the population to lead in the environment especially workers in industries. It affects many body organs especially the liver and kidneys. The aim of this study is to investigate the protective effect of natural honey against lead induced oxidative stress, hepatotoxicity and nephrotoxicity. Forty male albino rats were used in this study divided into 4 equal groups. Group [I] the control group were given distilled water orally for 4 weeks. Group [II] rats were given 1.5 ml/kg natural honey orally for 4 weeks. Group [III] rats were given lead acetate [0.2%] in drinking water for 4 weeks .Group [IV] rats were given lead acetate [0.2%] in drinking water and 1.5 ml/kg natural honey orally for 4 weeks. Blood and tissue samples were taken after four weeks. Lipid peroxidation product, malondialdehyde [MDA] in plasma, liver and kidney were determined, blood glutathione peroxidase activity [GPx] and serum nitric oxide [NO] levels were also measured, Liver function tests [serum alkaline phosphatase [ALP], aspartate transaminase [AST] and alanine transaminase[ALT] were measured. Kidney function tests [blood urea and s. creatinine] were estimated. Histopathological examination of liver and kidney sections was performed. showed significant [P>0.01] increase in the mean MDA of plasma. liver and kidney of lead acetate group [Group III] with decreased antioxidant enzyme activity [GPx] activity and [NO] and increase levels of AST, ALT, ALP, urea and serum creatinine together with histopathological changes in liver and kidney sections. Honey alleviated the increased MDA levels, and ameliorate the elevated AST, ALT, ALP, urea and serum creatinine in the combination group. The present study revealed that natural honey could diminish the adverse effects of lead acetate as shown in the histological analysis of rat livers and kidneys. The present results indicated that natural honey can modulate the damage in liver and kidney cells from oxidative stress induced by lead toxicity in tart

Electroneurophysiological monitoring as an early severity predictor in acute anticholinesterase poisoned patient and the effect of oxime therapy manipulation

The neuromuscular transmission failure in acute anticholinesterases [e.g. organophosphorus compounds and carbamates] poisoning occurs because of inactivation of the enzyme acetylcholinesterase located in the neuromuscular junction, and is distinguished by single electrical stimulus induced repetitive responses and decrement response upon high rate repetitive nerve stimulation [RNS]. Oxime therapy with its action at different sites in the neuromuscular junction would alter the neuroelectrophysiological findings in acute anticholinesterases poisoning. The aim of this study is to evaluate the usefulness of RNS as a prognostic indicator of severity in acute anticholinesterase poisoning and the recovery process and its use as a guide for oxime therapy continuation or discontinuation. The study was conducted on 32 patients with acute organophosphorus poisoning admitted to the poison control center, Ain Shams University Hospitals during the period from January 2007 to June 2007. Patients were subdivided into group I [mild group n=6], group II [moderate group n=20], and group III [severe group n=6]. All the cases were clinically evaluated, pseudocholinesterase levels were estimated and RNS was done before and after oxime therapy. The patients were classified according to the decremental response into 3 categories, type 1 response [initial improvement and subsequent lack of improvement], type 2 responce [Initial improvement and subsequent normalization of neuromuscular transmission] and type 3 response [lack of improvement with initial dose of toxogonin]. RNS is a sensitive prognostic test which can be used as an early predictor of acute anticholinesterase poisoning for grading its severity, and assessment of obidoxime [Toxogonin] therapy. As therapeutic benefit of obidoxime is limited by its short duration of action, it is recommended to be administered for a longer period of time under neuroelectrophysiological guidance