Study of zinc phosphide intoxicated cases admitted to poison control centre - Ain shams university hospitals - Egypt [A retrospective study]

Acute poisoning with pesticides is a global public health problem and accounts for as many as 300.000 deaths worldwide yearly. Zinc phosphide has been widely used as a rodenticide since 1942-43 and its easy availability pushed up the incidence of self poisoning. This retrospective study was designed to highlight and evaluate the problem of zinc phosphide intoxicated cases presented and admitted to poison control centre [PCCA] during the year 2007, and was compared with its incidence during the previous 5 years, 2002-2006. The comparative study of the previous five years included the number of all cases of intoxication presented to the PCCA from 2002-2006, the number of zinc phosphide intoxication cases during the same period and their classification according to hospital admission: Intensive care unit [ICU], inpatient and emergency room [ER]. Regarding the retrospective study of zinc phosphide cases during the year 2007, it was carried out on the medical records of all patients admitted to PCCA during the year 2007, with a discharge disgnosis of zinc phosphide. The following parameters were reviewed and analyzed: Sociodemographic data [age, sex, residence and social class], intoxication data [delay time, mode and route of intoxication], presenting symptoms, vital signs, laboratory investigations and ECG monitoring. Different treatment modalities were analyzed and the outcome was recorded. The percentage of zinc phosphide poisoning during the period 2002-2006 in relation to the total number of poisoning cases admitted to PCCA ranged from 2.09%-5.38% and during 2007 it was 3.03%. The inpatient group showed the highest number of cases followed by the ER and then the ICU group. Death rate ranged from 0.3%-0.7% during the years 2002-2006, while during 2007, it was only 0.15%. The total number of cases during the year 2007 were 650 cases. The inpatient group comprised most of the cases followed by ER and ICU groups. The majority of patients were in the age group of 10-

Glutathione monoethyl ester [GSH-MEE] versus N-acetyl cysteine in treatment of acetaminophen-induced hepatotoxicity in mice

Acetaminophen [APAP] overdose causes liver injury both in experimental animals and humans. N-Acetylcysteine [NAC] is clinically used as an antidote for APAP intoxication, and it is thought to act by providing cysteine as a precursor of glutathione, which traps a reactive metabolite [N-acetyl-p-benzoquinoneimine [NAPQI]] of APAP. It is believed that glutathione [GSH] itself cannot be used to restore hepatic glutathione as it poorly penetrates hepatic cells. However, Glutathione Monoethyl Ester [GSH-MEE] which is a derivative of GSH has been used often in research to increase intracellular GSH levels. The aim of this work was to evaluate the role Glutathione Monoethyl Ester [GSH-MEE] in treatment of acetaminophen-induced hepatic damage in mice compared with that of N-Acetylcysteine [NAC]. The study was conducted on 60 mice divided into 6 groups, the 1[st] served as the negative control group, the 2[nd] received a single dose of NAC, the 3[rd] received a single dose of GSH-MEE, the 4[th] received acetaminophen in a single toxic dose, the 5[th] received NAC following the toxic dose of acetaminophen and the 6[th] received a single dose of GSH-MEE following the toxic dose of acetaminophen. Serum alanine aminotransferase [ALT] and hepatic glutathione concentration were measured in addition to histopathological examination of the liver. Significant reduction of serum AL T, elevation of hepatic glutathione concentration together with significant regeneration of hepatic cells were noticed following NAC and GSH-MEE administration and it was more noticeable following GSH-MEE intake. GSH-MEE was effective in replenishment of hepatic glutathione pool

Systemic interleukin-6 response in patients bitten by viperidae snakes

Envenomation by viperidae snakes causes local tissue damage similar to acute trauma in addition to various systemic effects of which coagulopathy is a major and lethal complication. Interleukin-6 [IL-6] is an important proinflammatory cytokine produced usually due to trauma. The present study was designed to investigate the possible role of IL-6 in the development of coagulopathy and its association with the severity of envenomation in patients. Thirty one adults patients of both sexes were included in this study divided according to the scoring system used to classify the severity of envenomation caused by vipers to four groups [group II mild grade, group III moderate grade, group IV severe grade and group V critical grade] in addition to six healthy adults of both sexes served as control group [group I]. Blood samples were taken on admission to hospital, then 24 and 48 hours after snake bite. Coagulation profile [Prothrombin Time [PT], Activated Partial Thromboplastin Time [APTT], Fibrinogen level and Fibrin Degradation Products [FDPs] was determined. Also hematological tests were done [red blood cell count [RBCs], hemoglobin concentration [Hb%], white blood cell count [WBC] and platelet count]. Moreover IL-6 level was determined. The results revealed that envenomated patients presented with coagulopathy, showed significant increase of PT and APTT time, FDPs level and significant decrease of fibrinogen level, in addition to the abnormalities of hematological tests which manifested by significant decrease of RBCs, I-IB% and platelet count. These changes were significant in group V followed by IV and III while insignificant in group II. Such alterations were more on admission, decreased but still significant after 24 hours then returned to near normal values after 48 hours. As regard serum IL-6 level it showed significant increase in groups V followed by IV and III while there was insignificant increase in group II. Such increase was more on admission, decreased but still significant after 24 hours then returned to normal values after 48 hours. In conclusion, this study showed that IL-6 could be involved in the pathogenesis of systemic coagulopathy in envenomated patients also there was a significant association between severity of envenomation and IL-6 concentration, being higher in the critical and severe grades than the moderate and mild grades