Childhood's acute toxicity pattern at the poisoning treatment unit, zagazig university hospitals, from January 2009 to august 2010 a retrospective study

Acute poisoning represents one of the most common medical emergencies in childhood. Poisoning patterns change according to age group, type of exposure and the nature and dose of the poison. This study's objective is to understand the pattern of childhood poisoning in the poisoning treatment unit, Zagazig University Hospitals and to compare these results with those of other countries. retrospective descriptive study. Poisoning treatment Unit, Faculty of Medicine, Zagazig University Hospitals during the period from January 2009 to August 2010. All children 12 years old and below. 304 poisoned children were enrolled in this study. 1.6% of the cases involved children below 1 year old. 81% of the cases were between 1-6 years. Children between 7-12 years composed 17.4% of the cases. In all age groups more male cases [57%] were found as compared to female cases [43%]. 32% of the poisoned cases were living in Zagazig city while 68% were living in the suburban. In 90.5% of the cases, the accident happened at home while in 9.5% of cases, the accident occurred outside the home. 99.4% of the cases were accidental. The oral route was involved in 72% of the cases. The presenting symptoms were classic in 70% of the cases. 10.2% of the cases were admitted to the Intensive Care Unit. 3.6% were discharged against medical advice. In 86.2% of the cases, observation with or without supportive measures together with decontamination and antidotal therapy whenever needed were sufficient. Pesticide poisoning constituted 28.6% of the total cases. Petroleum products were implicated in 13.15% of the cases. Cleaning and disinfectant agents were the culprits in 17.1% of the cases. Therapeutic drugs constituted 22.9% of the causes of poisoning. Carbon monoxide poisoning was detected in 1.64% of the cases. Natural poisoning was detected in 7.89% of the cases. Conclusion: Our study showed that a relatively large proportion of the visits to the poisoning treatment unit were done by children between 1 and 6 years and that pesticide especially organophosphorus insecticide were the most incriminated agents. Good supportive care is the cornerstone of management for childhood poisoning. We need to reorganize the data collection and use modern techniques of information technology. Public health authorities can adopt the results as the basis for designing prevention measures for different age groups in the population

Toxic effects of lead exposure during gestation and lactation on testicular development in albino rat offspring: a hormonal and histopathological study

This study aims at exploring the effect of lead exposure during pregnancy and lactation on the rat testis, which was evaluated via light and electron microscopic examination of testicular tissue, besides estimation of serum follicle stimulating hormone [FSH], luteinizing hormone [LH] and testosterone [TT] levels. Dams were intoxicated with 10 mg/kg body weight [BW]/day lead acetate throughout the gestational period and lactation. Pups were sacrificed on postnatal [PN] days 1 and 21. The weights of the body and testes, as well as serum gonadotropins and TT concentrations were significantly reduced in pups from lead-intoxicated mothers compared with their controls. Light microscopic examination of testicular samples from lead-exposed pups revealed thin-walled seminiferous tubules with significant reduction in their size. In addition, multiple vacuoles were seen within the tubules and in the interstitium, and the interstitial spaces appeared enlarged with reduced number of Leydig cells. Apoptotic bodies were found among the basal parts of the spermatogenic epithelium. Examination of testicular tissue from the same group by electron microscopy revealed more cellular details confirming the toxic effects of lead. The altered seminiferous tubules showed multiple cytoplasmic vacuoles and precipitates along the nuclear membranes in Sertoli cells. Several seminiferous tubules showed apoptotic cells with heterochromatic nuclei and dense cytoplasm, whereas other tubules appeared ensheathed by single layers of myoid cells. Leydig cells revealed cytoplasmic vacuolations and irregular nuclei with chromatin masses. The results of this study indicate that lead intoxication affected the normal development of germinal cells and disrupted the testicular structure and endocrinal functions

Comparative study between two obidoxime regimens in acute organophosphate toxicity among some Egyptian patients

Organophosphorus [OP] poisoning is commonly encountered in agricultural communities probably due to the easy accessibility to the insecticide. In vitro studies in animals and on human erythrocytes have suggested beneficial effects of oximes on reactivating acetylcholine esterase [AChE] enzyme. This study was a single blinded randomized clinical trial to investigate the comparative effectiveness of the World Health Organization [WHO] obidoxime regimen with recommended dose - 250 mg IV shot loading dose then infusion of 750 mg every 24 hours [high-continuous dose regimen] versus the regimen of National Egyptian Center of Toxicology and Research [NECTR], Faculty of Medicine, Cairo University with recommended dose 250 mg in 150 ml saline, IV infusion over one hour and repeated every 6 hours over a period of 24 hours from the time of admission [low-interrupted dose regimen]. Twenty normal individuals were recruited as control [group I], with their AChE enzyme level determined to assess the normal level in the population. Fourty patients exposed to OP and treated with the WHO obidoxime regimen were classified as group II. Fourty patients exposed to OP and treated with the NECTR obidoxime regimen were classified as group III. There were significantly higher percent of patients in group III with respiratory depression than in the patients of group II [p<0.05]. There were no statistically significant differences between the patients of group II and the patients of group III regarding all other signs and symptoms of OP poisoning as well as AChE enzyme levels in the first 12 hours [p>0.05]. After 12 hours from admission, the AChE levels were progressively and significantly higher in the patients of group II than the patients of group III until discharge [p<0.05]. The severity of respiratory failure, as measured by the need for ventilation and the number of ventilated patients were significantly. higher in the patients of group III than in the patients of group II [p<0.05]. The outcomes, such as the occurrence of respiratory depression and the number of deaths, were reduced in the patients of group II. There was statistically significant difference between the patients of group II and the patients of group III regarding the time of recovery [p<0.05]. There were no deaths between the patients of group II but one patient died from group III. This indicates that the WHO regimen [high-continuous dose regimen] is more effective than the NECTR regimen [low-interrupted dose regimen] in reactivating AChE enzyme, reducing the duration of hospital stay and the mortality rate and increasing the early recovery rate. Regarding the collected results of the present work, we recommend the use of the WHO obidoxime regimen