Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2022.96815.1224
Mohammed Alwaeel, R. Gomaa, N. Ansari, L. Nader
Background: Immunoassay is a laboratory technique that identifies and quantifies the antibody or the antigen in a sample by using the binding between an antigen and the homologous antibody. Using immunoassay techniques in forensic toxicological laboratories is very crucial since they are easy, sensitive, and yield preliminary results. Objectives: This study intends to cross-check the accuracy of three immunoassay techniques; Randox Evidence, Siemens V-Twin, and Abbott Architect c-4000 as preliminary screening techniques for detection of drugs of abuse in urine by confirming the results using chromatographic techniques. A total of 919 random human urine samples were collected from the General Department of Forensic Sciences and Criminology in Dubai Police and run equally in all the three instruments known to be widely applied in the field of toxicology and forensic science laboratories across the world. They were checked for their capability and efficiency in screening drugs of abuse. Once the screening was done, the positive samples were confirmed for the detected drugs by using the extraction technique. The extracted samples were then analyzed for confirmation using Gas Chromatography-Mass Spectrometry and HPLC MS instrument where these drugs and their metabolites were identified. The results were then compared with the libraries database in the system hence confirming the study and its aim. Results : The results of the study confirmed that all three instruments were capable of screening drugs of abuse, but it also depends on the kits and the programs. It was seen that V-Twin and Architect c4000 showed almost similar results using EMIT but Randox which is using Biochip Array Technology was able to screen more varieties of drugs of abuse and their subclasses which were not detected in the screening with EMIT. Conclusion: The study concluded that Randox is the best screening accurate method for the detection of drugs of abuse. Each of the three instruments has its advantages and disadvantages as well as its maintenance technique, requisite time, and validity tests. Confirmatory tests run after extraction in GC-MS and HPLC-MS should also be taken into consideration. This study can aid in directing the course of forensic casework.
{"title":"A comparative analysis of three different immunoassay techniques for screening of drugs of abuse in urine and their confirmation using GC-MS& HPLC-MS","authors":"Mohammed Alwaeel, R. Gomaa, N. Ansari, L. Nader","doi":"10.21608/ejfsat.2022.96815.1224","DOIUrl":"https://doi.org/10.21608/ejfsat.2022.96815.1224","url":null,"abstract":"Background: Immunoassay is a laboratory technique that identifies and quantifies the antibody or the antigen in a sample by using the binding between an antigen and the homologous antibody. Using immunoassay techniques in forensic toxicological laboratories is very crucial since they are easy, sensitive, and yield preliminary results. Objectives: This study intends to cross-check the accuracy of three immunoassay techniques; Randox Evidence, Siemens V-Twin, and Abbott Architect c-4000 as preliminary screening techniques for detection of drugs of abuse in urine by confirming the results using chromatographic techniques. A total of 919 random human urine samples were collected from the General Department of Forensic Sciences and Criminology in Dubai Police and run equally in all the three instruments known to be widely applied in the field of toxicology and forensic science laboratories across the world. They were checked for their capability and efficiency in screening drugs of abuse. Once the screening was done, the positive samples were confirmed for the detected drugs by using the extraction technique. The extracted samples were then analyzed for confirmation using Gas Chromatography-Mass Spectrometry and HPLC MS instrument where these drugs and their metabolites were identified. The results were then compared with the libraries database in the system hence confirming the study and its aim. Results : The results of the study confirmed that all three instruments were capable of screening drugs of abuse, but it also depends on the kits and the programs. It was seen that V-Twin and Architect c4000 showed almost similar results using EMIT but Randox which is using Biochip Array Technology was able to screen more varieties of drugs of abuse and their subclasses which were not detected in the screening with EMIT. Conclusion: The study concluded that Randox is the best screening accurate method for the detection of drugs of abuse. Each of the three instruments has its advantages and disadvantages as well as its maintenance technique, requisite time, and validity tests. Confirmatory tests run after extraction in GC-MS and HPLC-MS should also be taken into consideration. This study can aid in directing the course of forensic casework.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82759607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2021.113010.1234
A. Hishmat, N. Adel, M. Amin, Rana Adel
: Introduction & objectives: The preliminary phase in the forensic investigation is sex determination. The hard palate attained significance in sexing cranium due to its nature, which is resistant and secluded location, especially in cases of burns and explosions, so the objective of this study is the analysis of palatine MDCT imaging for sexual dimorphism in a sample from the Egyptian population using the following measurements TPVD-M2, O-SNP, PWPA, and AWPA. Results: The results showed that there is a slight increase in measurements of males than females, but only PWPA and O-SNP had significant differences between both. Single regression analysis showed a low accuracy of O-SNP and PWPA ( 55 % & 58 %) respectively, using multiple discriminant function analysis didn't increase the accuracy as it reported an accuracy of 55.4%. ROC curve analysis for male sex prediction reported an accuracy of 58% with O-SNP and 59.4% with PAWA. Conclusion: In conclusion, palatine measurements obtained from CT images have a low value in sex determination in an Egyptian sample from the Minia governorate.
{"title":"PALATINE BONE ANALYSIS FOR SEXING HUMAN CRANIA: A COMPUTED TOMOGRAPHY STUDY OF 500 EGYPTIANS FROM MINIA GOVERNORATE","authors":"A. Hishmat, N. Adel, M. Amin, Rana Adel","doi":"10.21608/ejfsat.2021.113010.1234","DOIUrl":"https://doi.org/10.21608/ejfsat.2021.113010.1234","url":null,"abstract":": Introduction & objectives: The preliminary phase in the forensic investigation is sex determination. The hard palate attained significance in sexing cranium due to its nature, which is resistant and secluded location, especially in cases of burns and explosions, so the objective of this study is the analysis of palatine MDCT imaging for sexual dimorphism in a sample from the Egyptian population using the following measurements TPVD-M2, O-SNP, PWPA, and AWPA. Results: The results showed that there is a slight increase in measurements of males than females, but only PWPA and O-SNP had significant differences between both. Single regression analysis showed a low accuracy of O-SNP and PWPA ( 55 % & 58 %) respectively, using multiple discriminant function analysis didn't increase the accuracy as it reported an accuracy of 55.4%. ROC curve analysis for male sex prediction reported an accuracy of 58% with O-SNP and 59.4% with PAWA. Conclusion: In conclusion, palatine measurements obtained from CT images have a low value in sex determination in an Egyptian sample from the Minia governorate.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79570284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2022.34634.1157
M. Abdel-satar, M. Magdi, iman abdel-ghany, D. Galal
Introduction: Organophosphorus Compounds Intoxication [OPCI] is a likely fatal but completely manageable condition that is still quite common in our country. Early diagnosis is crucial in preventing fatality. Although rarely reported, it occurs in infants. However, history may not be forthcoming and initial presentation often deceptive. Case report: We report a case of neonate admitted to the neonatal intensive care unit (NICU) of Abu El-Reish Hospital; Faculty of Medicine; Cairo University with respiratory distress, pinpoint pupils and hypotonia. The symptoms appeared after spraying the home by insecticides. Plasma pseudocholinesterase level appeared to be low, consistent with acute intoxication with organophosphorus insecticide. Treatment: Management of OPCI consists of airway management, administration of oxygen and fluid, as well as atropine in increasing doses and obidoxime (Acetylcholine esterase reactivator). Plasma pseudocholinesterase analysis is a cheap and an easy measurement for OPCI. And it could be used for diagnosis and treatment monitoring.
{"title":"A CASE STUDY OF NEONATAL ORGANOPHOSPHATE POISONING PRESENTED AS ACUTE RESPIRATORY DISTRESS","authors":"M. Abdel-satar, M. Magdi, iman abdel-ghany, D. Galal","doi":"10.21608/ejfsat.2022.34634.1157","DOIUrl":"https://doi.org/10.21608/ejfsat.2022.34634.1157","url":null,"abstract":"Introduction: Organophosphorus Compounds Intoxication [OPCI] is a likely fatal but completely manageable condition that is still quite common in our country. Early diagnosis is crucial in preventing fatality. Although rarely reported, it occurs in infants. However, history may not be forthcoming and initial presentation often deceptive. Case report: We report a case of neonate admitted to the neonatal intensive care unit (NICU) of Abu El-Reish Hospital; Faculty of Medicine; Cairo University with respiratory distress, pinpoint pupils and hypotonia. The symptoms appeared after spraying the home by insecticides. Plasma pseudocholinesterase level appeared to be low, consistent with acute intoxication with organophosphorus insecticide. Treatment: Management of OPCI consists of airway management, administration of oxygen and fluid, as well as atropine in increasing doses and obidoxime (Acetylcholine esterase reactivator). Plasma pseudocholinesterase analysis is a cheap and an easy measurement for OPCI. And it could be used for diagnosis and treatment monitoring.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84990612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2022.151781.1262
Nevein A. El-Dessouky, M. Ismail, L. Rashed, W. Ibraheem, Mohamed El-Gebely
: Rationale and background: In forensic medical investigations, it is an important matter to determine whether a wound found on autopsy was inflicted before or after death and, if inflicted antemortem, how long before death it was sustained. Aim: This work was to compare the biochemical inflammatory cytokines (IL1-β and IL6) and immunohistochemical (TGF-α) techniques as tools for determining wound aging in cadavers and their relation to other factors related to the wound. Subjects and methods: Specimens of skin and subcutaneous tissue were taken from 50 cadavers with wounds other than firearms and with known postmortem intervals. They were 11 females (22%) and 39 males (78%), and their mean age was 30.3±19.88 years, with a minimum age of 4 months and a maximum of 82 years. Wound specimens were taken from every case to estimate IL1-β and IL6 by ELISA technique and evaluate TGF-α by immuno-histochemistry. Results: Significant correlations between the age of the victim and the value of both IL6 and IL1-β were reported. Moreover, no significant difference between males and females concerning the cytokines IL1-β and Cytokines IL6 was found. There was no significant correlation between the time between injury and death and both IL6 and IL1-β values, but there was a significant negative correlation between the time between death and autopsy and the value of IL1-β. However, a similar correlation was not detected concerning IL6. So, TGF-α and IL6 were independent predictors for wound age determination, while IL1-β was a dependent one. In this study, the estimation of the wound age, the time between injury and death, and the time between death and autopsy could be calculated using specific regression equations. Conclusion and recommendations: The quantitative analysis of pro-inflammatory cytokines in wound extracts can contribute to determining vitality and wound age.
{"title":"Wound Age Estimation: Pro-inflammatory Cytokines versus Immuno-histochemistry","authors":"Nevein A. El-Dessouky, M. Ismail, L. Rashed, W. Ibraheem, Mohamed El-Gebely","doi":"10.21608/ejfsat.2022.151781.1262","DOIUrl":"https://doi.org/10.21608/ejfsat.2022.151781.1262","url":null,"abstract":": Rationale and background: In forensic medical investigations, it is an important matter to determine whether a wound found on autopsy was inflicted before or after death and, if inflicted antemortem, how long before death it was sustained. Aim: This work was to compare the biochemical inflammatory cytokines (IL1-β and IL6) and immunohistochemical (TGF-α) techniques as tools for determining wound aging in cadavers and their relation to other factors related to the wound. Subjects and methods: Specimens of skin and subcutaneous tissue were taken from 50 cadavers with wounds other than firearms and with known postmortem intervals. They were 11 females (22%) and 39 males (78%), and their mean age was 30.3±19.88 years, with a minimum age of 4 months and a maximum of 82 years. Wound specimens were taken from every case to estimate IL1-β and IL6 by ELISA technique and evaluate TGF-α by immuno-histochemistry. Results: Significant correlations between the age of the victim and the value of both IL6 and IL1-β were reported. Moreover, no significant difference between males and females concerning the cytokines IL1-β and Cytokines IL6 was found. There was no significant correlation between the time between injury and death and both IL6 and IL1-β values, but there was a significant negative correlation between the time between death and autopsy and the value of IL1-β. However, a similar correlation was not detected concerning IL6. So, TGF-α and IL6 were independent predictors for wound age determination, while IL1-β was a dependent one. In this study, the estimation of the wound age, the time between injury and death, and the time between death and autopsy could be calculated using specific regression equations. Conclusion and recommendations: The quantitative analysis of pro-inflammatory cytokines in wound extracts can contribute to determining vitality and wound age.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80596462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2022.85911.1209
Hoda Mahmoud, Gehad S. Ahmed, A. Zidan, Rasha S. Elbahrawe, Amir Eid
Objectives; Determination of sex utilizing skeletal remains still displays a difficult issue to forensic specialists, particularly when body fragments are only found in a mass disaster, car or plane accident, fires, and even in the investigations of crimes. Sinus radiography is one of these methods that was utilized for determining the sex of a person. Consequently, the present study aimed to evaluate the reliability of the morphometric dimensions of the maxillary sinus in determining sex, and age via computed tomography (CT) scan images as paranasal sinuses still undamaged whether the skull and other bones are seriously damaged or not. Methodology; The present work involved 30 adult cases (15 males and 15 females) referred to the radiodiagnosis department of Beni-Suef university hospital. Determining the length, height, and width of the right and left maxillary sinuses was performed using a CT scan, and statistical analysis was performed. Results; there was a statistically significant (P < 0.05) difference in the width of the left maxillary sinus between females and males, while the other dimensions of the left and right maxillary sinuses showed an insignificant difference (P > 0.05). Conclusion; Dimensions of the maxillary sinuses alone cannot be used as an accurate diagnostic parameter for age and sex determination. We recommend doing such a study on a more significant number of people of the same sex, race, age, and who share the same food, habits, and environmental factors, to make this technique definite and attain standardizations for use in the field of forensic medicine.
{"title":"EVALUATION OF MAXILLARY SINUS DIMENSIONS IN SEX AND AGE DETERMINATION AMONG A SAMPLE OF EGYPTIANS USING COMPUTED TOMOGRAPHY","authors":"Hoda Mahmoud, Gehad S. Ahmed, A. Zidan, Rasha S. Elbahrawe, Amir Eid","doi":"10.21608/ejfsat.2022.85911.1209","DOIUrl":"https://doi.org/10.21608/ejfsat.2022.85911.1209","url":null,"abstract":"Objectives; Determination of sex utilizing skeletal remains still displays a difficult issue to forensic specialists, particularly when body fragments are only found in a mass disaster, car or plane accident, fires, and even in the investigations of crimes. Sinus radiography is one of these methods that was utilized for determining the sex of a person. Consequently, the present study aimed to evaluate the reliability of the morphometric dimensions of the maxillary sinus in determining sex, and age via computed tomography (CT) scan images as paranasal sinuses still undamaged whether the skull and other bones are seriously damaged or not. Methodology; The present work involved 30 adult cases (15 males and 15 females) referred to the radiodiagnosis department of Beni-Suef university hospital. Determining the length, height, and width of the right and left maxillary sinuses was performed using a CT scan, and statistical analysis was performed. Results; there was a statistically significant (P < 0.05) difference in the width of the left maxillary sinus between females and males, while the other dimensions of the left and right maxillary sinuses showed an insignificant difference (P > 0.05). Conclusion; Dimensions of the maxillary sinuses alone cannot be used as an accurate diagnostic parameter for age and sex determination. We recommend doing such a study on a more significant number of people of the same sex, race, age, and who share the same food, habits, and environmental factors, to make this technique definite and attain standardizations for use in the field of forensic medicine.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84022783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2022.82810.1206
Heba Rohym, Ghada Elgalad, E. Morsi
Background : Domestic violence could be a pattern of injurious behaviour in any relationship that's utilized by one partner to pick up or keep up control over another intimate partner. Aim: The present study aimed to determine factors that affect domestic violence injuries in Fayoum Governorate, Egypt, especially during Covid 19. Methods: This study consists of 2 parts. 1-A retrospective study was conducted on data obtained from domestic violence harmed patients who were recorded to Forensic Medical Authority in Fayoum Governorate, between January 2015 and December 2020. 2-A cross-sectional descriptive study was carried out at Fayoum governorate (Fayoum city, Itsa, and Ebshoy). The survey was conducted over six months from March 2020 to September 2020 (the period of closure of schools, shops, airports, and others) to analyze the incidence of domestic violence in the Fayoum governorate during Covid 19. Result: The retrospective study showed a significant increase in domestic violence, especially in 2020 during Covid 19 pandemic. Domestic violence cases were more common in females (100.0% of cases) than in males (0%). The study also revealed that domestic violence cases were more common in females between (20-40) years. There was a statistically significant difference between fatal and nonfatal injuries among cases of domestic violence. Most of the injuries of domestic violence in this study were fatal. The cross-sectional descriptive study showed that domestic violence cases were more common in less than 20 years of age. Most domestic violence cases were female. Rural areas were the main place for domestic violence. Most cases were more common in non-educated and low education people. The recorded types of domestic violence were physical (Hitting, pushing, slapping), verbal, and both verbal and physical. Conclusion: There was a significant increase in domestic violence, especially in 2020 during Covid 19 pandemic. The study showed the importance of community education towards domestic violence prevention.
{"title":"Domestic Violence During the Period From 2015 to 2020 and Effect of Covid 19 on Domestic Violence","authors":"Heba Rohym, Ghada Elgalad, E. Morsi","doi":"10.21608/ejfsat.2022.82810.1206","DOIUrl":"https://doi.org/10.21608/ejfsat.2022.82810.1206","url":null,"abstract":"Background : Domestic violence could be a pattern of injurious behaviour in any relationship that's utilized by one partner to pick up or keep up control over another intimate partner. Aim: The present study aimed to determine factors that affect domestic violence injuries in Fayoum Governorate, Egypt, especially during Covid 19. Methods: This study consists of 2 parts. 1-A retrospective study was conducted on data obtained from domestic violence harmed patients who were recorded to Forensic Medical Authority in Fayoum Governorate, between January 2015 and December 2020. 2-A cross-sectional descriptive study was carried out at Fayoum governorate (Fayoum city, Itsa, and Ebshoy). The survey was conducted over six months from March 2020 to September 2020 (the period of closure of schools, shops, airports, and others) to analyze the incidence of domestic violence in the Fayoum governorate during Covid 19. Result: The retrospective study showed a significant increase in domestic violence, especially in 2020 during Covid 19 pandemic. Domestic violence cases were more common in females (100.0% of cases) than in males (0%). The study also revealed that domestic violence cases were more common in females between (20-40) years. There was a statistically significant difference between fatal and nonfatal injuries among cases of domestic violence. Most of the injuries of domestic violence in this study were fatal. The cross-sectional descriptive study showed that domestic violence cases were more common in less than 20 years of age. Most domestic violence cases were female. Rural areas were the main place for domestic violence. Most cases were more common in non-educated and low education people. The recorded types of domestic violence were physical (Hitting, pushing, slapping), verbal, and both verbal and physical. Conclusion: There was a significant increase in domestic violence, especially in 2020 during Covid 19 pandemic. The study showed the importance of community education towards domestic violence prevention.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89896367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2021.94990.1219
Mohammed B A Sarhan, M. Hafez, Rana M. Adel
Background & objective: organophosphate (OP) insecticide poisoning is considered a major clinical problem, especially in developing countries with a 15–30% case fatality rate. These compounds act by inhibition of acetylcholinesterase enzymes, with clinical features of muscarinic overstimulation. Treatment mainly depends on muscarinic receptor antagonist, atropine, to relieve the symptoms of intoxication. This study aims to assess the benefits of adding nebulized atropine to infusion during the treatment of severe OP poisoning cases. Patients & methods: This cross-sectional observational study was conducted on 40 patients aged 18 to 58 years who were admitted with acute severe OP poisoning at the Poison Control Center of our university from September 2019 to August 2020. After first aid measures, the patients were divided randomly into two groups; the first group received atropine by infusion, while the second group was treated by nebulized and infused atropine. The following data were evaluated and compared between both groups; total atropine dose, oxime dose, heart rate, peak inspiratory pressure, plateau pressure, the number of endotracheal tubes used, development of pneumonia, total time of ventilation, and the number of survivors. Results: The results revealed that the cases who received atropine by the nebulizer and parenteral routes required a lesser dose of atropine for abolishing muscarinic symptoms, showed a significant decrease in plateau and peak inspiratory pressures, lower incidence of development of pneumonia, decreased need for chest tube insertion and better survival rate. Conclusions: nebulized atropine, besides infused one, would have many benefits with future considerations.
{"title":"BENEFITS OF ADDING NEBULIZED ATROPINE TO ATROPINE INFUSION IN TREATMENT OF ACUTE SEVERE ORGANOPHOSPHATE INSECTICIDE POISONING.","authors":"Mohammed B A Sarhan, M. Hafez, Rana M. Adel","doi":"10.21608/ejfsat.2021.94990.1219","DOIUrl":"https://doi.org/10.21608/ejfsat.2021.94990.1219","url":null,"abstract":"Background & objective: organophosphate (OP) insecticide poisoning is considered a major clinical problem, especially in developing countries with a 15–30% case fatality rate. These compounds act by inhibition of acetylcholinesterase enzymes, with clinical features of muscarinic overstimulation. Treatment mainly depends on muscarinic receptor antagonist, atropine, to relieve the symptoms of intoxication. This study aims to assess the benefits of adding nebulized atropine to infusion during the treatment of severe OP poisoning cases. Patients & methods: This cross-sectional observational study was conducted on 40 patients aged 18 to 58 years who were admitted with acute severe OP poisoning at the Poison Control Center of our university from September 2019 to August 2020. After first aid measures, the patients were divided randomly into two groups; the first group received atropine by infusion, while the second group was treated by nebulized and infused atropine. The following data were evaluated and compared between both groups; total atropine dose, oxime dose, heart rate, peak inspiratory pressure, plateau pressure, the number of endotracheal tubes used, development of pneumonia, total time of ventilation, and the number of survivors. Results: The results revealed that the cases who received atropine by the nebulizer and parenteral routes required a lesser dose of atropine for abolishing muscarinic symptoms, showed a significant decrease in plateau and peak inspiratory pressures, lower incidence of development of pneumonia, decreased need for chest tube insertion and better survival rate. Conclusions: nebulized atropine, besides infused one, would have many benefits with future considerations.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85424192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.21608/ejfsat.2022.165447.1273
N. Ramadan, Nora El-Saeed, N. Elbadri
Background: Poisoning is an important emergency in pediatric age groups throughout the world. The causes and types of poisoning vary from place to place in the world and even within the same country, also depending upon factors such as education, demography, socioeconomic factors, customs, and local belief. Aim of this study : To determine the frequency, etiology, characteristics, clinical presentation, and outcome of acute poisoning in children presenting to the National Environmental and Clinical Toxicological Research Center (NECTR), Cairo University. Participants and Methods: The current study is a prospective cross-sectional study, conducted on 240 pediatric patients (under 18 years old) who presented with acute poisoning to National Environmental and Clinical Toxicological Research Center (NECTR), Cairo University over three months during the COVID episode. Data were statistically analyzed for; demographic data of the participating children, manner of toxicity, place of exposure, type of poison, its availability to the child, the form of poison, duration between exposure and presentation, and the first aid that may be done to the child. Also, the severity and mortality rate detected by poison severity scoring (PSS) and rate of admission to the center or ICU and outcome were analyzed. Results: The current study showed that the long stay-at-home and school absence during COVID episodes may cause an increased risk of pediatric poisoning with household poisons and medications even in educated families. Also, accidental toxicity (84.6%) is still more common than intentional toxicity (15.4%), with negligence being the most significant probable precipitating factor. The incidence significantly increased in children with educated worker fathers and in cases where only the mother is accompanying the children. In addition, the risk for ICU admission was significantly higher (51.4%) in adolescents (13 to <18 years) with intentional poisoning. Conclusion: Pediatric poisoning is an emergency condition with younger children (< 9 yrs.) are highly susceptible to accidental exposure, however, with older ages (9 to <18 years), the incidence of intentional poisoning and risk of bad outcome increases.
{"title":"Acute child poisoning and its related risk factors during the COVID era","authors":"N. Ramadan, Nora El-Saeed, N. Elbadri","doi":"10.21608/ejfsat.2022.165447.1273","DOIUrl":"https://doi.org/10.21608/ejfsat.2022.165447.1273","url":null,"abstract":"Background: Poisoning is an important emergency in pediatric age groups throughout the world. The causes and types of poisoning vary from place to place in the world and even within the same country, also depending upon factors such as education, demography, socioeconomic factors, customs, and local belief. Aim of this study : To determine the frequency, etiology, characteristics, clinical presentation, and outcome of acute poisoning in children presenting to the National Environmental and Clinical Toxicological Research Center (NECTR), Cairo University. Participants and Methods: The current study is a prospective cross-sectional study, conducted on 240 pediatric patients (under 18 years old) who presented with acute poisoning to National Environmental and Clinical Toxicological Research Center (NECTR), Cairo University over three months during the COVID episode. Data were statistically analyzed for; demographic data of the participating children, manner of toxicity, place of exposure, type of poison, its availability to the child, the form of poison, duration between exposure and presentation, and the first aid that may be done to the child. Also, the severity and mortality rate detected by poison severity scoring (PSS) and rate of admission to the center or ICU and outcome were analyzed. Results: The current study showed that the long stay-at-home and school absence during COVID episodes may cause an increased risk of pediatric poisoning with household poisons and medications even in educated families. Also, accidental toxicity (84.6%) is still more common than intentional toxicity (15.4%), with negligence being the most significant probable precipitating factor. The incidence significantly increased in children with educated worker fathers and in cases where only the mother is accompanying the children. In addition, the risk for ICU admission was significantly higher (51.4%) in adolescents (13 to <18 years) with intentional poisoning. Conclusion: Pediatric poisoning is an emergency condition with younger children (< 9 yrs.) are highly susceptible to accidental exposure, however, with older ages (9 to <18 years), the incidence of intentional poisoning and risk of bad outcome increases.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78963371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-02DOI: 10.21608/ejfsat.2021.78014.1202
Eman S. Shaltout, Rania Makboul, Nora Z. Abdellah, N. Ebrahem
Introduction: Titanium dioxide (TiO2) is used abundantly as a white pigment with many applications, food coloring agents, additives, tooth whitening paste, pharmaceutical preparations, painting materials, and sunscreen creams. Objectives: The present study aimed to explore the possible toxicological effects of orally administered TiO 2 . Methodology : Twenty male albino rats were given food-grade TiO2 in a dose of 20 mg/kg BW via oral gavage at 1 mL daily volume for 120 consecutive days. 20 male rats were used as a control group. Liver enzymes (AST, ALT, and ALP), renal function (urea and creatinine), creatine kinase activity (CK-MB isoenzyme), and serum levels of troponin were measured at the end of the study for each rat. Histopathological analysis of cardiac, hepatic, renal, and gastrointestinal tissue sections was also performed for both groups. Results : Increased CK-MB, cardiac Troponin, ALT, ALP, and urea serum levels in TiO2 treated groups were recorded. Histopathological examination showed focal fibrosis of cardiac tissue. Hepatic sections showed inflammation and fat deposits. Gastrointestinal wall inflammations with blunting of the villi all over the small intestine, active inflammation of the colon and kidney tissues in the renal pelvis were found. Conclusion : Prolonged daily oral administration of food-grade TiO2 can induce cardiovascular, hepatic, intestinal, and renal adverse effects.
{"title":"Possible Multi-Organ Toxicity in Rats after Chronic Oral Administration of Titanium Dioxide: Biochemical and Histopathological Study.","authors":"Eman S. Shaltout, Rania Makboul, Nora Z. Abdellah, N. Ebrahem","doi":"10.21608/ejfsat.2021.78014.1202","DOIUrl":"https://doi.org/10.21608/ejfsat.2021.78014.1202","url":null,"abstract":"Introduction: Titanium dioxide (TiO2) is used abundantly as a white pigment with many applications, food coloring agents, additives, tooth whitening paste, pharmaceutical preparations, painting materials, and sunscreen creams. Objectives: The present study aimed to explore the possible toxicological effects of orally administered TiO 2 . Methodology : Twenty male albino rats were given food-grade TiO2 in a dose of 20 mg/kg BW via oral gavage at 1 mL daily volume for 120 consecutive days. 20 male rats were used as a control group. Liver enzymes (AST, ALT, and ALP), renal function (urea and creatinine), creatine kinase activity (CK-MB isoenzyme), and serum levels of troponin were measured at the end of the study for each rat. Histopathological analysis of cardiac, hepatic, renal, and gastrointestinal tissue sections was also performed for both groups. Results : Increased CK-MB, cardiac Troponin, ALT, ALP, and urea serum levels in TiO2 treated groups were recorded. Histopathological examination showed focal fibrosis of cardiac tissue. Hepatic sections showed inflammation and fat deposits. Gastrointestinal wall inflammations with blunting of the villi all over the small intestine, active inflammation of the colon and kidney tissues in the renal pelvis were found. Conclusion : Prolonged daily oral administration of food-grade TiO2 can induce cardiovascular, hepatic, intestinal, and renal adverse effects.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79098957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.21608/ejfsat.2021.80524.1204
G. Sagah, Amira Elhawary
Background: Aluminum phosphide (ALP) is used to protect stored grains from rodents & pests. ALP poisoning is considered one of the significant public health problems which could occur accidentally, suicidal, or even occupational. The main presentations of acute ALP poisoning are gastrointestinal symptoms, profound circulatory collapse, arrhythmia, and electrolyte & acid-base disturbances. Objectives: The current study evaluated acid-base disturbances on admission as a simple outcome predictor in acute ALP poisoned patients. Patients & methods: 100 adult patients with acute ALP poisoning were included in this study. Patients with cardiovascular, chronic renal and liver diseases were excluded. Additionally, patients admitted with mixed intoxication or associated trauma and those who received any medications before admission were excluded from this study. Arterial blood gases (ABG) were done and analyzed to all included patients on admission before receiving any medications. Results: There was a significant positive correlation between pH value and pre-hospitalization period, systolic blood pressure (SBP), diastolic blood pressure (DBP), and period of hospital stay. A significant negative correlation existed between pH and dose of ALP, respiratory rate, and dose of required vasopressor. Bicarbonate level (HCO3) registered a significant positive correlation with SBP and DBP. Meanwhile, a significant negative correlation existed between HCO3 and both respiratory rate and dose of required vasopressor. There was a significant difference between survivors and non-survivors regarding pH, HCO3, PaCO2, and PaO2. Furthermore, there was a significant difference between patients who required and did not require mechanical ventilation considering pH, HCO3, and PaO2. Conclusion: It could be concluded that determining acid-base disturbance on admission in acute ALP poisoned patients is a simple, cheap, and reliable marker that may help to predict mortality and mechanical ventilation requirement.
{"title":"Prognostic Significance of Acid Base Disturbances among Patients with Acute Aluminum Phosphide Poisoning","authors":"G. Sagah, Amira Elhawary","doi":"10.21608/ejfsat.2021.80524.1204","DOIUrl":"https://doi.org/10.21608/ejfsat.2021.80524.1204","url":null,"abstract":"Background: Aluminum phosphide (ALP) is used to protect stored grains from rodents & pests. ALP poisoning is considered one of the significant public health problems which could occur accidentally, suicidal, or even occupational. The main presentations of acute ALP poisoning are gastrointestinal symptoms, profound circulatory collapse, arrhythmia, and electrolyte & acid-base disturbances. Objectives: The current study evaluated acid-base disturbances on admission as a simple outcome predictor in acute ALP poisoned patients. Patients & methods: 100 adult patients with acute ALP poisoning were included in this study. Patients with cardiovascular, chronic renal and liver diseases were excluded. Additionally, patients admitted with mixed intoxication or associated trauma and those who received any medications before admission were excluded from this study. Arterial blood gases (ABG) were done and analyzed to all included patients on admission before receiving any medications. Results: There was a significant positive correlation between pH value and pre-hospitalization period, systolic blood pressure (SBP), diastolic blood pressure (DBP), and period of hospital stay. A significant negative correlation existed between pH and dose of ALP, respiratory rate, and dose of required vasopressor. Bicarbonate level (HCO3) registered a significant positive correlation with SBP and DBP. Meanwhile, a significant negative correlation existed between HCO3 and both respiratory rate and dose of required vasopressor. There was a significant difference between survivors and non-survivors regarding pH, HCO3, PaCO2, and PaO2. Furthermore, there was a significant difference between patients who required and did not require mechanical ventilation considering pH, HCO3, and PaO2. Conclusion: It could be concluded that determining acid-base disturbance on admission in acute ALP poisoned patients is a simple, cheap, and reliable marker that may help to predict mortality and mechanical ventilation requirement.","PeriodicalId":22435,"journal":{"name":"The Egyptian Journal of Forensic Sciences and Applied Toxicology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88949547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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