@article { author = {Azab, Gihan and Hafiz, Rabab}, title = {The Protective Effect of Short-term Infusion Regimens with Sodium Bicarbonate and Theophylline against Contrast Induced Nephropathy in Rats}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {1-14}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18315}, abstract = {Contrast-induced nephropathy (CIN) is a common condition associated with serious adverse outcomes. It may be preventable because its risk factors are well characterized and the timing of renal insult is commonly known in advance.The optimal strategy to prevent contrast nephropathy has not been established.  The AIM of this study is to compare the efficacy of short-term infusion regimens of sodium bicarbonate, theophylline and the combination of both for prevention of contrast-induced nephropathy in rats. METHODS: This work was conducted on seventy adult male albino rats. They were classified into seven groups. Group I: control group; Group II: received 1 mL intravenous bicarbonate (8.4%); Group III: received 15 mL/kg intra-peritoneal theophylline; Group IV:  received 6mL/kg intravenous urografin; Group V: intravenous bicarbonate three hours before urografin; Group VI: intra-peritoneal theophylline one hour before urografin; Group VII: bicarbonate three hours and theophylline one hour before urografin injection. Baseline blood samples were collected and analyzed for biochemical parameters then after waiting 48 hours for the development of contrast nephropathythe rats were sacrificed and biochemical parameters were re-examined:serum creatinine, blood urea nitrogen (BUN), creatinine clearance andfractional excretion of sodium (FENa+). Light microscopic examination for the kidneys sections was done. RESULTS: after 48 hours water deprivation, highly significant decrease in mean body weight was found in all groups when compared with the baseline mean values.On comparing baseline with the after experiment parameters mean values within each group, there was significant increase in the mean values of serum creatinine and BUN and significant decrease in the creatinine clearance and fractional excretion of sodium percentage in groups group IV, group V and group VI; while, group VII showed insignificant difference between baseline and after experiment in all the studied parameters. Comparing after experiment parameters between group IV and control group showed a highly significant increase in the mean values of serum creatinine, BUN and significant decrease in the creatinine clearance and fractional excretion of sodium percentage. Furthermore, group V and group VI showed marked amelioration of all after experimental parameters but it still shows significant difference when compared with the control group. Group VII showed insignificant difference in all parameters when compared with the control group. Histopathological examination of the examined specimens from group IV showed severe damage consisting of tubular necrosis and protein cast, tubule dilatation, intra-tubular obstruction by protein casts. The examined kidney specimens from group V and group VI showed mild damage while the percentage of pathological changes were significantly decreased when compared with group IV. Sections from group VII showed marked improvement of all changes. CONCLUSION: urografin injection resulted in marked nephrotoxicity manifested biochemically and histopathologically. Pre-treatment with sodium bicarbonate or theophylline partially ameliorated the CIN. While, combined administration of sodium bicarbonate and theophylline before urografin injection showed marked improvement of renal function and histopathological examination in rats.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18315.html}, eprint = {https://ajfm.journals.ekb.eg/article_18315_c90fc1d7c3ea39b1c486d7d532d32407.pdf} } @article { author = {Azab, Gihan and ELawady, Eglal}, title = {Comparative Study of the Acute Toxicity of Fluoxetine Versus Amitriptyline and the Predictive Factors for Their Complications}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {15-26}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18316}, abstract = {The aim of this study is to compare acute toxicity of fluoxetine versus that of amitriptyline among patients admitted to the Poison Control Centre, Ain Shams University (PCC-ASU) and to investigate some predictive factors for the development of complications in such cases. METHODS: A prospective study was conducted in the PCC-ASU during the period between January 2013 and December 2015. The study included 31 patients ingested fluoxetine alone and 49 patients ingested amitriptyline alone. Parameters: Descriptive variables: (age, gender, amount taken, delay time and manner of poisoning). Clinical variables: Vital signs, mean QRS duration, corrected QT (QTc), cardiac arrhythmias ,level of consciousness (assessed by Glasgow coma scale (GCS), pupil size and reactivity, seizures and symptoms of serotonin toxicity. Laboratory variables: (Serum sodium, potassium, calcium and magnesium and blood glucose level).The outcome variables: percentage of cases with: cardiac arrhythmias, QRS ≥100,QTc ≥440, seizures, GCS ≤10, serotonin toxicity, ICU admission, length of stay in ICU, length of hospital stay and survival. RESULTS: there was highly significant increase of the age, amount of drug ingested, mean QRS, QTc, mydriasis and significant decrease in the mean GCS and serum sodium in amitriptyline group compared to fluoxetine group. A highly significant increase of percentage of tremors, clonus, hyper-reflexia and diaphoresis was observed in fluoxetine group. As regards outcome variables, there was insignificant difference in percentage of cases with seizures and survival between both groups. There was significant increase in percentage of cases with QRS ≥100, QTc ≥440, GCS ≤10, ICU admission, length of stay in ICU and hospital in amitriptyline group. There was a highly significant increase of cases with serotonin toxicity in fluoxetine group.The patients who developed seizures after acute amitriptyline toxicity, showed a highly significant increase in the amount of drug intake, QRS, QTc duration and length of hospital stay and highly significant decrease of mean GCS and serum sodium level compared with patients without seizures. By applying logistic regression analysis, QRS ≥100 and QTc≥440 interval and  GCS ≤10 were identified as independent risk factors and QRS≥100 showed (sensitivity 97%, specificity 71%, PPV 67% and NPV 97%);  QTc ≥440 interval showed (sensitivity 65%,specificity 64%, PPV55% and NPV 68%) and GCS ≤10 showed (sensitivity 86%, specificity 71%, PPV 60% and NPV 80%).The patients who developed seizure after acute fluoxetine toxicity showed a highly significant increase in the amount of drug intake, QTc duration, and percentage of cases with serotonin toxicity and length of hospital stay and highly significant decrease of mean GCS compared with patients without seizures. By applying logistic regression analysis, QTc≥440, GCS≤10, and serotonin toxicitywere identified as independent risk factors. QTc interval ≥440 showed (sensitivity 62%, specificity 82%, PPV 55% and NPV 86%); GCS≤10 showed (sensitivity 72%, specificity 84%, PPV 60% and NPV 91%) and serotonin toxicity showed (sensitivity 100%, specificity 86%, PPV72% and NPV 100%). IN CONCLUSION: Fluoxetine intoxicated patients encountered complications as serotonin toxicity and seizure in acute large doses and the predictive risk factors for seizure were QTc ≥440, GCS ≤10 and serotonin toxicity. Amitriptyline intoxication associated with seizures and the predictive risk factors for seizure were QRS ≥100 and QTc ≥440 and GCS ≤10.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18316.html}, eprint = {https://ajfm.journals.ekb.eg/article_18316_5fef225ac407b5513a8a5f15548eab1e.pdf} } @article { author = {Khalaf, Mohemmed and A.A, Hefnawy and Abolhamd, Mostafa}, title = {Serum Cytokeratin 18-Asp396 as an Early Predictor of Acute Paracetamol Hepatotoxicity}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {27-36}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18317}, abstract = {Paracetamol is a well-known hepatotoxic drug in acute overdose. Early assessment of the severity of acute paracetamol toxicity still a problem. Serum Cytokeratin 18-Asp396is a novel biomarker that reflects the degree of liver damage.This study was carried out to investigate that Cytokeratin 18-Asp396can represent an early and valuable predictor of pre-clinical and clinical acute paracetamol toxicity in humans.The clinical work was conducted at Minia PCC during the period from January, 1st, 2011 to December, 31th, 2015 where 127 adult patients with a history of paracetamol overdose from whom 84 patients had confirmed to have acute paracetamol toxicity, were received.All subjects were investigated for serum paracetamol level 4 hours post-ingestion and for liver function tests (ALT, AST, ALP andtotal bilirubin) and Cytokeratin 18-Asp396 at 4, 24, 36, and 48 hours post-ingestion.The results of the current study revealed that all investigated liver function tests including ALT, AST, ALP and bilirubin started to be increased with statistically significant values 24 hours post-ingestion, reached a peak after 36 hours, and started to decline after 48 hours. On the other hand it has been found that Cytokeratin 18-Asp396 values were increased significantly 4 hours post-ingestion, when compared to mean value of healthy volunteers, reached a peak after 36 hours, and started to decline after 48 hours. The results reflects the earlier effects of paracetamol toxicity on Cytokeratin 18-Asp396 serum level than the other measured liver function tests. Accordingly, Cytokeratin 18-Asp396 serum level could be considered a promising predictor for early diagnosis of pre-clinical and clinical acute paracetamol toxicity in humans. Further studies are recommended to assess its sensitivity and specificity as a predictor for early diagnosis of acute Paracetamol-induced hepatotoxicity. }, keywords = {Paracetamol,Cytokeratin 18-Asp396,Liver function tests,Hepatotoxicity}, url = {https://ajfm.journals.ekb.eg/article_18317.html}, eprint = {https://ajfm.journals.ekb.eg/article_18317_02184a3c5cb5ff0bd46f683a099a0457.pdf} } @article { author = {A.A, Hefnawy and Moness, Hend and Zaki, Amr and Hassan, Manal and Adly A, Naglaa}, title = {Some Clinical and Biochemical Effects Associated With Acute Malathion-Induced Immunotoxicity in Minia City, Egypt}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {37-48}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18318}, abstract = {Pesticides have been implicated in increasing the prevalence of diseases associated with alterations of the immune response. The purpose of this review was to demonstrate some clinical effects and to investigate some biochemical changes that occur with acute malathion pesticide intoxication regarding immune system. During a period of six months that started from 1st of November 2014 till 30th of April2015, 43 subjects were chosen to be involved in this study. They were divided into 2 groups: group A (control): 10 apparently healthy subjects and group B: consists of 33 patients acutely intoxicated by malathion. Pseudocholine estrase enzyme level, interleukin 2 (IL-2), and cluster of differentiation cells (CD4, CD8 and CD19) were investigated for all subjects. The results of the current study revealed significant increase in male intoxicated cases andingestion was the most common route of intoxication. The mean ages of patients was 30.1±8.5 years old. Suicidal intent was the common mode of toxicity.The mean of delay interval between intoxication and hospital admission was 8.3±5.8 hours. Significant statistical differences in all vital signs, local and some systemic manifestation of the patient. Pseudocholine esterase level was reduced in all cases. Significant decrease in CD4, CD8 and CD19 cell count, while significant increase in IL-2 levels in group 2 patients as compared to control subjects.  Significant positive correlation was evident between IL-2 and CD4 count, while significant negative correlation between IL-2 and CD19 count appeared. Insignificant correlations between pseudocholine esterase level and (CD 19, CD8 & CD4) and between IL-2 and (CD8 & Pseudocholine esterase level) were noticed. Critical cases represent 27.3% of patients.Hospital stay duration mean was 8.6±4.8 days. The study concluded that acute malathion toxicity can carry the risk of immunotoxicity. There is demand to continue to improve immunotoxicological studies. A concerted effort is required to organize and standardize a study protocol.}, keywords = {immunotoxicological,malathione,interleukin 2 (IL-2),cluster of differentiation(CD4,CD8,CD19)}, url = {https://ajfm.journals.ekb.eg/article_18318.html}, eprint = {https://ajfm.journals.ekb.eg/article_18318_847da3a885a9aad258edbe398adfbfa8.pdf} } @article { author = {Wahdan, Amira and Shareef, Mohamed}, title = {Study of the Protective Effect of Vitamin C on Monosodium Glutamate Induced Cardiotoxicity in Adult Male Albino Rats}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {49-56}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18319}, abstract = {Introduction: Monosodium glutamate (MSG) is worldwide used food flavoring agent. Its safety as food additive is controversial. Vitamin C is a water soluble vitamin with antioxidant activities Aim of the study: The aim of this study was to evaluate the possible toxic effect of MSG on the heart and to evaluate the potential protective effect of concomitant administration of vitamin C together with MSG on the heart of adult male albino rats. Material and methods: The current study was conducted on 60 adult male albino rats. Rats were divided into six equal groups. The first group was used as control group. Group II was treated with vitamin C (100mg/kg/day). Group III was treated with MSG (100mg/kg/day). Group IV was treated with MSG (4g/kg/day). Group V was treated with MSG (100mg/kg/day) together with vitamin C (100mg/kg/day). Group VI was treated with MSG (4g/kg/day) together with vitamin C (100mg/kg/day). All drugs were given orally for 45 days. The weight of the heart was recorded. The level of cardiac troponin I (cTnI) enzyme and the activity of creatine kinase MB (CK- MB) enzyme in serum were assessed. Histopathological examination of heart tissue was carried out. Results: Administration of MSG led to significant increase in the heart weight with significant elevation in the serum cTnI levels and serum CK-MB activity. Sections from low dose MSG treated rats revealed cloudy swelling, while sections form high dose MSG treated rats revealed extensive cloudy swelling with fiber separation and vascular congestion. Concomitant administration of vitamin C together with MSG significantly protected against all these changes Conclusion: It was concluded that MSG is cardiotoxic and that concomitant administration of vitamin C is protective against MSG cardiotoxicity. Recommendations: The current study recommends that the use of MSG should be restricted to very small amounts and should be under supervision of health authorities. The use of vitamin C as a natural and cheap dietary supplement is highly recommended especially in persons who consume diets reach in flavoring agents such as MSG. }, keywords = {Monosodium glutamate,vitamin c,ascorbic acid,heart,cardiotoxicity}, url = {https://ajfm.journals.ekb.eg/article_18319.html}, eprint = {https://ajfm.journals.ekb.eg/article_18319_56896ccbbd7a4446b91db620730ac165.pdf} } @article { author = {Oreby, Merfat and El-Madah, Enas}, title = {Role of Electrocardiogram, Cardiac Biomarkers and Echocardiogram in Diagnosing Acute Carbon Monoxide Induced Myocardial Injury}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {57-65}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18320}, abstract = {Background: Carbon monoxide (CO) poisoning is a common accidental cause of toxicological morbidity and mortality worldwide. Aim of this study: the aim of this study was to evaluate the cardiovascular manifestations of acute CO poisoning and the value of ECG changes, cardiac biomarkers (troponin I and CK-MB) determination and echocardiography in diagnosing cardiac damage in acute carbon monoxide poisoning cases.  Additionally, evaluate the impact of delayed time of hospital presentation and duration of exposure on these parameters. Subjects & Methods: This is a cross-sectional study that was conducted on admitted patients with acute carbon monoxide poisoning to Toxicology Unit, Emergency Hospital, Tanta University in the period from the first of March 2014 to the end of September 2015. All patients were subjected to history taking and clinical examination. Additionally, ECG, echocardiogram, cardiac biomarkers (creatinephosphokinase CK-MB, and troponin I), and carboxyhemoglobin (COHb) levels were performed for all patients. Result: the age of the studied patients ranged from 15-55 years, the delay time from 1.5-10 hours and the duration of exposure to CO ranged from 0.5 to 5 hours. The most common cardiovascular manifestations were tachycardia; occurred in 50.9% of the patients then dyspnea (24.6%), chest pain (12.3%) and lastly hypotension (10.5%). The ECG findings showed that 48.2% of the studied patients had sinus tachycardia, 5.4% had T-wave inversion or ST depression and combination of T-wave inversion and ST depression occurred in 3.6% of the patients. All patients who had ECG suggestive of cardiac ischemia had abnormal CPK-MB, troponin I and cardiac wall motion abnormalities in echocardiography. Furthermore, significant negative correlation between delay time and duration of exposure with Glasgow coma scale was evident as well as significant positive correlation between both ECG & echocardiographic changes and delayed presentation. Conclusion: the present study revealed that sinus tachycardia was the most common cardiac manifestation of acute CO poisoning. ECG finding that suggested myocardial ischemia occurred in only 14.4% of the patients. Therefore, a baseline ECG should be routinely performed but, it is not necessary to routinely measure troponin I and do echocardiography.  But, it can be restricted to only cases with abnormal ECG findings. }, keywords = {Carbon Monoxide,Poisoning,eCG,troponin I,CK-MB,Echocardiogram}, url = {https://ajfm.journals.ekb.eg/article_18320.html}, eprint = {https://ajfm.journals.ekb.eg/article_18320_06a64df8d8b3348f65c4d723fa0a72a1.pdf} } @article { author = {Hodeib, Aliaa and Heshmat, Mona and Soliman, Eman and El- Maddah, Enas and Kasem, Elham}, title = {Detection of Subclinical Neuropathies in Some Egyptian Workers Exposed To Lead (Cross-Sectional Study)}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {66-82}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18321}, abstract = {Chronic lead toxicity is more common and serious for multiple organs. The objective of the present study was designed to detect subclinical neuropathies in Egyptian workers exposed to lead. A cross sectional study was carried out on sixty male Egyptian individuals; fifty workers were chronically occupationally exposed to lead and ten apparently healthy male volunteers not exposed to lead in their occupation served as a control group. All cases were subjected to clinical examination for lead toxicity. Neurological and nerve conduction study were done for both motor and sensory nerves. Estimation of blood and urine lead levels for all participants was done. A laboratory assessment was carried out for evaluation of hemoglobin level, reticulocytic count and basophilic stippling. The result of this study demonstrated elevation of both blood and urine lead levels of all workers. Increased in distal motor latency with slow conduction velocity and decreased amplitude of nerve conduction were observed in the studied nerves of all workers exposed to lead. Also, slow conduction velocity and decreased amplitude were the earliest and most sensitive finding of sensory conduction study of all workers exposed to lead. There were a significant correlation between blood and urine lead level, duration of exposure to lead and different parameters of nerve conduction. The present study concluded that nerve conduction either sensory or motor can give a clear image about chronic lead poisoning even with absence of any clinical findings (sub-clinical neuropathy). This study recommend periodic examination of workers exposed to lead for early detection and after recognition of these affected workers we must advise them improve their hygiene, use personal protective equipments or try to change their work and to notify industrial safety about them.}, keywords = {Lead,nerve conduction,Neuropathy}, url = {https://ajfm.journals.ekb.eg/article_18321.html}, eprint = {https://ajfm.journals.ekb.eg/article_18321_020fb8d73a2ed47654e30adeaafe015e.pdf} } @article { author = {Abbas, Mohamed and Hassan, Osama and El-Fakahany, Hasan}, title = {Mitigating Effect of Vardenafil against Colchicine–Induced Testicular Toxicity in Adult Male Albino Rats Authors}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {83-91}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18322}, abstract = {Vardenafil is a phosphodiesterase-5 inhibitor, preserving and increasing the levels of cGMP (cyclic guanosine monophosphate) in soft muscle of the penis and increasing the erection duration. These vasodilators have protective effects on vascular structures. In this study we evaluated the effect of vardenafil on testicular toxicity induced by colchicine in rats. Forty male adult albino rats were divided into 4 groups of 10 animals each. First group(control) received 1 ml of distilled water orally and injected with 0.2 ml saline subcutaneously (s.c.), second group (Vardenafil) received 1mg/kg /day vardenafil orally, third group (Colchicine) received 25 mg/kg/day of colchicine s.c. and fourth group (Colchicine + Vardenafil) received 25 mg/kg/day colchicine s.c. with vardenafil 1 mg/kg /day orally. The period of the experimental study extended to 28 days. At the end of the study the rats and testes were weighed and testicular toxicity was evaluated by investigating seminal parameters and testicular histopathological changes. Administration of colchicine led to significant decrease in sperm count, motility and viability with significant increase in abnormal sperm forms when compared to control group rats. There was non-significant change regarding both body and testicular weights after administration of colchicine when compared to control group rats. Histopathological changes showed damaged seminiferous tubules, depletion of spermatogenic cells with disruption and thickening of the basement membrane. Some tubules became shrunken and filled with debris of shedded cells and arrested spermatogenesis was noticed in scattered tubules with spermatogenic vacuolations and degenerated mitochondria. Administration of vardenafil with colchicine led to significant decrease of colchicine side effects on seminal parameters and testicular histopathological changes. It is concluded that treatment with vardenafil limits testicular toxicity induced by colchicine.}, keywords = {vardenafil,PDEI,Colchicine,testis}, url = {https://ajfm.journals.ekb.eg/article_18322.html}, eprint = {https://ajfm.journals.ekb.eg/article_18322_ce6ed2fd02c7e93d4593b517eaf98f28.pdf} } @article { author = {Abbas, Mohammed and El-sherbeney, Shereen and Ahmed, Rasha}, title = {The Possible Ameliorative effect of Zafirlukast on Renal Toxicity Induced by Methotrexate in Experimental Animals}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {92-104}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18323}, abstract = {Methotrexate is a chemotherapeutic agent. Nephrotoxicity is an important side effect of treatment with methotrexate. Zafirlukast is a cystenyl leukotriene antagonist that acts as an anti-inflammatory and antioxidant agent. The aim of this study was to analyze the nephrotoxicity induced by methotrexate in rats and to evaluate the possible ameliorative effect of zafirlukast. Ethanol (1ml/kg, orally once daily) and  zafirlukast (40mg/kg, orally once daily) were given for 10 days. Methotrexate (20mg/kg I.P, single injection) and, zafirlukast (40mg/kg, orally once daily) was given 5 days before methtrexate and then 5 days after the chemotherapeutic agent. Rats will be sacrificed after the 10th day from methotrexate intake. Rats given methotrexate alone had significantly higher MDA (malondialdehyde), lower reduced glutathione, catalase, superoxide dismutase in kidney tissue and higher blood urea nitrogen and serum creatinine levels than the control groups. Co-treatment of zafirlukast with methotrexate had an ameliorative effect on the previous parameters. Light & electronic microscopic pictures revealed that methotrexate caused marked degenerative changes in the kidney of rats. Restoration of the normal architecture of kidney tissues were observed in rats received methotrexate with zafirlukast. Thus, methotrexate can induce oxidative damage in rat kidney & zafirlukast has an ameliorative effect against this damage}, keywords = {Methotrexate,Nephrotoxicity,zafirlukast,oxidative damage}, url = {https://ajfm.journals.ekb.eg/article_18323.html}, eprint = {https://ajfm.journals.ekb.eg/article_18323_00d27941a0277d48a7c8b37c35c65d70.pdf} } @article { author = {Ramadan, Magda and Abdel Rahman, Amany and Mahmoud, Nesrine and Allam, Ahmed}, title = {Pitfalls Encountered during Documentation of Cases of Fatal Fall from Height Presented to Kafr EL Sheikh-Medico legal Department during the Period from (1999 to 2013)}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {105-116}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18324}, abstract = {Fall from height represents an important form of blunt trauma in society. The incidence of deaths due to fall from height is increasing day by day. So, determination of the manner of fatal fall from a height is very important issue. When establishing the mode of death, it is essential for the forensic pathologist to reconsider autopsy findings, outcome of toxicology screening, and circumstances at the death scene. The present study aimed first, at throwing light on the pitfalls encountered during examination of medico legal (ML) reports of cases of falling from height.  Second, design a ML protocol for documentation of deaths due to falling from height. The current study was a retrospective study of the records of cases of fatal fall from height presented to Kafr EL Sheikh-Medico legal Department during the period from 1st of January 1999 till the 31st of December 2013. The records were examined for: personal data, detailed history of the cases, scene examination, autopsy findings and Toxicological screening. The results of the present study showed that the total number of the reported cases was 21 cases. The age of the victims ranged from 8 to 69 years, males presented (61.9%) of cases. Data about employment was documented in only (38.1%) of cases. Data about the circumstantial events were missing in most of the records. Accidental falls were the most prevalent manner. Suicidal falls were the second prevalent manner .Scene examination revealed that falls of (71.44%) of cases was from buildings. The height of fall was found in majority of records to be from the 4th storey. Examination of the path of fall was not reported in most of cases (95.23%). The nature of impact surface was documented only in (38.1%) of cases. Body orientation in relation to impact surface was mentioned in (38.1%) of cases. Records describing the site of fall from inside were very defective. The presence of barrier and its height was reported in (33.33%) of cases. Whole body radiography and external body measurements were not performed in any of the studied cases. Autopsy findings showed that the head and the thorax were the most affected regions. The probable primary site of impact was concluded by autopsy in (47.62%) of cases. The cause of death was head injuries in the majority of cases either by itself or in conjunction with other injuries. Toxicological screening of the commonly used drugs was carried in (90.48%) of the cases, where it was negative in (85.72%) of cases. Blood alcohol content was performed in (61.9%) of the cases and it was negative. The study concluded deficient documentation of data about the history of the cases; scene examination, autopsy findings and toxicological screening. Many recommendations were suggested and a protocol for documentation of the cases of fatal fall from height was proposed.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18324.html}, eprint = {https://ajfm.journals.ekb.eg/article_18324_466dfeb4b2544a421a1bf3fb8deb6551.pdf} } @article { author = {Hafiz, Rabab and Fawzi, Marwa and Hamam, Ghada}, title = {The Potential Protective Effect of L-Ascorbic Acid against Chlorambucil Induced Hepatorenal Toxicity in Adults Male Albino Rats}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {27}, number = {2}, pages = {117-132}, year = {2016}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2016.18325}, abstract = {The high incidence of neoplastic diseases have led to manifacturing of many antineoplastic drugs to combat these diseases. Treatment with chloambucil in high dose is associated with toxicities to many organs. The aim of this study is to investigate the protective role of L-ascorbic acid for prevention of chlorambucil induced hepatic and renal toxicities in rats. Methods: This study was conducted on 160 adult male albino rats divided into 8 equal groups . Group: I rats surved as negative control. Group II received L-ascorbic acid in an oral dose of 100mg/kg/day . Group III received chlorambucil in an oral dose of 0.2mg/kg/day for 5 consecutive days .Group IV received chlorambucil in the same dose for 10 days. Group V received chlorambucil in the same dose for 15 days. Group VI recieved chlorambucil and L-ascorbic acid in oral doses of 100mg/kg/day,0.2mg/kg/day respectively for 5 days. Group VII recieved chlorambucil and L-ascorbic acid in the same doses for 10 days. Group VIII recieved chlorambucil and L-ascorbic acid in the same doses for 15 days Results: There was significant difference in mean values of serum ALT ,AST, bilirubin, createnine, blood urea nitrogen and hepatic and renal GSH in groups III,IV and V compared to group I .Also, groups VI,VII and VIII  showed  significant difference in all studied parameters compared to group Iand when groups VI,VII and VIII were compared with groups III,IV and V respectively, significant difference was also found. Histopathological examinationof liver revealed severe damage in the form of congested dilated central veins and portal tracts ,vaculated hepatocytes and pyknotic nuclei in groupIII, these changes were more obvious in  groups IV and V, the later revealed also mononuclear cellular infiltration.While there was mild damage in the form of mild congestion of the portal vein in group VI , dilated non congested portal veins in group VII and congestion of  some central veins and some portal tracts with some hepatocytes with pyknotic nuclei in group VIII. Histopathological examinationof kidneys revealed severe damage in the form of vacuolations of some renal tubules with some pyknotic nuclei in group III, loss of normal architecture of renal tubules in group IV and congested peritubular capillaries and frequently dilatated tubular lumen in group V.  On the other hand,there was mild damage in the form of few tubular cells  with pyknotic nucleiin group VI, vacuolations of some renal tubular cells in group VII and only  congestion of peritubular capillaries in group VIII. while the percentage of pathological changes in liver and kidneys were insignificantly decreased in groups VI ,VII and VIII when compared with group I. Conclusion: Chlorambucil produced significant hepatorenal toxicities in time dependent manner. Co administration of L-ascorbic acid improved such toxicities. This study was compared with other studies with larger number of experimental animals, using other antioxidants and affecting other organs. Recommendations: It is recommended to use L-ascorbic acid during therapy with chlorambucil in 5 days regimen and further studies about combined use of many antioxidants especially during prolonged therapy with chlorambucil are required.}, keywords = {Acute toxicity,Chlorambucil,L-ascorbic acid}, url = {https://ajfm.journals.ekb.eg/article_18325.html}, eprint = {https://ajfm.journals.ekb.eg/article_18325_a0e073dc251893ae25a0f02640be48df.pdf} }