Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
32
1
2019
01
01
Acute Poisoning Induced Coma: Characteristics and Predictive Role of Early Creatine Phosphokinase on Its Outcome
1
9
EN
Eman
Mohammed
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University.
EL -Sayed
Gawesh
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Al- Azhar University.
10.21608/ajfm.2019.23376
<strong>Background:</strong> Emergency physicians are often challenged with a comatose patient; 30% of patients with coma of unknown origin are due to intoxication<strong>. </strong>Comatose patients are at high risk for morbidity and mortality.<strong> Objective:</strong> The present study assessed poisoning-induced coma regarding demographic and intoxication data, causative agents, clinical data, management modalities and outcome. In addition to evaluation of the role of creatine phosphokinase (CPK) level on admission and other variables as predictive factors for the outcome in toxic coma.<strong> Subjects and Methods:</strong> This study was conducted prospectively on one hundred comatose intoxicated patients, admitted to Poison Control Center Ain Shams University Hospitals (PCCASU). <strong>Results: </strong>The majority of patients (64%) were in the age group 18-40 year, and there was male predominance (56%). Organophosphorus, carbamazepine and tramadol were the most common toxic agents inducing coma. Death rate was 12% and mortality is much higher in patients with older age, elevated admission creatine phosphokinase, longer duration of hospital stay and higher grade of Reed’s classification of coma.<strong> Conclusion: </strong>Organophosphorus followed by carbamazepine and tramadolwere the most common toxic agents inducing coma. Older age, elevated admission creatine phosphokinase, longer duration of hospitalization and higher grade of Reed’s classification of coma can predict the mortality. In addition, respiratory acidosis and the need of intubation and mechanical ventilation indicated poorer outcome, while administration of antidotes was correlated with better outcome.
Poisoning induced coma,creatine phosphokinase,Predictive factors,mortality,Poison Control Center
https://ajfm.journals.ekb.eg/article_23376.html
https://ajfm.journals.ekb.eg/article_23376_463bd90be0885c7fa104e3301f1e5587.pdf
Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
32
1
2019
01
01
Risk Factors Predicting Stricture Formation and Death in Patients with Caustic Ingestion
10
19
EN
Alaa
Mahmoud
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Eman
Mohammed
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Rasha
Al Husseini
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Sana
Bilal
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
10.21608/ajfm.2019.23377
<strong>Background:</strong> Caustic ingestion is still a difficult medical problem, and the outcome is often unexpected. <strong>Objectives:</strong> This study assessed the usefulness of intoxication data, clinical data and some laboratory parameters in predicting the outcome following caustic ingestion, and test the applicability of DROOL Score (DS) as a prognostic indicator of oesophageal stricture. <strong>Methods:</strong> Ninety-two patients with caustic ingestion admitted to Poison Control Centre Ain Shams University (PCCASU), during the period from 1st June to November 30, 2015 were prospectively studied. Diagnoses of stricture made via barium study. <strong>Results:</strong> Sixty-six percentage of cases were children under 5 years. In 48.9% of cases, the caustic agent was alkaline. Symptoms and signs can adequately predict the outcome of corrosive patients. DROOL Score and Total Leucocytic Count (TLC) ≥ 20,000 are useful tools for predicting both stricture formation and mortality, in addition blood pH ˂ 7.2 can also predict mortality. A new value of DS ≤ 5.5 to predict stricture formation and mortality of corrosive patients was proposed.<strong> Conclusion:</strong> Clinical manifestations can adequately predict the outcome also; DS and TLC ≥ 20,000 have predictive value for outcome prediction of corrosive patients. Moreover, blood pH ˂ 7.2 can predict mortality. A new value of DS ≤ 5.5 was identified as a prognostic indicator of outcome in caustic patients.
Corrosive,Outcome,poison centres,stricture,Prognostic factors
https://ajfm.journals.ekb.eg/article_23377.html
https://ajfm.journals.ekb.eg/article_23377_6521abfc30f2d34f3ee13e039325deda.pdf
Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
32
1
2019
01
01
Domestic Violence Inducing Females’ Gynecological and Urological Problems: The Forensic and Social Perspectives
20
30
EN
Abo Elyazied
Fouad
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Biomedical Science, Division of Forensic Medicine, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
Sayed
Ali
0000-0002-8808-6296
Department of Family and Community Medicine, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
Department of Educational Psychology, College of Education, Helwan University, Cairo, Egypt.
drsamas38@gmail.com
Mohamed
Soliman
Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
mohagab2006@yahoo.com
Amira
Osman
Department of Gynecology and Obstetrics, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
amiraokud@gmail.com
10.21608/ajfm.2019.23655
Background: Domestic violence is a major health and social issue. Forensic documentation of this problem might be of great significance. This study aims to define the primary forensic and social features of domestic violence.<br /> Materials and Subjects: The study materials consisted of 779 Saudi Arabian females, aged 15-60 years, attending the gynecology, and urology clinics at three secondary health centers in the Eastern Province, Saudi Arabia. A self-administrated questionnaire was employed in this study, which entails two scales to cover both forensic and social aspects of the assault. The SPSS/PC software package for version 25.0 was utilized to perform the statistical analysis.<br /> Results: During the study period, 950 women have attended the clinics with (82%) response rate. The percentage of physical violence was higher than the other forms (75%).The highest incidence of domestic violence (42.6%) was in the age group (20-30) and in married women. The frequency of abusing shows a significantly higher percentage of occasional answers (75.68%).The most commonly reported injury sites were the head (45.27%). Slaps/ push were the sorts of violation in (56.4%) of cases. Husbands (57.4%) were the main perpetrators. Six gynecological and urological symptoms were significantly more common in women with a history of domestic violence.<br /> Conclusion: The results of this work denoting the great importance of forensic practicing in the era of domestic violence investigations. Medicolegal researches should be considered as a cornerstone in the programs designed for proper reporting, and prevention of violence against women.
medicolegal,Domestic violence,Gynecological,and urological
https://ajfm.journals.ekb.eg/article_23655.html
https://ajfm.journals.ekb.eg/article_23655_f89b51e89329e904c1f5087fccc26275.pdf
Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
32
1
2019
01
01
Study of Child Sexually Abused Cases in Cairo Governorates in the Period from (2012) to (2016)
31
39
EN
Manar
abo-Seria
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Asmaa
AbdelRahman
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Hanan
Mostafa
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Hisham
Farag
Forensic Medicine Authority, Ministry of Justice, Cairo, Egypt
10.21608/ajfm.2019.23674
<br /> <br /> <br /> <br /> <br /> <span> </span><strong>Introduction </strong>Child sexual abuse (CSA) is a serious violation of human well-being and of the law. It is, sadly, an international problem of great magnitude that can affect children of all ages, sexes, races and socioeconomic classes. CSA is outlawed nearly everywhere in the world, generally with severe criminal penalties, including, in some jurisdictions, life imprisonment or capital punishment <br /> <strong>Aim of the study </strong>to examine the incidence, risk factors and pattern of sexual assault in children to provide grounds for effective preventive measures and to heighten awareness of the health professionals. <br /> <strong>Methods </strong>This is both retrospective and prospective study evaluating sexual assault against children that were referred to Medico-legal Office and violence against women and children clinic in the Medico-legal department of Ministry of Justice, Cairo, Egypt from 2012 to 2016. <br /> <strong>Results </strong>The total number of CSA cases was 740 in the age range from 1 to18 years, females 391 (52.8%) were more predominant than males 349 (47.2%). The age group from 11 to 18 years accounted for the highest rate (56%), mostly in females (62.6%). El-Salaam was the most common district of reporting cases of child sexual abuse (9.7%). Most CSA cases were committed by single perpetrator (87 %) and most perpetrators were non-relative (89.1%).The most frequently reported type of child sexual abuse was anal assault (55%). Physical violence (27.7%) was the most common threat used against child cases. Majority of cases were examined after the sexual assault by more than one week (40.4%). Ecchymosis (6.1%) was the most frequent wound seen upon examination of CSA cases. Head and neck were the most common site of traumatic lesions (5.1%). <br /> <strong>Conclusions </strong>Family doctors and other health professionals should be minded with suspecting signs of CSA and its short and long-term deleterious consequences to refer them to specialized authorities to overcome the delay of reporting and loss of forensic evidence
https://ajfm.journals.ekb.eg/article_23674.html
https://ajfm.journals.ekb.eg/article_23674_cc7d6b98ce919ecc62f0cda5e8823a74.pdf
Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
32
1
2019
01
01
The Potential Role of Intravenous Magnesium Sulfate Administration on the Outcome of Acute Organophosphorus Toxicity. A prospective study in Poison Control Center Ain Shams University
40
46
EN
Enas
El Taftazany
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Rabab
Hafez
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ghada
Ebeid
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
10.21608/ajfm.2019.23675
<br /> <br /> <br /> <br /> <br /> <span> </span><strong>Background: </strong>Organophosphate compounds (OP) have been used as pesticides and chemical warfare nerve agents worldwide. They are readily available because of inadequate regulations controlling their sale. The easy availability of these compounds has resulted in a gradual increase in accidental and suicidal poisoning. It also has resulted in many deaths that occur within hours of the ingestion. The efficacy of the traditional treatment of OP which includes atropine and oximes still an issue of debate. <br /> <strong>Aim of the Work: </strong>Assessing the potential role of intravenous MgSO<span>4 </span>administration on the outcome of acutely OP intoxicated patients via a prospective single-blind randomized controlled trial in the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH). <br /> <strong>Patients and Methods: </strong>The study assesses the potential role of intravenous MgSO<span>4 </span>administration on the outcome of 40 acutely OP intoxicated patients within the period from 8-11-2016 to 18-1-2018. The study is prospective single-blinded randomized controlled trial that was carried out on patients admitted to (PCC-ASUH) with acute OP toxicity. Patients were divided according severity into moderate and severe groups then each group was subdivided into two subgroups; one received MgSO<span>4 </span>and the other didn't receive it. MgSO<span>4 </span>treated patients received 4g/d for only the first 24 hours after admission. Patients were observed for outcomes such as; mortality, total duration of hospital stay, need for ICU admission and its duration and intermediate syndrome and CVS toxicity occurrence. <br /> <strong>Results: </strong>There was no significant difference in duration of ICU stay, total duration of hospital stay and need for mechanical ventilation between MgSO<span>4 </span>treated and non-treated patients. <br /> MgSO<span>4 </span>administration may have decreased mortality, intermediate syndrome and CVS toxicity, but the difference was statistically insignificant between MgSO<span>4 </span>treated and non-treated patients <br /> <strong>Conclusion: </strong>Our study found that intravenous MgSO<span>4 </span>administration didn’t modify the total dose of atropine and oximes given to OP intoxicated patients during their hospital stay, also MgSO<span>4 </span>didn’t modify the need for mechanical ventilation. Although MgSO<span>4 </span>had reduced the number of patients who developed intermediate syndrome and CVS toxicity, duration of ICU stay, total duration of hospital stay and mortality, but unfortunately this reduction was statistically insignificant.
Intravenous magnesium sulfate,Acute Organophosphorus Toxicity
https://ajfm.journals.ekb.eg/article_23675.html
https://ajfm.journals.ekb.eg/article_23675_80de52fdf452b48104647ebcaa91b51a.pdf
Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
32
1
2019
01
01
A study of Some Medico-Legal Aspects of Fatal Burn Cases Admitted to Menofia University Hospital over Five Years "A Retrospective Study"
57
64
EN
Fatma
Kandeel
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
10.21608/ajfm.2019.25004
<strong>Background</strong>: Burns are considered among the most devastating injuries facing healthcare organizationsglobally. Low- and middle-income countries have high incidence.<br /> <strong>Objectives:</strong> To evaluate cases of fatal burns admitted to Menoufia University Hospital, Egypt over five years (starting from the first of January 2013 to the end of December 2017). <strong>Results:</strong>The total number of burn deaths was 113case. Males slightly outnumbered females. Victims with the age group between 20-40years were most affected followed by thoseless than 10years (35.4% and 28.3%respectively). The majority of cases were from rural areas, had more than 50% of burnt total body surface area, burn occurred mainly indoors, with accidental manner (96.5%) and mainly due to flame (85%). Septicemia was the leading cause of death. There was a statistically significant difference as regards duration of survival in relation to burnt total body surface area and cause of death. <strong>Recommendations:</strong> Mass education of the public should be done about safety instructions to reduce the incidence of burn injuries especially indoors. Availability of selected burn centers and detailed recording of data are mandatory.
https://ajfm.journals.ekb.eg/article_25004.html
https://ajfm.journals.ekb.eg/article_25004_1eb777da97f4232bc56b82d173bc67dc.pdf