@article { author = {Abdel Hamid, Omaima and El-fakharany, Yara and Abdel-Salam, Amira}, title = {Toxic Effects of the Most Prevalent Addicting Drugs among Some Egyptian Secondary School Students on the Reproductive System: Clinical and Experimental Study}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {15-27}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18275}, abstract = {Substance abuse among adolescents is an increasing social and medical problem in Egypt especially with lacking of information regarding prevalence and types of abused drugs. Drug abuse in this critical period of testicular development seems to affect fertility. The objectives of this work was to study the prevalence of addicting drugs among adolescent males in secondary public schools and to examine the insult of most prevalent drugs on the fertility of adolescent male albino rats. Participated students were subjected to a structured questionnaire and urine screening for drugs of abuse. The overall prevalence of abused drugs was 13.6%, tramadol was the most (50.5%) followed by cannabis (14.6%). Animal equivalent doses of tramadol & hashish were given orally to 60 male albino rats for 4 months to test their toxic effects on the reproductive system. Significant reduction in testicular weight, relative testicular weight, luteinizing hormone (LH), testosterone in tramadol, hashish groups with the maximum decrease in combined tramadol+hashish group. Degenerative changes with sloughing &disorganization of epithelial cells were detected in H&E stained testicular sections in tramadol & hashish groups, while in the combined group the degeneration was severe with vaculation, interstitial fibrosis, hyalinization and no aggregated sperms in the lumen.It was concluded that the most prevalent abused drugs among adolescents were tramadol, hashish or combination. These drugs have a structural & functional disruption on the reproductive system in adolescent period.}, keywords = {testes,tramadol,Hashish,adolescence,Egypt}, url = {https://ajfm.journals.ekb.eg/article_18275.html}, eprint = {https://ajfm.journals.ekb.eg/article_18275_234ec9ff66964f9eda8905ff40e0bf2a.pdf} } @article { author = {El-fakharany, Yara and Abdel Hamid, Omaima}, title = {Toxic Effects of Chronic Chlorpyrifos Exposure on Jejunum of Adult Male Albino Rats and the Possible Ameliorative Role of Propolis}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {28-41}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18276}, abstract = {  Chlorpyrifos (CPF), as an extensively used organophosphorus pesticide, has many toxic hazards on health. There is a lack of data regarding the toxic effect of CPF on Gut. Aim of the work: to investigate the toxic effect of chronic oral exposure to chlorpyrifos on jejunum of adult male albino rats and to evaluate the ameliorative role of propolis. Methodology: The study extended for 12 weeks and included fifty male albino rats that were divided into 4 groups as follows: control group (I) consisted of 20 rats equally and randomly subdivided into 2 subgroups: Ia (-ve control) & Ib (+ve control). propolis group (II) 10 rats treated with 400 mg/kg body weight of propolis dissolved in corn oil by oral gavage. chlorpyrifos group (III): 10 rats treated with CPF at a daily dose of 6.75 mg/kg {1/20 of the oral LD50 of CPF (135mg/kg)} dissolved in corn oil. CPF+propolis group (IV) 10 rats each was gavaged orally with CPF (6.75 mg/kg body weight) with simultaneous administration of propolis (400 mg/kg body weight) once daily. The levels of serum citrulline, circulating endotoxin core antibodies (Endocab IgG) were assessed, GSH & MDA in jejunal mucosa were measured. Histopathological and morphological analysis of the jejunal mucosa was also evaluated. Results: Significant decrease in serum citrulline level, increase Endocab IgG with a significant decrease in tissue GSH and increase in MDA in CPF group when compared with control and CPF+Propolis groups with disruption of jejunal epithelium and decrease in both height and width of villi. CPF+propolis group showed no significant difference in MDA levels when compared with control, but significant difference regarding other biochemical and histopathological parameters was detected on comparison with CPF group. Conclusion: CPF induced disruption and increased permeability of epithelial barrier in the jejunum with bacterial translocation and chronic endotoxemia evidenced by Endocab IgG. This may be due to induction of oxidative stress. Propolis as a natural, cheap and available product could partially ameliorate the toxic effect of CPF on jejunum.                }, keywords = {chlorpyrifos,Propolis,Jejunum,toxicity,Endocab,Citrulline}, url = {https://ajfm.journals.ekb.eg/article_18276.html}, eprint = {https://ajfm.journals.ekb.eg/article_18276_8c84d6116306fbf49726d3cfe914c03d.pdf} } @article { author = {Abo El-Noor, Mona and Elgazzar, Fatma and Alshenawy, Hanan}, title = {Role of Inducible Nitric Oxide Synthase and Interleukin-6 Proteins Expression in Estimation of Skin Burn Age and Vitality: Immunohistochemical Study in Rat}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {28-37}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18277}, abstract = {Estimation of age and vitality of burn injury both in the living and dead is essential in forensic practice. Nitric oxide and interleukin-6 (IL-6) play an important role in skin burn healing. In this immunohistochemical study, the expression of inducible nitric oxide synthase (iNOS) and IL-6 proteins during skin burn injury healing in rats was studied for purposes of burn dating and to differentiate between ante-mortem and post-mortem burn. Ante-mortem full- thickness skin burns were created on forty five rats with a heated soldering iron applied for three seconds. Normal and burnt skin samples were taken at 1, 3, 5, 7, 9, 11, 13, 15 and 21 days following burn induction (5 rats for each stage). Post-mortem burn was inflicted 6h. after scarification in another five rats. There was a statistically significant difference in both iNOS and IL-6 expression between the different studied time intervals of the ante-mortem burn. Expression of both iNOS and IL-6 decreased remarkably in the post-mortem burn with a statistically significant difference from all the studied ante-mortem intervals. A statistically significant positive association between the two markers was found; both increased gradually in the inflammatory and early proliferation stages and started to decrease in late proliferative and remodeling stages while reaching the minimum in the post-mortem burn. These results indicate that both iNOS and IL-6 expression in ante-mortem burnt skin was time dependent and significantly differed from post-mortem burn. Further research on humans is recommended.}, keywords = {Skin burn aging,skin burn vitality,inducible nitric oxide synthase,Interleukin-6,immunohistochemistery,rat}, url = {https://ajfm.journals.ekb.eg/article_18277.html}, eprint = {https://ajfm.journals.ekb.eg/article_18277_73ee5410eb4ed88971d2e9dd8989d3c4.pdf} } @article { author = {El-Ebiary, Ahmad and Abuelfad, Arwa}, title = {N-acetylcysteine as an Adjuvant in The Treatment of Acute Aluminum Phosphide Poisoning: A Randomized Clinical Trial}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {38-46}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18278}, abstract = {Aluminum phosphide (ALP) is a common pesticide used for agricultural and non-agricultural purposes. Being cheap, widely available and highly toxic, it is responsible for many cases of poisoning. Aluminum phosphide poisoning has no specific antidote, therefore, based on role of oxidative stress in ALP poisoning, N-acetylcysteine (NAC) was suggested as adjuvant therapy in acute ALP poisoning.This study is a randomized clinical trial. It was conducted in Poison Control Center (Emergency Hospital, Tanta University). Thirty acute ALP intoxicated patients were randomly allocated into two equal groups A and B using the sequentially numbered, opaque sealed envelopes method. Group Areceived NAC 140 mg/Kg IV infusion as a loading dose followed by 70 mg/KgIV infusion every 4 hours up to 17 doses in addition to the routine treatment. Group B received only the routine treatment. Complete physical examination, routine laboratory investigations and oxidative stress markers; Malondialdehyde (MDA) and total antioxidant capacity (TAC) were performed for each patient.Results of the current study revealed no statistical significant difference between group A and group B patients regarding sociodemographic, toxicologicaland clinical data as well as routine laboratory investigation. On admission, MDA and TAC serum levels showed no statistical significant difference between group A and B. After treatment a statistical significant difference was observed in serum MDA and TAC levels between group A and B. Also, significant differenceswere noticed between group A and group B patients concerning mortality, dose of dopamine and hospitalization time.The study concluded that NAC might be a promising adjuvant therapy in treatment of acute ALP toxicity.}, keywords = {Aluminum phosphide,Poisoning,N-acetylcysteine,Oxidative Stress,Malondialdehyde,Total Antioxidant Capacity}, url = {https://ajfm.journals.ekb.eg/article_18278.html}, eprint = {https://ajfm.journals.ekb.eg/article_18278_d2a13491b98aa0e3bb51d5730b4e4056.pdf} } @article { author = {Abo El-Noor, Mona and Elgazzar, Fatma and Alshenawy, Hanan and Soliman, Wafaa and Shalaby, Nashwa}, title = {The Potential Impact of Magnesium Supplementation on Cisplatin-Induced Nephrotoxicity in Adult Male Albino Rats}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {47-61}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18279}, abstract = {Background: Cisplatin has been considered one of the most effective chemotherapeutic agents. It is associated with numerous toxicities at therapeutic doses like ototoxicity, gastrotoxicity, myelosuppression, allergic reactions and nephrotoxicity. The synergistic effects of Cisplatin and magnesium deficiency are believed to contribute to renal dysfunction. Aim:The aim of this study was to study the nephrotoxicity of cisplatin and evaluate potential impact of magnesium supplementation on such toxicity. Materials and Methods: Thirty-two adult male albino rats were divided into four equal groups. Group I served as (Control group). Group II (magnesium treated group) received single injection of magnesium sulphate (90mg/kg), Groups III (Cisplatin treated group) received single injection of 5 mg/kg body weight of cisplatin and Group IV (Cisplatinand magnesium treated group) received single injection of 90mg/kg magnesium sulphate and 5mg of cisplatin. After 14 days,biochemical parameters in serum were studied: creatinine,BUN, magnesium andinflammatory marker (IL-6) levels.Kidneyswere examined by light microscope as well. Results: results indicated that: serum levels of the creatinine,IL-6 and BUN of treated rats showeda highly significantincreased compared to control animals, whereas serum magnesium showedhighly significantdecreased.Magnesiumsupplementationreverse these chages. In conclusion:Our study demonstrated that cisplatin induced andomized in the kidney function andMg supplementation ameliorates it. It is recommendedto do further investigations to determine therole of magnesium in cisplatin induced nephrotoxicity.}, keywords = {Cisplatin,Magnesium,Nephrotoxicity,Chemotherapy}, url = {https://ajfm.journals.ekb.eg/article_18279.html}, eprint = {https://ajfm.journals.ekb.eg/article_18279_478c961a5ff4bd1217b2d8237809206b.pdf} } @article { author = {Abass, Marwa and Hassan, Mohamad and Abd Elhaleem, Manal and Abd Elaziz, Hesham and Abd-Allah, Rehab}, title = {Acute Toxicity of a Novel Class of Hallucinogen "Voodoo" (Clinical and Experimental Study)}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {62-73}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18280}, abstract = {Background: Voodoo is a newly emerged hallucinogenic substance in Egypt that target the youth aged 15-30 years causing many reported cases of acute toxicity. This made the Egyptian Ministry of Health in 2014 to list it in drug schedule 1 and warned traffickers and users that they are now under criminal penalties. Aim: this work was conducted to investigate the acute toxic effects of this hallucinogenic substance on human and experimental animals. Methods: this work included both clinical and experimental studies. The clinical study included 17 patients with acute Voodoo poisoning admitted to Poisoning Control Unit - Zagazig University Hospitals between July, 2015 and April, 2016. The experimental study included forty adult male albino rats were used for calculation of LD50 of Voodoo extract.  The extract was prepared using Gas chromatography/ Mass spectrophotometry (GC/MS) to be given intra peritoneally to experimental animals. Results: the patients' main complaints were hallucination, disorientation and extreme fear of death, a picture resemble acute cannabis poisoning but with negative urinary screening test for cannabis and other common addictive substances. GC/MS analysis revealed the chief substance in the extract (54.54%) was a chemical analogue of PB 22; a designer synthetic cannabinoids. LD 50 of the extract was estimated to be 1334 mg/Kg. Liver, kidneys and brain were the most affected studied organs. The liver showed severe congestion and macro vesicular steatosis with diffuse intracytoplasmic esinophlic bodies. Kidneys showed focal vacuolar degeneration of renal tubules, accentuation of glomerular basement membrane, hyallinosis of renal tubules with large areas of epithelial necrosis. Brain cells were markedly shrunken and vacuolated. Conclusion: it could be concluded that Voodoo proved to have many toxic effects on human and experimental animals and further studies are warranted to evaluate other toxic effects of this substance.}, keywords = {Acute toxicity,Hallucinogen,LD 50,Synthetic cannabinoids,Voodoo extract}, url = {https://ajfm.journals.ekb.eg/article_18280.html}, eprint = {https://ajfm.journals.ekb.eg/article_18280_5ee2d5407a30255844e99f78f490b487.pdf} } @article { author = {Shaaban, Afaf and El-Shall, Ossama}, title = {Age Estimation Based on Some Cervical Vertebral Measurements in a Sample of Egyptian Children}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {72-87}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18281}, abstract = {The need to estimate the age of living individuals becomes more frequent, because of the increasing number of immigrants (illegal or otherwise) without acceptable identification documents and with missing or uncertain birth dates. In the recent years, evaluation of cervical vertebrae has been increasingly used to determine skeletal maturation. Aim:The aim of this study was to establish two new formulae for objectively evaluatingskeletal maturation of cervical vertebrae inmale and female Egyptianchildren usinglateral cephalometric radiographs. Methods: The cases were selected from patients attending the clinics of the Faculty of Dental Medicine for girls, Al Azhar University, in Cairo. They were assessed into two groups. The first groupincluded 100 children; 50 males (aging from 8.45 to 15.75 years oldwith a mean age of12.41years) and 50 females (aging from 8.2 to 15.5 years oldwith a mean age of 11.9 years). The cervical vertebral bodies of C3 and C4were traced and measured.Regression formulae were developed to determinecervical vertebral bone age. The second group of lateral cephalometric and hand-wrist radiographs of 50 children; 25 males (aging from 8.25 to 15.85 years old with a mean age of 11.7 years) and 25 females (aging from 8.5 to 15.65 years old with a mean age of 12.12years) was used to verify the reliabilityof these developed regression formulae.Results:The results indicated that there was a statistical significant positive correlation between estimated cervical vertebral bone age (CVBA) and chronological age (r = 0.976 in males and 0.931 in females). Also there was a statistical significant positive correlation between estimated cervical vertebral bone age (CVBA) and estimated hand bone age (HBA) (r = 0.960 in males and 0.942 in females). Conclusion: These results suggest that cervical vertebral bone age reflects skeletal maturity because it approximates hand bone age, which is considered to be the most reliable method for evaluating skeletal maturation. Using cervical vertebral bone age may be helpful to estimate age in a detailed and objective manner on cephalometric radiographsforEgyptian children.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18281.html}, eprint = {https://ajfm.journals.ekb.eg/article_18281_9533a265c13af01fa499d4c4e97102f5.pdf} } @article { author = {Darwish, Ragaa and Megahed, Haidy and Attia, MennattAllah and El-Neily, Dalia}, title = {Paraoxonase 1 gene polymorphism and enzymatic activity as a prognostic marker in cases of poisoning by cholinesterase inhibitor pesticides among Egyptians}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {88-98}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18282}, abstract = {Paraoxonase1 (PON1) is a high-density lipoprotein associated A-esterase capable of hydrolysing activated metabolites (oxons) of several pesticides as organophosphorous, including chlorpyrifos, diazinon as well as carbamates. Human PON1 displays polymorphisms in the coding region (Q192R and L55M) and in the promoter and the 3’-UTR regions. Animal studies showed that high levels of PON1 protect individuals against acute organophosphatespoisoning. The PON1 genotype and enzymatic activity together contribute to determining an individual's PON1 “status”. In this study, the role of PON1 gene polymorphismsand its enzymatic activity was assessed as a prognostic marker in cases of acute poisoning by cholinestersase inhibitor (ChEI) pesticides among a sample of Egyptian population. Two equal groups of 100 unrelated individuals participated in the study: an exposed group and non-exposed group as control. Serum paraoxonase1 enzyme activitymeasured as arylesterase activity spectrophotometrically using the substrate phenyl acetate. PON1 Q192R gene was genotyped using PCR-RFLP technique. The PON1 Q192R genotype frequency distribution in control subjects was (QQ=64%, QR=28%, RR=8%) and in patients was (QQ=54%, QR=42%, RR=4%) and this was statistically significant (p=0.029). The arylesterase activity was significantly higher in control than exposed group (p=0.037). Regarding the effect of Q192R genotype and arylesterase activity on the outcome, there was no significant difference between the good and poor prognosis groups. Evaluation of PON1 status may be important for determining individual susceptibility to poisoning by ChEI pesticides. However, the estimated level of arylesterase after exposure to poisoning can’t be used in prediction of prognosis. Moreover, the coding genes show discrepant results even within the same ethnic group.}, keywords = {Paraoxonase 1 arylesterase activity,PON1 Q192R genotype,cholinestersase inhibitor pesticides}, url = {https://ajfm.journals.ekb.eg/article_18282.html}, eprint = {https://ajfm.journals.ekb.eg/article_18282_0340b2514034580285b111f3054d0a96.pdf} } @article { author = {Oreby, Merfat and El-Madah, Enas}, title = {Prediction of Acute Organophosphate Poisoning Using Glasgow Coma Sale, Serum Cholinesterase and S100B}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {100-107}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18309}, abstract = {Background: organophosphate (OP) poisoning is a major health problem worldwide, especially in developing countries, with millions of cases and hundreds thousands of deaths occurring each year. The aim of this study: was to evaluate the role of Glasgow Coma Sale (GCS), serum cholinesterase (SChE) and S100B protein levels in evaluation and prediction of outcome of patients with acute organophosphate poisoning.  Material and methods: the present study was conducted on admitted patients with acute organophosphate poisoning in Tanta Toxicological Unit, Tanta University Hospital during the period from the start of July 2014 to the end of June 2015.  For all patients; personal and toxicological history, complete clinical examination and measurement of SChE and S100B at admission and after 24hrs were performed for every patient. Outcome assessment; the patients were divided into two groups; group (1) included patients who survived and group (2) included patients who died. Results: the present study was carried out on 24 patients with acute severe organophosphate toxicity, their age ranged from 16-48 years. Sixteen patients (66.67%) were survived and eight (33.3%) were died. About two third of the patients were female (66.67%), half of them were students (50%) and took malathion (50%). All patients took organophosphates orally and in a suicidal attempt. The GCS was higher in survived patients (6-11) than died ones (3-5). Additionally, serum S100B level at both admission and after 24hrs, revealed significant increase in its level in died patients than survived. While, SChE showed non-significant decrease in both survived and died patients. SChE and S100B at both admission and after 24hrs cannot predict mortality. However, GCS can predict mortality with 100% sensitivity and 75% specificity at a cut off level of 9.  Conclusion: both GCS and S100B had significant correlation with the patients’ outcome. Inspite of that, only GCS can predict mortality in 100% of the patients who has a GCS equal to or lower than 9. Also, 75% of survivors had GCS above this cut off value.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18309.html}, eprint = {https://ajfm.journals.ekb.eg/article_18309_bb8c02f411c278ec4fef1f8256e40c50.pdf} } @article { author = {Elfeky, Ahmed and Mohamed, Abdelnaby}, title = {Effects of Tramadol Addiction on Brain of Adult Male Albino Rats and Role of lofexidine during Withdrawal Period: A Biochemical, Histopathological and Immunohistochemical Study}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {119-132}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18310}, abstract = {Background: Tramadol is a synthetic opioid analgesic commonly prescribed for moderate to severe pain, becoming abused more popular among teens in most countries. In addition to the euphoric and mood-enhancing effects sought by tramadol abusers, taking this drug for nonmedical purposes, abusing tramadol can lead to tolerance and dependence. Abusers who continue to take tramadol long enough and at high enough doses will eventually develop a physical dependence on the drug and experience unpleasant, or even dangerous, symptoms of withdrawal if they stop taking the medication. Objective: To study the biochemical, histopathological and immunohistochemical changes of repeated administration of tramadol on the brain cells of male albino rats and role of duration of addiction in the damaging effects produced, and to prove if there is a role for lofexidine in the treatment of tramadol addiction in withdrawal period and detect the changes after recovery period and withdrawal of tramadol .Materials and methods: 100 adult male albino rats were randomly divided into equal 5groups: Group I: (20 rats) Control group: including those given normal feeding. Group II: (20 rats) Tramadol treated group for one month. Group III: (20 rats) Tramadol treated group for 2 months. Group IV: (20 rats) Tramadol treated for one month then given lofexidine for another month during withdrawal. Group V: (20 rats) Tramadol treated for one month and left for another month for recovery. Animals were observed for any behavioral changes throughout the research and recorded. At the end of the experiment animals were scarified by cervical dislocation under inhalation anesthesia, autopsy was done and the brain specimens were obtained, prepared for biochemical study for dopamine level and others preserved for histopathological and immunohistochemical study with their specific procedures. Results: Repeated Tramadol administration resulted in rats behavioral changes( restlessness, irritability defensive aggressive reactions) and produced decreased dopamine levels and significant brain damage in the histopathological and immunohistochemical study that increased with increased period of intake (The maximum damage was recorded in group III with two months tramadol administration, varying degrees of recovery after stoppage of intake were noted in Group V and more improvement by Lofexidine treatment in Group IV). Conclusions: Repeated Tramadol administration causes degenerative changes on the rat brain which increased with increasing the period of this administration. Some improvement was detected after stoppage and more improvement with Lofexidine treatment in withdrawal period.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18310.html}, eprint = {https://ajfm.journals.ekb.eg/article_18310_19493c29d5a2fd894856bb8a0a772a92.pdf} } @article { author = {Elfeky, Ahmed and Moharm, Ismail and El Aswad, Bahaa}, title = {Role of House Fly in Determination of Post-Mortem Interval: An Experimental Study in Albino Rats}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {133-143}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18311}, abstract = {The potential for contributions of entomology to legal investigations has been known for at least 700 years, but only within the last two decades or so has entomology been defined as a discrete field of forensic science .There are many ways that insects can be used to help in solving a crime, but the primary purpose of forensic entomology is estimating time passed since death. Because blow flies arrive earlier in the decomposition process, they provide the most accurate estimation of time since death. House flies (Musca domestica Linnaeus) are medically and forensically important flies. The aim of this study was to investigate time passed since death according to different stages of house fly life cycle with time variations over months of the year. Materials and methods: 120 mature male albino rats were used, 2 rats were scarified every 6 days and left exposed to houseflies, the different stages of the fly life cycle in relation to different postmortem intervals and represented time were recorded, photographed and statistically analyzed. Results: There is a highly significant statistical difference between the duration of the presence  of the different stages housefly life cycle (eggs, 1st, 2nd, 3rd larval instars light colored (1st stage) and dark colored pupae(2nd stage) through different months of the year which was shorten in hot months of the year (August (9.6±1.57 h), July (1.5±0.52d), July (3.3±0.4d), August (7.6±0.69d), August (10.4±0.69d) and August (12.3±1.15d) respectively) and much prolonged in cold months of the year (January (27.2±2.85h) , January (3.6±0.51d), January (8.2±1.61d), Feb (14.1±1.52d), January (16.0±1.49d) , and January (21.2±1.22d) respectively). The results showed that time after death could be estimated from certain forms of housefly stage and every stage denote the time with consideration to seasonal temperature state. There is statistically difference between the duration of the presence (p.m. interval) of the different stages of housefly life cycle through different months of the year which was shorten in hot months and much prolonged in cold months.Conclusion: postmortem interval could be determined through the presented forms of the housefly developmental stage in and around the dead body with consideration of presented date of observation.}, keywords = {}, url = {https://ajfm.journals.ekb.eg/article_18311.html}, eprint = {https://ajfm.journals.ekb.eg/article_18311_559ff1e440a137b3e53b968e5a4e090e.pdf} } @article { author = {Khalaf, Mohamed and Abbas, Mohamed and Saleh, Samira}, title = {Pancreatic Dysfunction Associated With Severe Acute Anticholinesterase Insecticide Poisoning In Adults}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {144-148}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18312}, abstract = {Background: The current study was carried out to study the effect of severe acute organophosphate compounds (OP) toxicity on the pancreatic profile in adults. Subjects and Methods: Six ml of venous blood were drawn from 260 patients (18-52 years) with severe acute  OP toxicity who were admitted to the intensive care unit of Minia Poisoning Control Centre (PCC) during the period from May the 1st, 2012 to April, the 30th, 2014, and also from 20 healthy adults of the same age group acting as control. Blood samples were analyzed for: Pseudocholinestrase (PChE), serum insulin, serum α-amylase and serum lipase. Results: PChE level in intoxicated patients on the day of admission was highly significant decreased when compared with control. There was highly significant increase in the serum levels of amylase and lipase in intoxicated patients as compared to normal control group. In addition, there was highly significant increase in blood glucose level in intoxicated patients as compared with control group while there was no significant effect on the serum insulin level. A significant correlation was found between the degree of PChE inhibition and the elevation of serum amylase, lipase and serum glucose level. Conclusion: acute pancreatitis was evident in severe cases of OP intoxication on the day of admission, also OP -induced hyperglycemia is evident and most probably due to other cause rather than hypoinsulinemia.}, keywords = {Anticholinesterase,insecticide,Pancreatic dysfunction,amylase,Lipase,Insulin,hyperglycemia}, url = {https://ajfm.journals.ekb.eg/article_18312.html}, eprint = {https://ajfm.journals.ekb.eg/article_18312_dec13d19866a9ace64878ddae4486dde.pdf} } @article { author = {Tawfik, Hany and Hafiz, Rabab}, title = {Predictors of Clinical Decision Rule in Hydrocarbon Intoxicated Cases Admitted to Poison Control Center Ain Shams University Hospitals during 2015-2016}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {149-159}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18313}, abstract = {Hydrocarbon toxicity is a common cause of death among cases admitted to poison control centers due to its dangerous complications. The Aim of this study is to derive a clinical decision rule and to identify predictors of outcome after hydrocarbon poisoning. Methods: The prospective study included 674  cases admitted to the PCC ASU hospitals during the years 2015 – 2016. All cases subjected to full history ,clinical data and detection of acid base status by measuring ABG. Emergency interferences were evaluated. Results:563 cases  were due to kerosene poisoning,111 cases were due to benzene poisoning  .There was significant difference between the two types of hydrocarbon poisoning regarding admission,while there was no significant difference regarding death, mechanical ventilation and CNS abnormalities.  98.5% of cases lived,1.5% died. 33.5%of cases were in the age group >1 - ≤2 years,  17.7% >18 - ≤40years, all dead cases were children and 40%  of deaths were in the age group (>2 - ≤3years).Most of cases were males(65%) without significant difference between both genders. 71.2% were accidental, 28.5%were suicidal and 0.3% were criminal mode of toxicity. 77.6% used oral route, 15% were dermal and 7.4% were by injection. 88.6% of cases needed observasion in the ER for <6h, 4.7% admitted to the inpatient word,6.7% admitted to ICU.5.6% of cases admitted for 1 day, 3% for 2 days, 1.5% for 3 days, 0.7% admitted for 1 week and  0.6% for >1week. 12 cases needed endotracheal intubation and mechanical ventilation, 5 cases were shocked and needed dopamine as vasopressor, 31 cases received corticosteroid, 45 cases received bronchodilator by nebulizer and all cases received O2 therapy and antibiotics. Of symptomatic survived  cases, 66% , 70%,67%,46%,9% and 1.5%  had hyperthermia, tachycardia ,respiratory distress, acidosis, CNS abnormalities and hypotension respectively. All dead cases had hyperthermia, tachycardia, respiratory distress, acidosis and 50% had hypotension and 60% had CNS abnormalities.Lastly, Mchanical ventilation was used in 3% of symptomatic survived group and 100% of the dead group. The group of deaths showed significant predominance of hyperthermia, tachycardia, hypotension, respiratory distress, CNS abnormalities, acidosis and need of mechanical ventilation when compared with the survivors group. The Logistic regression analysis revealed that hypotension, CNS abnormalities, acidosis and need of mechanical ventilation all are predictors of in-hospital mortality Conclusion: Hydrocarbon poisoning is common oral accidental toxicity among children in the age group >1 - ≤2 years .Predictors of fatal outcome are: children especially the age group >2 - ≤3 years, hypotension, CNS abnormalities, acidosis, respiratory distress, hyperthermia and tachycardia. Recommendations: Any case presented with the previously mentioned predictors should be considered as a high risk group for proper management and in order to decrease risk of fatalities.  Preventive measures should be done as awareness of parents about hydrocarbon toxicity, proper packing and storage of such dangerous materials.}, keywords = {Hydrocarbon,hyperthermia,tachycardia,hypotension,respiratory distress,CNS abnormalities,Acidosis}, url = {https://ajfm.journals.ekb.eg/article_18313.html}, eprint = {https://ajfm.journals.ekb.eg/article_18313_9b4607e7eed356cb7c698799823f5d87.pdf} } @article { author = {Sweilum, Ola and El Farouny, Reham}, title = {Pattern of Flail Chest Injury Secondary to Blunt Chest Trauma in Menoufia University Hospital (a Prospective Study)}, journal = {Ain Shams Journal of Forensic Medicine and Clinical Toxicology}, volume = {28}, number = {1}, pages = {160-166}, year = {2017}, publisher = {Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department}, issn = {1687-1030}, eissn = {2636-3356}, doi = {10.21608/ajfm.2017.18314}, abstract = {Flail chest injury is a condition usually resulting from a blunt trauma with a great force to the chest wall causing multiple rib fractures with segmental chest wall instability and leading to significant morbidity and mortality. Flail chest is frequently accompanied by other injuries. This study aims to assess the pattern of traumatic flail chest injury secondary to blunt chest trauma, in patients admitted to Menoufia University Hospital. Demographic criteriaof the patients,type and cause of trauma, data about duration of intensive care unit (ICU) stay, hospital stay, time interval to returnto work (complete recovery), occurrence of chest wall deformity, new injury severity score (NISS) and mortality rate, were all collected and studied. Conclusion: Flail chest injury represented 8.2% of all blunt chest trauma admitted to Menoufia University Hospital during the period of thisstudy. Road traffic accident (RTA) is considered the first cause of flail chest injury. The NISS is a significant way for correlation between the condition of the patients and the mortality rate}, keywords = {Flail chest,NISS,mortality,Road traffic accidents}, url = {https://ajfm.journals.ekb.eg/article_18314.html}, eprint = {https://ajfm.journals.ekb.eg/article_18314_d4405f183d4d86e3354155989849a813.pdf} }