ORIGINAL_ARTICLE
Morbidity and Mortality Predictors in Patients with Acute Tricyclic Antidepressant Toxicity
Tricyclic antidepressant (TCA) drugs are well known medications for depression, nocturnal enuresis and chronic pain. The severe morbidity and mortality associated with these drugs is well documented due to their cardiovascular and neurological toxicity. The aim of this study is to predict the morbidity and mortality factors in patients with acute TCA toxicity in relation to outcome toxicity measures (coma grade, ECG findings and duration of hospitalization) and to detect early evidence of cardiotoxicity using quantitative analysis of Troponin I. The present study was conducted on 100 patients presented to the PCC of Ain Shams University hospitals during the period from October 2009 to March 2011 with acute TCA toxicity of both sex and different ages. Patients were divided into 3 groups according to poisoning severity score (PSS) into group I (mild toxicity), group II (moderate toxicity) and group III (severe toxicity). All subjects were examined for:I) sociodemographic data;II) medical evaluation; III) investigations including arterial blood gases, serum electrolytes (Na and K), random blood sugar, serum troponin I level and electrocardiography (ECG) monitoring; IV) outcome including coma grade, ECG findings and duration of hospitalization. Risk factors (sex, coingestion, time delay and previous attempts) had no effect on difference between groups, while age and mode of toxicity were significantly different (p-value <0.05) between groups. Type of TCA ingested had significant effect (p-value <0.05) on both coma grade and endotracheal intubation. The dose of TCA had a highly significant effect (p-value <0.0001) on severity of toxicity, coma grade and ECG findings. ADORA criteria (QRS interval >100 msec, cardiac dysrhythmias, altered mental status, seizures, respiratory depression and hypotension) had a high significant effect (p-value <0.0001) on ECG findings, coma grade and type of TCA ingested. The risk factors for intubation in the present study were evident in patients with dothiepin or amitriptyline ingestion, old age, abnormal ECG, deep coma, seizure and two or more ADORA criteria. ECG changes had no relation (P- value >0.05) with all risk factors except for the age and the mode of poisoning. Duration of hospitalization (DOH) had a highly significant (p-value < 0.001) relation with the severity of toxicity in the studied groups, ECG findings and coma grade. Grade of coma had no relation (P-value >0.05) with all risk factors except for the dose of TCA. Level of troponin I was non evident in predicting cardiotoxicity. Conclusion: Reed's coma scale is an indicator either for evaluation of poisoning severity in individual TCAs or for assessment of relative toxicity between different types of TCAs. ECG findings especially QRS duration is an easy, cheap and available diagnostic tool in Emergency Room (ER) to help not only in diagnosing TCA poisoning but also in predicting its severity and occurrence of other complications.
https://ajfm.journals.ekb.eg/article_19381_55e6e2a3575d82c567d388b3cdcdba90.pdf
2013-01-01
1
9
10.21608/ajfm.2013.19381
TCA
cardiotoxicity
Electrocardiogram
Reed's coma scale
Duration of hospitalization
Amro
Saleh
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Fayoum University, Fayoum
AUTHOR
Ghada
El-Galad
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Fayoum University, Fayoum
AUTHOR
Mohy
El-Masry
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
Abla
Abd El-Rhman
4
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Cairo University, Cairo
AUTHOR
Mervat
Abd El-Salam
5
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Cairo University, Cairo
AUTHOR
ORIGINAL_ARTICLE
2011 Annual Report of the Poison Control Centre of Ain Shams University Hospital, Cairo, Egypt
Background: Poisoning is a growing public concern and real potential threat to the Egyptian community. The Poison Control centre (PCC), Ain Shams University, the first and larger in Egypt and the Middle East managed and treated more than 21.000 patients on the year 2011. The aim of the study is to highlight the profile of poisoning in Poison Control Center Ain Shams University (Egypt) to facilitate the recognition of the different threats to which the Egyptian community is exposed. Methods: Computerized data of a specially designed program comprised demographic in addition to clinical and management data of the poisoning cases received in PCC on the year 2011. A descriptive analysis and statistics of the medical records is accomplished. Results: Overall, 21.550 poison exposure cases were recorded. Children under 7 years old were involved in 23.9% of cases, patients at group of age 15-40 years involved in 62.8%. In 49% of patients, the poisoning was deliberate. Attempted suicide was definitely more common in females and started as early as the pubertal age. Substances most frequently involved were food poisoning, organophosphate, cleaning products and tramadol that almost doubled yearly over the last few years. Clinical severity was mild in 75.1% of cases, 20.7% was moderate and 4.2% was severe. Sixty one fatalities were recorded. Management of these cases was described Conclusions: Specific attention has been drawn towards attempted suicide in adolescents and early adulthood, the younger age of drug users and the progressive increase of some of drugs of abuse and the changing pattern of poisoning over years.
https://ajfm.journals.ekb.eg/article_19382_a552035dee14fabdaec10f6c7dd0affb.pdf
2013-01-01
10
17
10.21608/ajfm.2013.19382
Mohy
El Masry
1
Poison Control Center, Ain Shams University Hospitals, Cairo, Egypt
AUTHOR
Hany
Tawfik
2
Poison Control Center, Ain Shams University Hospitals, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Role of Coenzyme Q10 against Cyclosporine-A Induced Cardiotoxicity in Adult Male Albino Rats (Histological and Toxicological Study)
Cyclosporine-A (CsA) has a potent immunosuppressive activity and is commonly used as anti-rejection drug after organ transplantation and for treatment of some autoimmune diseases. Several toxic effects on the cardiovascular system have been reported with CsA therapy. The toxicity induced by CsA is attributed to the formation of free oxygen radicals. Coenzyme Q10 (CoQ10) is a fat soluble, vitamin-like benzoquinone compound that functions primarily as an antioxidant, and a cofactor in the oxidative phosphorylation processes. The level of CoQ10 is reduced under the conditions of illness for example after renal transplantation. The present study was done aiming to detect the possible morphological and structural changes that may occur in the cardiac muscle of the adult male albino rats duo to CsA therapy and to test the protective effect of CoQ10 against CsA-induced cardiotoxicity. Thirty adult male albino rats were used in this study. They were classified into 3 groups and orally given the following materials for 28 days: Group (1) (Control group): that was further subdivided into 2 equal subgroups, each of 5 animals: subgroup 1a: received olive oil 1 ml/kg. Subgroup 1b: (CoQ10 group): received 5 mg/kg/day of CoQ10. Group (2) (CsA-treated group): The rats received 25 mg/kg/day of CsA. Group (3)(CoQ10 & CsA treated group): The rats were treated with the previously mentioned doses of both CoQ10 and CsA. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded three times per week. At the time of sacrifice, the hearts were dissected out and processed for light and electron microscopic examination. Oral administration of CsA, produced a significant (p < 0.05) elevation in SBP, DBP, and HR in comparison to the control group. Treatment with CoQ10 significantly (p < 0.05) reduced the increments in arterial blood pressure and heart rate. However, the recorded values were still significantly (p < 0.05) higher than that of the control group. The light microscopic study of sections of cardiac muscle of CsA-treated adult male albino rats showed increase in the number of infiltrated cells and disorganization of myocardial fibers with increase in the amount of connective tissue and interstitial fibrosis with perinuclear cytoplasmic vacuolation and decrease in the amount of myofilaments. Electron microscopy showed distension of the Z lines with disintegration of some of them, loss of some microfilaments and disorganized intercalated discs. CoQ10 partially prevented most of the pathological changes revealed by the light and electron microscope. From the above mentioned results we could conclude that treatment with CoQ10 partially prevented the CsA-induced cardiotoxicity in adult male albino rats. We could recommend using CoQ10 during CsA therapy to prevent its cardiotoxicity.
https://ajfm.journals.ekb.eg/article_19383_77eee18e937d335cbfe26b650dc524a6.pdf
2013-01-01
18
29
10.21608/ajfm.2013.19383
cyclosporine-A
Coenzyme Q10
cardiotoxicity
antioxidants
Gehan
Ahmed
1
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Siam
M.G
2
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Sahar
Shaban
3
Histology and Cell Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Ibrahim
Awwad
4
Pharmacology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt; College of pharmacy, Qassim University, KSA
AUTHOR
ORIGINAL_ARTICLE
Can Foot Length be used as a Tool for Sex and Stature Determination among People Sample from Upper Egypt?
Sex and stature identification from different parts of the body help in solving crime mysteries related to human identity. Estimation of stature becomes equally important along with other parameters like age and sex. The aim of this study was to determine whether foot length can be used in accurate sex and stature identification among people sample from Upper Egyptor not. The study was conducted onone hundred and twenty healthy Egyptian subjects from Minia city; 67 males with age ranged from 22- 40 years and 53 females with age ranged from 20- 38 years. Foot length and stature were accurately measured for each case by right angle triangle and weight and height scales indicator (health care provider). The collected data were statistically analyzed. The results showed that males had significantly greater mean value for foot length than females. Correct sex can be predicted from foot length with 90% accuracy. For all subjects; foot length showed strong positive correlation coefficients with stature. Males had slightly higher but moderate correlation coefficients than females. A regression formula was designed to calculate stature for Egyptians. It was concluded that foot length could be relied on to determine sex and stature accurately among Egyptians.
https://ajfm.journals.ekb.eg/article_19384_38f7f10537d7d9dbe6fd96fd417b5b3d.pdf
2013-01-01
30
37
10.21608/ajfm.2013.19384
Foot length
Stature
sex determination
Egyptians
Morid
Hanna
1
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Ghada
Eshak
2
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Eman
Mostafa
3
Public health and Preventive Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Possible Ameliorative Effect of Melatonin on Oxidative Stress and Delayed Apoptosis in Rat's Brain Exposed to Deltamethrin
Deltamethrin is a broad spectrum, non- cumulative, fast acting neurotoxic synthetic pyrethroid. The aim of this study was to analyze the neurotoxicity induced by deltamethrin which caused neuro-oxidative stress, histopathological & immunohistochemical changes in adult male Wistar rats and to evaluate the possible ameliorative effect of melatonin. Melatonin (10mg/Kg, once daily), ethanol 99% (1 ml/kg, once daily), corn oil (0.005ml/Kg, once daily), deltamethrin (12.5mg/Kg, once daily), and melatonin (10mg/Kg) + deltamethrin (12.5mg/Kg) combination were given to rats I.P for 8 weeks. By the end of 8th week, rats given deltamethrin alone had significantly higher MDA (malondialdehyde), lower reduced glutathione and catalase levels in the hippocampus and lower ACTH (adrenocortocotrophic hormone) & cortisol hormone levels than the control group. Co- treatment of deltamethrin with melatonin had an ameliorative effect on the previous parameters. Light microscopic investigations revealed that deltamethrin caused marked degenerative changes in the hippocampus & pituitary gland of rats. Mild degenerative changes were observed in rats received deltamethrin + melatonin combination. Immunohistochemical studies revealed that deltamethrin caused marked expression of P-53 (a marker for apoptosis) in the hippocampus & pituitary gland. Mild expression of P-53 was observed in rats received deltamethrin & melatonin combination. Thus, deltamethrin can induce oxidative damage in rat brain & melatonin has an ameliorative effect against this damage.
https://ajfm.journals.ekb.eg/article_19385_41b964456d166ee4bc857ba1ad4cae2d.pdf
2013-01-01
38
50
10.21608/ajfm.2013.19385
Deltamethrin
Neurotoxicity
histopathology
Immunohistochemistry
Melatonin
Shereen
El-sherbeney
1
Forensic Medicine and Clinical Toxicology department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Hala
Ahmed
2
Forensic Medicine and Clinical Toxicology department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Nashwa
El-Tahawy
3
Histology department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Ahlam
Abdalla
4
Biochemistry department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Correlation between Serum Digoxin Concentration and Impaired Renal or/and Hepatic Functions in Cardiac Patients
Digitalis toxicity is characterized by gastrointestinal, neurologic and non-specific cardiac manifestations with striking similarities to the clinical picture of primary congestive heart failure (CHF) making diagnosis of chronic digitalis toxicity in particular relatively difficult. Serum digoxin measurement is today becoming a crucial subject of concern because of the narrow therapeutic window of digoxin besides increasing mortality and morbidity due to its intoxication. The present work is focused on evaluating the clinical value of serum digoxin concentrations (SDCs) in relation to appropriate assessment of chronic digitalis toxicity in cardiac patients. The current study was conducted in the form of a cross-sectional electronic medical record (EMR) review study of patients presently on continuous prescriptions for digoxin with there being zero gaps in therapy for at least 10 days prior to SDC result entered into the Online Analytical Toxicology Request Result (OTARR). There was also a complete clinical examination report as well as a review of the results of serum potassium concentration, liver and kidney functions. This study comprised of 217 adult patients (78 males and 139 females) with mean age ± SD (63.18 ±19 years). There were high concentrations of digoxin which led to unstable renal and liver functions. About 12% of the total cases showed an abnormal serum potassium concentration of electrolyte fluctuations. From this, one can conclude that a regular monitoring of serum digoxin concentration would be seen as mandatory for the verification of digoxin’s therapeutic effects and then the subsequent prevention and early diagnosis of chronic toxicity
https://ajfm.journals.ekb.eg/article_19386_6596d7d87acb1ddc5704de72d935355f.pdf
2013-01-01
51
60
10.21608/ajfm.2013.19386
serum digoxin concentration
Cardiac patients
digitalis toxicity
Ahmed
Ragab
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Mansoura University, Mansoura, Egypt Dammam Regional Poison Control Center, Eastern Region, KSA
AUTHOR
Maha
Al-Mazroua
2
Dammam Regional Poison Control Center, Eastern Region, KSA
AUTHOR
Rania
Abdel-Rahman
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Some Household Products (Kerosene, Insecticide and Perfume) on Arthropods Colonization on Rats' Cadavers
The most common task of a forensic entomologist is to determine an accurate minimum post-mortem interval (PMI) using necrophagous fly larvae found on carrion. The presence of repellent substances on cadaver is not generally well informed and can be difficult to detect. This study aimed to evaluate the effect of some common household products (kerosene, insecticide, perfume) on arthropods colonization on rats' cadavers including their effect on the type of species, and first insect’s arrival time. As well as relation of the stage of decomposition to both the type of species and first insect’s arrival time. The experiment was performed during spring season. Twenty healthy rat carrions (200 ± 50 g) were randomly divided into four groups; each group was consisted of five rats. Group (1) served as a control, was kept without any substance poured on it. Group 2, Kerosene poured rats, where kerosene was splashed on each rat. Group 3, Insecticide poured rats, where flying insects killer was splashed on each rat. Lastly, 4th group, Perfume poured rats, where perfume was splashed on each one. The presence of arthropods was checked at regular intervals during the period of experiment. The use of these products didn't only affect the time of first insect's arrival but also type of insects and stage of decomposition. In control group, during the fresh stage of decomposition, the first insects appeared and the most abundant orders were Diptera of families Sarcophagidae, Calliphoridae and Muscidae, followed by Coleoptera (Dermestidae) during the bloat and wet decomposition stages.All presented species were collected from the control group, while Musca domestica and Dermestes frischiididn't appear in any of the poured cadavers (Groups 2, 3, 4) till the end of the experiment. Colonisation delay was for (96.5h ± 0.55) in rats of group (2), (3.5 h ±0.3) in rats of group (3) and (4.5 h ±S.D. 0.4) in rats of group (4). Distinct delay in decomposition stages was observed in kerosene poured rats (Group 2. These results together confirm the repellent effect of some household products on flies and the necessity for forensic entomologists to consider this hypothesis when estimating the PMI.
https://ajfm.journals.ekb.eg/article_19387_efc37cb964560007b71616776a831f4d.pdf
2013-01-01
61
71
10.21608/ajfm.2013.19387
Forensic entomology
Postmortem interval
Flies
Nagwa
Ghandour
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Rasha
Attia
2
Department of Medical Parasitology, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Possible Cardiopulmonary and Cerebral Toxic Effects of Sildenafil Citrate (Viagra) on Adult Male Albino Rats
It has been asked whether sildenafil safety live up to its expectations or not. Most of the previous studies stated that sildenafil is safe and well tolerated by most users without serious effects. The drug has attained great popularity and widely used even without prescription or as one of the over the counter preparation. So, this work was carried out to assess the possible cardio pulmonary and cerebral toxicities of sildenafil citrate in adult male albino rats. The study included three parts; acute, short term and chronic toxicity studies. At the end of each experimental study, the animals were subjected to ECG and blood pressure recording. Then blood samples were collected for estimation of the levels of enzymes relevant to cardiotoxicity (CPK, CPKMB, LDH and SGOT). Furthermore, histopathological examination of the rats׳ heart, lung and brain was carried out by light microscopy. The results showed evident cardiac toxicity in the form of ECG and blood pressure changes as well as elevated cardiac enzymes. Histopathological changes in the chronic toxicity group were more severe and extensive than either acute or short term study groups. So, it can be concluded that sildenafil caused biochemical and histopathological alterations in the heart along with histopathological changes in the lung and brain that correlated with the duration of administration. It is recommended that sildenafil should be used only on medical prescription. Also, serum levels of CPK, CPKMB, LDH and ECG recording are sensitive indicators for sildenafil induced cardiac toxicity.
https://ajfm.journals.ekb.eg/article_19388_94f172816cca565ccb804ceee79feee4.pdf
2013-01-01
72
91
10.21608/ajfm.2013.19388
Heba
Mohammed
1
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Nabil
Rezk
2
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Zeinab
Abdel Haleem
3
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Safaa
Shaker
4
Histology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Medico-Legal Aspects of Permanent Infirmities as a Sequel of Different Types of Injuries (A Retrospective Study in Assiut Governorate, Egypt)
Objective: To describe the percentage of permanent infirmities, the size of the problem in Assiut governorate during 2007 and 2008. Methods: A retrospective study of all cases of injuries lead to permanent infirmity from 1 January 2007 to 31 December 2008 through manual review of all files of Assiut Medico-legal department of Ministry of Justice. Results: The total cases of injuries with permanent infirmity were 144(7.28%). The highest percent was in age group >21-30 (43.75%) followed by age group >31-40 years (25.69%). Male cases represented (92.36%) while females represented (7.64%). Educated victims represented (37.5%) where illiterate victims represented (62.5%).The highest percent of victims were farmers (68.75%). Most of victims were from rural areas (93.05%). Blunt instruments were responsible for (59.72%) followed by sharp instruments (21.53%) and firearms (18.75%). Extremities, represented (38.19%) of cases, of which (15.28%) due to nerve injuries while (22.91%) were due to bone injuries. Head were the second site (32.64%), followed by eye (10.42%), abdomen (8.33%) ear (5.55%) and nose (4.86%). The cause of injury was due to criminal assault (81.94%), accidental (18.06%), while there were no suicidal cases that ended in permanent infirmities.
https://ajfm.journals.ekb.eg/article_19389_30769ca20d1e62f901e83bc6fbc0eec9.pdf
2013-01-01
92
98
10.21608/ajfm.2013.19389
Medico-legal
Forensic medicine
Disability
permanent infirmities
injuries
Assiut
Egypt
Randa
Abd El-Hady
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Hayam
Thabet
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Nagwa
Ghandour
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Amr
Mandor
4
Assiut Forensic Department of Ministry of Justice, Assiut, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Toxicological Effects Induced by Chlorpyrifos Administration on Thyroid and Suprarenal Glands in Adult Male Albino Rats
Chlorpyrifos (CPF) is a broad spectrum organophosphorus (OP) insecticide used in the control of a wide variety of insects. Its wide use in agriculture raises a growing public concern about the accumulation of these insecticides in food products and water supplies. The aim of this work was to evaluate the toxicological effect of CPF on thyroid and suprarenal glands. Twenty adult male albino rats were used in this work and divided into two groups: control (group І) and CPF-treated (group ІІ). The treated group received CPF daily in a dose of 5.4 mg/kg orally for 28 days. Serum T3, T4, TSH, corticosterone and malondialdehyde (MDA) were determined. The thyroid and suprarenal glands were evaluated for oxidative stress and microscopically. Results showed that CPF induced a significant decrease of serum T3 and T4 and a significant increase of serum TSH. Serum corticosterone was increased but statistically insignificant. Serum and tissues MDA were significantly increased. Histological examination of thyroid gland revealed that most follicles appeared degenerated with empty lumen due to decrease colloid, obvious exfoliation of the follicular epithelial cells and vascular congestion. Adrenals showed increased vacuolations of zona granulosa cells. Thus, it was concluded that chlorpyrifos exposure for 28 days causes damage to thyroid and suprarenal glands.
https://ajfm.journals.ekb.eg/article_19390_87b8b9ce2ddef122f5db88e407cbbfc6.pdf
2013-01-01
99
105
10.21608/ajfm.2013.19390
Melad
Paules
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Jaklin
Zaher
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
Esam
Hafez
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Minia University, Minia, Egypt.
AUTHOR
Nashoa
El-Tahawy
4
Histology Department, Faculty of Medicine, Minia University, Minia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Sub-Chronic Effects of Gibberellic Acid Repeated Exposure on the Testis of Adult Albino Rats (Biochemical, Histopathological and Immunohistochemical Study)
Objective: Gibberellic acid (GA3) is a plant growth regulator (PGR), largely used in agriculture in many countries including Egypt. The purpose of this study was to investigate the effects of sub-chronic toxicity (8 weeks) of GA3 on testicular function and structure in adult albino rats, and to determine the effects of withholding of GA3 on the affected parameters for another 8 weeks of follow up period. Material and Methods: Forty adult male albino rats were equally divided into four groups; the first group was used as a negative control, the second group received 1ml of 1N NaOH (positive control group), the third group received 75 ppm of GA3 daily in drinking water for 8 weeks (GA3 group), and the last group received the same treatment as the third group for 8 weeks then was left without any treatment for another 8 weeks (recovery group). At the end of the experimental period, rats were sacrificed and the testes were examined by light and transmission electron microscope for detecting the histopathological changes, examination of sperm viability & count and measuring testicular malondialdhyde. Testicular sections were examined immunohistochemically for the detection of the anti-apoptotic Bcl-2 protein. Results: In GA3 treated group, histopathological changes were in the form of regression in spermatogenesis using light microscope, while electron microscopic examination revealed apoptotic changes in the Leydig cells and distortion of the adluminal compartment. These changes were accompanied by significant elevation in testicular malondialdehyde, while Bcl-2 showed week immunoreactions in the layers of spermatids. After the 8 weeks of GA3 withholding, significant improvement in the testicular function and structure with improvement of Bcl-2 immunoreaction. Conclusion: From the previous results, it can be concluded that GA3 exposure can induce reversible toxic changes in the testes of adult albino rats on sub-chronic exposures.
https://ajfm.journals.ekb.eg/article_19391_1073b0ddca418315a17944c7d364b001.pdf
2013-01-01
106
115
10.21608/ajfm.2013.19391
gibberellic acid
testis
spermatogenesis
Bcl-2
Rats
Fatma
Farahat
1
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Nermien
Ibrahim
2
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Sherien
Elkhateeb
3
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Azza
Shehata
4
Departments of Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
AUTHOR
ORIGINAL_ARTICLE
دراسة طرق تحرير التقارير الطبية الشرعية الأولية الصادرة من بعض المستشفيات بمحافظة الغربية و المقدمة للجهات القضائية
يعتبر التقرير الطبي الشرعي الأولي من بين المستندات الهامة المقدمة للنيابة العامة والقضاء في العديد من القضايا مثل قضايا الضرب والاغتصاب بل وقد يکون المستند والشاهد الفني الوحيد في بعض القضايا. ويهدف هذا البحث إلى دراسة الطرق التي يتم بها تحرير التقارير الطبية الشرعية الأولية ومعرفة الأخطاء الموجودة بها واقتراح اتفاقية موحدة في فحص الحالات الطبية الشرعية وهيکل مناسب لکتابة التقرير الطبي الشرعي الأولي لتحقيق طلبات النيابة العامة والمحکمة طبقا للقانون المصري ليتم تطبيقه في جميع المستشفيات المصرح لها بإعطاء مثل هذه التقارير. وقد تم دراسة خمسمائة تقرير طبي شرعي أولي تم تحريرها في مستشفى طنطا الجامعي وبعض المستشفيات التابعة لوزارة الصحة بالغربية من حيث الجزء الإداري الخاص بالتقارير(اسم المستشفى الصادر منها التقرير – تاريخ وساعة إصدار التقارير- بيانات المصاب -الجهة الطالبة للتقرير- سبب الإصابة – توقيع مدير المستشفى –خاتم المستشفى) والجزء الفني بالتقارير من حيث (بيانات الفحص العام للمصاب – بيانات الفحص الموضعي للإصابات – الإجراءات التشخيصية والعلاجية – العروضات والتحويلات) و الرأي الطبي فيما يتعلق بالوقت اللازم للشفاء وبيانات الطبيب المناظر للحالة والمحرر للتقرير. وقد توصلت الدراسة إلى وجود بعض نقاط قصور من إهمال تسجيل بعض البيانات بالتقرير ووجود بعض الأخطاء الإدارية والفنية في التقارير الطبية الشرعية الأولية التي تمت دراستها. و بدراسة نقاط القصور وبالرجوع إلى المراجع العلمية وإلى تعليمات النيابة العامة بجمهورية مصر العربية تم اقتراح برتوکول لفحص الحالات الطبية الشرعية کما تم تصميم مقترح نموذج لکتابة التقرير الطبي الشرعي الأولي يغطى نقاط القصور في التقارير الحالية.
https://ajfm.journals.ekb.eg/article_19395_69d2fe928a94174cbfea6062abb790b7.pdf
2013-01-01
116
134
10.21608/ajfm.2013.19395
منى
الجوهري
1
قسم الطب الشرعي و السموم الإکلينيکية – کلية الطب – جامعة طنطا – طنطا – مصر.
AUTHOR
رباب
الکيلاني
2
قسم الطب الشرعي و السموم الإکلينيکية – کلية الطب – جامعة طنطا – طنطا – مصر.
AUTHOR
أبو اليزيد
فؤاد
3
قسم الطب الشرعي و السموم الإکلينيکية – کلية الطب – جامعة طنطا – طنطا – مصر.
AUTHOR
سماح
البسطويسى
4
قسم الطب الشرعي و السموم الإکلينيکية – کلية الطب – جامعة طنطا – طنطا – مصر.
AUTHOR
ORIGINAL_ARTICLE
Acute and Subchronic Tramadol Toxicity on Brain and Spinal Cord of Male Albino Rats
Tramadol is one of typical centrally acting opioids. It is indicated for management of moderate to severe pain. Now it is considered to be the most widely sold analgesic in the world. Aim: To detect the effect of subchronic administration of tramadol on brain and spinal cord of the experimental animals as histopathologic changes in brain cells. Methods: Sixty adult male albino rats were divided into three equal groups each was 20 rats. Control group, group I that received Tramadol orally at increasing doses 1/10 LD50, 1/5 LD50 and lastly four times the initial dose for the first, second and third months respectively, and Group II that received 1/10 LD50 for one month. All rats were scarified after 24 hours of the last dose at the end of each experimental period under ether anesthesia. Craniotomy and laminectomy were performed for histopathological studies. The presences of number of red neurons which are histological marker of apoptosis were investigated in brain and spinal cord. Results: The number of small sized neurons was greater in group II than in group I. There was statistical difference regarding neuopil density and color staining among three groups. Neuopil was lighter in staining and less dense in groups I and II comparing to control (p≤0.002 and p≤0.001) using SPSS program. The highest number of red neurons was found in hippocampal region followed by occipital and frontal regions. The abnormalities regions in the spinal cord tissue were less than those in the brain tissue. Conclusions: chronic use of Tramadolis an important factor responsible for histopathological changes inneurons.
https://ajfm.journals.ekb.eg/article_19397_cd885a2a1a5b6770478cc0b02fc46b68.pdf
2013-01-01
135
145
10.21608/ajfm.2013.19397
Hala
Fathy
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt.
AUTHOR
Heba
Yassa
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt.
AUTHOR
Doaa
Almaz
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt.
AUTHOR
Rabab
Mohamed
4
Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Titanium-Induced Histological and Immunohistochemical Alterations in Liver, Spleen, Lung and Kidney in Male Albino Rats
Different metals are increasingly used to manufacture implants, especially in the field of dentistry. Metallic implants of titanium are used therapeutically in biomedicine because of their high corrosion resistance and excellent biocompatibility when compared to more conventional stainless steels and cobalt-based alloys. However, no metal or alloy is completely inert. Thus the aim of the present study was to determine the histopathological and immuno-histochemical effects in some target organs of adult male albino rats induced by titanium exposure. This work was carried out on two groups: control group which included 10 rats and treated group which included 20 rats that received intraperitoneal injection of suspension of titanium dioxide (TiO2) in a dose of 150 mg/kg body weight (BW) per day for 45 days. Samples of liver, spleen, kidney, and lung were processed for histological examination. Cryostat sections of spleen samples from each group were stained with common lymphocytic antigen (CLA) for lymphocyte detection. Results revealed histopathological changes in the liver, spleen, lung and kidney of the treated group. The CLA staining of the spleen in the treated group revealed toxic alteration within the spleen, indicating that the immune system may be affected and so interfering in the body defense mechanism.
https://ajfm.journals.ekb.eg/article_19400_30b554ecba632531a1fc8b93fa8282ab.pdf
2013-01-01
146
157
10.21608/ajfm.2013.19400
Rabab
El Kelany
1
Forensic Medicine & Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
AUTHOR
Khaled
Moustafa
2
Histology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
AUTHOR
Ghada
El Mehy
3
Orthodontics Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Pattern of Acute Poisoning among Patients Admitted to Tanta Poison Control Center during 2012
Background: Acute poisoning remains a major publichealth problem and represents a frequent cause of admission in emergency units, especially in developing countries. Many studies must be focused on the different patterns of acute poisoning in patients admitted to poison control centers. So, the aim of this study is to characterize the poisoning cases admitted to poison control center, Tanta University Emergency Hospital, Egypt. Study design: All admitted acutely poisoned patients from January to December 2012 were evaluated retrospectively. Data of socio-demographic characteristics, time of admission, circumstances of poisoning, agents, route of exposure and mortality rate were collected from medical records of the hospital. During this period, 1104 patients were admitted. Results: Of the admitted patients, 57.1% were females and 42.9% were males. The majority (31.2%) of cases were in the age group between 1-10 years. Most poisonings were accidental (55.2%) while suicidal attempts were 44.8%. Females were 76.2% of all suicidal poisoning while males were 58.5% of all accidental poisoning. The most important agents used were therapeutic drugs (32.3%) especially sedatives and hypnotics (12.6%) followed by analgesics (9.24%) and CVS drugs (8.96%). Pesticides were the second common agents used (28.6%) of which organophosphates were the commonest (67.7%). Mortality rate was 0.5% which was due to suicidal attempts by pesticides. Conclusion: The study concluded that high rate of acute poisoning was between patients of age group between 1-10 years. Females were of high suicidal attempts than males, while males were predominant in accidental poisoning. The most commonly substances included are drugs and pesticides. Prevention strategies should be directed towards limiting access to the implicated substances involved in both accidental and suicidal poisoning.
https://ajfm.journals.ekb.eg/article_19402_09f81757a1b102925b95672aa128fcff.pdf
2013-01-01
158
169
10.21608/ajfm.2013.19402
Mona
Abo El- Noor
1
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Relation between Theophylline Serum Level with ECG Changes and Poison Severity Score (PSS) Among Some Theophylline Intoxicated Patients in Menofia Poison Control Center (MPCC) A Prospective Study
There are numerous toxins and drugs that can cause, in overdose, ECG changes, even in patients without history of cardiac pathology. Theophylline intoxication results in substantial morbidity and mortality, particularly in those with chronic overmedication. The aim of this work was to study ECG changes in cases of poisoning by theophylline overdose that were admitted to MPCC over 2011 and the relation between ECG changes, theophylline blood level and poison severity score. In this study, theophylline overdose patients admitted to MPCC in the period from 1st of January 2011 to 31st of December 2011 were included. The total patients' number was 44 patients. Most cases of the study were females (77.2%) in the age group of (20-<40) years (40.9%), mainly from rural side (65.9%). Regarding relation between theophylline serum level and clinical manifestations, a significant relation was found between serum level and each of vomiting and dizziness, where both were noticed with majority of cases of minimal and moderate toxicity serum level. Regarding poison severity score, exactly one half of moderate and severe cases had minimal toxicity serum level, and the other half had moderate toxicity level. A significant negative correlation between theophylline serum level and PCO2 was found. There was a non significant negative correlation between theophylline serum level and each of Na and K blood level. Concerning ECG changes, a significant relation was found between theophylline serum level and each of sinus tachycardia and second degree heart block.
https://ajfm.journals.ekb.eg/article_19404_aefc87323ee8b9879f4bfa495efe0af8.pdf
2013-01-01
170
179
10.21608/ajfm.2013.19404
Theophylline
poison
eCG
Poison Severity Score
Chemiluminescent immunoassay
Safaa
Amin
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt.
AUTHOR
Amira
El Seidy
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt.
AUTHOR
Samy
Hammad
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt.
AUTHOR
Nagwa
Habib
4
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Acute and Subchronic Toxic Effects of Thioridazine versus Pimozide on Liver, Kidney and Heart of Adult Male Albino Rats: Biochemical and Histological Study
Antipsychotic drugs are potent drugs that therapeutically modify behavior. They are widely used all over the world. This study was planned to compare the biochemical and histological alterations induced by acute and subchronic toxic effects of the typical antipsychotic drugs "Thioridazine (Melleril) and Pimozide (Orap)" on liver, kidney and heart of adult male albino rats. Animals were divided into two main groups. Group I "Acute Toxicity Group" included 18 rats that were divided equally into 3 subgroups; 6 rats each: subgroup Ia: served as control. Subgroup Ibreceived a single oral toxic dose of thioridazine (26.4 mg/100 gm B.W) and subgroup Icreceived a single oral toxic dose of pimozide (11 mg/100 gm B.W). Group II "Subchronic Toxicity Group" included 30 rats which were divided equally into 5 subgroups; 6 rats each that were given daily doses of the drugs orally for 12 weeks: Subgroup IIa: Served as control.Subgroup IIbreceived dose equal to 1/20 of LD50 of thioridazine (5.4 mg/100gm B.W), Subgroup IIc received dose equal to 1/10 of LD50 of thioridazine (10.8 mg/100 gm B.W).Subgroup IIdreceived dose equal to 1/50 of LD50 of pimozide (2.2 mg/100 gm B.W). Subgroup IIereceived dose equal to 1/25 of LD50 of pimozide (4.4 mg/100 gm B.W). At the end of the experiment, blood samples were taken for biochemical analysis of liver transaminases (serum AST, ALT levels), serum LDH, cholesterol level and kidney function tests (urea, creatinine, and uric acid levels). Sections from the liver, kidney and heart were subjected to H&E stain (those from liver and heart were also stained with Masson′s Trichrome). Mean sinusoidal area in liver sections, mean glomerular area in kidney sections and mean area % of collagen in ventricular sections. Results were compared statistically. Results of the acute study revealed significant elevation in liver enzymes and LDH of rats receiving both drugs as well as some morphological alterations in pimozide group. Biochemical changes in subchronic study showed significant elevation of liver enzymes and LDH in rats receiving both drugs at both doses. Cholesterol level increased significantly only with intake of pimozide (subgroups IId and IIe). Moreover, urea and creatinine levels increased significantly with the intake of the higher toxic dose of each drug (subgroups IIc and IIe). Concerning the histological assessment, lower toxic dose of thioridazine spared the liver and heart while affecting the kidney sections. Using the higher toxic dose of thioridazine as well as both doses of pimozide induced marked morphological alterations in all organs. In conclusion, both drugs tested in the current work proved to have definite toxic effects on the liver, kidney and heart. However, pimozide was more injurious and toxic than thioridazine. Thus, they should be prescribed under restricted conditions and periodic assessment of cardiac, hepatic and renal functions should be done detect early toxic effects.
https://ajfm.journals.ekb.eg/article_19407_e3ed651d59748271b50218219e895a33.pdf
2013-01-01
180
198
10.21608/ajfm.2013.19407
Thioridazine
pimozide
Antipsychotics
toxicity
histology
kidney
Liver
heart
urea
creatinine
AST
ALT
LDH
Cholesterol
Amany
Mohammed
1
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
AUTHOR
Noha
Afifi
2
Histology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Ameliorative Effect of Vitamin C against Monosodium Glutamate Induced Toxicity on Testes and Cauda Epididymal Sperm Reserves in Adult Male Albino Rats
Background: Monosodium glutamate (MSG) isa commonly used food enhancer which causes a wide range of endocrinal disorders including reduced fertility rate in both sexes. Earlier studies have shown that chronic administration of MSG induces oxidative stress in some organs of experimental animals. Accordingly, this work was carried out to study the possible ameliorative effect of vitamin C on monosodium glutamate induced testicular toxicity in adult male albino rats. Study design: Sixty adult male albino rats were included in this study and divided into four main groups. Group I used as control group (10 rats). Group II (10 rats) received 100mg/kg/day vitamin C. Group III (20 rats) was subdivided into two subgroups (10 rats each): 100mg/kg/day and 4gm/kg/day MSG treated rats. Group IV (20 rats) was also subdivided into two subgroups and received both MSG and vitamin C in their previous doses. All animals were treated orally by gastric tube for two months. Body weight, serum testosterone level, cauda epididymal sperm reserves, histopathological examination using H&E stain and survivin immunostaining were studied. Results: There was a significant increase in the body weight (p < 0.05) and in the percentage of sperm abnormal forms (p < 0.05), while a significant reduction in the sperm count and motility (p < 0.05) was noticed. These results were dose dependent. Animals treated with 4gm/kg MSG showed severely damaged seminiferous tubules with few primary spermatocytes in H&E stained sections and marked reduction in survivin expression in histochemical study compared to other groups. Moreover, there was significant improvement in all studied parameters on administration of vitamin C concomitant with MSG which was more observed with low MSG dose (100mg/kg). Thus, vitamin C holds a promise as an agent that can reduce MSG induced toxic effects in testes.
https://ajfm.journals.ekb.eg/article_19409_90d16016873b7149fd77d5c7c463301e.pdf
2013-01-01
199
220
10.21608/ajfm.2013.19409
Enas
El-Maddah
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
AUTHOR
Mona
Abo El-Noor
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
AUTHOR
Mona
Abd El-Azeem
3
Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Influence of Silymarin on Valproic Acid Induced Hepatotoxicity in Adult Male Albino Rats
Introduction: Valproic acid (VPA) is a widely prescribed antiepileptic drug, which might induce serious hepatic disorders . Silymarin is currently used as a supportive therapy of liver disorders. Aim of the study: In this study we evaluated the protective effects of silymarin on valproic acid induced hepatotoxicity . Material and Methods: seventy adult male albino rats were divided into 7 groups (10 each), (Ia) negative control, (Ib) positive control, (II) silymarin group, received17.5 mg/kg. (IIIa) low dose VAP group, received 200mg/kg , (IIIb) high dose VAP group received 400 mg/kg (IVa) low dose VPA + silymarin group and (IVb) high dose VPA + silymarin group received doses as previously mentioned. The drugs were gavaged once daily, 6 days/week for 8 weeks, at the end of the experiment rats were sacrificed and estimation of alanine aminotransferase (ALT) and alkaline phosphatase (ALP) in the blood, malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) in liver tissues and histopathological and immunnohistochemical examination of liver tissues were carried out. Results: this study showed significant increase in serum ALT, ALP and hepatic MDA contents while GSH-Px activity significantly reduced (especially in high dose VPA group) when compared with the control. Histopathological changes showed patchy microvesicular steatosis, focal necrosis of hepatocytes, dilated congested central vein and sinusoids. Immunolocalization of Bcl-2 revealed dose dependent weak cytoplasmic staining in the hepatocytes surrounding the central vein. VPA+ Silymarin groups showed partial improvement. Conclusion: It concluded that VPA has dose dependent toxic effects on liver that might be ameliorated by concomitant use of silymarin.
https://ajfm.journals.ekb.eg/article_19412_dffa90ca946dd795b5fcc910107a52bf.pdf
2013-01-01
221
232
10.21608/ajfm.2013.19412
Valproate
Silymarin
Oxidative Stress
ALT
ALP
MDA
GSH-Px
Bcl-2
Shereen
El-Khateeb
1
Department of Forensic Medicine and Clinical Toxicology,Faculty of Medicine, Zagazig University, Zagazig, Egypt.
AUTHOR
Manar
Arafa
2
Department of Forensic Medicine and Clinical Toxicology,Faculty of Medicine, Zagazig University, Zagazig, Egypt.
AUTHOR
Taiseer
Ibraheem
3
Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
AUTHOR