Ain Shams University, Faculty of Medicine, Forensic Medicine & Clinical Toxicology Department
Ain Shams Journal of Forensic Medicine and Clinical Toxicology
1687-1030
2636-3356
24
1
2015
01
01
Mitigation of Fluoride Toxicity by the Use of Thymoquinone in Adult Male Albino Rat
1
10
EN
Rasha
Abou Anza
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Hoda
Salah Eldin
0000-0001-8368-3019
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
hodasalah1974@gmail.com
10.21608/ajfm.2015.18652
<strong>Background</strong>: Fluoride is widely distributed in nature in many forms and its compounds are being used extensively. Increased oxidative stress is proposed to mediate the toxic effects of fluoride on soft tissues. Thymoquinone (TQ), the major bioactive ingredient isolated from Nigella sativa seed, has been studied for its anti-oxidant properties. Accordingly, this work was conducted to investigate the possible protective effects of TQ against sodium fluoride (NaF)-induced hematological and biochemical toxicity in male albino rats<br /> <strong>Method: </strong>Seventy animals were divided into 7 equal groups. Group I served as negative control group. Group II or positive control group received distilled water orally. Group III received TQ orally at a dose of 10 mg/kg for 5 weeks. Group IV and group V were intoxicated with NaF orally in two different doses: 10 mg/kg and 20 mg/kg respectively for 4 weeks. Group VI was given 10 mg/kg TQ one week prior administration of both TQ and Na F at a dose of 10mg/kg for 4 weeks. Similarly group VII received 10 mg/kg TQ for one week then concomitantly with Na F at a dose of 20 mg/kg for 4 weeks. At the end of the experiment, the animals were sacrificed and blood samples were obtained for assessment of hemoglobin (Hb) concentration, red cell count (RBC), total leucocytic count (TLC), platelet count, serum cholesterol, triglycerides (TG) and blood glucose level in addition to liver enzymes, total bilirubin level and total serum proteins. Oxidative indices including antioxidant enzyme superoxide dismutase (SOD), total antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS) and advanced oxidation protein product (AOPP) were also assessed.<br /> <strong>Results: </strong>NaF intoxicated groups showed significant alterations of hematological and biochemical indices with significantly depleted SOD, decreased TAC and concomitant increase in TBARS and AOPP. Pretreatment by TQ mitigated both hematological and biochemical changes induced by NaF probably due to its strong antioxidant activity.<br /> <strong>Conclusions: </strong>The results obtained indicate the role of oxidative stress in NaF toxicity and suggest a possible protective effect of TQ against the toxicity of fluoride compounds.
Na fluoride,Thymoquinone,Oxidative Stress,SOD,TAC,tbars,AOPP
https://ajfm.journals.ekb.eg/article_18652.html
https://ajfm.journals.ekb.eg/article_18652_dff65d1222a5fcf4609bfcef164122b9.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
24
1
2015
01
01
Possible Protective Mechanisms of Sitagliptin against Isoproternol Induced Myocardial Injury in Rat
11
20
EN
Wesam
El-Bakly
Pharmacology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
10.21608/ajfm.2015.18653
Sitaglebtin, dipeptidyl peptidase 4 inhibitors, has been investigated and proved to improve<br /> triglycerides, low density lipoprotein and blood pressure, which are important risk factors for<br /> cardiovascular diseases. Aim: The present study was designed to investigate the potential protective<br /> effect of sitaglebtin in isoproterenol induced myocardial injury. Further assessment was done to<br /> address the cardioprotective mechanism. Method: Male Wister rats were treated with sitaglebtin (30<br /> mg/kg/day for 2 weeks by gavage) and/ or isoproterenol (85mg /kg; i.p. 24 hours apart at day 14<span>th </span>and<br /> 15<span>th </span>of the experiment). Results: Isoproternol induced a significant ECG changes, several pathological<br /> changes and elevated cardiac enzymes. These changes were significantly attenuated by pre-treatment<br /> of rats with sitaglebtin. As a marker of oxidative stress, isoproterenol caused significant decrease in<br /> reduced glutathione level and superoxide dismutase with increase in malondialdhyde compared to the<br /> control group. Sitaglebtin pretreatment restored these markers toward normal values. Energy decline<br /> was assessed by measuring ATP/ADP, which decreased significantly in isoproterenol group and<br /> significantly increased by sitaglebtin pretreatment. Isoproternol caused inflammatory effects indicated<br /> by up-regulation of tumor necrosis factor-α expression in the myocardial tissue. Sitaglebtin also<br /> counteracted inflammatory cell infiltration, other histopathological changes, and the overexpression<br /> tumor necrosis factor-α in myocardial tissue. Collectively, these findings suggest that sitaglebtin, an<br /> anti-diabetic agent, has cardioprotective effect against isoproterenol induced myocardial injury that<br /> could be through antioxidant properties, TNF-α inhibition, and an enhancement of myocardial energy<br /> state<span> .</span>
Isoproternol (ISO),Sitagliptin (SL),ATP/ADP, oxidative stress,myocardium
https://ajfm.journals.ekb.eg/article_18653.html
https://ajfm.journals.ekb.eg/article_18653_6b5b47f2a9c19413a994c73b48a643d4.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
24
1
2015
01
01
Neurotoxic and Genotoxic Potentials of Short Term Copper Exposure in Adult Male Albino Rats (Biochemical, Histopathological, Immunohistochemical and Genotoxic Study)
21
30
EN
Heba
Mostafa
Departments of Forensic Medicine & Clinical Toxicology and Pathology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
Eman
Alaa-Eldin
Departments of Forensic Medicine & Clinical Toxicology and Pathology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
Nehal
Abouhashem
Departments of Forensic Medicine & Clinical Toxicology and Pathology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
10.21608/ajfm.2015.18654
Objective: Although copper is an essential micronutrient involved in a variety of biological processes indispensable for sustaining life yet it can be toxic when administered in excess. Material and Methods: Thirty six adult male albino rats were equally divided into three groups; the first group was used as a negative control, the second group received normal saline intraperitoneal (positive control group) and the third group received copper chloride 7mg/kg twice weekly intraperitoneal for 8 weeks (treated group). At the end of the experimental period, blood was withdrawn for measuring serum malondialdhyde (MDA) and catalase (CAT), then the rats were sacrificed and the brain was examined by light microscope for detecting histopathological changes. Brain sections were examined immunohistochemically for the detection of the apoptotic BaX protein and finally, the bone marrow was examined for detection of chromosomal aberrations. Results: In Cu chloride treated group (group III), there was a significant elevation in serum malondialdehyde & a significant decrease in serum catalase. Histopathological changes were in the form of increased cellularity of astrocytes, swelling of astrocytes that showed dense eosinophilic cytoplasm, with pyknotic nuclei and multiple apoptotic bodies. Also, there were degenerated neurons with deep eosinophilc cytoplasm using light microscope and BaX showed strong immunoreactions in the brain. Bone marrow showed significant increase in all types of chromosomal aberrations after 8 weeks of Cu chloride treatment. Conclusion: From the previous results, it can be concluded that Cu chloride exposure can induce oxidative stress changes in the form of a significant increase in MDA and significant decrease in CAT enzyme as well as histopathological changes in the brain and genotoxicity in adult male albino rats after short term exposure.
I copper,Brain,Genotoxic,Bax,Rats
https://ajfm.journals.ekb.eg/article_18654.html
https://ajfm.journals.ekb.eg/article_18654_3f913e88aaab984c219a6add6505471d.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
24
1
2015
01
01
Epidemiological Study of Acute Toxicity in Children Admitted to Poison Control Center, Ain Shams University Hospitals during the Year 2012 -A Retrospective Study
31
43
EN
Sawsan
Shalaby
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine,Ain Shams University, Cairo, Egypt.
Sonya
Azab
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine,Ain Shams University, Cairo, Egypt.
Noha
El Rafie
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine,Ain Shams University, Cairo, Egypt.
Hany
Tawfik
Consultant of clinical toxicology and head of the Information System Department, Poison Control Centre, Ain Shams University, Cairo, Egypt.
10.21608/ajfm.2015.18655
Acute poisoning represents a major cause of morbidity and mortality among children. The pattern of incidence and risk factors for acute poisoning in children change with time and differ from country to country. Thus, specific epidemiological studies for each country are necessary for determination of the extent and characteristics of the problem, accordingly appropriate preventive measures can be taken.<br /> <strong>Aim of the study:</strong> This is an epidemiological retrospective study aimed to determine the pattern of acute poisoning in children admitted to PCC, Ain Shams University Hospitals during the year 2012.<br /> <strong>Methods: </strong>The collected data about the cases included demographic data (age, gender and residence), circumstances of poisoning (substance of exposure; place, time, mode and route of exposure and co-ingestion of other agents) and cases’ outcome (recovery and discharge or death).<br /> <strong>Results:</strong> This study included 1,521 children; adolescents represented the most frequent age group (55.6%), followed by toddlers (21.9%). Female gender was more frequent than male (67.8% versus 32.2%). The majority of admitted pediatric cases were resident in Greater Cairo governorates. Drugs were more common cause of poisoning in the included cases than non-medicinal agents (57.1% vs 42.9%) and theophylline was the most frequent drug. Pesticides were the most frequent non-medicinal agent in all age groups, except for toddlers where chemicals (kerosene and corrosives) were the most frequent agent. Intentional poisoning was more frequent than unintentional poisoning (55.5% vs 44.5%). While unintentional poisoning occurred in all age groups, intentional poisoning (mainly suicidal) occurred exclusively in older age groups (school age group and adolescents).<br /> The house was the site of exposure to poisons in all cases. The winter was the season of greatest frequency of poisoning by pesticides, gases and drugs while the summer was the season of greatest frequency of animal, food, fish and plant poisoning as well as poisoning by chemicals. Ingestion was the most common route of exposure in all age groups (1484 cases, 97.4%) and it was the only route of exposure in infants. About 3.5% of the included cases (59 cases) were presented with co-ingestion of other substances; most of them were in the adolescent group. The percentage of mortality of the admitted cases was 2.2% (33 cases). Iatrogenic/ therapeutic poisoning had the highest mortality ratio (25%) followed by accidental poisoning (2.8%) and suicidal poisoning (1.4%).<br /> <strong>Conclusion: </strong>The greatest frequency of poisoning in children was in adolescents, followed by toddlers. Oral route was the most common route of exposure. Poisoning in children may occur unintentional (in all age group) or intentional (only in older age groups). Suicidal poisoning was the main manner of exposure in adolescents. The percentage of mortality was 2.2%.<br /> <strong>Recommendations:</strong> Appropriate injury prevention strategies, such as safe storage of medicines and cleaning supplies should be implemented. Also, more restrictive measures on the use and storage of pesticides should be taken.<br /> Further studies on the risk factors of deliberate self-poisoning in adolescents are recommended as it was found as a major manner of exposure to poisoning in this stage.
https://ajfm.journals.ekb.eg/article_18655.html
https://ajfm.journals.ekb.eg/article_18655_acb1afc7bb026205e1d9a84a943e9dd8.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
24
1
2015
01
01
Cardiotoxicity in Acute Zinc Phosphide Intoxicated Patients (A Prospective Study)
44
52
EN
Aya
Khater
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
Nesrine
Sarhan
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
10.21608/ajfm.2015.18656
Phosphides are common pesticides widely used as a grain preservative. Zinc phosphide toxicity is a major health problem with a high mortality rate especially in developing countries. Cardiotoxicity is the main cause of death in phosphide poisonings. <strong>Aim of study: </strong>This prospective study aimed to evaluate the cardiovascular affection among zinc phosphide intoxicated patients admitted to the Poison Control Center, Ain Shams University Hospitals (PCC- ASUH) during the period from 1<sup>st</sup> June 2013 to 1<sup>st</sup> June 2014 and to determine factors predicting the outcome of patients with zinc phosphide cardiotoxicity with special reference to determination of serum troponin I.<br /> <strong> Methods:</strong> Clinical characteristics (systolic blood pressure and central venous pressure), laboratory parameters (liver enzymes, renal function, serum electrolytes: (sodium and potassium), random blood sugar, serum bicarbonate and qualitative assessment of cardiac troponin I,electrocardiographic ( ECG) findings and treatment characteristics were all recorded.<br /> <strong>Results: </strong>Cardiotoxicity was evident in 18 patients out of 144 (12.5%) with zinc phosphide intoxication, twelve of them died. Systolic blood pressure was significantly lower among non survivors (60 ± 7 mmHg) compared to survivors (75 ± 5 mmHg). Central venous pressure was elevated in 6 patients, all of them died. Serum cardiac troponin I was positive in 67% (12 patients) and it did not predict mortality. Eight patients out of the 18 patients had dysrhythmias which found to be a predictor of mortality.<br /> <strong>Conclusion: </strong>The statistically significant factors useful in predicting mortality in our study were shock (which required vasoactive drugs), increased central venous pressure and ventricular arrhythmias.
https://ajfm.journals.ekb.eg/article_18656.html
https://ajfm.journals.ekb.eg/article_18656_2ff8a8ae6bf4cf21a151a46abc8febbd.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
24
1
2015
01
01
A Prospective Study of Poisoning Severity Score among Acute Antipsychotic Poisoned Cases Admitted to Menoufia Poison Control Center (MPCC) Throughout One Year
53
63
EN
Samy
Hammad
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Naira
Girgis
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Safaa
Amin
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Azza
Zanaty
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Haidy
Abou Hatab
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
10.21608/ajfm.2015.18657
<strong>Introduction</strong>: Antipsychotics rank in the top five substance classes involved in human exposures. Overdose of antipsychotic medications is common.<br /> <strong>Aim of the work:</strong> to study antipsychotic drug poisoning cases that were admitted to MPCC during one year as regarding: socio demographic pattern,<em> their clinical manifestation, investigation and outcome according to poisoning severity score (PSS). </em><strong>Patients and Method:</strong> Patients complaining of antipsychotic drug overdose admitted to MPCC from 1<sup>st</sup> October 2012 to 30<sup>th</sup> September 2013 were included. The socio-demographic and clinical data were collected from each patient in a designed clinical toxicological sheet. The studied cases were classified according to poisoning severity score. <strong>Results:</strong> The total patient's number was 60 patients. Females outnumbered males. Cases 33.3% below 10 years old were males, while females above 40 years old constituted 50.2%. Accidental poisoning was in males below age of 10 years from rural side, on the other hand 75% of females exposed to suicidal mode mainly from urban area. Regarding (PSS); most of cases were of moderate degree and the least were of severe and fatal degrees. Palpitation and abnormal movements were the commonest symptoms. Sinus tachycardia was the most prominent ECG changes seen in 20% of cases. ICU admission was indicated for 16.7% of cases. <em>Improvement has occurred in 40% of cases, while only one case died.</em><strong>Conclusion and Recommendation:</strong> Significant relation was found between PSS and poison history as regard Co-ingestion and patients on antipsychotic therapy. Cases with moderate severity toxicity had palpation and abnormal movements. Acute antipsychotic overdose seldom results in death. Therefore it is recommended to improve awareness of physician about appropriate pharmacologic treatment of psychiatric problems.
Antipsychotics,toxicity- poisoning severity score
https://ajfm.journals.ekb.eg/article_18657.html
https://ajfm.journals.ekb.eg/article_18657_3b34b02ed70956822983ee2a73b64385.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
24
1
2015
01
01
A Study of the Effect of Iron and Silicon As Cement Components on Cerebral and Cerebellar cortices of Albino Rats and the Possible Protective Role of Omega 3: A Toxicological and Histological Study
64
80
EN
Abeer
Sheta
Forensic Medicine and Clinical Toxicology Department,Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Noha
Zahran
Histology and Cell Biology Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
10.21608/ajfm.2015.18658
<strong>Introduction </strong>Cement industry generates dust during its production. The main route of entry of cement dust particles in the body is the respiratory tract and / or the gastrointestinal tract by inhalation or swallowing, producing both respiratory and non-respiratory systems involvement. Content of Portland cement is a mixture of elements that include iron and silicon. Yet, there is a lack of the studies concerned with the effects of cement on different organs in humans or animals. Therefore, the aim of the present study was to investigate the effect of two of cement components (silicon and iron) on brain tissues and the possible protective effect of omega-3.<br /> <strong>Material and methods </strong>fifty male adult albino rats were divided into three groups; Group I (control group), Group II (treated group) that was subdivided into three subgroups; subgroup IIa, received iron as ferrous chloride, subgroup IIb, received silicon as sodium silicate and subgroup IIc, received both elements orally for two months and Group III (protected group) received iron and silicon, simultaneously with omega- 3. Energy Dispersive X-ray Spectrometry (EDX) analysis was done. Frontal cerebral & cerebellar cortices were subjected for biochemical oxidative assay. Histological study and immunohistochemical staining for Glial fibrillary acidic protein (GFAP) were performed as well as morphometric study.<br /> <strong>Results </strong>cerebral & cerebellar cortices of treated rats (subgroup IIc) showed peaks for iron and silicon. The profile of oxidative stress markers, in group (II), revealed significantly decreased antioxidant enzymes activity, superoxide dismutase (SOD) and catalase (CAT), while malondialdehyde (MDA) level increased significantly as compared with control group. Histological findings of cerebral and cerebellar cortices revealed different degrees of degenerated nerve cells, tissue vacuolation, and degenerated neuropil in group II. Immunohistochemial results showed marked proliferation of astrocytes. The co-administration of omega-3 (group III) showed significant increase of both SOD and CAT activities and significant decrease of MDA. Marked preservation of cerebral and cerebellar cortical tissues was noticed. <strong>Conclusion </strong>The present work revealed the hazardous effect of cement component (iron and silicon) on cerebral & cerebellar cortices of albino rats. The role of protective effect of omega-3 might find a clinical application against the hazardous effect among the exposed workers. Further studies are needed to magnitude the problem on health.
https://ajfm.journals.ekb.eg/article_18658.html
https://ajfm.journals.ekb.eg/article_18658_7bcb91d88be5a9189e13e162d1eabe8e.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
24
1
2015
01
01
Possibility of Age Determination of Bruises in Living Children Using High Frequency Ultrasonography in Addition to the Naked Eye Estimation
81
87
EN
Sahar
Moustafa
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University, Suez, Egypt.
10.21608/ajfm.2015.18659
The bruise is a significant injury in the eyes of the law and the need to determine the age of bruises is becoming important in routine clinical settings. Clinicians may be asked to comment on the age of any bruise found during child examination, while the coexistence of old and fresh bruises is a strong evidence for a diagnosis of chronic child abuse. It is accepted by forensic practitioners that visual assessment is far from accuracy and more frequently misleading and till now there is no standardized accepted scheme for bruise age determination. Ultrasonography (US) is a suitable tool for measuring the factors affecting the age of bruises, so the present study aims to investigate the possibility of age the bruises by measuring the depth, thickness and ultrasonography findings of subcutaneous hemorrhage using high-frequency US in a trial to estimate its age with a high degree of accuracy in addition to the naked eye assessment. 48 children of age less than 18 years were enrolled (31 boys and 17 girls) with bruises caused by trauma from accidents. The bruises were examined and photographed by a single observer to age them by naked eye. In addition, the depth, the thickness of subcutaneous hemorrhage and their characters were evaluated by using the high frequency Ultrasonography. The results indicated that naked eye estimation of the bruises was correct in (66.7%) of the cases. Ultrasonographic results showed that a fresh thin subcutaneous hemorrhage was observed as a thickening of the fibrous partition (hyperechoic), sometimes with an isoechoic area while fresh thicker bruise was observed as a hyperechoic area scattered around the fibrous partition. The echogenicity of the older bruise is less hyperechoic than the fresh one. The depth of subcutaneous hemorrhage did not generally change with time in contrast with the thickness of the subcutaneous hemorrhage which decreased with time. Ultrasonography estimation was correct in (93.8%) of the cases so, high frequency Ultrasonography can provide an evaluation of characters, depth and thickness of the bruise and allow a more accurate estimate of its age and may provide a clue that adds more accuracy to the naked eye estimation.
Age bruises,Ultrasonography and Child abuse
https://ajfm.journals.ekb.eg/article_18659.html
https://ajfm.journals.ekb.eg/article_18659_cb225cc25c014e1b738b98b6776423a2.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
24
1
2015
01
01
The Possible Protective Role of Ginger against Carbon Tetrachloride-Induced Nephrotoxicity in Rats. Histopathological and Morphometric Study
88
94
EN
Ahmad
El-Ebiary
Departments of Forensic Medicine and Clinical Toxicology,Faculty of Medicine, Tanta University, Tanta, Egypt.
Arwa
Abuelfadl
Departments of Forensic Medicine and Clinical Toxicology,Faculty of Medicine, Tanta University, Tanta, Egypt.
Ehab
Hantash
Departments of Anatomy,Faculty of Medicine, Tanta University, Tanta, Egypt.
Ahmed
Abdalfattah
Departments of Physiology,Faculty of Medicine, Tanta University, Tanta, Egypt.
Ahmed
Abdelmotelb
Departments of Pharmacology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Sabah
El-Ghaiesh
Departments of Pharmacology, Faculty of Medicine, Tanta University, Tanta, Egypt.
10.21608/ajfm.2015.18660
Carbon tetrachloride (CCl<sub>4</sub>) has long been known as a model toxicant. Several reports have discussed its toxic effects on different organs by inducing oxidative stress and free radical production. A number of antioxidant agents, including herbal extracts, have been reported to reduce CCl<sub>4 </sub>induced toxicity. Many studies have reported the beneficial effects of ginger including its antioxidant properties. This work was performed to assess the possible protective role of ginger against CCl<sub>4</sub> induced renal injury in adult male albino rats. A total of 48 adult male rats were divided into 3 groups. Group I served as the control group. Group II received CCl<sub>4 </sub>by intraperitoneal injections, twice weekly, for 4 weeks. Group III received CCl<sub>4 </sub>(as previously described) and aqueous extract of ginger orally, once daily, for 4 weeks. At the end of the experiment, renal specimens were processed for light and electron microscopic examination. In addition, morphometric analysis was performed on electromicrographs to assess the filtration barrier integrity. Carbon tetrachloride treated rats showed renal corpuscles with shrunken, lobulated, and hypercellular glomeruli, podocyte affection, as well as mesangial cell proliferation. Morphometric analysis demonstrated disordered filtration barrier integrity. The use of ginger prevented most of these structural changes. Exposure to CCl<sub>4</sub> resulted in nephrotoxicity associated with glomerular and tubular alterations in adult male rats. Ginger exhibited a protective effect against CCl<sub>4 </sub>induced renal damage.
Carbon tetrachloride,Nephrotoxicity,Ginger,rat,glomerular filtration integrity
https://ajfm.journals.ekb.eg/article_18660.html
https://ajfm.journals.ekb.eg/article_18660_8459791155aaebc767ce05ed0c0e94d1.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
24
1
2015
01
01
Acute Paraphenylenediamine (PPD) Toxic Effects upon the Kidney after Single Oral Dose: An Experimental Study
95
105
EN
Abdel-wahab
Dawood
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Assiut University
Maha
Hilal
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Sohag University, Egypt
Soheir
Mohammed
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Sohag University, Egypt
Reda
Elsayed
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Sohag University, Egypt
Khaled
Mohamed
Assiut Chemical Laboratory, Medico-Legal Department, Ministry of Justice, Egypt.
Hoda
Elsayed
Histology Department, Faculty of Medicine, Sohag University, Egypt.
10.21608/ajfm.2015.18661
Paraphenylenediamine (PPD) is a synthetic compound used widely as a hair dye. Ingestion of PPD results in major systemic problems which depend mainly on the dose taken.<br /> The current study was designed to investigate PPD toxic effects upon the kidney after single oral dose of PPD in three groups of adult male albino rats. Groups II, III, and IV which received (8, 16, 80 mg/kg toxic, sublethal and lethal dose of PPD respectively), 10 per each group. Another 10 animals were served as a control group (group I) received only distilled water. Blood was collected for evaluation of kidney functions and measurement of PPD and its metabolites levels by HPLC. The kidneys were preserved for histopathological examinations and measurement of the level of PPD and its metabolites by HPLC. The results proved that acute ingestion of PPD can induce disturbed kidney functions. PPD was detected in plasma and the kidney in group IV and in the kidney only in group II and group III, while the metabolites (MAPPD and DAPPD) were detected in all treated groups. The histopathological findings showed that PPD cause mild, moderate and severe tubular damage. In a conclusion, this study established the renal toxic effects of acute ingestion of paraphenylene-diamine.
Paraphenylenediamine (PPD),Renal toxicity,oral exposure HPLC
https://ajfm.journals.ekb.eg/article_18661.html
https://ajfm.journals.ekb.eg/article_18661_f9121ac8f03d903ae72b82c77073fa39.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
24
1
2015
01
01
Curative Role of D-Penicillamine versus Combined Garlic and Silymarin Extracts on Lead-Induced Nephrotoxicity and Oxidative Stress in Adult Male Albino Rats
106
119
EN
Amal
Abd Elkhalek
Department of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt.
Nermien
Ibrahim
Department of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt.
10.21608/ajfm.2015.18663
<strong>Background</strong> Lead (Pb) poisoning is still an important global health problem, especially in developing countries. Lead has been extensively used for many years ago, and it will continue to be used in future. <strong>Aim of work</strong>: This study was conducted to compare the curative role of D-penicillamine versus combined garlic and silymarin extracts for treating nephrotoxicity in adult male rats exposed to Pb for 3 months. <strong>Material and methods</strong>: The study was conducted on 70 adult male albino rats divided into 7 groups each of 10 rats, where they received all chemicals by oral gavage. Groups I & II were the negative and positive control rats, respectively. Group III received 25 mg/kg/day D-penicillamine for 1 month (4<sup>th</sup> month). Group IV received combined garlic 20 mg/kg/day+ silymarin 200 mg/kg/day for 1 month (4<sup>th</sup> month). Group V received 20 mg/kg/day Pb acetate for 3 months. Group VI received Pb acetate for 3 months followed by D-penicillamine for another 1 month, with the previously mentioned doses. Group VII received Pb acetate for 3 months followed by combined garlic & silymarin for another 1 month, with the previously mentioned doses. At the end of the experimental period (4 months), Pb-level in blood, urine & kidney tissue, kidney function tests (blood urea and serum creatinine) and serum malondialdehyde (MDA) & glutathione peroxidase (GSH-Px) were measured. Light microscopic examination of hematoxylin and eosin stained kidney tissue was performed to detect histopathological changes. <strong>Results</strong>: Lead administration significantly elevated blood lead level (BLL), kidney lead level (KLL), urinary lead level (ULL) and malondialdehyde (MDA), while glutathione peroxidase (GSH-Px) showed significant decrease when compared with the negative control rats. In Pb treated group, histopathological examination of the kidney revealed extensive tubular damage by presence of necrotic epithelial cells, tubular degeneration, necrosis, cell swelling, mononuclear cell infiltration, and degenerated organelles. Kidney functions didn't show any significant differences among all groups. Treatment of rats by D-penicillamine or combined garlic & silymarin extracts resulted in significant decrease in Pb-levels and MDA with a significant increase in blood GSH-PX levels. Also, significant improvement of lead induced histopathological lesions in the kidneys was observed. Combined garlic and silymarin extract treatment showed more significant improvement than D-penicillamine treated Pb-administered groups, in most of the tested parameters. <strong>Conclusion</strong>: Both D-penicillamine and combined garlic & silymarin extracts can reduce lead induced nephrotoxicity and oxidative stress. Moreover, garlic & silymarin curative effect is better than that of D-penicillamine. <strong>Recommendations</strong>: Exposure of the population to lead must be controlled. Search for sensitive blood or urinary marker for early detection of kidney damage and further studies are needed to consider a combination of garlic and silymarin is effective in the treatment of lead-induced toxicities.
Lead,D-penicillamine,Garlic,Silymarin,kidney
https://ajfm.journals.ekb.eg/article_18663.html
https://ajfm.journals.ekb.eg/article_18663_313eef4c56a9bfcc46c8fb0315a8bb6e.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
24
1
2015
01
01
Pattern of Child Poisoning at Ain Shams University Hospital of Year 2012 Compared to 1983: What Has Changed in Three Decades?
120
128
EN
Eman
Khalifa
0000-0001-7626-1619
Department of Forensic medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
dr.emankhalifa10@yahoo.com
Amany
Sayed
Department of Community, Environmental and Occupational medicine.Faculty of Medicine, Ain Shams University, Cairo, Egypt.
10.21608/ajfm.2015.18664
Childhood poisoning is a major cause of morbidity in the developing as well as the developed world. In spite of the success of some interventions to prevent accidental poisoning in the pediatric population, deaths due to un-intentional poisonings still occur<br /> The present study aims to describe epidemiology of child poisoning at Ain Shams University Hospital during year 2012 and to compare the most common poisoning agents during 2012 with that during year 1983.<br /> Descriptive Cross sectional study was carried out atPoison Control Centre (PPC), Ain Shams University Hospital. 4240 cases of child poisoning(age <strong>≤</strong>15 years) reach the Emergency Room (ER) during year 2012 and 145 cases during the year 1983 was included. Then analysis were done using SPSS version 18 and all results presented in the form of frequency and percentage.<br /> Results revealed that more than 50% of child poisoning during 2012 were at age group less than three years and accidental manner was responsible for 68.5% of cases, non-drug poisoning was responsible for larger percentage (55.7%) of cases of child poisoning than drugs poisoning (44.3%). The opposite was the condition during 1983, drugs poisoning responsible for more than 83% of cases.
https://ajfm.journals.ekb.eg/article_18664.html
https://ajfm.journals.ekb.eg/article_18664_d53c0f1f98f1513ff19619fe5bfa6280.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
24
1
2015
01
01
Protective Effect of Captopril and Nigella Sativa Oil against Carbon Tetrachloride Induced Nephrotoxicity in Male Rats
129
144
EN
Khaled
Abdel Aal
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut, Egypt
Nashwa
Mostafa
Departments of Histology, Faculty of Medicine, Assiut University, Assiut, Egypt
10.21608/ajfm.2015.18665
Carbon tetrachloride (CCl<sub>4</sub>) is considered an environmental pollutant. Exposure to CCl<sub>4</sub> is commonly associated with nephrotoxicity. Objective: The aim of this study was to demonstrate the possible preventive role and underlying mechanism of the single and combined administration of captopril and nigella sativa oil against CCl<sub>4</sub> induced nephrotoxicty in male rats. Methods: This study was conducted on sixty four adult healthy male albino rats and divided into 8 groups (8 rats/group). Group I, rats which served as negative control, group II, rats which given liquid paraffin and saline (positive control), groups III, rats which given captopril in a dose of 100 mg/kg daily by gavage (positive control), group IV, rats which given nigella sativa oil in a dose of 4 ml/kg daily by gavage (positive control), group V, rats which injected i.p. with CCl<sub>4</sub> three times/ week in a dose of 20 μL/100 gm body weight, group VI, rats which given captopril concurrently with CCl<sub>4</sub> in the same mentioned dose and route, group VII, rats which given nigella sativa oil concurrently with CCl<sub>4</sub> in the same mentioned dose and route; group VIII, rats which given captopril and nigella sativa oil daily concurrently with CCl<sub>4</sub> in the same mentioned dose and route. All rats were given treatment for 6 weeks then sacrificed by decapitation. Biochemical parameters were assessed in all rat groups and statistically analyzed. In addition, histological and immunohistochemical investigations of renal tissues were done. Results: In CCl<sub>4</sub> treated rats, the biochemical assays revealed significant statistical increase in the level of serum urea, creatinine, uric acid and nitric oxide as well as increase level of lipid peroxides, reduced glutathione and superoxide dimutase in the kidney tissue. Histological examination showed degeneration of glomeruli and tubules. High immunolabelling for activated caspase-3 in the kidney was detected on immunohistochemical examination. Treatment with captopril and nigella oil singly or in combination with CCl<sub>4</sub> resulted in improvement of the biochemical, histological and immunohistological changes and this effect is more evident on their combined administration. Conclusion: Captopril and nigella sativa oil can be used as therapeutic agents in protection against CCl<sub>4</sub> induced nephrotoxicity. This effect is attributed to decrease free radicals generation and apoptosis through inhibition of casapse-3 activity in renal tissue. It is recommended to conduct further experimental studies on large numbers and to investigate this effect on nephrotoxic patients.
CCl4,Oxidative Stress,captopril,nigella sativa oil and kidney
https://ajfm.journals.ekb.eg/article_18665.html
https://ajfm.journals.ekb.eg/article_18665_3253450fe92f8b12bfe9a1c4e617cf11.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
24
1
2015
01
01
Alcohol and Other Drug Abuse among Cases of Road Traffic Crashes In Port-Said General Hospitals, Egypt 2014
145
153
EN
Heba
Mohamed
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Port Said University, Port said, Egypt .
Mohamed
Seif El-din
Ministry of health & population, Egypt
Ayat
Tawfik
Public Health department, Faculty of Medicine, Port Said University, Port said, Egypt
10.21608/ajfm.2015.18666
<strong>Background:</strong> Road traffic crashes RTC are the leading injury-related cause of death among people aged 15-44 years. A clear dose-effect relationship has been demonstrated for drugs and/or alcohol use and (RTC).<br /> <strong>Aim:</strong>The objective of this study was to estimate the prevalence of drug and/or alcohol use in cases admitted for RTC to emergency departments in Port-said general hospitals.<br /> <strong>Methods:</strong> In this study, conducted between January to December 2014, where 1200 cases of road traffic crashes of both sexes and their age were form 18 to 65 years were examined. Toxicological screening urine test was used to detect drugs by the emergency department staff using enzyme linked Immunosorbent assay ELISA . Alcohol and drug of abuse concentration was confirmed from blood samples at the central laboratory using Gas Chromatography Mass Spectrometry GC-MS .<br /> <strong>Results:</strong> Most of the cases were males, drivers and under 40 years of age. It was found that 70% of RTC occurred during winter, 34% at the weekend; Friday and most crashes (68%) were caused by trucks. At the time of crashes alcohol was positive in 18.3% of cases, cannabis positive in 27.5%, tramadol in 47.5%, amphetamine in 8 %, cocaine in 1.25% ,while sedative hypnotics drugs were positive in only 1.92%.<br /> <strong>Conclusion:</strong> The risk of road traffic crashes is greatly increased among drivers who tested positive for alcohol, in particular, those who had also ingested tramadol or more psychoactive drugs .<br /> <strong>Recommendations:</strong> Planning and implementing a national RTC risk management strategy for prevention of mortalities and morbidities due to driving under the influence of drugs. Toxicological screening should be done by immunoassay method followed by confirmation by GC-MS method
Alcohol,Psychoactive drugs,Road traffic crashes
https://ajfm.journals.ekb.eg/article_18666.html
https://ajfm.journals.ekb.eg/article_18666_2ef39bb265c6368b5a8927cb3a655afe.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
24
1
2015
01
01
Toxicological Profile of Acutely Poisoned Cases Admitted to Poison Control Center, Ain-Shams University Hospitals during Year 2013
154
163
EN
Hany
Tawfik
Fellow of clinical toxicology, Poison Control Centre, Ain Shams University, Cairo, Egypt
Hend
ElHelaly
Department of Forensic medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
10.21608/ajfm.2015.18667
<strong>Background</strong>: Acute poisoning is a medical emergency that mandate brief analysis of the nature, severity and outcome of acute poisoning cases in order to take up appropriate planning, prevention and management techniques. The Poison Control Center Ain Shams University, Hospitals (PCCASUH) is the first established in the Middle East managed and treated more than 20474 patients during year (2013).<br /> <strong>The aim of the study </strong>is to estimate the pattern of poisoning of cases admitted to the Poison Control Centre Ain Shams University Hospitals (PCCASUH) during year (2013). In-addition, to figure out the commonest poisoning causes, ways of management and outcomes during this year.<br /> <strong>Patients and Methods</strong>: Clinical and Management data were obtained from medical records of cases admitted at PCCASUH during year (2013) and descriptive statistical analysis of this data was accomplished.<br /> <strong>Results</strong>: Overall, (20474) intoxicated cases were recorded and (60.9%) were 15 to 40 year old. Female cases were 53.9% and that was more than male cases which were (46.1%). Children up to 15 year old represented (31.5%) of cases. Attempts of suicide were more common (47.1%) among cases presented while accidental exposures constituted (45.4 %) of cases. Food poisoning, organophosphates, household products and drugs of abuse were the more frequent case presentations. Cases were classified as mild cases (82.7%), moderate cases (12.1%) and severe cases (5.2%) according to <strong>Person et., al. (1998).</strong> Seventy four fatalities were recorded during (2013) at PCCASUH. Management of these cases was described with (3%) needed emergency measures.<br /> <strong>Conclusions and Recommendations</strong>: This study revealed mortalities and morbidities presented to PCCASUH during (2013) were more than that recorded during year (2011) and (2012) as well as most of cases were suicidal attempts. This might be attributed to the security, economic and political problems affecting Egyptian community and population personality in negative way. Strict laws and regulations are needed to control the medication as well as households marketing and drugs of abuse availability.
https://ajfm.journals.ekb.eg/article_18667.html
https://ajfm.journals.ekb.eg/article_18667_07a07dfcf65f11bd31724daa5be8e115.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
24
1
2015
01
01
Clinical Profile and Outcome of Poisoned Pediatric Patients Admitted To Poison Control Center, Ain Shams University Hospitals during the Year 2012
164
179
EN
Sawsan
Shalaby
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Sonya
Azab
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Noha
El Rafie
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Hany
Tawfik
Consultant of clinical toxicology and head of the Information System Department, Poison Control Center
10.21608/ajfm.2015.18668
<br /> <br /> <br /> <br /> <br /> <span> </span>Childhood poisoning comprises a significant component of injury-related morbidity and mortality all over the world and exerts a huge amount of pressure on the resources of the health care system as well as the workload on the health care staff. Early and accurate diagnosis and management of poisoning decrease the risk of morbidity and mortality. Therefore, study of manifestations and severity of poisoning by variable agents, effects of treatments and outcome is essential to assess the impact of poisonous substances and the effectiveness of treatment. <br /> <strong>Aim of the study: </strong>this study aims to determine the clinical profile, management and outcome of acutely poisoned children admitted to Poison Control Center (PCC), Ain Shams University Hospitals during a one year period starting from 1/1/2012 to 31/12/2012. <br /> <strong>Methods: </strong>The collected data from the cases’ medical records included: age, gender, delay time, pre-consultation treatment, clinical manifestations, findings of investigations, place and period of hospitalization, received treatment in the PCC and the outcome. <br /> <strong>Results: </strong>adolescence where the most frequent age group in this study and female gender was more prominent than male gender. Delay time was significantly increased in non-survivors than survivors. The proportion of deaths in group of patients who received pre-consultation treatment was significantly higher than that in patients who didn’t receive any treatment before arrival to the PCC. Faulty management in the form of induction of emesis by salty water intake was found in 2.6% of the cases; 7.7% of these cases were died. Most cases presented with unremarkable changes in vital signs and gastrointestinal manifestations (mainly nausea and vomiting) were the most frequent manifestations in the cases. Hypoglycemia, hyponatremia, hypokalemia and metabolic acidosis were the most common abnormalities found in laboratory investigations. Sinus tachycardia was the most common abnormality found in ECG. <br /> Most of the included cases in this study were admitted in the inpatient section (83 %). The majority of the cases (75%) were hospitalized for short period that didn’t exceed 24 hours. Higher PSS was associated with longer hospital stay periods. Corrosives, followed by pesticides were the most frequent cause of prolonged hospitalization (≥4 days). Emergency managements were indicated in 11% of the cases and procedures for gastric decontamination were done for 1296 cases (87.3%). All cases received supportive and symptomatic treatments. Atropine was the most frequent antidote that was used either alone or with toxogonin. <br /> The overall mortality ratio was 2.2%. Preschool age group had the greatest mortality ratio (3.7%), followed by infant group (3.6%). Hypernatremia had the highest case fatality rate (100 %), followed by CO poisoning (28.6%). <br /> <strong>Conclusion: </strong>Gastrointestinal manifestations (mainly nausea and vomiting) were the most frequent manifestations. Hypoglycemia, hyponatremia, hypokalemia and metabolic acidosis were the most common abnormalities found in laboratory investigations. Sinus tachycardia was the most common abnormality found in ECG. Corrosives, followed by pesticides were the most frequent cause of prolonged hospitalization. Atropine was the most frequently used antidote. The overall mortality was 2.2%. Hypernatremia had the highest case fatality rate (100 %). <br /> <strong>Recommendations: </strong>Increasing public awareness of the first aid measures in childhood poisoning is crucial to avoid complications of faulty measures. Also, it is important to increase public awareness of the services of the information center in the PCC as it presents guidance about management of poisoned cases. Ongoing childhood poisoning surveillance is needed to track its effects and risk factors and to monitor the impact of appropriate interventions.
https://ajfm.journals.ekb.eg/article_18668.html
https://ajfm.journals.ekb.eg/article_18668_5030feed456ec2ddab13077d4e818da8.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
24
1
2015
01
01
Role of Repetitive Nerve Stimulation, Serum Creatine Phosphokinase and Lactate Dehydrogenase in Early Prediction of Respiratory Failure in Acute Organophosphorus Poisoning
180
195
EN
Samah
Elnagdy
Departments of Forensic Medicine &Clinical Toxicology and Neurology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
Nahed
Shehta
Departments of Forensic Medicine &Clinical Toxicology and Neurology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
10.21608/ajfm.2015.18669
The most serious complication associated with acute organophosphorus (OP) poisoning is intermediate syndrome (IMS) due to the possibility of developing respiratory failure. Abnormalities observed in repetitive nerve stimulation (RNS) may help to assess severity of IMS and eventually help to predict the cases which are more liable to develop respiratory failure. Also, some researchers suggested that IMS is associated with rhabdomyolysis which is followed by a rise in creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) serum levels. The aim of this work was to study the role of RNS and serum levels of CPK and LDH in predicting respiratory failure in acute OP poisoning. The study was carried out on 55 patients who were diagnosed as acute OP poisoning and admitted at Poison Control Center, Zagazig University Hospitals in the period from April 2013 to June 2014. The patients were subjected to estimation of serum pseudocholinesterase, CPK and LDH levels at time of admission and repeated at the 4<sup>th</sup> day of poisoning. Also, RNS test at 3 hertz (HZ) frequency was done to all patients at 2nd, 3rd and 4<sup>th</sup> day of poisoning (the period at which IMS is expected). At the end of the study, it was found that the patients who developed respiratory failure showed significant increase in decrement response recorded by RNS and in serum CPK level. On the other hand, there was non-significant difference between patient who developed respiratory failure and those who didn’t as regard serum LDH level. It was concluded from this study that, RNS test at 3 HZ and serum CPK level can be used as early predictors of respiratory failure in acute OP poisoning and it’s recommended to use them especially in patients who are clinically diagnosed as severe poisoning at time of admission.
Organophosphorus,IMS,CPK,LDH,RNS,decrement response
https://ajfm.journals.ekb.eg/article_18669.html
https://ajfm.journals.ekb.eg/article_18669_2ea7f4e98ebc348a9c81051aae72925a.pdf