Organophosphorus compounds are widely used pesticides. They are associated with a significant risk of acute intoxication. Oxidative stress is a contributing factor of acute organophosphorus poisoning morbidity and mortality. L-carnitine was found to have free-radical scavenging and antioxidant properties. Therefore, we aimed to evaluate the efficacy and safety of L-carnitine as an adjuvant in treatment of patients with acute organophosphorus poisoning. A randomized clinical trial was conducted on 30 patients suffering from acute organophosphorus poisoning admitted to Poison Control Center, Tanta University Emergency Hospital, Egypt, from April 2017 till January 2018. Patients were randomly divided into two equal groups. Group I received the standard treatment only and group II received the standard treatment plus L-carnitine in a dose of 1gm/8 hours IV.At time of admission, malondialdehyde, reduced glutathione, serum total antioxidant capacity and psudocholinesterase enzyme activity registered no significant difference between the two studied groups. After treatment, malondialdehyde, reduced glutathione and serum total antioxidant capacity showed significant improvement in group II. The mean value of atropine dose in group II (5.6mg) was significantly lower than group I(10.9mg). We concluded that the use of L-carnitine improved the antioxidant status and reduced total atropine dose required for treatment of patients with acute organophosphorus poisoning.

Theophylline is a bronchodilator drug that is used in the treatment of asthma and chronic obstructive pulmonary diseases. Cardiovascular complications contribute to morbidity and mortality that associate acute theophylline intoxication. The current study aimed to investigate troponin I and creatine kinase-MB as predictors of the severity and outcomes in cases of acute theophylline intoxication. This prospective cohort study included thirty one patients with acute theophylline toxicity admitted to Tanta Poison Control Center during the period from the first of March 2018 to the end of February 2019. Patients were subjected to personal and toxicological history taking, vital signs collection, grading of acute theophylline toxicity and measurement of serum theophylline level. Both troponin I and creatine kinase-MB were measured at admission and 12 hours post admission. Results revealed that, troponin I at time of admission and 12 hours post admission in addition to creatine kinase-MB 12 hours post admission were significantly higher in cases with severe acute theophylline intoxication and patients who required intensive care unit admission. It was concluded that, troponin I could predict the severity and the requirement of intensive care unit admission in acute theophylline toxicity either with early or delayed presentation. On the other hand, creatine kinase-MB could be considered for patients with delayed presentation.

Introduction: Safety is considered the main mission in life. Decreasing death rate in homes, at work and among communities must be done through education and researches promotion. About 90% of poisoning happened due to lack of awareness. The aim of this study: is to illustrate the efficacy of Clinical Toxicology Curriculum on the 4 th year Egyptian students-academic year 2018-2019 Faculty of Medicine-Tanta University in improvement their concept about human safety from toxicity. Methodology: Self designed questionnaire-based survey was conducted on the 4 th year Egyptian students-Faculty of Medicine-Tanta University, administered in two parts; part I: pre course test was done in the second day of Clinical Toxicology curriculum and part II: post course test was done at the end of Clinical Toxicology curriculum which lasting for two months. Results: Number of 4 th year Egyptian students participated in the study were 755. More than half of them were males, urban, and interesting in Clinical Toxicology study. The mean total knowledge score of participants was statistically significantly higher in post course test. Additionally, despite both genders showed significant increase in the mean total knowledge score, but the magnitude of knowledge gain was observed to be higher in females than males. Conclusion: it could be concluded that, many subjects in Clinical Toxicology Curriculum introduced satisfactory knowledge about safety like; how to maintain safety from household cleaning agents, but others need modifications like; safety from medications poisoning.

Chronic lead toxicity is more common and serious for multiple organs. The objective of the present study was designed to detect subclinical neuropathies in Egyptian workers exposed to lead. A cross sectional study was carried out on sixty male Egyptian individuals; fifty workers were chronically occupationally exposed to lead and ten apparently healthy male volunteers not exposed to lead in their occupation served as a control group. All cases were subjected to clinical examination for lead toxicity. Neurological and nerve conduction study were done for both motor and sensory nerves. Estimation of blood and urine lead levels for all participants was done. A laboratory assessment was carried out for evaluation of hemoglobin level, reticulocytic count and basophilic stippling. The result of this study demonstrated elevation of both blood and urine lead levels of all workers. Increased in distal motor latency with slow conduction velocity and decreased amplitude of nerve conduction were observed in the studied nerves of all workers exposed to lead. Also, slow conduction velocity and decreased amplitude were the earliest and most sensitive finding of sensory conduction study of all workers exposed to lead. There were a significant correlation between blood and urine lead level, duration of exposure to lead and different parameters of nerve conduction. The present study concluded that nerve conduction either sensory or motor can give a clear image about chronic lead poisoning even with absence of any clinical findings (sub-clinical neuropathy). This study recommend periodic examination of workers exposed to lead for early detection and after recognition of these affected workers we must advise them improve their hygiene, use personal protective equipments or try to change their work and to notify industrial safety about them.

Introduction: Acute organophosphate (OP) poisoning is a global health problem and responsible for many deaths worldwide every year. It acts by inhibition of acetylcholinesterase causing cholinergic crises that lead to muscarinic, nicotinic and central manifestations. One of the most serious complications of organophosphate exposure is cardiac toxicity including electrocardiogram changes.This study aimed to evaluate corrected QT interval as predictor of major outcome events which included mortality, need for mechanical ventilation, number of atropine and toxogonine ampoules and duration of hospital stay in acute organophosphate toxicity. Methods: The study recruited 98 patients suffering from acute OP poisoning, who were admitted to Tanta University Poison Control Unit. QTc interval length and the different outcomes of the patients were recorded. Results: Fifty five patients (56.1 %) showed a prolonged QTc interval. Significant statistical association was recorded between QTc interval and delay time, manner & route of poisoning, severity of oranophosphrous toxicity and pseudocholinesterase level. Also, significant statistical association was recorded between QTc interval and need for mechanical ventilation, mortality, number of atropine & toxogonine ampoules and duration of hospital stay. Conclusion: Finally, it was concluded that QTc interval could be a good predictor for outcomes of acute organophosphrous poisoning.