Pesticides are a large and heterogeneous group of chemicals which have long been used to control and repel pests in different fields.The organophosphates are the most widely used pesticides in industry, agriculture and houses. This study intends to evaluate the effectiveness of obidoxime therapy for reactivation of cholinesterase enzyme and its correlation with severity of poisoning among organophosphorus poisoning cases presented to Mansoura poisoning control unit (received oxime as aline of therapy) and Damietta general hospital, (did not received oxime as aline of therapy) during the period from 1 st March 2015 to the end of February 2017. A total number of 303 patients presented with acute anticholiesterase poisoning (150 in Damietta and 153 in Mansoura Emergency Hospital). A total of 250 cases were diagnosed to be organophosphorus by TLC {112 in Damietta and 138 in Mansoura emergency hospital} and only 200 of them were included in this study according to exclusion criteria. Data on evaluation of obidoximes in treatment of organophosphorus (OP) poisoning incorporating the maximal clinical parameters and comparing the two groups in an unbiased manner, revealed that the use of obidoximes decreased the required dose of atropine and duration of hospital stay when compared with atropine alone. It is clear that there may be potential benefit from oximes as acetyl cholinesterase (AChE) activity is clearly increased by treatment.

Early assessment of patients presented with acute organophosphorus toxicity in the Emergency Department is an essential step to detect their pathway in the hospital. The present study aimed to assess the overall accuracy of Acute Physiology and Chronic Health Evaluation (APACHE II), Modifies Early Warning Score (MEWS), and Worthing Physiological Score (WPS) in predicting mechanical ventilation in acute organophosphorus toxicity patients. A cross-sectional cohort study was conducted on 132 patients presented with acute organophosphorus patients. From each patient, the following was collected: clinical data, routine laboratory investigations results, and blood samples for estimation of cholinesterase levels. The clinical and laboratory data were used to calculate APACHE II, MEWS, and WPS scores within six hours from admission. Statistical analysis revealed that the median values of APACHE II, MEWS, and WPS differed significantly between mechanically ventilated and non-mechanically ventilated patients. A strong significant negative correlation was detected between clinical severity and cholinesterase levels. WPS score showed the highest discriminatory power for predicting mechanical ventilation (area under the curve [AUC] 0.977). However, APACHE II and MEWS scores were nearly equal in their discriminatory power (AUC 0.924 and 0.927 respectively). Cholinesterase levels can be used as a useful diagnostic tool but are very poor in predicting patient outcomes (AUC 0.209 and 0.129 for acetylcholinesterase and butyrylcholinesterase respectively). In conclusion, using the WPS score for clinical evaluation of acute organophosphorus toxicity patients has valuable prognostic abilities for predicting patients' outcomes.

GATA binding protein 3 was more sensitive than traditional markers such as gross cystic disease fluid protein 15 and mammaglobin for identifying primary and metastatic breast carcinomas, but its significance decreased in triple-negative breast cancer. Recent studies showed a high expression rate of proline glutamic acid and leucine-rich protein in breast cancer and their superiority over GATA3 in triple-negative breast cancer. Our study provided new insights into the diagnostic and prognostic roles of PELP1 and GATA3 in primary and metastatic breast cancer. An immunohistochemical assay was carried out using PELP1 and GATA3 in 60 cases of primary breast cancer and 15 metastatic. Invasive carcinoma of no special type was the predominant type (80%). The majority of cases were grade 3 (68.3%). GATA3 expression was 83.3% positive in primary breast carcinomas and 73.5% positive in metastatic breast carcinomas. In comparison, PELP1 had a 96.7% positive expression rate in primary breast carcinomas and an 86.7% positive expression rate in metastasis. There was a statistically significant agreement between GATA3 and PELP1 in the diagnosis of the cases. PELP1 is a significantly higher proportion of both primary and metastatic breast carcinomas than GATA3. In breast cancer, there was a strong association between favorable prognostic factors and GATA3 expression, with evidence of an inverse association with Ki-67 overexpression.

Background and study aim: Treatment of HCV with interferon takes a long duration and has many side effects. The use of antioxidants with interferon/ribavirin therapy is believed to minimize the side effects and improves adherence and hence improves response to therapy. Reactive oxygen species are part of the human defense mechanisms towards infection and they increase due to hepatitis C virus infection. In this study we aim to study the impact of the concomitant use of antioxidants with interferon/ribavirin combination therapy for HCV on response as regards enzymes level, rate of viral clearance as well as liver histopathology.. Patients and methods: 240 patients on interferon/ribavirin therapy for chronic hepatitis C divided in two groups. The test group received concomitant antioxidant combination while the control group received only interferon/ribavirin. Follow up of liver function tests, complete blood count, viral load by PCR and post treatment histopathology by liver biopsy were performed. Results: Liver enzymes level in test group achieved a larger and faster decline than in control group. Hematological parameters were significantly higher in the test group all through period of follow up. Viral load and histopathology showed no significant difference between the two groups. Conclusion: concomitant use of antioxidants with interferon/ ribavirin therapy minimizes complications of therapy and rapidly normalizes the liver enzymes level without affecting the rate of response to therapy or histopathology of the liver.

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