All rights reserved. AbstractTricyclic 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.

Background Low-dose mercury exposure has been shown to be associated with adverse childhood health outcomes. Fish is the major source of mercury exposure in children. Our aim was to investigate the associations between estimated fish intake with total mercury (tHg), inorganic mercury (iHg), and methylmercury (MeHg). Methods Based on fish food frequency questionnaire (FFQ) data, subjects above the top and below the bottom quartiles of monthly fish intake frequency were contacted for recruitment. Subject hair tHg, iHg, MeHg levels were determined, and fish intake assessed by fish FFQ and 14-day food diary (FD). Associations between fish intake and hair mercury were analysed. Results 96 children were recruited and 38 of them completed the FD. Among these 96 children and those who have FD data, 55% and 50% were high fish consumers, respectively. The mean ratio of iHg: MeHg was 1:1.4. Comparisons between hair mercury levels and fish intake levels of high and low fish consumers are shown in Figure 1. Fish intakes calculated from both FFQs and FD were positively correlated with tHg, iHg and MeHg (all p < 0.05). However, in general, better correlations were found between FD data and hair mercury (Spearman's rho for tHg = 0.416; iHg = 0.352; MeHg = 0.448) than between FFQ and hair mercury (Spearman's rho for tHg = 0.308; iHg = 0.360; MeHg = 0.262). Conclusions Fish intake data obtained from both FFQs and FDs were positively associated with hair mercury levels. FDs performed better than FFQs. The high proportion of iHg: MeHg is unexpected and warrants further study. Objective Guiyu is the major electronic-waste (e-waste) recycling town in China. This study was to measure the effect of e-waste exposure on the synthesis of haemoglobin (Hb) in preschool children. Methods 222 children lived at Guiyu town and 204 children lived in a no e-waste polluted town were chosen to test their blood lead, Hb, ferritin, folate, vitamin B 12 levels and hemoglobinopathy, then fill the self-questionnaires by their parents. Results There were no significant differences in the levels of ferritin, folate, vitamin B 12 between exposure and control groups, and all children had been excluded thalassemia. The blood lead levels (BLLs) and rate of BLLs ≥ 10 ug/dL in exposure group were signifcantly higher than that in control group (all p < 0.01). Three groups were divided according to BLLs (Group A: <5.0 ug/dL, Group B: 5.0-9.9 ug/dL, Group C: ≥10.0 ug/dL). It can be seen that the levels of Hb were decreased along with elevated BLLs significantly in exposure group (F = 3.52, p = 0.03), however, not shown in control group (F = 1.98, p = 0.14). Furthermore, the prevalence rate of anaemia along with BLLs ≥10 ug/dL in exposure group was significant higher than that in control group (4.0% vs. 0.5%, p < 0.05), and the prevalence rate of anaemia without BLLs ≥10 ug/dL and iron deficiency in exposure group was significant higher than that in control group (6.5% vs. 2.0%, p < 0.05). PS-002 EFFECTS OF E-WASTE EXPOSURE ON THE SYNTHESIS OF HAEMOGLOBIN IN PRESCH...