Evaluation of Potential Oxidative Stress in Egyptian Patients with Acute Zinc Phosphide Poisoning and the Role of Vitamin C

Abstract

Objective: To evaluate potential oxidative stress in patients with acute phosphide poisoning and the effect of vitamin C. Methods:Participants were females and divided into three groups; group I: healthy volunteers group II: healthy volunteers received vitamin C, group III: patients with acute phosphide poisoning received the supportive and symptomatic treatment and group IV: patients with acute phosphide poisoning received the supportive and symptomatic treatment in addition to vitamin C. All the participants were subjected to thorough history, clinical examination, ECG and laboratory investigations were carried on collected blood and gastric lavage samples on admission. Blood samples were divided into two parts, one for measurement of routine investigations and the second part was used for evaluation of malondialdehyde and total thiol levels before and after receiving the treatment regimen.Results: Most of the cases in this study were among the age group of 15-25 years, females, single, secondary school education, from rural areas and suicidal. All vital signs were within normal range and the most common complaint was vomiting and abdominal pain. All cases in this study showed normal routine investigations. The mean MDA levels after receiving treatment decreased significantly in groups II and IV. The mean total thiol levels increased significantly after receiving treatment in groups II and IV. Conclusion:It can be concluded that vitamin C has a potential benefit due to its antioxidant property on zinc phosphide induced-oxidative stress in acute zinc phosphide poisoned patients.

Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

“…Regarding the amount of phosphides, 29.3% of studied patients were exposed to unknown amount of phosphides with the majority of ZnP poisoned patients were exposed to one sachet while ALP intoxicated patients were exposed to 0.25-1 tablet. In line with our results, Sagah et al (2015) study reported that ZnP intoxicated patients ingested from 0.25-2 sachets and all of them were asymptomatic. Trakulsrichai et al (2017) found that most of their studied patients were exposed to less than one sachet of ZnP.…”

“…Majority of acute phosphides intoxicated patients were females (63.3%). Our result was supported by other studies, explained by higher liability of female to stress (Mahmoud et al, 2013;Sagah et al, 2015 and. Etemadi-Aleagha et al (2015) and Trakulsrichai et al (2017) are against the current study as they reported that males were more exposed to acute phosphides toxicity than females and explained this by their involvement in various social activities exposing them to more stress.…”

“…Most of studied patients were students (46.3%).This in agreement with Murari and Sharma (2014) and Sagah et al (2015) who reported that acute phosphides poisoning was common in students in secondary school education due to admonishment from their teachers and failure or less percentages in exams. In contrast to our study, Anand et al (2011) in India found that most of exposed patients were farmers or workers in the agriculture field.…”

“…Metal phosphides are type of rodenticides that are extremely lethal with low safety and high mortality rates as high as 70-100% (Mehrpour et al, 2012;Etemadi-Aleagha et al, 2015). They are commonly used as a powerful suicidal tool in Egypt and developing countries due to their lower price, widespread use as a strong rodenticide and easy availability (Sagah et al, 2015;Badawi et al, 2018).…”

“…A similar mechanism could also play a role in humans and contribute to the missing link in the pathogenesis of their toxicity but there is a limitation of data measuring the total antioxidant capacity in patients with aluminum phosphide (ALP) toxicity. Many studies have been carried out to calculate oxidative stress markers in acute aluminium phosphide poisoning while no studies have been done on acute zinc phosphide (ZnP) poisoning (Kariman et al, 2012 andSagah et al, 2015).…”