Search results for: organophosphorus poisoning

Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: Acute poisoning is the common cause of morbidity and mortality. Characteristics of acute poisoning differ between countries. While other countries operate the database system for poisoning, Korea has not collected the database for acute poisoning. Distribution of incidence of acute poisoning depending on the types of materials have also not studied in Korea. Our aims are to evaluate the etiologic and demographic characteristics of acute poisoning cases and to obtain up-to-date information on acute poisonings. Method: We retrospectively recorded cases of acute poisoning from eight emergency departments of second level or university hospitals from different cities in Gyeonggi province in Korea from April 2006 and March 2015. The distributions of incidence of acute poisoning depending on the types of materials are mapped by geographic information system. Result: A total of 3,449 poisoned cases were analyzed. Mean estimated age of patients was 39.56 ± 22.40 years. Mean male to female ratio of patients was 1:1.4. Mean proportion of intentional poisoning was 57.9%. Common materials are benzodiazepine (16.6%), carbon monoxide (10.5%), pesticide (8.1%) and zolpidem (7.1%) Common route of exposure is ingestion (79.5%) and followed by inhalation (16.5%). Common treatment methods are gastric lavage (20%) and activated charcoal (30%). Most cases had uneventful recovery; 61.4% were treated as outpatients and 0.1% of the poisoning resulted in death in ER. Conclusion: Even though the cases enrolled in our study is not the overall cases of acute poisoning in Korea, our study could be the basis of countermeasures for analysis and prevention of acute poisoning in Korea.

Keywords: acute poisoning, emergency department, epidemiology, Korea

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Authors: Lubica Muckova, Petr Jost, Jaroslav Pejchal, Daniel Jun

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The development of acetylcholinesterase reactivators, i.e. antidotes against organophosphorus poisoning, is an important goal of defence research. The aim of this study was to compare cytotoxicity and chemical structure of 5 currently available (pralidoxime, trimedoxime, obidoxime, methoxime, and asoxime) and 4 newly developed compounds (K027, K074, K075, and K203). In oximes, there could be at least four important structural factors affecting their toxicity, including the number of oxime groups in the molecule, the position of oxime group(s) on pyridinium ring, the length of carbon linker, and the substitution by oxygen or insertion of the double bond into the connection chain. The cytotoxicity of tested substances was measured using colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay (MTT assay) in SH-SY5Y cell line. Toxicity was expressed as toxicological index IC₅₀. The tested compounds showed different cytotoxicity ranging from 1.5 to 27 mM. K027 was the least, and methoxime was the most toxic reactivator. The lowest toxicity was found in a monopyridinium reactivator and bispyridinium reactivators with simple 3C carbon linker. Shortening of connection chain length to 1C, incorporation of oxygen moiety into 3C compounds, elongation of carbon linker to 4C and insertion of a double bond into 4C substances increase AChE reactivators' cytotoxicity. Acknowledgements: This work was supported by a long-term organization development plan Medical Aspects of Weapons of Mass Destruction of the Faculty of Military Health Sciences, University of Defence.

Keywords: acetylcholinesterase, cytotoxicity, organophosphorus poisoning, reactivators of acetylcholinesterase

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Authors: Mudafara Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: poisoning, children, hospital, medical

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Authors: Priyanka Ghosh, Priti Kumar Roy

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Every year a considerable number of people die due to methyl alcohol poisoning, in which most of them die even before proper treatment. This work gives a simple and cheap first aid to those affected individuals by the administration of activated charcoal. In this article, we emphasise on the adsorption capability of activated charcoal for the treatment of poisoning and use an impulsive differential equation to study the effect of activated charcoal during adsorption. We also investigate the effects of various parameters on the adsorption which are incorporated in the model system.

Keywords: activated charcoal, adsorption, impulsive differential equation, methanol poisoning

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Authors: Michaela Vašková, Jiří Barta, Otakar J. Mika, Jan Hrdlička, Josef Kellner

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The paper is focused on the method to solutions the crisis situation in the Czech Republic associated with the mass methanol poisoning. The emphasis is put on tasks of individual state bodies and of Integrated Rescue System during the handling of the crisis. The theoretical part describes poisonings, ways of intoxication, types of intoxicants and cases of mass poisoning by dangerous substances in the world. The practical part describes the development, causes and solutions of extraordinary event, mass methanol poisoning in the Czech Republic. The main emphasis was put on the crisis management of the Czech Republic in solving this situation.

Keywords: crisis management, poisoning, methanol, hazardous substances, extraordinary event

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Authors: Beulah Rani Inbanathan

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In the present era, it is vivid from the numerous outcomes that data privacy is being compromised in various ways. Machine learning is one technology that uses the centralized server, and then data is given as input which is being analyzed by the algorithms present on this mentioned server, and hence outputs are predicted. However, each time the data must be sent by the user as the algorithm will analyze the input data in order to predict the output, which is prone to threats. The solution to overcome this issue is federated learning, where the models alone get updated while the data resides on the local machine and does not get exchanged with the other local models. Nevertheless, even on these local models, there are chances of data poisoning, and it is crystal clear from various experiments done by many people. This paper delves into many ways where data poisoning occurs and the many methods through which it is prevalent that data poisoning still exists. It includes the poisoning attacks on IoT devices, Edge devices, Autoregressive model, and also, on Industrial IoT systems and also, few points on how these could be evadible in order to protect our data which is personal, or sensitive, or harmful when exposed.

Keywords: data poisoning, federated learning, Internet of Things, edge computing

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Authors: Michael Stevens

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David Hunter, a musicologist, has suggested that both Beethoven and Handel had chronic lead poisoning from the wine that they drank. These two eminent musical composers had some striking similarities. Beethoven had alcohol dependency and preferred wine, to which lead had been added to improve the taste. Handel was obese due to an eating disorder that included drinking tainted wine after large meals. They both had paresthesia of their extremities that they interpreted as rheumatism. This is a common sensory symptom from chronic lead poisoning. Their differences are marked in that Beethoven was profoundly deaf by the end of his life, whereas Handel had remarkably good hearing. Handel had paresis of three fingers of his right hand, whereas Beethoven lacked any motor symptoms. Beethoven reported recurrent abdominal pain suggestive of lead colic, whereas it can only be inferred that this symptom was present in Handel. Lead poisoning is likely in Handel because his paralysis was consistent with radial nerve involvement in the dominant hand. In addition, it was cured by hot baths, which have been shown to reduce total body lead content by exchanging with iron and calcium ions in water. Although lead produces predominantly motor symptoms in classic or subacute lead poisoning, and sensory symptoms in chronic lead poisoning, lead poisoning causes a variety of symptoms that depending on duration and level of exposure, are extremely variable from person to person. It therefore seems likely that Handel had lead poisoning, but extremely likely that Beethoven did because of the confirmatory finding of high levels of lead deep in his skull bone, which is a good measure of total body burden.

Keywords: beethoven, handel, lead, poisoning

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Authors: Sabiha Sahin

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Introduction: We have planned this study because of the increasing number of corrosive substance poisoning who admitted to the Pediatric Emergency Department. Method: 636 corrosive substance poisoning cases applied to the Osmangazi University PED between 1 January 2015 - 31 December 2017 were retrospectively analyzed. Results: 438 (69%) cases were male.The poisoning rate of groups 0-4 was significantly higher and occurred by accident. A total of 616 cases (96.9%) were poisoned by the oral route, and 20 cases were poisoned by inhalation.462 Patients were admitted to the hospital within an hour (72.8%). Of the 134 patients who had only erosion and redness around the mouth, 24 patients had salivation and dysphagia symptoms besides these. Of the 28 cases of 158 patients with symptoms, eusaphegeal stenosis was detected. on third day examination. Although there was no statistically significant correlation between esophageal stenosis and erosion and redness around the mouth, there was a statistically significant correlation between dysphagia and salivation between esophageal stenosis Conclusion: The increased salivation and the dysphagia are important signs of risk of devoloping esophageal stenosis at first examination corrosive poisoning in children.

Keywords: caustic, corrosive, poisoning, children

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Authors: Atitallah Sofien, Bouyahia Olfa, Hadj Salah Ibrahim, Ben Saleh Foued, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Carbon monoxide (CO) poisoning is a common pathology responsible for high morbidity and mortality worldwide. Aim: The purpose of this study was to determine the epidemiological profile of CO poisoning as well as its clinical, paraclinical, therapeutic, and evolutionary aspects. Methods: Our study included observations of CO poisoning in children hospitalized in the pediatric department C of the Children's Hospital in Tunis over a period of 3 years. Results: We have collected 199 cases of CO poisoning in children. The average age was 5.43 years, with a sex ratio of 0.98. The source of CO was inside the home in 73.2% of cases, and it was the gas bath heater in 68.8% of cases. The intoxication was collective in 93.5% of the cases, and it occurred during the month of January in 35.8% of the cases. The clinical manifestations were headaches in 69.5% of cases. The rate of carboxyhemoglobin was pathological in 73.9% of cases. All patients received normobaric oxygen therapy, and only 3.6% of patients had a hyperbaric oxygen therapy session. We did not deplore any case of death in our study. Conclusion: CO poisoning remains a public health problem in Tunisia with high morbidity. The risk of secondary complications, particularly neuropsychiatric, requires clinical and possibly neuroradiological monitoring of these victims.

Keywords: poisoning, carbon monoxide, children, hyperbaric oxygenation

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Authors: Turker Yardan, Bahattin Avci, S. Sirri Bilge, Ayhan Bozkurt

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Sinapic acid (SA) is a phenylpropanoid compound with anti-inflammatory, antioxidant, and neuroprotective activities. The purpose of this study was to characterize the possible protective effect of sinapic acid on chlorpyrifos (CPF), a common organophosphorus pesticide used worldwide, induced toxicity in rats. Forty male and female rats (240-270 g) were used in this study. Each group was composed of 5 male and 5 female rats. Sinapic acid (20 mg/kg or 40 mg/kg) or vehicle (olive oil, 1 ml ⁄ rat) were given orally for 5 days. CPF (279 mg/kg) or vehicle (peanut oil, 2 ml ⁄ kg, s.c.) was administered on the sixth day, immediately after the recording of the body weight of the animals. Twenty four hours following CPF administration body weight, body temperature and locomotor activity values were recorded before decapitation of the animals. Trunk blood, brain, and liver samples were collected for biochemical examinations. Chlorpyrifos administration decreased butyrylcholinesterase activity in blood, brain, and liver, while it increased malondialdehyde (MDA) levels and advanced oxidation protein products (AOPPs) (p < 0.01 - 0.001). Additionally, CPF administration reduced the body weight, body temperature, and locomotor activity values of the animals (p < 0.01 - 0.001). All these physiological and biochemical changes induced by CPF were reduced with the 40 mg/kg dose of SA (p < 0.05 - 0.001). Our results suggest that SA administration ameliorates CPF induced toxicity in rats, possibly by supporting the antioxidant mechanism.

Keywords: antioxidant, Chlorpyrifos, poisoning, sinapic acid

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Authors: J. C. Akan, F. I. Abdulrahman, Z. M. Chellube

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The aim of this study was to determine the levels of some organochlorine (o, p-DDE, p,p’-DDD, o,p’-DDD, p,p’-DDT, p,p’-DDT, α-BHC, γ-BHC, lindane, Endosulfan sulphate, dieldrin and aldrin and organophosphorus (Dichlorvos, Diazinon, Chlorpyrifos, fenitrothion and Fenitrothion) pesticide residues in the gills, liver, stomach, kidney and flesh of four fish species (Tilapia zilli, Clarias anguillaris Hetrotis niloticus and Oreochronmis niloticus) between the periods of September 2010 to October, 2011. Samples were collected from Kwantan turare in Lake Chad, Baga, Borno State, Nigeria. Extraction of the fish samples and de-fattening of the fish sample extracts were performed using standard procedures. Analysis of the fish samples for pesticide residues were carried out using Shimadzu GC/MS (GC – 17A), equipped with fluorescence detector. Large differences in the levels of pesticide residues were observed between tissues within each fish. The concentrations of all the organophosphorus pesticides were higher in the organs of Oreochronmis niloticus, while Hetrotis niloticus shows the lowest. For organochlorine pesticides, the organs of Tilapia zilli showed the highest concentrations, while Hetrotis niloticus shows the lowest. The highest pesticide concentrations were observed in gills and liver tissues of all the species of fish study, while the lowest concentrations were observed in flesh. Based on the above results, it can therefore be concluded that the concentrations of pesticide in the four fish species study did exceed the permissible limits set by FAO and FEPA.

Keywords: organochlorine, organophosphorus, pesticides, accumulation, fish, lake chad

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Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav

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The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.

Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care

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Authors: Tachita Vlad-Bubulac, Ionela-Daniela Carja, Diana Serbezeanu, Corneliu Hamciuc, Vicente Javier Forrat Perez

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The present work describes the preparation of new organophosphorus compounds with high content of phosphorus followed by the incorporation of these compounds into epoxy resin systems in order to investigate the phosphorus effect in terms of thermal stability, flame-retardant and mechanical properties of modified epoxy resins. Thus, two new organophosphorus compounds have been synthesized and fully characterized. 6-Oxido-6H-dibenz[c,e][1,2]oxaphosphorinyl-phenylcarbinol has been prepared by the addition reaction of P–H group of 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide to carbonyl group of benzaldehyde. By treating the phenylcarbinol derivative with POCl3 a new phosphorus compound was obtained, having a content of 12.227% P. The organophosphorus compounds have been purified by recrystallization while their chemical structures have been confirmed by melting point measurements, FTIR and HNMR spectroscopies. In the next step various flame-retardant epoxy resins with different content of phosphorus have been prepared starting from a commercial epoxy resin and using dicyandiamide (DICY) as a latent curing agent in the presence of an accelerator. Differential scanning calorimetry (DSC) has been applied to investigate the behavior and kinetics of curing process of thermosetting systems. The results showed that the best curing characteristic and glass transition temperature are obtained at a ratio of epoxy resin: DICY: accelerator equal to 94:5:1. The thermal stability of the phosphorus-containing epoxy resins was investigated by thermogravimetric analysis in nitrogen and air, DSC, SEM and LOI test measurements.

Keywords: epoxy resins, flame retardant properties, phosphorus-containing compounds, thermal stability

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: Hasibe Caballero-Gomez, Richard Pepino

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Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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Authors: M. A. Hannan, N. Matthias Neisius

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Organophosphorus compound diethyloxymethyl-9-oxa-10-phosphaphenanthrene-10-oxide (DOPAC) was applied on cotton cellulose to impart eco-friendly flame retardant property to it. Here acetal linkage was introduced rather than conventionally used ester linkage to rescue from the undurability problem of flame retardant compound. Some acidic catalysts, sodium dihydrogen phosphate (NaH2PO4), ammonium dihydrogen phosphate (NH4H2PO4) and phosphoric acid (H3PO4) were successfully used to form acetal linkage between the base material and flame retardant compound. Inspiring limiting oxygen index (LOI) value of 22.4 was found after exclusive washing treatment. A good outcome of total heat of combustion (THC) 6.05 KJ/g was found possible during pyrolysis combustion flow calorimetry (PCFC) test of the treated sample. Low temperature dehydration with sufficient amount of char residue (14.89%) was experienced in case of treated sample. In addition, the temperature of peak heat release rate (TPHRR) 343.061°C supported the expected low temperature pyrolysis in condensed phase mechanism. With the consequence of pyrolysis effects, thermogravimetric analysis (TGA) also reported inspiring weight retention% of the treated samples.

Keywords: acetal linkage, char residue, cotton cellulose, flame retardant, loi, low temperature pyrolysis, organophosphorus, THC, THRR

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Authors: Ali Mohagheghzadeh, Samad Vaez Badiegard, Bita Shomali

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Nowadays, with the increase in population, the need for protein sources is increasing. Different bacteria can cause food poisoning while most of the symptoms of food poisoning are similar to those of gastrointestinal infections. As a result, the diagnosis of bacteria and viruses causing food poisoning would not be possible without a stool culture. Cases of food poisoning are often accompanied by gastrointestinal disorders such as diarrhea, vomit, and gastrointestinal stomach cramps. Thus, providing enough food, taking into account health issues has always been a concern of authorities. Since E. coli bacterium is one of the important indicators of food hygiene and quality, producing food without being contaminated by this bacterium is desired in the food industry. This study aimed at assessing the E. coli contamination of poultry meat produced in slaughterhouses. Samples were taken from critical areas of slaughterhouses, namely the feather picking area, viscera and carcass evacuation area the area after cooling chillers. The results showed that 60% of contamination occurs in feather picking area. Among antiseptic and detergent materials, the highest reduction belongs to Epimax.

Keywords: slaughterhouse, E. coli, Epimax, contamination

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Authors: Sathvika Reddy, Devi Revathi

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Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Alexandre S. Guimarães, Marcelo B. Mansur

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The performance of organophosphorus extractants Cyanex 272 and D2EHPA on the purification of concentrate nickel sulfate solutions was evaluated. Batch scale tests were carried out at pH range of 2 to 7 using a laboratory solution simulating concentrate nickel liquors as those typically obtained when sulfate intermediates from nickel laterite are re-leached and treated for the selective removal of cobalt, zinc, manganese and copper with Cyanex 272 ([Ca] = 0.57 g/L, [Mg] = 3.2 g/L, and [Ni] = 88 g/L). The increase on the concentration of D2EHPA favored the calcium extraction. The extraction of magnesium is dependent on the pH and of ratio of extractants D2EHPA and Cyanex 272 in the organic phase. The composition of the investigated organic phase did not affect nickel extraction. The number of stages is dependent on the magnesium extraction. The most favorable operating condition to selectively remove calcium and magnesium was determined.

Keywords: solvent extraction, organophosphorus extractants, alkaline earth metals, nickel

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Authors: Ahmed Boucherit, Hussein Khalaf, Eduardo Paredes, José Luis Todolí

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Solvent extraction studies of molybdenum (VI) with two organophosphorus reagents namely TBP and D2EHPA have been carried out from aqueous acidic solutions of HCl, H2SO4 and H3PO4 under microwave irradiations. The extraction efficiencies of the investigated extractants in the extraction of molybdenum (Vl) were compared. Extraction yield was found unchanged when microwave power varied in the range 20-100 Watts from H2SO4 or H3PO4 but it decreases in the range 20-60 Watts and increases in the range 60-100 Watts when TBP is used for extraction of molybdenum (VI) from 1 M HCl solutions. Extraction yield of molybdenum (VI) was found higher with TBP for HCl molarities greater than 1 M than with D2EHPA for H3PO4 molarities lower than 1 M. Extraction yield increases with HCl molarities in the range 0.50 - 1.80 M but it decreases with the increase in H2SO4 and H3PO4 molarities in the range of 0.05 - 1 M and 0.50 - 1 M, respectively.

Keywords: extraction, molybdenum, microwave, solvent

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Authors: Somayeh Khanjani, Samaneh Nabavi, Shirin Jalili

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Aluminum phosphide (ALP) is an inorganic phosphide used to control insects and is a highly effective insecticide and rodenticide used frequently to protect stored grain. Acute poisoning with this compound is common in some countries including India and Iran, and is a serious health problem. In Iran it was known as "rice tablet", for its use to preserve rice. Two kinds of rice tablets one being herbal while other containing 3g aluminum phosphide (AlP) are available for use in Iranian households to protect stored food grains from pests and rodents. The toxicity of Aluminum phosphide is attributed to the liberation of phosphine gas in contact with water or weak acid and is the major cause of poisoning and deaths. Rice tablet (Aluminum Phosphid) poisoning may be associated with serious and sometimes incurable complications. In 61.3% of patients were shown uniform ingestion. Vomiting was the most common symptoms reported by 96.4% patients. Agitation was reported in 36.9% and felling of thirsty in 27.9 %. Although many complications such as Hypotension, Adult Respiratory Distress Syndrome (ARDS), Acute Renal Failure (ARF) AND Multi Organ Failure (MOF) were the common complications observed in these patients, but the most lethal complication was Cardiac Arrhythmias occurred in 36.9% of cases. Abdominal pain in 31.4% of the patients, nausea in 79.4% of the patients and 41.1% of the patients showed metabolic acidosis. Suicidal intention was the most common cause of poisoning leading to deaths in 18.6% of the patients. Aluminum phosphide can cause either elevation, decrease or no change in electrolytes, bicarbonate and blood glucose level. The possible mechanism for changes in blood glucose levels are complex and depend on the balance of factors which increase its concentration and those which reduce it. AlP poisoning has been postulated to stimulate cortisol which leads to increasing blood level of cortisol, also it may cause stimulation of glucagon, and Adrenaline secretion; in addition, it can inhibit insulin synthesis which may lead to hyperglycemia. Another suggested mechanism of hyperglycemia is rennin activity in some cases, an increase in magnesium level of plasma and that of tissues, and high phosphate level. Although hyperglycemia is most frequent in this poisoning and also is known as a marker of poor prognostic, hypoglycemia in aluminum phosphide poisoning is a rare finding which may be so dangerous. Patients showed sever hypotension and sever acidosis in addition to sever hypoglycemia. The presenting features of AlP intoxication are rapid onset of shock, severe metabolic acidosis, cardiac dysrhythmias and adult respiratory distress syndrome (ARDS).

Keywords: aluminum phosphide (ALP), rice tablet, poisoning, phosphine gas

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Authors: Yu-Chen Luo, Wan-Tzu Yen, I-Ping Liu, Po-Hsuan Yeh, Yuh-Lang Lee

Abstract:

The use of a Pt electrode leads to high catalytic efficiency in the ethanol electro-oxidation. However, the carbon monoxide (CO) released in the reaction will poison the Pt surfaces, lowering the electrocatalytic activity. In this study, composite electrodes are prepared to overcome the poisoning issue, and the related electro-oxidation behaviors are studied by surface-enhanced infrared absorption spectroscopy (SEIRAS) and cyclic voltammetry (CV). An electroless plating method is utilized to deposit Pt catalytic layers on the Pd film-coated FTO substrates. According to the SEIRAS spectra, the carbon dioxide signal of the Pt/Pd composite electrode is larger than that of the Pt one, whereas the CO signal of the composite electrode is relatively smaller. This result suggests that the studied Pt/Pd electrode has a better ability against CO poisoning. The CV analyses are conducted in alkaline environments, and current densities related to the ethanol oxidation in the forward scan (If) and to the CO poisoning in the backward scan (Ib) are measured. A higher ratio of If to Ib (If/Ib) usually represents a better ability against the poisoning effect. The If/Ib values are 2.53 and 2.07 for the Pt and Pt/Pd electrodes, respectively, which is possibly attributed to the increasing ability of CO adsorption of Pt electrode. Despite the lower If/Ib, the Pt/Pd composite electrode shows a higher ethanol oxidation performance in the alkaline system than the Pt does. Furthermore, its stability is also superior.

Keywords: cyclic voltammogram, electroless deposition, ethanol electro-oxidation, surface-enhanced infrared absorption spectroscopy

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Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

Abstract:

Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

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Authors: Enayat Enayati, Reza Behtash

Abstract:

The purpose of the H2 removal system is to reduce a content of hydrogen and other combustibles in the CO2 feed owing to avoid developing a possible explosive condition in the synthesis. In order to reduce the possibility of forming an explosive gas mixture in the synthesis as much as possible, the hydrogen percent in the fresh CO2, will be removed in hydrogen converter. Therefore the partly compressed CO2/Air mixture is led through Hydrogen converter (Reactor) where the H2, present in the CO2, is reduced by catalytic combustion to values less than 50 ppm (vol). According the following exothermic chemical reaction: 2H2 + O2 → 2H2O + Heat. The catalyst in hydrogen converter consist of platinum on a aluminum oxide carrier. Low catalyst activity maybe due to catalyst poisoning. This will result in an increase of the hydrogen content in the CO2 to the synthesis. It is advised to shut down the plant when the outlet of hydrogen converter increased above 100 ppm, to prevent undesirable gas composition in the plant. Replacement of catalyst will be time exhausting and costly so as to prevent this, we increase the inlet temperature of hydrogen converter according to following Arrhenius' equation: K=K0e (-E_a/RT) K is rate constant of a chemical reaction where K0 is the pre-exponential factor, E_a is the activation energy, and R is the universal gas constant. Increment of inlet temperature of hydrogen converter caused to increase the rate constant of chemical reaction and so declining the amount of hydrogen from 125 ppm to 70 ppm.

Keywords: catalyst, converter, poisoning, temperature

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Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

Abstract:

The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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Authors: J. Bravo, F. Cabrera Suárez, B. Vega, L. Román, M. Martel, F. Acosta

Abstract:

Ciguatera fish poisoning (CFP) is the most common non-bacterial intoxication in the world caused by ingestion of fish with bio-accumulated ciguatoxins (CTXs). It is typical in tropical and subtropical areas, mainly affecting the Caribbean Sea, Polynesia and other areas in the Pacific and Indian Oceans. Interest in Europe by the CFP is increasing in recent years as more and more cases in European hospitals are appearing, usually by people who have consumed ciguatoxin imported fish or have travelled to areas of risk for this poisoning. Since 2004 a series of poisonings raised the question of a possible occurrence of ciguatoxin in Europe, especially in the area of Macaronesia in the East Atlantic temperate zone. Furthermore, some studies have identified the presence of Gambierdiscus spp. in waters surrounding the Canary Islands and Madeira, a toxic dinoflagellate related to this poisoning. The toxin accumulates and concentrates through the food chain and affects to the end of the chain, the human consumer. Fish were collected from the Canary Islands waters and the toxin has been extracted and purified by using acetone and liquid/liquid partition in order to eliminate the excess of fatty acids that may interfere with the detection of the toxin. The fish extracts were inoculated in Neuroblastoma (neuro-2a) cells. After 24-h cell viability was used as an endpoint for cytotoxic effects measurement. Since 2011 our laboratory is collecting data for species such Seriola spp., Epinephelus spp., Makaira spp., Pomatomus spp., Xiphias spp., and Acantocybium spp., from all islands and including the sports fishing and professional activities, we obtained a 8% of fish that have ciguatoxin in their muscle. With these results, we conclude that the island where fishing and fish size affects the probability of catching a fish with the ciguatoxin.

Keywords: Canary Islands, ciguatera fish poisoning, ciguatoxin, Europe

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Authors: M.Younus, M. Athar Khan, Asif Adrees

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The present research endeavour was made to investigate the Public Health impact of Salmonellosis through consuming the meat and eggs of the carrier’s birds and to see the prevalence of Salmonella enteritidis and Salmonella typhimurium from poultry feed, poultry meat, and poultry eggs and their role in the chain of transmission of salmonellae to human beings and causing food poisoning. The ultimate objective was to generate data to improve the quality of poultry products and human health awareness. Salmonellosis is one of the most wide spread food borne zoonoses in all the continents of the world. The etiological agents Salmonella enteritidis and Salmonella typhimurium not only produce the disease but during the convalescent phase (after the recovery of disease) remain carriers for indefinite period of time. The carrier state was not only the source of spread of disease with in the poultry but also caused typhoid fever in humans. The chain of transmission started from poultry feed to poultry meat and ultimately to humans as dead end hosts. In this experiment a total number of 200 samples of human stool and blood were collected randomly (100 samples of human stool and 100 samples of human blood) of 100 patients suspected from food poisoning patients from different hospitals of Lahore area for the identification of Salmonella enteritidis and Salmonella typhimurium through PCR method in order to see the public health impact of Salmonellosis through consuming the meat and eggs of the carrier birds. On the average 14 and 10 stool samples were found positive against Salmonella enteritidis and Salmonella typhimurium from each of the 25 patients from each hospital respectively in case of suspected food poisoning patients. Similarly on an average 5% and 6% blood samples were found positive from 25 patients of each hospital respectively. There was a significant difference (P< 0.05) in the sero positivity of stool and blood samples of suspected food poisoning patients as far as Salmonella enteritidis and Salmonella typhimurium was concerned. However there was no significant difference (P<0.05) between the hospitals.

Keywords: salmonella, zoonosis, food, transmission, eggs

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

Abstract:

Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Abdurrauf M. Gusbi, Mahmud H. Arhima, Abdurrahim A. Elouzi, Ebtisam A. Benomran, Salsabeela Elmezwghi, Aram Elhatan, Nafesa Elgusbi

Abstract:

Mass poisonings with methanol are rare but occur regularly both in developed and in non-developing countries. As a result of the tragedy that happened in the city of Tripoli Libya in March during year 2013 a number of patients were admitted to Tripoli Medical Center and Tripoli Central Hospital suffering from poisoning following ingestion of methanol by mistake. Our aims have been formulated to collect Information about those cases as much as we can from the archiving departments from the two hospitals including the number of cases that had been admitted, recovered patients and died victims. This retrospective study was planned to find out the reasons which allow those patients to drink methanol in our Muslim community and also the role of pharmacist to prevent such a disaster that claimed the lives of many people. During this tragedy 291 ospitalized patients their ages between 16-32 years old were admitted to both hospitals, total number of died 189 (121 at Tripoli medical center) and (68 at Tripoli central hospital), demographic data also shows that most of them are male (97%) and (3% female), about 4% of the patients foreigners and 96% were Libyans. There were a lot of obstacles and poor facilities at the time of patient admission as recognized in many cases including lack of first line of treatment. The morbidity was high due to the lack of antidote and availability of dialysis machines at this two main hospitals in Tripoli also according to survey done to the medical staff and also a random number of medical students shows about 28% have no idea about the first aid procedure used for methanol poisoning cases and this due to the absence of continuing education for all medical staff through the establishment of training courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: ethanol, fomepizole, methanol, poisoning

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