@article { author = {Rashidi, Mohammad Amin and MAHABADI, HASSAN ASILIAN and KHAVANIN, Ali}, title = {Evaluation of the effects of chronic exposure to organophosphorus pesticides on thyroid function}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {35-43}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16385}, abstract = {Background:Organophosphorus (OP) compounds are considered among the most common insecticides. The major mechanism of organophosphorus toxicants includes inhibiting cholinesterase enzyme. organophosphorus toxicants cause impaired thyroid hormones through affecting different parts of the hypothalamus-pituitary-thyroid axis. The aim of this study is to determine the effects of chronic exposure to organophosphorus pesticides on thyroid function. Methods: The present descriptive-analytical study was conducted cross-sectionally on male workers employed in a factory producing OP as the exposure group as well as the personnel of the administrative department of the same factory as the control group chosen through census method. According to Helsinki declaration, 5 ml of venous blood was collected, and the activity of TT3, TT4, FT3, FT4, and TSH hormones was measured through CLIA method, while the activity of serum cholinesterase enzyme (CHE) was measured through colorimetry. Results: T-test indicated that there was no significant difference in the mean of activity of hormones and enzyme studied between exposure and control groups (p>0.05). Nevertheless, the activity of TT3, TT4, FT3, FT4 hormones, and CHE enzyme was lower in the exposure group, while that of TSH was higher than in the control group. Pearson correlation test indicated that there was no significant correlation between the activity of all studied hormones and CHE enzyme (p>0.05). Conclusions: In the present study, the workers employed in the factory producing OP did not suffer thyroid disorders. Further, OP did not have a considerable effect on the activity of CHE enzyme.}, keywords = {Organophosphorus compounds,Cholinesterase,Hormones,Thyroid gland,endocrine glands}, url = {https://apjmt.mums.ac.ir/article_16385.html}, eprint = {https://apjmt.mums.ac.ir/article_16385_44132b43cd218fcacb2514f7e3352f3d.pdf} } @article { author = {Farag, Amina and Said, Emtenan and Fakher, Haidy}, title = {Pattern of Acute Pediatric Poisoning at Banha Poisoning Control Center, Egypt: One-Year Prospective Study}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {44-51}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16386}, abstract = {Background: Acute children poisoning is considered a serious issue worldwide, and a common cause of children morbidity and mortality. It is a preventable burden on emergency departments and healthcare facilities. Thus, surveillance of epidemiology and patterns of children acute poisoning in each country is beneficial to define the scope of the problem and its management regarding prevention and treatment. The aim of this work is to study the patterns of children acute poisoning in Banha poisoning control center, Banha University, Egypt. Methods: One year prospective cross-sectional study of the pattern of acute poisoning of children equal to or less than 18 years old, who presented to Banha poisoning control center from January 1st 2019 to December 31st 2019. The analyzed data included demographics, mode and route of poisoning, causative poisonous agents, clinical presentation and patients' outcome. Results: The peak of poisoning occurred in children from 2 to 6 year old accounted for (36.5%) of all cases. Accidental poisoning was the predominant method representedrepresented 82.1% of all cases. Pharmaceutical drugs were the most common cause of poisoning (42.3%) followed by household cleaning products (27.8%). In addition, poisoning occurred more indoors (91%) and in the summer season (45.2%). The majority of poisoned cases presented by mild symptoms (70.9%) and mainly were gastrointestinal (70.8%). As regards the outcome, most of the cases recovered and discharged. Conclusion: Pediatric acute poisoning is still a matter of great concern in Egypt. More attention and prevention strategies are needed.}, keywords = {Poisoning,Pediatrics,Epidemiology,toxicology}, url = {https://apjmt.mums.ac.ir/article_16386.html}, eprint = {https://apjmt.mums.ac.ir/article_16386_e7722020c9d0ca7ce7324f10a36c6b4d.pdf} } @article { author = {masihipour, behzad and Zare Mirakabadi, Abbas and Haji Hosseini, Reza and Tebianian, Majid}, title = {Immunomodulatory effect of a purified peptide fraction isolated from Mesobuthus eupeus scorpion venom on astrocytoma cell line (1321N1)}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {52-59}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16387}, abstract = {Objective(s): Multiple Sclerosis is a central nervous system disease which belongs to the category of autoimmune diseases. The prevalence of this disease in Iran is approaching the European level. Astrocyte cells are nerve tissues that regulate the immune system activity by secreting various cytokines such as IL- 17.  The aim of this study was partial purification of toxin from M.eupeus scorpion venom that has immunomodulatory effect on astrocyte cell line (1321N1) Materials and Methods: In the present study, purified crude venom of M.eupeus scorpion. Size exclusion and reverse-phase high-performance liquid chromatography was used for fractionation. The fractional molecular weight was determined by Using SDS and Tricine electrophoresis, Astrocyte cells (1321N1) were selected as functional cells in testing the immunomodulatory effect of venom. The viability of cells were determined by MTT and LDH assays. Astrocyte cells were activated by lipopolysaccharide and the release of interleukin-17 in activated cells was estimated using ELISA kit. Results:  fraction 331 (F331) from RP-HPLC contain the purified peptide with molecular weight of about 4500 Dalton. When activated cells exposed to purified peptide the rate of interleukin-17 release was found to be 85 pg/ml which is almost similar to un-activated cells (78 pg/ml). However in activated cells by LPS without treatment with purified peptide the rate of IL-17 release was found to be 147 pg/ml which was significantly (p <0.05) higher than control group.   Conclusion: The purified peptide (F331) from   venom of Mesobouthus eupeus can inactivate the astrocyte 1321N1 cells activated by LPS as indicated by decreased secretion of IL-17 from the cells.}, keywords = {Scorpion,Interleukin-17,Venom,Astrocyte,Lipopolysaccharide}, url = {https://apjmt.mums.ac.ir/article_16387.html}, eprint = {https://apjmt.mums.ac.ir/article_16387_6ec9a5725386d42492c6919f23ee8cee.pdf} } @article { author = {Fakher, Haidy and Metwally, Eslam and EL-Shafey, Rabab}, title = {The Potential Genotoxic Effects of Antineoplastic Drugs in Occupationally Exposed Nurses}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {60-66}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16388}, abstract = {Background: Antineoplastic drugs are commonly used globally. They directly interact with the tumor cell deoxyribonucleic acid and inhibit their growth. These actions are non-selectiveaffecting both tumor cells and healthy cells producing toxic effects. The present study was designed to evaluate oxidative stress and genotoxic effects of antineoplastic drugs in occupationally exposed nurses under routine working conditions. Methods: The studied groups included 28 nurses working in Hematology and Oncology unit, Benha University Hospitals and 20 non exposed subjects that work in academic jobs in Benha Faculty of Medicine, matched in age, gender & socioeconomic status.  Malondoaldehyde (MDA) & reduced glutathione (GSH) were measured for all participants as markers of oxidative stress. Extent of DNA damage in leucocytes was also evaluated by comet assay as a biomarker of genotoxicity. Results: There were a significant increase in MDA & reduction in GSH in occupationally exposed subjects than control. Also, extent of DNA damage in the lymphocytes of occupationally exposed participants has a high significance than the controls. The work duration and age had a significant impact on degree of DNA damage. Conclusion: occupationally exposed nurses to antineoplastic agents are at greater risk of oxidative stress with consequent DNA damage and potential genotoxic damage.  }, keywords = {}, url = {https://apjmt.mums.ac.ir/article_16388.html}, eprint = {https://apjmt.mums.ac.ir/article_16388_6198702df848ccb50b46f953c5610244.pdf} } @article { author = {D, ANANDHI and Raju, KNJ Prakash and BDS, BALAJI and SS, Anuusha}, title = {Acute fulminant hepatic failure due to colchicine – a rare manifestation of Gloriosa superba poisoning.}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {67-71}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16389}, abstract = {Background: Patients presenting to Emergency department following consumption of toxic substances is not an uncommon phenomenon globally. It becomes essential for the Emergency physicians to have in-depth knowledge of all the toxic products available in their locality. In rural parts of South India, the most common method of poisoning is by consumption of pesticides, followed by plant poisons, because of its easy availability. Gloriosa superba is an important medicinal plant growing in several parts of Southeast Asia. All parts of this plant contain several alkaloids including colchicine with the highest concentration in seeds and tubers. Acute intoxication following ingestion of G. superba is indistinguishable from colchicine overdose. Clinical presentation: The symptoms of intoxication can be classified in three phases. Phase 1:(2-24 hours) early gastrointestinal symptoms mimicking gastroenteritis, volume depletion, hypotension, peripheral leucocytosis; Phase 2:(24 to 72 hours) mental status changes, oliguric renal failure, hematopoietic problems, electrolyte imbalance, acid-base disturbance, shock, bone marrow suppression, liver failure, ARDS, arrhythmias, cardiovascular collapse, encephalopathy and neuromuscular involvement; and Phase 3:(1-3 weeks) Recovery typically occurs within few weeks of ingestion but with rebound leucocytosis and alopecia. Case report: We present a patient who ingested Gloriosa superba tubers with suicidal intent and developed acute fulminant liver failure a week after ingestion. Two weeks later, he also developed alopecia. Liver functions gradually improved and normalized after three weeks of hospitalisation. He was provided supportive treatment and he improved remarkably. At discharge, total bilirubin was 1.3 mg/dL, direct bilirubin 0.6 mg/dL, serum urea 15mg/dL and serum creatinine 0.9 mg/dL. On follow-up visits, alopecia showed an improving trend. Conclusion: Colchicine exerts a multiorgan toxicity. Acute fulminant hepatic failure can be a life threatening manifestation of Gloriosa superba poisoning. Hepatic failure can be due to colchicine induced direct hepatic injury with cytolysis. Management is essentially supportive with anecdotal reports showing benefit in plasmapheresis.}, keywords = {Poisoning,Liver failure,Drug Induced Liver injury,toxicology}, url = {https://apjmt.mums.ac.ir/article_16389.html}, eprint = {https://apjmt.mums.ac.ir/article_16389_0780036398d58261d8adfc2f43e905b4.pdf} } @article { author = {Rathnayaka, R.M.M.K.Namal and Ranathunga, P.E.A.Nishanthi and Kularatne, S.A.M.}, title = {Pulmonary hemorrhage and the management following Russell’s viper (Daboia russelii) envenoming in Sri Lanka}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {72-76}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16390}, abstract = {Background: Patients presenting to Emergency department following consumption of toxic substances is not an uncommon phenomenon globally. It becomes essential for the Emergency physicians to have in-depth knowledge of all the toxic products available in their locality. In rural parts of South India, the most common method of poisoning is by consumption of pesticides, followed by plant poisons, because of its easy availability. Gloriosa superba is an important medicinal plant growing in several parts of Southeast Asia. All parts of this plant contain several alkaloids including colchicine with the highest concentration in seeds and tubers. Acute intoxication following ingestion of G. superba is indistinguishable from colchicine overdose. Clinical presentation: The symptoms of intoxication can be classified in three phases. Phase 1:(2-24 hours) early gastrointestinal symptoms mimicking gastroenteritis, volume depletion, hypotension, peripheral leucocytosis; Phase 2:(24 to 72 hours) mental status changes, oliguric renal failure, hematopoietic problems, electrolyte imbalance, acid-base disturbance, shock, bone marrow suppression, liver failure, ARDS, arrhythmias, cardiovascular collapse, encephalopathy and neuromuscular involvement; and Phase 3:(1-3 weeks) Recovery typically occurs within few weeks of ingestion but with rebound leucocytosis and alopecia. Case report: We present a patient who ingested Gloriosa superba tubers with suicidal intent and developed acute fulminant liver failure a week after ingestion. Two weeks later, he also developed alopecia. Liver functions gradually improved and normalized after three weeks of hospitalisation. He was provided supportive treatment and he improved remarkably. At discharge, total bilirubin was 1.3 mg/dL, direct bilirubin 0.6 mg/dL, serum urea 15mg/dL and serum creatinine 0.9 mg/dL. On follow-up visits, alopecia showed an improving trend. Conclusion: Colchicine exerts a multiorgan toxicity. Acute fulminant hepatic failure can be a life threatening manifestation of Gloriosa superba poisoning. Hepatic failure can be due to colchicine induced direct hepatic injury with cytolysis. Management is essentially supportive with anecdotal reports showing benefit in plasmapheresis.}, keywords = {Poisoning,Liver failure,Drug Induced Liver injury,toxicology}, url = {https://apjmt.mums.ac.ir/article_16390.html}, eprint = {https://apjmt.mums.ac.ir/article_16390_ad594b9850025ea526a0ca87fde39e74.pdf} } @article { author = {Monotya-Giraldo, Maria and Chinchilla, Edna and Díaz, Luisa and Zuluaga, Andres}, title = {Severe rhabdomyolysis induced by cocaine contaminated with caffeine: a case report}, journal = {Asia Pacific Journal of Medical Toxicology}, volume = {9}, number = {2}, pages = {77-80}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2322-2611}, eissn = {2322-4320}, doi = {10.22038/apjmt.2020.16391}, abstract = {Background: Global consumption of illicit substances has increased, and cocaine dependence remains an important public health problem. Currently, the use of adulterants can overlap or exacerbate the symptoms of cocaine intoxication hindering the diagnosis. This case shows how the morbidity and mortality of inhaled cocaine consumption adulterated with caffeine can increase by generating unusual severe rhabdomyolysis and rare serious complications. Case presentation: 31-year-old Hispanic male, single, construction worker, generally healthy except for the past history of inhaled cocaine hydrochloride dependence, who after three days of cocaine snorting presented profound altered state of consciousness and multiple complications,   liver damage, kidney failure and severe rhabdomyolysis (CPK=657625 U/L, troponin=3.6, potassium=6 mEq/L). After fourty-five days in the ICU, the patient stayed for two more months hospitalized for the treatment of healthcare-associated infections before being discharged without sequelae. An analysis of the powdered substance consumed by the patient confirms the presence of caffeine as cocaine adulterant. None other additional substance was detected in the sample. Discussion. This clinical case describes serious complications presented by the excessive consumption of cocaine adulterated with caffeine. Notably, most of the complications herein described were of unexpected severity and duration for an acute cocaine intoxication.  This case can suggest that in patients suffering from cocaine who have severe rhabdomyolysis, a simultaneous consumption of adulterants such as caffeine should be considered.}, keywords = {Cocaine,cocaine-related disorders,Caffeine,rhabdomyolysis,Renal Insufficiency}, url = {https://apjmt.mums.ac.ir/article_16391.html}, eprint = {https://apjmt.mums.ac.ir/article_16391_42652353dda9f7bf9d0e832e4356675e.pdf} }