The adjuvant effect of oil-based gastric lavage on the outcome of acute Aluminum phosphide poisoning: a systematic review and meta-analysis

Toxicology Research, Journal Year: 2024, Volume and Issue: 13(2)

Published: March 1, 2024

Abstract Introduction Aluminum Phosphide (AlP) poisoning constituted the most common cause of death in some low- and middle-income countries (LMICs). This study aimed to evaluate safety efficacy oil-based gastric lavage (GL) compared with standard therapy for treatment AlP poisoning. Materials methods. systematic review complied “Preferred Reporting Items Systematic Reviews Meta-Analyses” (PRISMA) Protocols. A comprehensive search was carried out, identifying randomized controlled trials (RCTs), including anyone presenting within 6 h exposure AlP, administration GL oils, liquid paraffin or coconut oil. Results We identified 7 RCTs. The evidence from 4 RCTs indicates that oil is an effective acute poisoning, decreasing mortality rate (RR = 0.62; 95% CI 0.48 0.81; participants 226; I 2 10%; low-quality evidence). estimate Number Needed Treat 4. Likewise, this intervention reduces need intubation mechanical ventilation 0.40 0.79; I2 0%; Regarding oil, RCTs, a slight reduction 0.82; 0.69 0.98; 112; very Conclusions Limited suggests reducing rate. limited showed favor concerning ventilation. Very could reduce mortality. Both interventions would have benign profile.

Language: Английский

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Development and validation of a nomogram for predicting mechanical ventilation need among acutely intoxicated patients with impaired consciousness

Human & Experimental Toxicology, Journal Year: 2024, Volume and Issue: 43

Published: Jan. 1, 2024

Background A considerable portion of acutely intoxicated patients is presented with impaired consciousness. Early identification those who require advanced medical care, such as mechanical ventilation (MV), can improve their prognosis. Methods This study included 330 were consciousness and admitted to Tanta University Poison Control Center, Egypt, in the period from January 2021 December 2023. Patients enrolled derivation (257 patients) validation (73 cohorts. Patients’ data analyzed develop validate a predictive nomogram determine probability MV need patients. Results Significant predictors for mean arterial blood pressure (OR = 0.96, p .014), PaO 2 .001), pH 0.00, < . 001), glucose/potassium ratio 1.59, .030). These four parameters used formulate bedside nomogram. Receiver-operating characteristic (ROC) analysis proposed shows that area under curve (AUC) 95.7%, accuracy 93.4%, sensitivity 88.9%, specificity 95.1%. The internal developed was assessed using bootstrapping method calibration curve. Regarding external validation, AUCs 96.5%, predicted 97.8%. Conclusion current provides validated could be reliable tool accurate prediction among It assist early will MV, especially low-income countries limited resources.

Language: Английский

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Pattern, severity, and treatment outcomes in acute poisoning patients admitted to the Saint Peter Specialized Hospital Toxicology Center in Addis Ababa, Ethiopia, 2023: a retrospective study

Frontiers in Toxicology, Journal Year: 2025, Volume and Issue: 7

Published: Feb. 26, 2025

Poisoning is a global public health problem that has more unfavorable outcomes in developing countries. This study aimed to assess treatment and associated factors among poisoned patients treated at Saint Peter Specialized Hospital Toxicology Center. An institutional-based retrospective cohort was employed by reviewing medical chart records of acutely who had been admitted St. Center on 01/01/2017 30/12/2023 the review from 01/01/2024 30/01/2024. analyzed 553 patients. A systematic random sampling technique used select unit. Data were entered using Statistical Package for Social Sciences (SPSS) Windows version 26. binary logistic regression model identify p-value <0.05 considered statistically significant. total documents assessed. The overall mortality rate 18 (3.25%), four developed chronic complications. Factor analyses show arrival center before 4 h (AOR = 0.43, P 0.008) predicted recovery, whereas toxicology after 8 2.21, 0.004), being hypotensive 1.85, 0.002), needing intubation 2.52, 0.014), presence two or complication 3.3, < 0.001) admission predictors mortality. (3.25%). In this study, delayed center, hypotensive, intubation, complications with morbidity Establishing strong referral link between regional institutions, ensuring availability possible advanced clinical setup early recognition, aggressively resuscitating critically ill will help minimize outcomes.

Language: Английский

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Impulsivity and Its Association with Depression and Anxiety in the Normal Egyptian Population Post COVID-19 Pandemic

Medicina, Journal Year: 2024, Volume and Issue: 60(8), P. 1367 - 1367

Published: Aug. 22, 2024

Background and Objectives: It is well known that depression, anxiety, impulsiveness are interrelated; however, studies have assessed their association with the coronavirus outbreak scarce. Hence, our study aimed to evaluate impulsivity incidence its correlation anxiety depression following COVID-19 infection between November 2022 June 2023. Materials Methods: The 201 participants completed Hamilton Depression Rating Scale (HDRS), Anxiety (HAM-A), Sheehan Disability (SDS), short UPPS-P scales (urgency, premeditation, perseverance, sensation seeking, positive urgency) allow us determine symptoms, functional impairment, impulsivity, respectively. Results: Among respondents, 22%, 26.7% had moderate severe depression. scale significantly correlated HAM-A HDRS scales. Participants showed higher impairment scores, especially in work/study domain (mean (SD): 3.12 (2.2) vs. 2.43 (2.3); p = 0.037). COVID-19-related disruption negative urgency, HAM-A, HDRS, SDS total subscales. Conclusions: Our findings a notable increase among population infection. research highlights psychological distress experienced pandemic.

Language: Английский

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Development of a risk-prediction nomogram for in-hospital adverse cardiovascular events in acute cardiotoxic agents poisoning

Toxicology Reports, Journal Year: 2024, Volume and Issue: 13, P. 101826 - 101826

Published: Nov. 20, 2024

Adverse cardiovascular events (ACVE) are serious sequelae of acute poisoning with cardiotoxic agents. They include shock, myocardial injury, ventricular dysrhythmias, and cardiac arrest. Early identification high-risk patients could improve their prognosis. Therefore, this study developed a risk-prediction nomogram to assess the risk ACVE in cardiotoxicities. This prospective cohort was conducted at Tanta University Poison Control Center, Tanta, Egypt, from April 2023 March 2024. It included 186 agent poisoning. occurred 36 % were significantly associated ICU admission mortality (

Language: Английский

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Clinical course and demographic insights into suicide by self-poisoning: patterns of substance use and socio-economic factors

Social Psychiatry and Psychiatric Epidemiology, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 24, 2024

Abstract Purpose To analyze whether sociodemographic characteristics influence the substance choice and preclinical clinical course of suicidal poisoning. Methods This was a retrospective single-center study in patients hospitalized due to poisoning who received at least one psychiatric exploration during their inpatient stay. Patients’ sociodemographic, anamnestic, preclinical, parameters were analyzed with respect sex age. Results 1090 included, 727 (67%) females, median age 39 years (min–max: 13–91) 603 (55%) aged 18–44 years. 595 (54.8%) ingested single for self-poisoning, 609 (59.5%) used own long-term medication. Comparing males, females preferred antidepressants ( n = 223, 30.7%, vs 85, 23.4%; p 0.013) benzodiazepines 202, 27.8%, 65, 17.9%; < 0.001); males more often cardiovascular drugs 33, 9.1%, 34, 4.7%; 0.005) carbon monoxide 18, 5.0%, 2, 0.3%; 0.001). Use Z-drugs 1, 1.7%, 37, 33.3%; 0.001) 4, 6.9%, 29.7%; 0.003) increased (< 18 > 64 years), while use non-opioid analgesics 23, 39.7%, 20, 18.0%; decreased. Average dose 12.9 ± 18.4 times higher than recommended maximum daily (compared 8.7 15.2 those years; Males required intensive care 150, 41.3%, 205 28.2%; Conclusion These results underline complexity (para-)suicidal poisonings identify potential measures prevention, such as restricting access better oversight over certain substances.

Language: Английский

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Discovering the most impactful treatments for aluminum phosphide cardiotoxicity gleaned from systematic review of animal studies

Human & Experimental Toxicology, Journal Year: 2024, Volume and Issue: 43

Published: Jan. 1, 2024

Introduction Aluminum phosphide (AlP) is a chemical compound that can cause death in some countries. AlP inhibits the functioning of cytochrome C oxidase mitochondria cardiomyocytes, leading to toxicity. Oxidative stress and ROS production, as well inflammatory signaling, mediate mechanisms AlP-related toxicity poisoned patient. Unfortunately, there are no approved medicines available treat poisoning yet. To address this issue, researchers have explored various interventions reduce associated with tablets. Methods We systematically searched relevant databases for English articles published between 2013 2024. Results The evaluated treatments included correcting oxidative parameters, enhancing exogenous antioxidant capacity, modifying electrocardiographic abnormalities, improving heart contraction strength. Our evaluation indicated compounds like Triiodothyronine, Vasopressin milrinone, Iron sucrose, Acetyl-l-carnitine, Melatonin, Fresh red blood cell transfusion, Minocycline, Moringa oleifera extract, Dihydroxyacetone, Selegiline, Nanocurcumin, Levosimendan, Exenatide, Taurine, Cannabidiol Edaravone effective lessening AlP-induced cardiotoxicity. Conclusion Based on present study’s findings clinical studies, dihydroxyacetone, fresh infusion, Oil-based disinfection, gastric lavage most potential save patients’ lives acute aluminum phosphide. However, need more research regard.

Language: Английский

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The effect of educational programs on parents’ knowledge, behavior, and practices regarding aluminum phosphide poisoning and its first-aid measures

BMC Pediatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Dec. 31, 2024

Aluminum phosphide is an excellent insecticide available as a chalky white or brown tablet. traded in the Egyptian market tablets under brand name celphos. To date, no specific antidotes for aluminum poisoning have been identified. Management primarily supportive, to control toxic symptoms and prevent anticipated consequences. Therefore, educating parents about first aid management of utmost importance. This study aimed evaluate knowledge, behavior, practices concerning its first-aid measures. used quasi-experimental research design was conducted inpatient clinical toxicology department ward Menoufia University Hospital between June 2022 May 2023. Children (n = 98) who met inclusion criteria (aged 0 18 years experienced accidental suicidal poisoning) were recruited from ward, intensive care unit emergency department, critical Hospital. Four questionnaires collect data this study: (1) sociodemographics, data, physical examination, laboratory investigations; (2) knowledge parents; (3) practice (4) behavior response scales. analyzed 98 cases acute ALP poisoning, predominantly affecting females (67.3%) aged 16–18 years, with most incidents occurring summer (51.1%) rural areas (80.6%). Suicidal ingestion accounted 86.7% cases, delays hospital arrival noted 65.3%. Clinical findings included vomiting (76.6%), dyspnea (77.5%), cardiogenic shock (84.8%). ECG abnormalities found 82.7% patients, metabolic acidosis present 82.3% patients. An educational program significantly improved participants regarding highlighting need enhanced awareness intervention strategies. Community programs, such education initiatives, can positively influence practices, behaviors mothers terms providing toxicity.

Language: Английский

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The precedent of defensive medicine practice among physicians with a glance at the impact of the COVID‐19 pandemic

World Medical & Health Policy, Journal Year: 2024, Volume and Issue: 16(4), P. 630 - 648

Published: July 26, 2024

Abstract The practice of defensive medicine is highly evident with the purpose legal self‐interest physicians. It might be widely increased during coronavirus disease 2019 (COVID‐19) pandemic to avoid lawsuits, especially in absence specific effective treatment. This study aimed evaluate among Egyptian physicians, and identify impact COVID‐19 on malpractice suits. An electronic survey link was sent sampled physicians working at Faculty Medicine, Tanta University Hospitals. included personal information, two questions measuring physicians' perceptions about medicine, Defensive Medicine Behavior Scale (DMBS) eight evaluating concerns terms effects. enrolled 1074 physicians; 78.5% them didn't possess sufficient knowledge medicine. About 73% participants practiced more after pandemic, 68.2% demonstrated increasing suits emergence COVID‐19. DMBS statistically significant high surgical specialties those who spent less duration field their expertise. There a need legislate law control precedent increase Egypt. will help prevalence practice, improve quality care, reduce healthcare costs.

Language: Английский

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Efficacy of therapeutic options in patients with aluminum phosphide poisoning

Deleted Journal, Journal Year: 2024, Volume and Issue: 1(1)

Published: Oct. 30, 2024

Language: Английский

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