Plasma and erythrocyte cholinesterase (ChE) activities of male farm workers exposed to pesticides during their routine work were lower than those of unexposed control subjects by 14 and 4%, respectively. Diphenhydramine and Carbaryl inhibited plasma and erythrocyte ChE activities in vitro in pesticide-exposed and unexposed subjects. The percentages of in vitro ChE inhibition induced by carbaryl in the plasma and erythrocytes of unexposed controls ranged between 47-85% and 19-47%, respectively, whereas they were 35-60% and 3-12% in the pesticide-exposed group, respectively. In vitro pretreatment of plasma and erythrocyte ChE with diphenhydramine (20 μM) significantly reduced the inhibitory effect of carbaryl (10 μM) on them by 18% and 10%, respectively. In conclusion, subjects exposed to pesticides during their routine work in agriculture are at risk of reduced blood ChE activity. Diphenhydramine appeared to partially protect blood ChE in vitro from additional carbaryl-induced enzyme inhibition in both pesticide-exposed and unexposed subjects.

Diphenhydramine antagonizes poisoning produced by cholinesterase (ChE) inhibiting insecticides. This study examines the effects of diphenhydramine against acute poisoning induced by the carbamate insecticide carbaryl in a chick model. The effects of diphenhydramine on the 24 h median Lethal Dose (LD50), and acute toxicity of carbaryl were assessed in chicks (7-15 days old). The plasma and whole brain ChE activities were measured electrometrically in vitro and in vivo. Diphenhydramine at 10mg/Kg Body wt. administered intramuscularly 15 min before carbaryl dosing increased the oral LD50 value of carbaryl (207 mg/Kg Body wt.) by 62%. Carbaryl at 250 mg/Kg Body wt. has orally produced toxidrome of cholinergic poisoning with 100% lethality in 24 h. Diphenhydramine (10mg/ Kg Body wt.) used 15 min before carbaryl (250mg/Kg Body wt., orally) was the most effective dose (vs 5 and 20mg/Kg Body wt.) in delaying carbaryl-toxicity and increasing survivals in chicks. The intramuscular median effective dose (ED50) of diphenhydramine which prevented 24 h carbaryl-death in chicks was 8.6mg/ Kg Body wt. The antidotal response to diphenhydramine was similar to that of the standard antidote atropine sulfate. Diphenhydramine at 10mg/Kg Body wt., given immediately after carbaryl (200mg/Kg Body wt.), reduced the percentages of plasma and whole brain ChE inhibitions in vivo by 12- and 13%, respectively. Carbaryl (10μmol/L) in vitro inhibited ChE activities in the plasma and brain by 53 and 77%, respectively; these inhibitions were reduced by 13- and 14%, respectively, when diphenhydramine (10μmol/L) was added to in vitro reactions. Diphenhydramine exerted antidotal action against a model of acute and lethal carbaryl intoxication in chicks.

Objectives Malaria infection is still known to be a worldwide public health problem, especially in tropical and sub-tropical African countries like Sudan. A pilot study conducted to describe the trend of P. falciparum drug resistance markers in 2017–2018 in comparison to CQ and AS/SP eras in Sudan. The Pfcrt, Pfmdr-1, Pfdhfr, and Pfdhps genes were investigated. Data deposited by the worldwide antimalarial resistance network was consulted, and the molecular markers previously reported from Sudan were analyzed. Results Drug molecular markers analysis was successfully done on 20 P. falciparum isolates. The Pfcrt K76 showed high frequency; 16 (80%). For the Pfmdr-1, 9 (45%) isolates were carrying the N86 allele, and 11 (55%) were 86Y allele. While the Y184F of the Pfmdr-1 showed a higher frequency of 184F compared to Y184; 16 (80%) and 4 (20%), respectively. In the Pfdhfr, 51I allele showed higher frequency compared to N51; 18 (90%) and 2 (10%), respectively. For S108N, 18 (90%) were 108 N and 2 (10%) were S108. In the Pfdhps, all isolates were carrying the mutant alleles; 437G and 540E. The frequency distribution of the Pfcrt, Pfmdr-1, Pfdhfr, Pfdhps was significantly different across the whole years in Sudan.

Measurements of blood cholinesterase (ChE) activities, including those of erythrocytes (EChE), plasma or serum (PChE), and whole blood (WBChE), are used to assess exposure to ChE-inhibiting pesticides. The purpose of this review was to report normal reference ChE activities in the blood of healthy adult humans, as determined by a modified electrometric method. We performed a systematic review following PRISMA guidelines. Single-group meta-analysis of means of PChE, EChE, and WBChE activities of adult healthy subjects was conducted using the random effects model. The programs used were Open-Meta Analyst and Meta-Essentials Version 1.5. Studies selected for analysis comprised 21, 19, and 4 reports of normal reference/baseline PChE, EChE, and WBChE activities in 690, 635, and 121 healthy adult males and/or females, respectively. The meta-analysis showed normal reference values of the means (effect sizes) with 95% CI of PChE, EChE, and WBChE activities of healthy adult subjects, which were 1.078 (1.015, 1.142), 1.075 (1.024, 1.125) and 1.331 (1.226, 1.436), respectively. By the subgroup analysis, heterogeneity (I2>89%) was considerably reduced in females to 4.4% and 30.1% for PChE and EChE, respectively. Funnel plots indicated no publication bias. However, Egger's regression confirmed the symmetry of the data points for PChE and WBChE activities with a significant effect on EChE. This meta-analysis showed normal reference values of PChE, EChE, and WBChE activities, measured by a modified electrometric method, in healthy adult humans.

Background: Partial seizure is well-defined as sudden extreme, profligate, and limited electrical discharges by gray matter from some portions of the brain due to certain structural & metabolic abnormalities. Objective: To distinguish the etiologies of partial seizures and to clarify its association with the age of affected patients. Patients and Methods: A prospective study, done on all patients with neurological consultation in Al- Batool Teaching Hospital, Baqubah Teaching Hospital and Al Yarmouk teaching Hospital from Nov, 2016 to Dec, 2018. Patients with partial seizures and/with secondary generalization were merged. This was fortified through a full history, physical checkup, EEG, and MRI of the brain. The study’s sample comprising 106 patients with partial seizures, the age ranged from 6-75 years, with 52 males and 54 females. Results: Atypical neuroimaging was found in (61%) of patients. Tumors occurred in (19.7%) of patients, the highest of them below 40 years of age while infarctions comprised 25.5% of patients outside this age. Complex partial seizures(CPS) patients with temporal lobe foci comprised 83.7 % and (16.2%) had frontal lobe problems, while (49%) of Simple partial seizures (SPS) patients had frontal lobe foci, 22% frontoparietal and 13% had parietal lobe foci and had brain lesions were spotted in 75.4% of patients with SPS and (35.1%) with complex partial seizures. Conclusion: Infarction is a common reason for partial seizures in patients above 40 years while below this age the tumor is common etiology. A partial seizure is connected mostly with brain lesions. Keywords: Partial seizures, comorbid factors, brain lesions