Suicide is one of the leading causes of death worldwide. Deliberate self-poisoning (DSP), is the most common method of attempted suicide and accounts for the majority of suicide-related hospital admissions. The incidence in Egypt tends to be under-estimated. Aim: Evaluating the pattern of deliberate self-poisoning cases who were admitted to Poison Control Center Ain Shams University Hospitals (PCC-ASUH) from January 2015 to December 2016. Method: An observational study was conducted including all patients deliberately self-poisoned throughout the study period .Recorded data in the present study included: age, gender, and residence, type of causative agent, severity of poisoning, and mortality. Results: A total of 10035 and 10758 self-poisoned patients were received in 2015 and 2016 respectively. Results remained similar in both years of the study. Cases were predominantly in the age group between 19 and 30 years, females 69% and were received from Cairo. Used substances were mainly drugs: centrally-acting drugs ranked first including Tricyclic antidepressants TCA, Benzodiazepines (BZD), antipsychotics and carbamazepine followed by analgesics and cardiopulmonary drugs. Among non-drug agents, organophosphorus insecticides were the most common .Lower number of cases used phosphides, corrosives and detergents, petroleum distillates, phenol and paraphenylenediamine (PPD). The majority of cases were mild (>70%) in both years of the study. Severe cases constituted 6.8% of DSP cases, with overall in-hospital mortality 0.6%. Organophosphorus insecticides topped the agents responsible for mortality followed by unknown drugs with small contributions by other drug and non-drug agents. Conclusion: Deliberate self-poisoning is a common presentation to PCC-ASUH .General trends show significant predominance of adolescents and young adults especially females, usage of drugs mainly centrally-acting agents, and low case fatality which is mainly in relation to organophosphorus compounds.
All rights reserved. AbstractOverdose by tricyclic antidepressants and antipsychotic drugs can lead to potentially lifethreatening cardiotoxicity. In clinical medicine, B-type natriuretic peptide (BNP) and cardiac troponin I (cTnI) are used as serum biomarkers in the diagnosis of cardiac affection. Aim: The study aimed to investigate the utility of BNP and troponin I as early predictors for TCA and antipsychotic drug -induced cardiotoxicity and correlation with severity of poisoning. Method: The study enrolled 45 patients admitted in ICU of Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) with history of tricyclic antidepressants (TCA) and /or antipsychotics overdose. Collected data included sociodemographic data, manner of exposure, clinical variables, ECG changes, Poison Severity Score (PSS), serum levels of BNP and cTnI. Duration of ICU and hospital stay, and outcome were also noted. Results: In contrast to cTnI level, BNP level was significantly higher in cardiotoxicity group. Mean BNP level correlated with ECG and blood pressure changes. Biomarkers levels were nonsignificantly correlated with PSS, total hospital stay &ICU stay. PSS had low sensitivity and accuracy for prediction of cardiotoxicity. Both BNP and cTnI showed at specific cut off point showed 100% specificity with sensitivity of 53.13% & 25.0% respectively Conclusion: Although unsuitable for screening purposes, BNP surpassed cTnI as a useful tool for the diagnosis of cardiotoxicity due to overdose by tricyclic antidepressants and antipsychotic drugs
Viper species are distributed allover Egypt. Venomous bites by Viperidae snakes are associated with local and systemic manifestations and may be exacerbated by the development of acute kidney injury (AKI). THE AIM of the study was to assess acute renal injury in cases of envenomations by locally prevalent vipers as regards incidence, clinical and laboratory parameters and final outcome. METHODS:The current study was conducted on all patients, of both sex, admitted in Poison Control Center of Ain Shams University hospitals following envenomation by Viperidae snakes during 2014, 2015, and 2016. Diagnosis was based on history of snake bite with suggestive clinical data. Recorded data included patient characteristics (age, gender, delay time), vital data (heart rate, blood pressure), presence of local signs, bleeding manifestations, laboratory parameters (INR, platelet count, hemoglobin level, BUN and serum creatinine), number of antivenom vials used , duration of hospital stay and survival. Cases were sub-grouped to group I with AKI and group II without AKI. RESULTS: A total of 120 cases of venomous bites by Viperidae snakes were recorded during the study period with mortality of 4.2%. Cases were predominantly males with mean age of 35 +/-14.7years. A subset of 5.8% cases developed AKI which statistically was related to older age, longer delay time, increased incidence of bleeding manifestations and tachycardia, higher values of INR, serum creatinine, and blood urea nitrogen, lower platelet count, higher number of used antivenom vials and longer duration of hospital stay. Gender, hypotension, presence of local manifestations and hemoglobin level were insignificant among AKI. Mortality among AKI cases was statistically linked to old age, prolonged delay time, increased incidence of bleeding manifestations, higher INR values, low platelet count and low hemoglobin level and increased number of used antivenom vials and duration of hospital stay. The incidence of tachycardia, hypotension and local manifestations, serum creatinine and blood urea nitrogen levels were not statistically different among non-survivors. CONCLUSION: Acute renal injury may complicate the course of viper envenomations. Venom hemotoxicity is related to morbidity and mortality especially with older age and longer time between bite to antivenom therapy.
Introduction: Synthetic cannabinoids (SCs) are psychoactive substances that are gaining popularity for being available and indetectable by standardized drug tests. Synthetic cannabinoids products have similar effects to cannabis, yet are more potent, and have been associated with dangerous adverse effects. Aim of the study: evaluation of the dangerous effects of SCs in comparison to cannabis. Methods: This study was an observational retrospective cohort study including patients admitted to Poisoning Control Centre Ain Shams University Hospitals with acute toxicity of cannabis or synthetic cannabinoids over 5 years period from January 2015 to December 2019. Results: The study included 834 patients. SCs group included 113 patients mostly males (96%) between 13-40 years of age and due to recreational use by smoking (95%). Compared to the cannabis group, the SCs group showed a significant increase in mortality, occurrence of seizures, and need for mechanical ventilation. Conclusion and recommendations: SCs drugs show greater toxicity than cannabis. Further investigations of acute and long-lasting adverse effects are required.
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