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The discovery of cannabinoid receptors in the immune system and a family of endogenous ligands of these receptors provides a basis for understanding the cellular and molecular mechanisms of cannabis–induced immunotoxicity. The present study was conducted on 90 nonsmoker males of high school and university students living in Tanta city of matched age and socioeconomic lifetyle. They were divided into a control group (30 males) and a bhang user group (60 males), which used bhang by eating its sweet juice after boiling with a little water and drying in an oven, ‘fola’. The bhang group was divided equally into two subgroups: subgroup 1 used bhang for 6–24 months (average 199–1.2) and subgroup 2 used bhang for 24 / 36 months (average 319–1.7). The immunotoxic effects of using bhang appeared in the form of a significant decrease in serum immunoglobulins (IgG and IgM), and C3 and C4 complement protein concentrations (P<0.05). In addition, our results demonstrated a significant decrease in the absolute number of functionally different subsets of peripheral blood mononuclear lymphocytes, T and B lymphocytes and natural killer (NK) cells in bhang users as compared to controls (P<0.05). Moreover, the fatty acid amide hydrolase (FAAH) showed significant decrease in bhang users as compared to controls and in subgroup 2 as compared to subgroup 1 (P<0.05), indicating that the decrease in FAAH protein level is closely related to the duration of bhang use. Positive correlations were found between FAAH level and the absolute number of mononuclear cells (T, B lymphocytes and NK cells) among bhang user subgroups. The present study is the first study to report on the effect of bhang on complement proteins and immunoglobulins in humans. Our study revealed that bhang–induced immunotoxicity could be attributed to decrease in FAAH protein.

Introduction: Clozapine is a frequently prescribed atypical antipsychotic drug. Various case reports documented the successful recovery of acute antipsychotics toxicity in association with the administration of intralipid emulsion (ILE). Aim: This study aimed to assess the adjuvant therapeutic role of SMOF Lipid administration on the outcomes of acute clozapine poisoning. Methods: Forty patients with acute clozapine poisoning were randomly allocated into two equal groups. The control group received the standard supportive treatment only, whereas the intervention group received the standard supportive treatment plus SMOF Lipid 20% infusion. All patients were subjected to history taking, full clinical examination, and laboratory investigations. The study outcomes were evaluated. Results: The mean Glasgow Coma Scale (GCS) at 6 hours (13.1 ± 2.3 vs 9.2 ± 2, p < 0.001) and 12 hours (14.3 ± 1.5 vs 9.6 ± 2, p < 0.001) after admission was significantly higher in the intervention group compared to the control group. The intervention group showed a significantly lower frequency of prolonged QTc interval 12 hours after admission (p = 0.003), as well as a significantly shorter hospital stay (p < 0.001). Conclusions: SMOF Lipid infusion seemed to have improved GCS, the prolonged QTc interval, and shortened the length of hospital stay. Furthermore, there were no adverse effects related to its administration.

Lead exposure during intrauterine life was found to result in reduced birth weight, impaired skeletal development and post-natal neurotoxic effects. In this study, the effect of pre-natal exposure to different doses of lead on the development of craniofacial skeleton in rat fetuses was investigated. Vitamin E was tested as a concomitant treatment, aiming to improve the fetotoxic effects of lead. Positively pregnant female rats were randomly divided into four groups; groups I and II (L250 and L500), exposed to lead acetate in doses of 250 and 500 mg/l respectively, group III (L500 + E), exposed to lead acetate (500 mg/l) wit concomitant vitamin E and group IV (Control) which was given sodium acetate only. All the treatments started from the first day of gestation till the 20th day, where all rats were sacrificed and the fetuses were recovered. Fetuses were processed to alizarin red staining for ossified components. Twenty-seven bones of the craniofacial skeleton were studied in each fetus where the ossification was scored as being complete, delayed or absent. In all studied fetuses from all groups, changes were found only in eight bones while the remaining craniofacial bones were normally ossified. In affected bones there was a significant decrease in the number of completely ossified bones; associated with a significant increase of both partially ossified and absent bones in L(250) and L(500) treated groups when compared to the control group. These differences were more significant in the L(500) treated group. Giving vitamin E improved the percentage of completely ossified craniofacial bones and decreased the percentage of both partially ossified and absent bones. The most affected bone was presphenoid, then to a lesser extent supraoccipital, squamosal, parietal, interparietal and frontal bone respectively. In conclusion, lead exposure to rats during pregnancy led to varying degrees of fetal growth retardation as well as delayed ossification of some craniofacial bones which were dose dependent and the concomitant supplementation with vitamin E greatly improved the deleterious effect of lead.

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Background: Sexual assault is a special type of violence with great effects on the victims. In Egypt, there are no accurate statistical data about sexual assault. Objective: The aim of this work was to study the pattern of sexual assault in Gharbia Governorate, Egypt. Subjects and methods: This study was conducted in Tanta Department of Forensic Institute of Ministry of Justice, Egypt. It included collection of retrospective data during the period from the start of January 2011 to the end of June 2014.Cross section study of sexual assault cases was also done from the start of July 2014 to the end of December 2014.Complete history taking as well as full general and local examination was done for the studied cases. Results and conclusion: Total number of sexual assault cases was 229 over the studied period. The median age of victims was 16 years with interquartile range of 10-21 ranging from 3 to 63 years. Most cases (63.3%) were less than 18 years, 76% of the cases were females, and came from urban areas (63.3%). Unmarried cases constituted 83%. Rape was the most frequent type of assault (41%). Most of the assailants were outside the familial relations to the victims (91.3%), and a single assailant was responsible in 78.6% of the cases. The most common type of physical injury was abrasion (46.75%), whereas the least were bites (1.29%). Most cases (68.6%) were examined within 10 days after the assault; hymnal tear was the commonest injury on vulvovaginal examination (88.4%). Anal examination revealed chronic habit of anal sex in 18.52% of cases. The present study concluded that unmarried females under the age of 18years from urban areas constituted the major victims of sexual assault in Gharbia Governorate. Rape was the commonest reported assault in this study. Logistic regression analysis revealed that age, gender and marital status were good predictors of type of sexual assault. Recommendations: Medico legal examination of sexual assaults should be done as early as possible for the value of collecting evidence. Medical education for the children and their family about methods of protection against sexual assault should be considered.

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Background: Antipsychotics toxicity is one of the top five substances most frequently included in human poisoning. Various case reports documented successful use of intravenous lipid emulsion (ILE) in the management of acute antipsychotics poisoning. Aim: The aim of this study was to assess the efficacy and safety of ILE as adjuvant therapy for acute antipsychotic poisoning. Patients and methods: Forty patients presented with moderate to severe acute antipsychotic poisoning were randomly allocated into two equal groups. The control group was given the standard treatment only while the intervention group was given the standard treatment plus ILE infusion. For all patients, history, clinical examination, ECG, and laboratory investigations were done. The safety and efficacy outcomes were evaluated. Results: results revealed that the median Glasgow Coma Scale assessed at 6 and 12 hours after admission was significantly higher in the intervention group compared to the control group. Both corrected QT intervals measured 12 hours after admission and period of hospital stay were significantly shorter in the intervention group compared to the control group. During follow-up of the intervention group, there were no significant differences between serum triglycerides levels, liver enzymes and, platelet count measured at admission and 12 hours later. Conclusion: It was concluded that ILE was a safe and effective therapy for acute antipsychotic poisoning.