Acute corrosive toxicity is a serious problem in clinical toxicology as it may be associated with severe complications. Prediction of complications related to corrosive toxicity is very important for better management and outcome. Inflammation is considered a predisposing factor for the development of corrosive toxicity complications. Leucocytes are a component of the inflammatory process. The aim of this study is to evaluate leucocytes' parameters as predictors for complications of acute corrosive toxicity. Forty four patients with acute corrosive toxicity were subjected to history taking (personal and toxicological), general and local oral examination. A venous blood sample was obtained from each participant. Total and differential leucocyte counts together with neutrophil-to-lymphocyte ratio were obtained. Total leucocyte count, neutrophil count and neutrophil-tolymphocyte ratio were good predictors for complications at cut off > 15100/mm 3 , > 9308/mm 3 and > 2.42 respectively. It is concluded that total leucocyte count, neutrophil count and neutrophil-to-lymphocyte ratio could serve as good predictor markers for corrosive toxicity complications.

Organophosphorus compounds are widely used pesticides. They are associated with a significant risk of acute intoxication. Oxidative stress is a contributing factor of acute organophosphorus poisoning morbidity and mortality. L-carnitine was found to have free-radical scavenging and antioxidant properties. Therefore, we aimed to evaluate the efficacy and safety of L-carnitine as an adjuvant in treatment of patients with acute organophosphorus poisoning. A randomized clinical trial was conducted on 30 patients suffering from acute organophosphorus poisoning admitted to Poison Control Center, Tanta University Emergency Hospital, Egypt, from April 2017 till January 2018. Patients were randomly divided into two equal groups. Group I received the standard treatment only and group II received the standard treatment plus L-carnitine in a dose of 1gm/8 hours IV.At time of admission, malondialdehyde, reduced glutathione, serum total antioxidant capacity and psudocholinesterase enzyme activity registered no significant difference between the two studied groups. After treatment, malondialdehyde, reduced glutathione and serum total antioxidant capacity showed significant improvement in group II. The mean value of atropine dose in group II (5.6mg) was significantly lower than group I(10.9mg). We concluded that the use of L-carnitine improved the antioxidant status and reduced total atropine dose required for treatment of patients with acute organophosphorus poisoning.

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Background: Antipsychotics are a class of medications that are primarily used for treatment of psychosis especially schizophrenia. The most common cardio-toxic features of antipsychotics overdose are tachycardia, hypotension, and prolonged corrected QT interval. Aim: This study aimed at assessment of ECG changes utilization as a predictor of major outcome events in antipsychotic poisoned patients. Patients and methods: This prospective observational study was conducted at Tanta Poison Control Unit on 43 patients of both sexes with antipsychotics poisoning. For each patient, socio-demographic and toxicological data were collected, physical examination was performed, and routine investigations were measured. Electrocardiogram was done, and corrected QT was calculated. The severity of symptoms and signs of antipsychotics poisoning and related ECG changes were graded according to poisoning severity score. Results: This study revealed significant association between ECG grading and each of seizures, ICU admission, and in-hospital mortality. Significant association was also detected between corrected QT interval and ICU admission. Conclusion: It was concluded that, ECG changes could be used to predict mortality and major outcome events in antipsychotics intoxicated patients.

Background: Poisoning is defined as exposure of an individual to a potentiality harmful substance either by inhalation, skin contact, ingestion, or injection. Aim of the Work: This study aimed to develop and validate a novel scoring system using vital signs, arterial blood gases (ABG) and consciousness level as a tool of triage for evaluation and outcome prediction of acutely poisoned patients. Methods: The current prospective cohort study was conducted on patients with acute poisoning who were admitted at Tanta University Poisoning Treating Center (TUPTC) throughout a period of start of April 2020 to the end of June 2021. For each patient, age, sex, and toxicological characteristics were obtained. Clinical examination and routine laboratory investigations were also done. Results: Significant differences were observed between survivors and non-survivors in the derivation group (444 patients) regarding systolic blood pressure, diastolic blood pressure, respiratory rate, temperature, blood pH, PaCO2, serum HCO3, and O2 saturation. Using univariate and multivariate regression analysis SBP, serum HCO3, and O2 saturation were valid to construct the prediction score at cut off ≤100 mmHg, ≤16.6 mEq/L, and ≤93% respectively. Variables were given points and the score has range from 0 (the best score) to 3 (the worst score). The discrimination power in the derivation group at cut-off point >1 was excellent (AUC: 0.925) with 91.3% sensitivity and 94.9% specificity. Additionally, the discrimination power in the validation group (140 patients) at cut-off point >1 was excellent (AUC: 0.965) with 87.5% sensitivity and 93.8% specificity. Conclusion: This proposed score could be considered a simple and excellent tool for triage to identify acutely poisoned patients who are at risk of mortality. In addition, it is validated and so it could be used in other populations.