Myeloneuritis due to acute organophosphate (DDVP) intoxication

PubMedID: 19922373Given the importance of agriculture and widespread use of pesticides, intoxication due to organophosphate insecticides is common in Turkey. Organophosphorus compounds may cause late-onset distal polyneuropathy occurring 2 or more weeks after the acute exposure. An 18-year-old woman and a 22-year-old man were admitted to the hospital with weakness, paresthesia, and gait disturbances at 35 and 22 days, respectively, after ingesting dimethyl-2,2-dichloro vinyl phosphate (DDVP). Neurological examination revealed weakness, vibration sense loss, bilateral dropped foot, brisk deep tendon reflexes, and bilaterally positive Babinski sign. Electroneurography demonstrated distal motor polyneuropathy with segmental demyelination associated with axonal degeneration prominent in the distal parts of both lower extremities. © 2009 Informa Healthcare USA, Inc

Association of chronic pesticide exposure with serum cholinesterase levels and pulmonary functions

The present study focused on the analysis of serum cholinesterase levels and the pulmonary function tests in seasonal farm workers who were chronically exposed to pesticides, mostly organophosphorus, in comparison with non-farm workers in the farming areas of Cukurova region, Turkey. Serum cholinesterase levels and pulmonary function tests using spyrometer in 50 male seasonal farm workers (study group) were compared to 50 male non-farm workers (control group) in this cross-sectional study. The mean serum cholinesterase enzyme level in the farm worker group (7095.5±1699.4 U/L) was significantly lower than those of the control group (9716.4±1484.4 U/L) (p .05). These results show that chronic environmental organophosphorus exposure caused a decrease in the serum cholinesterase enzyme levels in farm workers, emphasizing the importance of primary prevention. © 2011 Copyright Taylor and Francis Group, LLC

Efficacy of tramadol vs meperidine in vasoocclusive sickle cell crisis

PubMedID: 20466223Despite progress in management, patients with sickle cell disease who are experiencing acute painful episode are often incompletely treated. We compared meperidine and tramadol with respect to their effects on the hemodynamics and pain relief in patients with sickle cell disease who were admitted to the emergency department with painful crisis. A total of 68 patients with sickle cell disease were randomly assigned to receive either tramadol 1.5 mg/kg (n = 34) or meperidine 1 mg/kg (n = 34). Hemodynamic parameters were recorded at regular intervals after analgesic infusions. Pain intensity and relief were documented by visual analog and pain relief scale, respectively. Sedation level was defined according to Ramsay sedation scale. Both meperidine and tramadol administration resulted in a significant reduction in systolic and diastolic blood pressure after 2 hours (P < .05). Efficacy in pain relief between the analgesics was more rapid and better in the meperidine group, although the degree of relief were significantly improved compared to baseline levels in both groups (P < .05). Sedation was more commonly seen in the meperidine arm. None of the patients had experienced neurotoxicity. In summary, both agents had proven safe and effective for emergent use in patients with sickle cell disease. Avoiding meperidine injections as recommended with previous guidelines needs to be carefully reconsidered especially when low doses are mentioned. © 2010

Utilization of plasmapheresis for organophosphate intoxication: A case report

Organophosphate (OP) compounds are extremely toxic chemicals that may be absorbed via skin, conjunctiva, gastrointestinal and respiratory systems. Treatment of OP poisoning is a critical and aggressive process which includes decontamination, antidote administration (atropin and oximes), mechanical ventilation support and extracorporeal elimination procedures if needed. Here we present a young female patient who was unintentionally poisoned by an OP (trichlorfon) after using it to moisture her skin. The importance of this patient is the dermal disease that makes her unprotective to dermal exposure of chemicals and application of plasmapheresis to treat her poisoning. © 2016 The Emergency Medicine Association of Turke

Analysis of altered mental status in Turkey

PubMedID: 18446577The aim of this study was to determine the frequency and etiology of altered mental status in adults at an Emergency Department. Medical records of 790 patients with altered mental status were reviewed. Out of 790 patients, 414 (52.3%) were male, 376 (47.7%) were female. Mean age was 45.65 ± 15.5 years. Etiologic factors were neurological (n = 566; 71.6%), head trauma (n = 82; 10.4%), endocrine/metabolic (n = 48; 6.1%), cardiovascular/pulmonary (n = 49; 6.2%), infectious (n = 30; 3.8%), gynecologic and obstetric (n = 2; 0. 4%), toxicologic (n = 12; 1.5%). Of patients, 40% were in deep coma, 11% were confused, 20% were in agitated confusion, 15% were lethargic, and 14% were in stupor. Eighteen percent of were hypertensive. Total mortality rate was 20.1% (n = 159). Common causes of death were cerebrovascular disease and trauma. Most patients presenting with altered mental status seem to be elderly with the most frequent cause being cerebrovascular accidents. Fatality rate is very high. Copyright © 2008 Informa Healthcare USA, Inc

Poisoned after dinner: Dolma with datura stramonium

Datura stramonium, which is also known as Thorn Apple or Jimson Weed, is an alkaloid containing plant that is entirely toxic. The active toxic constituents of the plant are atropine, scopolamine and hyoscyamine. It has been abused worldwide for hundreds of years because of its hallucinogenic properties. Previous reports have shown that herbal medication overdose and accidental food contamination are ways it can cause poisoning. Herein we present a family that had three of its members poisoned after eating a traditional meal "dolma" made of datura flowers. None had fatal complications and all were discharged healthy. Datura stromonium may be used accidentally as a food ingredient. Since its poisonous effects are not known, people should be informed and warned about the effects of this plant

The effect of antioxidants (N-acetylcysteine and melatonin) on hypoxia due to carbonmonoxide poisoning

PubMedID: 20586144We aimed to determine the effect NAC (N-acetylcysteine) and melatonin on the histopathological and biochemical paramethers in the rats poisoned with CO (Carbon monoxide) experimentally. Winster albino female rats were placed in a plexiglass chamber and they were poisoned with CO. After the poisoning, rats were randomly divided into 3 groups. The group given only normal saline, was used as a control group (n=9). The second group was given 30 mg/kg intraperitonally NAC (n=10). And the third group was treated with 10 mg/kg of melatonin intramuscularly (n=9). It is determined that some biochemical values affected by NAC but not by melatonin. CK, ALT, Lactate, MDA levels were significantly higher in NAC group than control and Melatonin group (p<0.01 for all comparisons). Thiol level was lower in NAC group than control group and Melatonin group (p<0.01 and p<0.001, respectively). There were no statistical significant differences between the melatonin and control group. There were statistically significant difference between control, NAC and Melatonin groups according to brain and lung tissue damage. It is shown that both NAC and Melatonin are reducing the brain and lung tissue damage of CO poisoning but due to biochemical results worsened by NAC, Melatonin may recommend for CO poisoning

Applicability of leachates originating from solid-waste landfills for irrigation in landfill restoration projects

PubMedID: 19295082Since, landfill areas are still the most widely used solid waste disposal method across the world, leachate generated from landfills should be given importance. Leachate of landfills exerts environmental risks mostly on surface and groundwater, with its high pollutant content, which may cause unbearable water quality. This leads to the obligation for decontamination and remediation program to be taken into progress for the landfill area. Among a number of alternatives to cope with leachate, one is to employ the technology of phytoremediation. The main objective of this study was to determine the N accumulation ratios and the effects of landfill leachate in diluted proportions of chosen ratios (as 1/1, 1/2, 1/4, 0), on the growth and development of Cynodon dactylon, Stenotaphrum secundatum, Paspalum notatum, Pennisetum clandestinum, Mentha piperita, Rosmarinus officinalis, Nerium oleander, Pelargonium peltatum and Kochia scoparia species. In order to simulate the actual conditions of the landfill, soil covering the landfill is taken and used as medium for the trials. The study showed that S, secundatum, K. scoparia and N. oleander species had an impressive survival rate of 100%, being irrigated with pure leachate, while the others' survival rates were between 0 to 35% under the same conditions. As expected, application of leachate to the plants caused an increase in the accumulation of N, in the upper parts of all plants except P. peltatum. The highest N content incresase was observed at S. Secundatum set, accumulating 3.70 times higher than its control set, whereas P. clandestinum value was 3.41 times of its control set. © Triveni Enterprises, Lucknow (India)