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العنوان
The Potential Role of Intravenous Magnesium Sulfate Administration on the Outcome of Acute Organophosphorus Toxicity. A Prospective Study in Poison Control Center Ain Shams University /
المؤلف
Ebeid,Ghada Mohamed.
هيئة الاعداد
باحث / Ghada Mohamed Ebeid
مشرف / Enas El Taftazany
مشرف / Rabab Nabil Hafez
تاريخ النشر
2018
عدد الصفحات
163p.;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
علم الأمراض والطب الشرعي
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - السموم الاكلينيكية
الفهرس
Only 14 pages are availabe for public view

from 163

from 163

Abstract

Organophosphate compounds have been used as pesticides and chemical warfare nerve agents worldwide. They are readily available because of inadequate regulations controlling their sale. The easy availability of these compounds has resulted in a gradual increase in accidental and suicidal poisoning. It also has resulted in many deaths that occur within hours of the ingestion.
The mechanism of OPs toxicity is the inhibition of acetylcholinesterase, which results in accumulation of acetylcholine and subsequent muscarinic, nicotinic and central manifestations.
For its prevention, speedy diagnosis and prompt treatment is required. Classic treatment of OPs toxicity includes decontamination, giving atropine and oximes (pralidoxime or obidoxime). However, the efficacy of oximes not well established yet and some studies indicate lack of efficacy of oximes in OP poisoning. Therefore, the task to find additional therapeutic agents continues and one of the proposed agents is MgSo4.
Our study aimed to assess the potential role of intravenous MgSo4 administration on the outcome of acutely OP intoxicated patients via a prospective single-blinded randomized controlled trial that was carried out on 40 patients admitted to (PCC-ASUH) with acute OP toxicity.Our study included 40 patients of both sexes with acute OP intoxication who were classified as regards the severity of intoxication into moderate and severe groups and each group was subdivided into two subgroups; one received MgSo4 and another subgroup that didn‘t receive MgSo4.
Informed consent, full history were taken from each patient, clinical examination was done, a blood sample was withdrawn on admission for routine investigations, electrolytes and pseudocholinesterase level determination and another sample was withdrawn after 24 hours for serum magnesium level monitoring and ECG was done for every patient every day during hospital stay.
In addition to the traditional treatment of OP which was given to all patients, MgSo4 treated group received MgSo4 at dose of 4g/d for only the first 24 hours after admission with monitoring of serum Mg level.
All the patients were observed for short-term outcomes; that were either complete recovery or death and total duration of hospital stay, also they were observed for complications developed during hospital stay e.g intermediate syndrome, need for ICU admission, duration of ICU stay, need for mechanical ventilation, CVS toxicity.
In our study, there was no significant difference in duration of ICU stay, total duration of hospital stay and need for mechanical ventilation between MgSo4 treated and non-treated patients.
MgSo4 administration may have decreased mortality, intermediate syndrome and CVS toxicity, but the difference was statistically insignificant between MgSo4 treated and non-treated patients.