ABSTRACT
Aims and Objectives: We evaluated the incidence of coronary artery disease (CAD) in Sulfur mustard (SM) exposed veterans. We also evaluated the relationship between exposure to SM and angiography findings and compared angiography findings of SM exposed individuals with unexposed ones after two decades from the time of exposure to SM. Materials and Methods: A case-control study was conducted on 200 consecutive patients (100 SM exposed vs. 100 unexposed) undergoing angiographic assessments due to CAD. Results: The coronary angiography findings between two groups were significantly different ( P < 0.001). Ninety two (92%) patients in SM exposed group and 82 (82%) in unexposed group had abnormal findings in their coronary arteries ( P = 0.031). Conclusions: The incidence of CAD and angiographic changes were significantly increased with exposure to SM. Further studies on cardiovascular effects of SM are needed.
Subject(s)
Chemical Warfare Agents/poisoning , Coronary Angiography , Coronary Disease/chemically induced , Coronary Disease/diagnostic imaging , Female , Humans , Iran , Lung Injury/chemically induced , Male , Middle Aged , Mustard Gas/poisoning , VeteransABSTRACT
BACKGROUND: Organophosphorus (OP) compounds are the most common suicidal poison in developing countries and mortality continues to be high. METHODS: A study was done to see butyryl cholinesterase (BuChE) profile after OP poisoning in pralidoxime (P2AM) and placebo treated cases. Highest recommended dose of P2AM was used to study the reactivation of cholinesterase. Clinical outcomes like, correlation of BuChE and severity of poisoning, mortality and complications like Type I and II paralysis, need for ventilation and ICU stay were also studied. RESULTS: Twenty one cases of moderate and severe poisoning with OP compounds were included in the study. Mean BuChE levels came up gradually over 6-7 days, some taking up to two weeks. There was no. difference between the treatment and placebo groups. BuChE levels did not correlate with severity of poisoning nor did it correlate with Type I or II paralysis, need for ventilation, ICU stay or mortality. CONCLUSIONS: Treatment with P2AM does not make any difference in BuChE reactivation or complications of moderate and severe OP poisoning. We have not been using P2AM for OP poisoning in our medical ICU with good patient outcomes.
Subject(s)
Antidotes/administration & dosage , Butyrylcholinesterase/blood , Chemical Warfare Agents/poisoning , Cholinesterase Reactivators/administration & dosage , Developing Countries , Humans , Occupational Exposure/adverse effects , Pesticides/poisoning , Organophosphates/poisoning , Poisoning/drug therapy , Pralidoxime Compounds/administration & dosage , Suicide, Attempted , Treatment OutcomeABSTRACT
The subject of chemical warfare [CW] Agents has gained importance in recent years. Research is on-going on different chemicals. This paper highlights anticholinesterases, the nerve agents, which present the main threat. Emphasis has been laid upon the clinical manifestatins, decontamination and treatment with enzyme reactivators, atropine and anticonvulsants. Ocular treatment has also been stressed. Decontamination of the casualties is an important measure which should be dealt with speedily and effectively. Lack of clinical experience precludes proper diagnosis of such casualties in the theatre of war, thus precious time is wasted before the casualty is recognized and treated. Certain recommendations have also been made keeping in view the geoplitical scenario and our preparation to combat CW threat