Approaches for a field diagnosis of abamectin poisoning in calves / Abordagem para um diagnóstico a campo da intoxicação por abamectina em bezerros

An approach for the diagnosis of an abamectin outbreak in calves in the field is described and discussed. In a Midwestern Brazilian property, nine out of a 52 newborn calves were affected and died, making up for morbidity, mortality, and lethality ratios of 17.3%, 17.3%, and 100%, respectively. Major clinical signs included tremors in various muscle groups, inability to stand, and difficult, wheezing breathing. Each affected calf had been treated subcutaneously with abamectin (0.4mg/kg/body weight). No lesions were found at necropsy or at histological examination. Major diseases of newborn calves were included in the differential diagnosis.(AU)

Uma abordagem para o diagnóstico de um surto de abamectina em bezerros a campo é descrita e discutida. Numa propriedade do Centro-Oeste brasileiro, nove de um lote de 52 bezerros de 3 dias de idade foram afetados e morreram, perfazendo quocientes de morbidade, mortalidade e letalidade, respectivamente, de 17,3%, 17,3% e 100%. Os principais sinais clínicos incluíam tremores em vários grupos musculares, incapacidade em se manter em pé, e respiração difícil e estertorosa. Cada bezerro afetado havia sido tratado por via subcutânea com abamectina, na dose de 0,4mg/kg/peso corporal. Não foram encontradas lesões na necropsia, nem no exame histológico. As principais doenças de bezerros recém-nascidos foram incluídas no diagnóstico diferencial.(AU)

Assessment of Primary Health Care for rural workers exposed to pesticides / Avaliação da atenção primária à saúde de trabalhadores rurais expostos a praguicidas

ABSTRACT OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

ABSTRACT OBJETIVO Avaliar os atributos da atenção primária à saúde (APS) na assistência à saúde de trabalhadores rurais; analisar condições sociodemográficas, histórico de intoxicação e internações por agrotóxicos e uso de equipamentos de proteção individual; e verificar a exposição aos praguicidas pela determinação de bioindicadores. MÉTODOS Estudo transversal, descritivo-analítico, com amostra de 1.027 trabalhadores rurais residentes em municípios pertencentes a uma superintendência regional de saúde do sul de Minas Gerais, cuja APS é regida pelo modelo da Estratégia Saúde da Família. Utilizou-se o Instrumento de Avaliação da Atenção Primária (PCATool Brasil) versão adulto e um questionário estruturado para coleta de dados socioeconômicos, histórico de intoxicação e internação por agrotóxicos e uso de equipamentos de proteção individual. Foram coletadas amostras sanguíneas para dosagem de biomarcadores de exposição a praguicidas e de sinais de sequelas renais e hepáticas. RESULTADOS A baixa escolaridade foi prevalente, bem como o contato intenso dos trabalhadores com praguicidas. O uso frequente de equipamentos de proteção individual foi maior entre os homens, assim como o histórico de intoxicação e de internações por agrotóxicos. Detectaram-se índices de 20% de intoxicação, 15% de hepatopatia e 2% de nefropatia. Os sinais de hepatotoxicidade foram mais frequentes em homens. As diferenças entre sexos foram todas estatisticamente significantes. Com relação à APS, apenas o atributo "grau de afiliação" apresentou escore elevado. Nenhum dos casos de intoxicação detectados no estudo tinha diagnóstico prévio. CONCLUSÕES A despeito de uma alta cobertura da Estratégia Saúde da Família, o risco ocupacional e suas consequências não têm sido detectados pelos serviços de saúde, que se apresentam como não orientados à atenção primária, carecendo mesmo de seus atributos essenciais. Percebe-se a necessidade de adequação imediata e efetiva das políticas públicas no que concerne à saúde do trabalhador rural, com adequada capacitação das equipes e revisão da carteira de serviços da APS ofertados.

Validación de un método para la determinación del ácido 3-fenoxibenzoico en orina por QuEChERS, microextracción líquido-líquido dispersiva y cromatografía líquida de alta resolución-arreglo de diodos / Validation of a method for the determination of 3-phenoxybenzoic acid in urine using QuEChERS, microextraction liquid-liquid dispersive and high-performance liquid chromatography-diode array

Los piretroides son insecticidas ampliamente usados no sólo en el ámbito agropecuario y doméstico sino también en salud pública. Una vez absorbidos, son rápidamente metabolizados a compuestos polares eliminados por vía renal. Uno de los metabolitos común a un gran número de piretroides es el ácido 3-fenoxibenzoico (3-PBA) el cual es utilizado como marcador de exposición. Se presenta en este trabajo, la validación de una metodología analítica para la determinación del 3-PBA utilizando QuEChERS acoplado a microextracción líquido-líquido dispersiva con tricloroetileno como disolvente extractivo y cromatografía líquida de alta resolución con detector de foto-arreglo de diodos. La validación se realizó con muestras aisladas de orina de voluntarios adultos de ambos sexos sin exposición conocida y orina sintética. El método resultó lineal en el intervalo 9 μg L-1-79 μg L-1; los límites de detección y cuantificación fueron de 3 μg L-1 y 9 μg L-1, respectivamente. No se observaron señales de interferentes a los tiempos de retención del 3-PBA y del ácido 2-fenoxibenzoico (2-PBA), estándar interno, en las muestras de orina blanco. Las señales cromatográficas en las muestras enriquecidas fueron espectralmente homogéneas. Las precisiones intradiarias (RSDr%) (n= 5) para 9 μg L-1 estuvieron comprendidas entre 9,3%-9,9% y para 27 μg L-1 entre 5,9%-10,6%. Las precisiciones interdiarias (RSDint%) (n=15) para los mismos niveles de concentración fueron de 11,8% y 9,1%, respectivamente. El rango de porcentajes de recuperación para 9 μg L-1 fue de 87%-119% y para 27 μg L-1 de 70%-91%. Se evaluó la estabilidad del analito en la muestra y en el extracto. El analito resultó estable a -20 °C durante 7 días en la muestra y durante 1 día en el extracto. Los valores de incertidumbre relativa e incertidumbre expandida fueron evaluados mediante la ecuación de Horwitz, los resultados obtenidos fueron para el nivel 9 μg L-1 de 33% y 65% y para el nivel 27 μg L-1 de 28% y 55%. La aplicabilidad del método validado fue evaluada con muestras reales de personas sin exposición laboral conocida, quienes declararon haber usado insecticidas piretroides. El método resultó sensible y selectivo.

Pyrethroid insecticides are used not only in the agricultural and domestic environment, but also in public health. Once absorbed, they are rapidly metabolized into polar compounds eliminated by the kidneys. One of the metabolites common to many pyrethroids is 3-phenoxybenzoic acid (3-PBA) which are used to evaluate exposure. We present in this paper the validation of an analytical methodology for the determination of 3-PBA using QuEChERS coupled to dispersive liquid-liquid microextraction with trichloroethylene as an extractive solvent and high-performance liquid chromatography with a photodiode array detector. Validation was carried out with isolated samples of urine from adult volunteers of both sexes without exposure and synthetic urine. The method was linear in the interval 9 μg L-1-79 μg L-1; the limit of detection and quantitation were 3 μg L-1 and 9 μg L-1, respectively. Interfering signals were not observed in the blank urine samples and the chromatographic signals in the enriched samples were spectrally homogeneous. The within-run precision (RSDr%) (n = 5) for 9 μg L-1 were between 9.3%-9.9% and for 27 μg L-1 between 5.9%-10.6%. The between-run precision (RSDint%) (n = 15) for the same concentration levels were 11.8% and 9.1%, respectively. The recovery for 9 μg L-1 ranged from 87%-119% and for 27 μg L-1 from 70%-91 %. The stability of the analyte was evaluated in the sample and in the extract. The analyte in the sample was stable at -20 °C for 7 days and in the extract was stable for 1 day. The values of relative uncertainty and expanded uncertainty obtained by the Horwitz equation were 33% and 65% for 9 μg L-1, and 28% and 55% for 27 μg L-1. The applicability of the validated method was evaluated with real samples of people without known occupational exposure, who declared having used pyrethroid insecticides. The method was sensitive and selective.

Reporte de caso: intoxicación por clorfenapir con desenlace fatal / Report a case: chlorfenapyr intoxication with a fatal ending

El clorfenapir es un insecticida de uso agrícola, cuya ingesta en las personas produce un envenenamiento que a veces es fatal. Se presenta un caso clínico de paciente de sexo masculino con ingesta por vía oral del clorfenapir, con presentación de un cuadro compatible con deterioro neurológico y rabdomiolisis con desenlace fatal a pesar del tratamiento de soporte. El mecanismo de acción de esta substancia es la inhibición de la fosforilación oxidativa en las mitocondrias y se postula que este sea el mecanismo condicionante de la mortalidad en las personas, con lesiones en órganos principales como SNC y musculo, reportados en casos clínicos alrededor del mundo.

Chlorfenapyr is an insecticide for agricultural use, whose ingestion in people produces a poisoning that is sometimes fatal. It is presented a clinical case of a male patient with oral intake of chlorfenapyr, presenting a likeness compatible with neurological deterioration and rhabdomyolysis with fatal outcome despite supportive treatment. The mechanism of action of this substance is the inhibition of oxidative phosphorylation in the mitochondria and it is postulated that this is the conditioning mechanism of mortality in people, with lesions in major organs such as CNS and muscle, reported in clinical cases around the world.

Histopathological effect of sub-lethal concentration of aluminum phosphide (phostoxin) on Clarias gariepinus juveniles

The study evaluated the effect of sub-lethal concentration of phostoxin on Clarias gariepinus juveniles. C. gariepinus juveniles belonging to the same cohort (40.1±1.2g; 18.1±1.1cm) from a commercial fish farm were randomly placed ten in each of 15 plastic tanks containing 15 liters of water. They were exposed for 96 hrs to three sub-lethal concentrations (treatments) of phostoxin (0.125, 0.250, 0.5mg L-1) and a phostoxin free control. At the end of 96 hrs exposure, they were dissected and the tissues need for histopathology removed and fixed in Bouin's fluid. The gill filament exhibited fusion at the secondary lamella that was progressive with concentration. At the highest concentration of exposure, the secondary lamellae showed marked pyknotic and necrotic changes characterized by epithelia detachment. The hepatic tissue showed mild inflammatory changes at lower concentrations while at the highest concentration of exposure there was marked inflammation with observed hydropic degeneration. In the kidney, an inflammatory change was only observed in the interstices at the highest dose of exposure with the convoluted tubules showing partial shrinkage. Phostoxin showed to have significantly caused alterations in cyto-architecture of the gills and to a considerable extent liver and kidney of C. gariepinus.(AU)

Intoxicações por agrotóxicos: registros de um serviço sentinela de assistência toxicológica / Pesticide poisoning: records of a toxicological assistance sentinel service

Na vigilância das populações expostas a agrotóxicos, é relevante o protagonismo da rede nacional de centros de informação e assistência toxicológica para produção de dados confiáveis sobre as intoxicações. O objetivo do estudo foi caracterizar as intoxicações por agrotóxicos reportadas a um centro de assistência toxicológica do Paraná, por meio de análise retrospectiva de fichas epidemiológicas de Ocorrência Toxicológica de 1240 indivíduos com diagnóstico médico de intoxicação aguda ou crônica por agrotóxicos, registrados no período de 2003 a 2011. Foram verificados sexo e idade das vítimas, classificação química dos agrotóxicos, e circunstância, gravidade e desfecho dos eventos. Os dados foram tabulados em planilha no Software Excel 2007 e analisados por estatística descritiva simples. A média foi de 138 intoxicações/ano. O perfil das intoxicações apontou predomínio do sexo masculino e em idade produtiva; destaque para as profissões agrícolas e a presença de trabalho infantil e do idoso; alta incidência de intoxicação por inseticidas inibidores das colinesterases e maioria dos casos notificados por unidades hospitalares; maior percentual de intoxicações e óbitos na circunstância intencional; e maior proporção de cura. No entanto, elevadas taxas de internação em terapia intensiva e a letalidade indicaram gravidade dos casos.

In surveillance of populations exposed to pesticides is important the role of the national network information centers and toxicological assistance to produce reliable data on poisonings. The aim of the study was to characterize pesticide poisoning reported to a poison control center of Parana, through retrospective analysis of Toxicological Occurrence epidemiological forms of 1240 individuals with diagnosis of acute or chronic intoxication by pesticide from 2003 to 2011. Sex and age of the victims were checked, classification of chemical pesticides, circumstance, severity and outcome of events. Data were tabulated in Excel 2007 software spreadsheet and analyzed by simple descriptive statistics. The average was 138 poisoning/year. The profile of poisonings pointed predominance of working-age male; especially the agricultural professions and the presence of child and elderly labor; high incidence of poisoning by cholinesterase inhibitors insecticides and most cases were reported by hospitals; higher percentage of poisonings deaths in the intentional condition; and high cure proportion. However, high rates of admission to intensive care and lethality indicated severity of the cases.

The Initial Hyperglycemia in Acute Type II Pyrethroid Poisoning

This retrospective observational case series study was conducted to describe the clinical feature of acute type II pyrethroid poisoning, and to investigate whether hyperglycemia at presentation can predict the outcome in patients with type II pyrethroid poisoning. This study included 104 type II pyrethroid poisoned patients. The complication rate and mortality rate was 26.9% and 2.9% in type II pyrethroid poisoned patients. The most common complication was respiratory failure followed by acidosis and hypotension. In non-diabetic type II pyrethroid poisoned patients, patients with complications showed a higher frequency of hyperglycemia, abnormalities on the initial X ray, depressed mentality, lower PaCO2 and HCO3- levels, and a higher WBC and AST levels at the time of admission compared to patients without complication. Hyperglycemia was an independent factor for predicting complications in non-diabetic patients. Diabetic patients had a significantly higher incidence of complications than non-diabetic patients. However, there was no significant predictive factor for complications in patients with diabetes mellitus probably because of small number of diabetes mellitus. In contrast to the relatively low toxicity of pyrethroids in mammals, type II pyrethroid poisoning is not a mild disease. Hyperglycemia at presentation may be useful to predict the critical complications in non-diabetic patients.

Clinical, biochemical and haemathological effects in Rhamdia quelen exposed to cypermethrin / Efeitos clínicos, bioquímicos e hematológicos em Rhamdia quelen expostos à cipermetrina

The acute intoxication of Cypermethrin in Silver Catfish (Rhamdia quelen) was evaluated. Animals weighing 56.67±4.43g and measuring 18.92±1.16cm were exposed to sublethal concentrations of Cypermethrin for the species in hydrological conditions during 96 hours. A total of 52 fish divided into three groups were used and received the following concentrations of Cypermethrin: 0 (n=12); 1.5 (n=20) and 2.5 (n=20)mg/L. The intoxicated animals suffered behavioral changes such as loss of balance, swimming alteration, dyspnea, upright swimming and sudden spiral swimming movements. As soon as the 96-hour period was over, a blood collection for hematological and biochemical analyses was performed. A complete haemogram test, plasmatic protein test, albumin, alanine transaminase (ALT), aspartate aminotransferase (AST), gamma glutamyltransferase and alkaline phosphatase (ALP) were studied. The values of erythrocytes, hematocrits, haemoglobin, total number of leukocytes, thrombocyte, ALT, AST and ALP changed according to the groups. The results have shown that the environmental contamination by Cypermethrin is toxic to the species...

Avaliou-se a intoxicação aguda da cipermetrina em jundiás (Rhamdia quelen). Jundiás que pesavam 56,67±4.43g e mediam 18,92±1,16cm foram expostos a concentrações subletais de cipermetrina para a espécie em 96 horas, via hídrica, utilizando-se 52 peixes, distribuídos em três grupos, segundo a concentração de cipermetrina: 0 (n = 12); 1,5 (n = 20) e 2,5 (n = 20)mg/L. Os animais intoxicados apresentaram alterações comportamentais, como perda de equilíbrio, dispneia, natação na posição vertical e movimentos bruscos de natação em espiral. Após 96 horas de exposição, foi coletado sangue para análises de hemograma completo, proteína plasmática, albumina, alanina aminotransferase (ALT), aspartato aminotransferase (AST), fosfatase alcalina (ALP) e gamaglutamiltransferase. Os valores de eritrócitos, hematócrito, hemoglobina, número total de leucócitos, número total de plaquetas, ALT, AST e ALP diferiram entre os grupos. Os resultados demonstraram que a contaminação ambiental por cipermetrina é tóxica para a espécie...

An Outbreak of Food Borne Illness Due to Methomyl Pesticide Intoxication in Korea

On February 21, 2013, 6 elderly people collapsed abruptly after eating bean sprout bibimbab (boiled rice mixed with bean sprouts and seasoned with soybean sauce) at a countryside restaurant in the Chungbuk Province, Korea. Minutes after eating the meal, all of the patients lapsed into a state of stupor. Respiratory arrest developed in 2 patients; and one of two patients died of cardiac arrest. The autopsy identified methomyl and methanol in the deceased patient's gastric contents and in the remaining soybeanbean sauce seasoning. Five of the 6 patients ingested one spoonful of the soybeanbean sauce seasoning and survived, while one patient who died of cardiac arrest, ingested approximately two spoons. Symptoms of toxicity presented quickly in the subjects and progressed rapidly, including chest tightness, an unusual sensation in the pit of the stomach, dizziness, ataxia, and finally, collapse. Three patients who drank ethanol with the meal experienced only mild toxic symptoms. Our analysis of the clinical observations in these cases suggests that ingestion of methomyl pesticide and the additive toxicity of methanol may have been responsible for the intoxication.

Study of profile of deaths due to poisoning in Bhavnagar region.

The present study was undertaken to evaluate the pattern of poisoning deaths in Bhavnagar region of Gujarat. The Paper presents the study of 143 cases of poisoning during the span of one year from 01/04/2008 to 31/03/2009. Out of 878 Post mortem examination done during the study period 143 cases were of poisoning. The cases were then analyzed on various parameters in the proforma prepared for this purpose. We concluded that majority of victims were married, Hindu, males from rural area and low socioeconomic group. The incidence of poisoning was more common during 21-30years of life. Suicidal cases were more common than accidental cases. No case of homicidal poisoning was detected in present study, chemical analysis of viscera done in 122 cases. Insecticide still topped the list as killer, while Aluminium phosphide & snake bite was second common fatal poisoning.

Immobilization of organophosphate hydrolase on biocompatible gelatin pads and its use in removal of organophosphate compounds and nerve agents.

Bacterial organophosphate hydrolases (OPH) have been shown to hydrolyze structurally diverse group of organophosphate (OP) compounds and nerve agents. Due to broad substrate range and unusual catalytic properties, the OPH has successfully been used to develop eco-friendly strategies for detection and decontamination of OP compounds. However, their usage has failed to gain necessary acceptance, due to short half-life of the enzyme and loss of activity during process development. In the present study, we report a simple procedure for immobilization of OPH on biocompatible gelatin pads. The covalent coupling of OPH using glutaraldehyde spacer has been found to dramatically improve the enzyme stability. There is no apparent loss of OPH activity in OPH-gelatin pads stored at room temperature for more than six months. As revealed by a number of kinetic parameters, the catalytic properties of immobilized enzyme are found to be comparable to the free enzyme. Further, the OPH‑gelatin pads effectively eliminate OP insecticide methyl parathion and nerve agent sarin.

Acute and late complications of organophosphate poisoning

To describe the acute and late complications of organophosphate [OP] poisoning. Case series. Medicine Department at Peoples Medical College Hospital, Nawabshah, from June 2008 to December 2009. A total of 300 patients with organophosphate poisoning admitted to the Medical ICU were included. Baseline investigations included blood complete picture, urea, creatinine, arterial blood gas values, and serum cholinesterase levels. Data was retrieved from the files on a structured proforma. Studied variables included gender, mode of exposure, acute [occurring within 4 weeks] and delayed [occurring after 4 weeks onwards] complications. There were 50 [16.66%] males and 250 [83.33%] females with ratio of 1:5. Two hundred and forty eight [82.6%] had ingested while 18 [6%] had inhaled the poison. Acute complications included fits in 50 [16.66] bradycardia in 30 [10%] and hyperglycemia in 15 [5%] patients. Delayed complications [after 4 weeks and later] included monoplegia and mild sensory loss of lower limbs in 4 [2.66] and paraplegia and weakness of upper limbs in 2 [0.66%] patients each. A total of 50 patients died due to different complications in acute period making a mortality rate of 16.66%. Frequency of acute organophosphate [OP] poisoning complications is much higher and related with high mortality and morbidity and where as late complications are less frequent and less life threatening

Espontánea reversibilidad de un síndrome de parkinson tardío y de alteraciones cognitivas frontales; después de una intoxicación aguda con órganofosforados / Reversible parkinson syndrome and cognitive impairments due organophosphate acute poisoning

Clásicamente, la intoxicación aguda por órganofosforados produce una crisis colinérgica, que con frecuencia es continuada con un cuadro de debilidad muscular, expresión de un síndrome intermedio. La génesis de estos cuadros está relacionada con la inactivación de la acetilcolinesterasa por el insecticida. Mecanismos diferentes darían origen a polineuropatías y síndromes extrapiramidales tardíos. Se describe un paciente intoxicado agudamente con órganofosforados, que desarrolló una florida crisis colinérgica, que requirió ventilación mecánica invasiva. Después de tres semanas, ya recuperado de una neumonía y del síndrome colinérgico, se pudo definir un daño cognitivo de apariencia frontal, y se apreció la progresiva aparición de hipomimia, rigidez generalizada, bradikinesia y temblor, que configuraron un síndrome de Parkinson. Esta condición clínica se mantuvo al menos por dos semanas, siendo seguida de manera espontánea por una progresiva y completa mejoría del cuadro extrapiramidal y cognitivo. La literatura ha reportado, sólo por excepción casos similares, en los que se destacó tanto la aparición tardía del cuadro parkinsoniano, como su completa y espontánea remisión. Aunque la patogenia del cuadro parkinsoniano no está completamente establecida, existen evidencias experimentales que demuestran que los órganofosforados producen modificaciones en el transporte y en la recaptación de la dopamina. En este paciente se confirmó la doble acción patogénica de los órganofosforados, que habiéndose iniciado con un síndrome colinérgico agudo, finalizó con un compromiso dopaminérgico tardío. La completa recuperación de ambos efectos, permite encasillar a estos insecticidas como generadores de alteraciones funcionales, más que de gestores de daños o cambios estructurales.

Acute organophosphate poisoning usually produces a cholinergic crisis followed by muscular weakness or intermediate syndrome. The basis for these clinical manifestations is inactivation of acetylcholinesterase at the nicotinic and muscarinic nerve terminals and junctions. Different mechanism might lead to polyneuropathy and late extrapyramidal syndromes. We report a case of a male patient who ingested organophosphate with suicidal intentions. He developed a typical cholinergic crisis and required invasive mechanical ventilation. Three weeks later, frontal cognitive impairment was noticed and masklike face, generalized rigidity, bradykinesia and tremor progressively developed until a Parkinson syndrome was established. After his clinical condition had remained stable for at least two weeks, overt spontaneous improvement in motor and cognitive functions was observed. Similar reports in literature are infrequent. Although the pathophysiology that underlies extrapyramidal manifestations due organophosphate poisoning remains unclear, experimental evidence demostróte that organophosphate compounds impair dopamine transport and uptake. This case report suggests that organophosphate might act through a double pathogenic action i.e an initial acute cholinergic syndrome and a delayed disfunction in dopaminergic pathways. Complete spontaneous resolution of both effects allow us to classify organophosphate substances as a cause of functional impairment in the basal ganglia.

A retrospective study of 5 years: organ phosphorous poisoning in Ahmedabad.

Poisons are known to mankind since time immemorial. Of the various substances used for suicide in India, Organ phosphorous compounds form a significant group as observed by much workers. The study was aimed to generate a baseline data on the epidemiological factors contributing to the incidence and mortality due to O.P. Poisoning. So as to highlight the problem this requires planned and concentrated effort in dealing with it on a broader horizon. Since prevention is the only logical approach there is an urgent need to take appropriate steps to prevent loss of lives. The analysis of the data revealed that 65 cases of O.P. poisoning brought to the mortuary of Smt. NHL MMC, Ahmedabad for medico-legal autopsy, during 5 years period i.e. 1995 to 1999.The age group ranged between10 years to 40 years and above, with maximum incidence between 21–30 years and males outnumbering females. The main mode of poisoning was suicidal by ingestion.

Accidental poisoning in children: frequency and outcome of the cases at a military hospital

To determine the frequency of accidental poisoning by various agents and their associated outcome in children. Descriptive Study. The study was carried out in emergency department at PNS Shifa hospital Karachi, from January 2007 to December 2008. A total of 200 patients reported with accidental poisoning during the study period. Detailed history and examination regarding the nature of poisoning was taken. Relevant investigations for purpose of diagnosis were carried out. Mortality and morbidity was noted on predesigned proforma. Total 200 patients were admitted with accidental poisoning during the study period. 155[77.5%] of patients belonged to less than 5 year age group. Most frequently ingested poison was kerosene oil [51%], followed by insecticides [17.5%], Oral route was involved in majority of cases 194[97%]. Complications were observed in 6% of cases, Pneumonia was the most frequently occurring complication in 8 [4%] cases of kerosene oil ingestion, followed by seizures in 2 [1%] cases of insecticide ingestion. No mortality was reported in this study. Acute childhood poisoning is a significant public health problem affecting mainly toddlers. Main substances responsible for acute poisoning are Kerosene oil, insecticides, bleach and drugs

Epidemiology of acute poisoning in children due to household substances. Mortality and morbidity in Hazara division

Acute Poisoning in children due to house hold substances is a global problem, however mortality and morbidity is nowadays very less in developed countries due to precautionary measures and better treatment facilities while situation in developing countries like Pakistan is alarming one. The present study was conducted to know about the death and injuries due to household poisoning in children in Hazara Division. The purpose of study was also too seek measures to reduce the risk factor. This prospective study was carried out in the Paedriatic unit of Ayub Hospital Complex and Department of Forensic Medicine and Toxicology, Ayub Medical College, Abbottabad from July to 2008 to September 2009. A total number of 6 leases of acute poisoning of children were brought to emergency department of Ayub Hospital Complex. 45 cases were admitted in Paedriatic unit while 16 were treated in emergency department were sent back to home. There were 37 male children [60.65%] and 24 [39.34%] female. The maximum number of cases were between age group 1-5 years 43 [70.49%]. 99% percent cases in our this study were of accidental nature only one case was homicidal nature while suicidal was none. Insecticide / rodenticide were the commonist agent ingested, followed by pharmacutical products. Kerosene oil was the third commonist agent ingested in our studies. Mortality rate was 3.27%. Organo-phosphorus compound [insecticide], rodentcide and kerosene oil [petroleum products] and pharmaceutical products are common source of household accidental poison globally. In developed countries there frequencies is decreasing rapidly due to health education and precautionary measures adopted mandatorily by manufacturers but in developing countries like Pakistan the situation is same as 50 years back. The risk factor can be reduced by adopting preventive measures at national level through health education of masses and parents and making products safety measures mandatory for manufacturers, moreover parents must be educated about the harms of some Herbal agents containing Opiates and on safe storage of medicines and house hold poisonous agents

Intoxicación por amitraz / Amitraz poisoning

En nuestro medio, la intoxicación por amitraz y su solvente xileno es una patología poco frecuente, pero puede observarse un aumento en zonas rurales, donde se lo emplea como insecticida-ectoparasiticida. Por tal razón, se cuenta con escasa bibliografía que oriente su manejo en niños. Presentamos el caso de un paciente de 2 años de edad, con ingestión accidental de amitraz, internado en nuestra Unidad de Cuidados Intensivos Pediátricos y que requirió ventilación mecánica. Creemos que comunicar este caso puede ser útil para alertar sobre esta intoxicación, poco frecuente en nuestro medio.

Poisoning due to amitraz together with its solvent xilene, is an unusual condition although may be increasing in rural areas where it is used as insecticide-ectoparasiticide. At present, there is scare references to orient physicians concerning its handlingin childhood. We present the case of a 2-year-old boy who suffered an accidental intake of amitraz and was admitted into our Pediatric Intensive Care Unit requiring mechanical ventilation. We consider the usefulness of informing the medical community about this case so as to be aware of this rare kind of poisoning in our community.

Resistência de Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae) a acaricidas inibidores da respiração celular em citros: resistência cruzada e custo adaptativo / Resistance of Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae) to acaricides that inhibit cellular respiration in citrus: cross-resistance and fitness cost

Acaricidas inibidores da respiração celular são importantes para o controle de Brevipalpus phoenicis (Geijskes) na cultura dos citros no Brasil. Foram conduzidos estudos para avaliar: (a) a variabilidade na suscetibilidade de populações de B. phoenicis coletadas em pomares de citros para cihexatim, azociclotim, propargite e enxofre; (b) relações de resistência cruzada entre propargite e os acaricidas azociclotim, cihexatim, dinocape, piridabem e enxofre; e (c) o custo adaptativo associado à resistência de B. phoenicis a propargite em condições de laboratório. O método de bioensaio adotado foi o contato residual. A suscetibilidade foi estimada com concentrações diagnósticas baseadas na CL95 de cada acaricida. A resistência cruzada foi avaliada pela caracterização da curva de concentração-mortalidade das linhagens suscetível (S) e resistente a propargite (Propargite-R). O custo adaptativo foi avaliado mediante comparação de parâmetros biológicos das linhagens S e Propargite-R em frutos de laranja a 25 ± 1°C e fotofase de 14h. Diferenças significativas na sobrevivência de B. phoenicis foram verificadas aos acaricidas cihexatim (de 16,3 por cento a 80,5 por cento), azociclotim (de 3,0 por cento a 15,0 por cento), propargite (de 1,0 por cento a 71,6 por cento) e enxofre (de 9,0 por cento a 82,6 por cento). Baixa intensidade de resistência cruzada foi verificada entre propargite e os acaricidas azociclotim (1,8 vezes), cihexatim (4,6 vezes), dinocape (3,5 vezes) e piridabem (3,5 vezes). Por outro lado, a intensidade de resistência cruzada a enxofre (> 111 vezes) foi bastante alta. Não foi verificada presença de custo adaptativo associado à resistência de B. phoenicis a propargite. Portanto, o uso desses acaricidas também deve ser feito de maneira criteriosa no manejo da resistência de B. phoenicis a acaricidas.

Acaricides that inhibit cellular respiration play an important role in the control of Brevipalpus phoenicis (Geijskes) in citrus groves in Brazil. Studies were conducted to evaluate: (a) the variability in the susceptibility among B. phoenicis populations collected from citrus groves to cyhexatin, azocyclotin, propargite and sulphur; (b) cross-resistance relationships between propargite and azocyclotin, cyhexatin, dinocap, pyridaben and sulphur; and (c) the fitness cost associated with propargite resistance in B. phoenicis under laboratory conditions. A residual-type contact bioassay was used to characterize the susceptibility. The susceptibility was estimated with diagnostic concentrations based LC95 of each acaricide. The cross-resistance was evaluated by characterizing the concentration-mortality responses of susceptible (S) and propargite-resistant (Propargite-R) strains. The fitness cost was evaluated by measuring the biological parameters of S and Propargite-R strains on citrus fruits at 25 ± 1°C and fotophase of 14h. Significant differences in the susceptibility of B. phoenicis were detected at diagnostic concentration of cyhexatin (survivorship from 16.3 percent to 80.5 percent), azocyclotin (from 3.0 percent to 15.0 percent), propargite (from 1.0 percent a 71.6 percent) and sulphur (from 9.0 percent to 82.6 percent). A low intensity of cross-resistance was detected between propargite and the acaricides azocyclotin (1.8-fold), cyhexatin (4.6-fold), dinocap (3.5-fold) and pyridaben (3.5-fold). On the other hand, the intensity of cross-resistance to sulphur (> 111-fold) was very high. There was no fitness cost associated with B. phoenicis resistance to propargite, based on biological parameters evaluated. Therefore, the use of these acaricides should also be done very carefully in resistance management of B. phoenicis to acaricides.

Organophosphate induced delayed neuropathy.

A 19 year young male who consumed organophosphorous compound and required assisted mechanical ventilation for two weeks, later on developed delayed neuropathy is described.

The practices of spray operators in the Mpumalanga Malaria Control Programme using insecticides for residual indoor spraying

Pesticide poisoning poses a health risk to individuals throughout the world. In Mpumalanga Province spray teams apply local insecticides to indoor surfaces of households just prior to the rainy season to control malaria. Workers are exposed to pesticides during this process. This cross sectional study compared prescribed safe handling and deltamethrin application practices of Mpumalanga malaria spray operators versus actual practices in the field. Most (91) of the spray operators were included in the study. A tick list and interview was utilized to observe field practices and enquire about reasons for non-compliance. Only 28 of operators complied with all prescribed safe handling practices. Gloves; face shields and masks were not utilized as recommended and contributed to the highest levels of non-compliance. Compliance was found to be dependent on gender; age; years of experience; education level and employment status. The low compliance rate necessitates further investigation of the malaria programme occupational safety management system. All stakeholders need to be aware of the consequences of pesticide poisoning and to collaborate in efforts to work towards prevention