Profile of Acute Poisoning among Adult Patients at the Emergency Room of a Tertiary Hospital, South-western Nigeria.

BACKGROUND AND OBJECTIVE: Acute poisoning often presents as an acute medical condition necessitating prompt medical care. Few data exist on adult poisoning and management protocol often are inadequate. Assessing the cases may inform a more robust protocol for case management, necessitating this study. The objective was to assess cases of acute poisoning and determine the agents as well as their outcomes. METHODS: This was a retrospective study involving 53 adult cases of acute poisoning at the emergency room (ER) of a tertiary hospital over 5 years (2016­2020). The ER register was assessed for the gender, type of agent and outcome of the medical condition. Cases admitted to the ward were followed up to determine their outcomes. RESULTS: There were more males, 34 (64.2%) than females. 19 (35.8%) with a mean age of 29.2 ± 13.5 years and 24.6 ± 8.2 years respectively. Organophosphates accounted for 22 (41.5%) of cases followed by a cocktail of unknown mixture in 12 (22.6%) and paraquat in 6 (11.3%) cases. Alcohol, medications, and alkali were responsible for 5 (9.5%), 4 (7.5%) and 4 (7.5%) cases respectively. Mortality was recorded in 11 (20.8%) of cases this was mostly associated with paraquat. In addition, 1 (1.9%) case was referred to another facility while 2 (3.8%) cases required longer hospital stay. More than 50% of the cases were discharged within 24 to 48 hours while 6 (11.3%) cases were discharged against medical advice. CONCLUSION: Organophosphate appears to be the most common agent responsible for acute poisoning in adults in this environment and young male adults have a higher risk. Most of the poisoning cases were discharged however, mortality was high, particularly among those with paraquat poisoning.

CONTEXTE ET OBJECTIF: L'intoxication aiguë se présente souvent comme une condition médicale aiguë nécessitant des soins médicaux rapides. Il existe peu de données sur l'empoisonnement chez les adultes et le protocole de gestion est souvent inadéquat. L'évaluation des cas peut éclairer un protocole plus robuste pour la gestion des cas, ce qui nécessite cette étude. L'objectif estd'évaluer les cas d'intoxication aiguë et de déterminer les agents ainsi que leurs résultats. MÉTHODES: Il s'agissait d'une étude rétrospective portant sur tous les cas d'intoxication aiguë auxurgences d'un hôpital tertiairesur une période de 5 ans (2016-2020). Le registre des urgences a été évalué pour le sexe, le type d'agent et l'issue de l'état de santé. Les cas renvoyés au service ont fait l'objet d'un suivi pour déterminer les résultats. RÉSULTATS: La proportion de bières était plus élevée que celle des femmes (64,2 % contre 35,8 %) avec un âge moyen de 29,2 ±13,5 ans et 24,6 ±8,2 ans respectivement. L'organophosphate représentait 41,5 % des cas, suivi du mélange cocktail (22,6 %) et du paraquat (11,3 %). L'alcool, les drogues et les alcalis étaient responsables de 9,4 %, 7,6 % et 7,5 % respectivement. Mortalité wtelle qu'enregistrée dans 20. 8 % des cas; 1,9 % ont été référés tandis que 3,8 % ont dû rester plus longtemps à l'hôpital. Plus de 50 % des cas ont reçu leur congé dans les 24 à 48 heures, tandis que 11,3 % ont reçu leur congé contre avis médical. Le paraquat était le plus souvent responsable de la mort, tandis que l'alcool, les alcalis et les opioïdes avaient le même taux de mortalité. Neuf (17,0 %) des 11 (20,8 %) mortalités étaient des hommes CONCLUSION: La mortalité par intoxication aiguë est élevée et l'empoisonnement au paraquat est l'agent le plus mortel suivi par l'organophosphate. Les jeunes hommes sont prédisposés à l'empoisonnement par l'organophosphate ou le paraquat pour lesquels la mortalité est élevée. Mots-clés: Empoisonnement, Paraquat, Urgence, Organophosphate, MMortalité.

Biofilm is associated with chronic streptococcal meningoencephalitis in fish.

Biofilms are aggregates of attached microbial organisms whose existence on tissues is often recognised as a mechanism for the establishment of most chronic diseases. Herein we investigated the ability of piscine Streptococcus agalactiae, an important aquatic pathogen, for adaptation to this sessile lifestyle in vitro and in the brain of a tilapia fish model. Piscine S. agalactiae exhibited a weak attachment to polystyrene plates and expressed a low biofilm phenotype under the study conditions. Furthermore, fluorescent in situ hybridization and confocal laser scanning microscopy revealed discrete aggregates of attached S. agalactiae within brain tissues and around meningeal surfaces. They were embedded in an exopolysaccharide containing matrix, intractable to inflammatory response and showed some level of resistance to penicillin despite proven susceptibility on sensitivity test. Intracellular bacterial aggregates were also observed, moreover, antibody mediated response was not demonstrated during infection. Nucleated erythrocytes appear to facilitate brain invasion possibly via the Trojan horse mechanism leading to a granulomatous inflammation. We have demonstrated that biofilm is associated with persistence of S. agalactiae and the development of chronic meningoencephalitis in fish.

Setting up equine embryo gender determination by preimplantation genetic diagnosis in a commercial embryo transfer program.

Preimplantation genetic diagnosis (PGD) allows identifying genetic traits in early embryos. Because in some equine breeds, like Polo Argentino, females are preferred to males for competition, PGD can be used to determine the gender of the embryo before transfer and thus allow the production of only female pregnancies. This procedure could have a great impact on commercial embryo production programs. The present study was conducted to adapt gender selection by PGD to a large-scale equine embryo transfer program. To achieve this, we studied (i) the effect on pregnancy rates of holding biopsied embryos for 7 to 10 hours in holding medium at 32 °C before transfer, (ii) the effect on pregnancy rates of using embryos of different sizes for biopsy, and (iii) the efficiency of amplification by heating biopsies before polymerase chain reaction. Equine embryos were classified by size (≤300, 300-1000, and >1000 µm), biopsied, and transferred 1 to 2 or 7 to 10 hours after flushing. Some of the biopsy samples obtained were incubated for 10 minutes at 95 °C and the rest remained untreated. Pregnancy rates were recorded at 25 days of gestation; fetal gender was determined using ultrasonography and compared with PGD results. Holding biopsied embryos for 7 to 10 hours before transfer produced pregnancy rates similar to those for biopsied embryos transferred within 2 hours (63% and 57%, respectively). These results did not differ from pregnancy rates of nonbiopsied embryos undergoing the same holding times (50% for 7-10 hours and 63% for 1-2 hours). Pregnancy rates for biopsied and nonbiopsied embryos did not differ between size groups or between biopsied and nonbiopsied embryos within the same size group (P > 0.05). Incubating biopsy samples for 10 minutes at 95 °C before polymerase chain reaction significantly increased the diagnosis rate (78.5% vs. 45.5% for treated and nontreated biopsy samples respectively). Gender determination using incubated biopsy samples matched the results obtained using ultrasonography in all pregnancies assessed (11/11, 100%); untreated biopsy samples were correctly diagnosed in 36 of 41 assessed pregnancies (87.8%), although the difference between treated and untreated biopsy samples was not significant. Our results demonstrated that biopsied embryos can remain in holding medium before being transferred, until gender diagnosis by PGD is complete (7-10 hours), without affecting pregnancy rates. This simplifies the management of an embryo transfer program willing to incorporate PGD for gender selection, by transferring only embryos of the desired sex. Embryo biopsy can be performed in a clinical setting on embryos of different sizes, without affecting their viability. Additionally, we showed that pretreating biopsy samples with a short incubation at 95 °C improved the overall efficiency of embryo sex determination.