Heba Youssef

A retrospective study was performed on the patients exposed to acute Castor oil intoxication admitted to (PCCASU) in the period from January 2003 to December 2007.Data were retrieved from patient sheets regarding the following parameters: Sociodemographic, clinical, investigational and therapeutic interventions. The total numbers of cases were 60 patients. Most of cases were below 12 years (76.2%), (61.9%) were males. Street intoxication constitute (78.3%). The majority of cases were coming from Cairo governorate. Most of patients were students (91.7%). The mean delay time was 6.03± 3.3 hours. The mode of toxicity in most of cases was the accidental mode (93.3%). The oral route of intoxication was recorded in 100% cases. Regarding the vital signs; the mean core body temperature was 37.0±0.1ºC, the mean respiratory rate was 20.7±7.1/ min, the mean pulse rate was 93.0/ min and the mean arterial blood pressure was Systolic BP104.6±10.6 mmHg, while the diastolic BP was 68.0±10.2 mmHg. The GIT manifestations were the main clinical findings. The mean blood sugar level was 105.3±27.6(mg/dl),the mean serum sodium level was139.4±5.7 m Eq/L the mean serum potassium levels was 3.9±0.6 m Eq/L. Mean blood Urea level was34.3±21.5(mg/dl).The Mean serum creatinin level was 0.92 ±0.6 (mg/ dl).The mean hospital stay duration was 22.0 ±12.9 hours. In conclusion All cases recovered completely and were discharged without any reported morbidities. This reflect the efficiency of therapy and successful management in PCCASU of cases intoxicated by Castor oil and may also reflect the mild or moderate presentations of the cases under the study..

As viper snake bites are the most important cause of snake-bite mortality in several places of the world, the present study spotlighted this type of snake bites among snakebites patients received at the Poison Control Center, Ain Shams Faculty of Medicine (PCCA). The study aimed at scrutinizing the epidemiology, the presenting symptoms and signs, the therapeutic procedures employed and the outcome of these cases during the year 2006. It was found that out of 140 cases of snake bites received at the center, forty patients were bitten by a viper snake. Full history taking and clinical examination were done to every case. Blood samples were drawn from every case for biochemical analysis of the coagulation profile, blood picture, CPK, AST, ALT, serum creatinine, blood urea, serum sodium and potassium, blood glucose and C3 and C4. The study revealed that most of the patients were adult males (60%) and adult females were 20%. Children represented 20% of the cases and were equally distributed betweeen both sexes. Biting was accidental in 82.5% of cases and occupational in the remaining 17.5%. Forty five per cent of the bites took place in the street and 37.5 % happened at home. The lower limbs were the site of the bite in 78.5 % of cases. Most of the bites had occurred during summer months (April through August). Winter months (November through March) showed no cases at all. The Greater Cairo was the habitat of most cases. It was found that 90% of cases presented to the center within 30 min to 3 hours after being bitten. Only 10% presented with a delay of 4 hours or more. The presenting manifestations included fang marks and alterations of pulse rate , blood pressure, respiration and body temperature. Lymphadenopathy was evident in 75% of cases. Hematological manifestation included bleeding gums, heamaturia, petechial hemorrhages and ecchymosis. Neurogenic shock and panic were evident in 95 % of the patients. The coagulation profile of the 40 cases showed significant prolongation of PT and PTT, lowering of fibrinogen level and significant increase of Fibrin Degradation Products (FDP) before treatment. CPK was relatively elevated before treatment, however, liver enzymes and renal indices were normal. Complement 3 and 4 were also relatively decreased before treatment. All the cases received antivenom therapy after being diagnosed. Two to four vials were enough in 26 cases (68 %) and 5 vials or more were needed in 14 cases (32%). Fresh frozen plasma was neecessary in 6 cases (15%) and whole blood transfusion was required to 16 cases (40%). All relatively altered biochemical parameters were normalized after treatment. No deaths occurred among the patients and all of them were treated and discharged whether from the receiving outpatient ward (24 patients) or after being admitted to the ICU (16 patients). It was concluded that the management protocol employed was effective. Investigating cases of snakebites caused by other types of snakes is recommended and exchange of information about this problem with similar health facilities should be done.

This work aims at the study of the socio-demographic and drug history profile of acute opiate overdosed Egyptian Patients admitted to PCCA during the year 2007. Data on demographic and drug intake features were extracted from available patients' sheets and from the information unit Of PCCA. The socio-demographic profile showed that age group most affected was adolescents especially teenagers (53%). The majority of cases were males (89.4%). Almost all subjects were single (95%) and 80.7% of them were from urban background. 90.2 % of subjects were unemployed, 80% of social class type (IV). Examining the drug history profile of the subjects, it appeared that 60% of the subjects received opiate drug through oral route, 20% Intravenous and 15% through inhalation route. A minority received it through rectal route (5%). The most common mode of administration was overdose in addicts (99%). Almost all the subjects were dependent on at least one or more of other substance abuse at the time of presentation as follows (94%) tobacco, (84%) alcoholics (82%) were abusing benzodiazepines. Almost all cases were dependent on opioids drugs for a mean duration 22.5 ± 10.3 months.

Medical information center MIC of faculty of medicine Ain Shams University have installed the "MOODLE" program for course management on a dedicated server. It is copyrighted since 2007.All staff members are welcomed to upload their own courses to this server. Students are also invited to use these resources and to send us their feed back so that this will improve the quality of E-learning service. The URL of the faculty E-learning forum is Each student in each grade had a password and username to enter on the forum corresponding to the year of study .Beside the MIC also provides other services like site news ,The faculty vision and mission ,Students guide ,Basic life support training program and the activities of Crisis and disaster management unit .For postgraduate students the postgraduate recent upgraded bylaws as well as the training program of house officers .Also Family medicine practices guidelines Methodology faculty of medicine Ain Shams University have installed the "MOODLE" program for course management on a dedicated server. It is copyrighted since 2007.All staff members are welcomed to upload their own courses to this server. Students are also invited to use these resources and to send us their feed back so that this will improve the quality of E-learning service. The URL of the faculty E-learning forum is http://mic.shams.edu.eg. Each student in each grade had a password and username to enter on the forum corresponding to the year of study.For postgraduate students the postgraduate recent upgraded bylaws as well as the training program of house officers .Also Family medicine practices guidelines .The students final scores are also uploaded on the MIC .The summer training programs in USA is also included on the web site. RESULTS The number of forums are equivalent to the number of the faculty departments which are 16. For the first two years the web site address is http:// mic1 .shams.edu.eg.com Anatomy Histology Biochemistry Physiology

Hundred pediatric patients were presented with acute digitalis toxicity to both children's hospital and poison control center, Ain Shams University hospitals during years 2009-2010.Their sociodemographic results showed that their ages ranged from early infancy (6 months) up to adolescent (18 years old). Early infancy (32%), late infancy (20%), early childhood (4%), late childhood (24%) and adolescents (20%). Most of them were males (68%). 80% of cases came from urban areas and near half of them belong to social class III (48%).The oral route of intake was the main route (64%). The clinical data showed that the indications of digitalis intake were DCM (28%), RHD (28%), CHD (28%) 12% were exposed accidently to digitalis toxicity while 8% due suicidal attempts. The main presenting clinical manifestations were nausea and vomiting 72%. Followed by bradycardia (50%).There was higly significant correlation between serum digitalis level measured and serum electrolytes K, and Ca. The renal function tests (Creatinine and BUN) showed nonsignificant difference with serum digitalis level. The outcome of cases showed that the mean hospital stay duration was 5.6±3 days. Thirteen percent showed CVS morbidities in the form of different types of arrhythmias as follows: PVCs (3%), Bigenny (3%), bradycardia (3%), Torsades de points (3%) and first degree heart block (1%). 100% of cases survived with mean serum digitalis level 2.8±0.7ng/ml .No mortalities occurred. In conclusion: All cases recovered completely and were discharged without any reported morbidities. This reflects the efficiency of therapy and successful management in both children's hospital and PCCASU.

Background: Nowadays tramadol is becoming abused more popular among teens in most countries worldwide; especially between males. The aim of present study was to investigate the histopathological and biochemical profiles of acute and chronic toxic effects of tramadol hydrochloride on hepatic, renal and testicular functions. Materials and methods: Sixty male adult albino Sprague-Dawley rats were used in this experimental study. Rats were divided into three equal groups. Each group contained twenty rats. Group I: served as control group. Group II: representing acute tramadol toxicity and group III: representing tramadol dependent use daily for 60 days. Results: Histopathological results regarding hepatic tissues of group II displayed hemorrhage and cytolysis in the hepatocytes. In group III hepatic tissue showed complete cell membrane degeneration of hepatocytes when both groups compared to group I. Renal tissues in group II showed glomerular hemorrhage while in group III there was atrophied glomeruli with collapsed tufts, wide Bowman's space, degenerated tubules and cellular infiltration when both groups compared to group I. The histopathological examination of testicular tissues revealed atrophy of seminiferous tubules with interstitial calcification in group II. The histopathological lesions were inform of focal testicular degeneration with single or multiple layer of vacuolated spermatocytes, with a little evidence of spermatogenesis in group III when both groups were compared to group I. Biochemical results indicated that the levels of liver enzymes specific (ALT, AST and ALP) and serum bilirubin were significantly increased in group II and III when compared to the control group. Similarly for renal function, the levels of creatinine and blood urea nitrogen (BUN) were also significantly increased in group II and III when compared to control group. The sex hormones levels were significantly increased (estradiol (E2) and prolactin (PRL) compared to control group , while tramadol administration caused a significant decrease in testosterone level with a gradual reduction in luteinizing hormone (LH) and follicular stimulating hormone (FSH) as compared to control group. Conclusion: Evidence of histopathological and biochemical affection of hepatic, renal and sexual function evoked by acute toxicity of tramadol and its repeated administration for long periods. Recommendations: The necessity of designing a national awareness campaign to the public especially the youth to spotlights on the health hazards of tramadol abuse.

Background: Several studies indicated that monosodium glutamate (MSG) disrupts the metabolism, the development, and the functions of various organs, such as liver, thymus, ovaries, kidney, and many parts of brain, including cerebellum. Nitric Oxide (NO) is known to be responsible for the organization of many biological events in the mammalian body as a second messenger and a neural messenger. Some studies found that NO is a neuroprotective substance while others qualify it as a neurotoxic. Aim: This study was designed to investigate the effect of non-selective inhibition of nitric oxide synthase enzyme isoforms on cerebellar structure and function in normal rats and in rats with MSG-induced cerebellar toxicity. Material and methods: The study groups included thirty two male adult albino Sprague-Dawley rats which were divided into four groups; group I (control), group II (LNAME-treated), group III (MSG-treated) and group IV (combined LNAME and MSG-treated). Motor coordination was assessed by rotarod test. Cerebellar nitrite concentration was measured. Histopathological evaluation of cerebellar structure and immunohistochemical examination for caspase-3 were done. Results: Both LNAME and MSG significantly impaired cerebellar function and resulted in marked cerebellar injury and an increase in apoptosis. This effect was most prominent in group III. Conclusion: Inhibition of nitric oxide synthase enzyme disturbed cerebellar structure and function in normal rats and potentiated MSG-induced cerebellar toxicity. Further studies are required for better understanding of the role of the NO pathway and developing therapeutic strategies that are based on manipulation of NO synthesis. [Heba Youssef M. Sayed, Dalia M. Abd-Elhalim, Mona A Hussain and Horeya E Korayem. Monosodium Glutamate-Induced Cerebellar Toxicity; Possible Role of Nitric Oxide in Adult Albino Rats. J Am Sci 2016;12(1):123-131]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 15.

Health Ministry announced on first of The April 2013 the first incident (group I) of food poisoning outbreak among Al-Azhar University males students. On 29 th of The April 2013, a second incident (group II) occurred. The head of the Central Administration of Intensive Care and Emergency Ministry of Health triaged cases into seven hospitals. The PCCASU received 152 out of 479 cases of (group I) and 89 out of 180 of (group II) .Their mean ages were 19±1.5 for group I and20±0.7 for group II. The students became affected after eating their lunch meal in the dormitory cafeteria. Group I were admitted to PCCASU within 3 hours while group II were admitted after two hours delay time. They were complaining of panic attack and sudden onset of GIT upset in the form of nausea, vomiting, abdominal cramps associated with fever. Samples were taken from vomitus, stools and food specimens and examined microbiologically. Cases were treated symptomatically. All cases undergone observation for 24-48 hours. The results attributed the cause of the first outbreak to staph aureus and the second to salmonella bacteria. All cases were discharged without mortalities or morbidities. It was concluded that bacterial food poisoning outbreak necessitates setting of a mass causality plan and early transfer to specialized poison control centers for better management and prognosis. It is recommended that food safety measures should be applied in every organization serving food according to National and International standards to avoid the occurrence of such outbreaks.

It has been asked whether sildenafil safety live up to its expectations or not. Most of the previous studies stated that sildenafil is safe and well tolerated by most users without serious effects. The drug has attained great popularity and widely used even without prescription or as one of the over the counter preparation. So, this work was carried out to assess the possible cardio pulmonary and cerebral toxicities of sildenafil citrate in adult male albino rats. The study included three parts; acute, short term and chronic toxicity studies. At the end of each experimental study, the animals were subjected to ECG and blood pressure recording. Then blood samples were collected for estimation of the levels of enzymes relevant to cardiotoxicity (CPK, CPKMB, LDH and SGOT). Furthermore, histopathological examination of the rats‫׳‬ heart, lung and brain was carried out by light microscopy. The results showed evident cardiac toxicity in the form of ECG and blood pressure changes as well as elevated cardiac enzymes. Histopathological changes in the chronic toxicity group were more severe and extensive than either acute or short term study groups. So, it can be concluded that sildenafil caused biochemical and histopathological alterations in the heart along with histopathological changes in the lung and brain that correlated with the duration of administration. It is recommended that sildenafil should be used only on medical prescription. Also, serum levels of CPK, CPKMB, LDH and ECG recording are sensitive indicators for sildenafil induced cardiac toxicity.