Aluminum Phosphide Tablets Research Articles

The effectiveness of phosphine fumigation of wheat in a farm-scale thermosyphon silo

Fumigation of pests is essential for maintaining the quality of stored grain. Rapid and effective pest control is the key to minimise damage to the valuable grain. The current study investigated the efficiency of a farm-scale thermosyphon silo to passively circulate phosphine fumigant gas by measuring the phosphine concentrations at a series of points throughout the silo. A 50 tonne sealable grain silo with an external thermosyphon was fitted with gas sampling lines at three different levels in the grain body, and also in the headspace. The grain was fumigated with phosphine gas 12 times over a 12 month period to contrast the thermosyphon system efficiency under varied external environmental conditions. The minimum fumigation standards of 200 ppm for 10 days or 300 ppm for 7 days were reached and exceeded in all fumigation cycles throughout the year in 12.5–22 days, demonstrating the effectiveness of the thermosyphon system. In addition, the final fumigation was held until the phosphine concentration dropped to 200 ppm. The silo reached 200 ppm only four days after fumigation, reached a maximum of approximately 600 ppm after 30 days, and did not fall below 200 ppm until 106 days after fumigation. Linear air velocity in the was also measured in the thermosyphon pipe and showed that airflow could reach as high as 2.7 m/s, but flow was sporadic and not consistent, most likely due to pressure build up on the headspace of the silo due to resistance to airflow by the bulk grain body. Temperature and humidity results indicated that while both parameters are fundamental in the production of phosphine from aluminium phosphide tablets, they work against each other. This provides an effective control mechanism that prevents the rapid production of phosphine, thereby reducing the buildup of phosphine and reducing the risk of an explosion.

Phosphine estimation in fumigated food grains using gas chromatography equipped with FPD detector.

Phosphine, as per several reports, is considered to be an ideal and effective alternative to methyl bromide (MB) fumigant, phased out globally honouring 'Montreal Protocol'. The food grains fumigated with phosphine are perceived to be residue-free; however, estimation of its residues is imperative. In the present study, the phosphine residues were estimated in grains of wheat, rice, green gram, chickpea and yellow pea fumigated with different formulations of phosphine under 7 and 10days exposure periods at various locations in India. For efficacy studies, the conventional aluminium phosphide (AlP) tablet (56% @2 and 3 tablet/MT) and granular AlP (77.5% @1.0 and 1.5g phosphine/m3) formulations were applied. Each treatment including untreated control was replicated thrice. The concentration was monitored every 24h until the end of exposure periods. Food grain samples were drawn before and post fumigation following a certain waiting period for estimation of phosphine residues using gas chromatography equipped with FPD detector. Residues in fumigated food grains were observed in traces in all the experimental stacks, but below the MRL (0.1ppm), fixed by Codex Alimentarius Commission (CAC). Phosphine can be considered safe for use as an alternate fumigant in quarantine and long-term storage of food grains leaving residues below MRL.

Prevalence and Life-Threatening Electrocardiographic Changes in Aluminum Phosphide Poisoned Patients

Background: According to World Health Organization report, poisoning with phosphides is the most common fatal poisoning in most of the world, especially developing countries. One of the leading causes of morbidity and mortality in these patients is cardiovascular complications; therefore, the researchers aimed to study the prevalence and type of electrocardiographic changes, especially life-threatening electrocardiographic changes observed in poisoned patients with aluminum Phosphide.
 Methods: This retrospective cohort study was carried out on all the individuals poisoned with aluminum phosphide tablet and were admitted to the toxicology center in northwest Iran and met the inclusion criteria and no exclusion criteria. After categorization, the data were entered into SPSS (SPSS Inc, Chicago, USA) software, and appropriate statistical analyses were done. In all the tests, p<0.05 was considered statistically significant.
 Results: Our findings pointed out that the majority of the patients were in the 20-40 age group and male-to-female ratio was 2.00. Electrocardiographic changes were prevalent in 86.1 percent of the patients who consumed aluminum phosphide. The most common change was sinus bradycardia. The mean consumed aluminum phosphide was 1.93±1.88 tablets, and the mean interval from consumption to medical care was 3.67±2.05 hr which did not have significant correlations with electrocardiographic changes.
 Conclusion: The most common electrocardiographic change is bradycardia, but the most lethal is ventricular tachycardia; therefore, taking repeated electrocardiograms and echocardiography could help the decision making in the process of patient management. Definitive conclusions need further studies.

Deliberate Ingestion of Aluminum Phosphide Tablets as a Treatment for Dyspepsia.

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Suicides by pesticide ingestion in Pakistan and the impact of pesticide regulation

IntroductionSuicide is a major public health problem in Pakistan, accounting to approximately 19,331 deaths every year. Many are due to consumption of acutely toxic pesticides; however, there is a lack of national suicide data, limiting knowledge and potential for intervention. In this paper, we aimed to review the literature on pesticide self-poisoning in Pakistan to identify the most problematic pesticides in relation to national pesticide regulations.MethodsInformation on the currently registered and banned pesticides was obtained from Ministry of National Food Security and Research while data on pesticide import and use was extracted from FAOSTAT. We searched the following sources for articles and research papers on poisoning in Pakistan: Cumulative Index to Nursing and Allied Health (CINAHL), Google Scholar, Applied Social Sciences Index and s (ASSIA), Excerpta Medica (EMBASE), National Library of Medicine’s MEDLINE (PUBMED), PS102YCHINFO and Pakmedinet.com using the search terms ‘self-poisoning’, ‘deliberate self-harm’, ‘suicide’, ‘methods and means of suicide’, ‘organophosphate’, ‘wheat pill’, ‘aluminium phosphide’, ‘acute poisoning’, OR ‘pesticides’, AND ‘Pakistan’.ResultsAs of May 2021, 382 pesticide active ingredients (substances) were registered in Pakistan, of which five were WHO hazard class Ia (extremely hazardous) and 17 WHO hazard class Ib (highly hazardous). Twenty-six pesticides, four formulations, and seven non-registered pesticides had been banned, of which two were WHO class Ia and five Ib. We identified 106 hospital-level studies of poisoning conducted in Pakistan, of which 23 did not mention self-poisoning cases and one reported no suicidal poisoning cases. We found no community or forensic medicine studies. Of 52,323 poisoning cases identified in these papers, 24,546 [47%] were due to pesticides. The most commonly identified pesticide classes were organophosphorus (OP) insecticides (13,816 cases, 56%) and the fumigant aluminium phosphide (3 g 56% tablets, often termed ‘wheat pills’; 686 cases, 2.7%). Few studies identified the particular pesticides involved or the resulting case fatality.ConclusionWe found pesticide poisoning to be a major cause of poisoning in Pakistan, with OP insecticides and the fumigant aluminium phosphide the main pesticides identified. Withdrawal of Class I pesticides (as proposed to occur nationally in 2022) and high concentration aluminium phosphide tablets should rapidly reduce suicidal deaths by reducing the case fatality for low-intention poisoning cases. National cause of death data and forensic toxicology laboratory data identifying the pesticides responsible for deaths will be important to assess impacts of the proposed national ban.

ECG CHANGES IN ALUMINIUM PHOSPHIDE POISONING

Background: Aluminium phosphide is a solid fumigant pesticide.Aluminium phosphide (AlP) is a common suicidal poison with a high mortality rate due to its cardiovascular impact and lack of antidote. The clinical spectrum of poisoning varies depending upon the dosage and duration of consumption.The main effect of the poison is due to the release of phosphine which inhibits cytochrome oxidase and thereby hampers cellular oxygen utilization.Death is due to its direct toxic effect over the heart leading to peripheral circulatory failure.The aim of the study was to describe the electrocardiographic changes in Aluminium phosphide poisoning. Methods: 36 patients,who were admitted in MICU, following consumption of aluminium phosphide tablets were included in the study. Patients clinical evaluation was done.ECG of the patients was done to study the cardiac abnormalities. Results: Out of 36 cases,ECG was normal in 16 cases and abnormal in 20 cases. Atrial fibrillation was most common finding-6 patients (30%), supraventricular tachycardia-2 (10%),ventricular tachycardia-2 (10%),ST-T changes-6 { ST elevation-4 (20%) and ST depression-2 (10%) },bundle branch block-1 (5%),prolonged QTc-3 (15%).Conclusions: ECG was done bedside, it is a cost effective tool and should be done in all cases.Whenever it is available, it must be done in cases of aluminium phosphide poisoning. Thus, proper clinical work out along with relevant investigations and management as per standard protocol may save many more live

Numerical Simulation of Phosphine Movement in Bulk-Stored Grain

Highlights Develop a CFD model that reveals the detailed mechanisms of phosphine movement in bunkers. Evaluate factors that impact phosphine distribution in grain bunkers. Provide recommendations for best management practices for phosphine fumigation in bunkers. Abstract. Bunker storage is an inexpensive and, thus, popular method for medium- and long-term storage of wheat. To control insect infestations in bunker storage, phosphine (PH3) fumigant, released from aluminum phosphide (AlP) tablets, is commonly used, especially in Australia. For fumigation to be effective, a lethal concentration of PH3 throughout the bunker must be ensured. Because bunkers are exposed to ambient conditions, temperature gradients are created throughout the bunker, resulting in natural convection currents that move PH3 from areas around the fumigation points to the entire bunker. This research used computational fluid dynamics (CFD) simulation to investigate the effect of natural convection on fumigation in bunkers. The model was validated against published benchmarks and a field experiment with a full-scale bin with sorption and leakage. The effects of PH3 release points location, bunker shape, bunker orientation, leakage, sorption, ambient temperature fluctuation, and PH3 motion in 3D were studied. Results agreed well with the experimental data and provided various recommendations for best management practices for PH3 fumigations in bunkers. Results showed that diffusion and natural convection solely are insufficient in spreading out PH3 within bunkers. Further research is needed on the effects of tarpaulin billowing in relation to PH3 behavior. Keywords: Bin, Bunker, CFD, Fumigation, Natural convection, Phosphine, Porous media, Simulation, Sorption, Species transport, Wheat.

Fatal outcome due to aluminum phosphide poisoning in an old man with a psychiatric disorder as a latent post-COVID-19 challenge: A case report

Aluminum phosphide is a metal phosphide widely implemented as a pesticide. In the country of Iran, it is recognized by the colloquial name of rice pill. Any trace of accidental or intentional ingestion of aluminum phosphidecan result in severe hemodynamic disorders and metabolic acidosis, ultimately leading to the patient’s mortality. In this report, we document the unfortunate demise of an 85-year-old man who lived in isolation, having lost his wife to COVID-19. The patient consumed aluminum phosphide tablets and, despite resuscitation efforts, inevitably succumbed to the toxic effects.

Cardiovascular manifestations of acute aluminium phosphide poisoning and their impact on survival

Background: Aluminium phosphide (AlP) is a common suicidal poison with a high mortality rate due to its cardiovascular impact and lack of antidote. The aim of the study was to describe the electrocardiographic changes and other cardio-vascular manifestations in acute AlP poisoning and evaluate its impact on survival outcomes.Methods: A prospective cross-sectional study was conducted in a tertiary care hospital including patients who presented with acute AlP ingestion in any form. Patients’ vitals and ECG at the time of admission were taken and outcomes of survival were identified. A descriptive study of echocardiography was also done. The clinical parameters were correlated with the survival outcomes.Results: Fifty patients were included with 30 males and 20 females. The consumption of AlP in tablet form caused more hemodynamic compromise (hypotension and high anion gap metabolic acidosis) as compared to the powder form. ECG changes were seen in 42% of the cases, the most common finding was prolonged QTc interval (26%). The mortality was 30%. Hypotension, bradycardia, and QRS widening were found to be significant predictors of mortality (p<0.05). Echocardiography was performed for 10 patients, of which, one had right ventricular dysfunction and two had left ventricular dysfunction.Conclusions: AlP tablets are more lethal and hemodynamically compromising than AlP powder. Hypotension, bradycardia, and QRS widening are significant predictors of mortality. Direct cardiotoxicity leads to ECG changes, of which, QTc prolongation is the most common.

Temporal dynamics of phosphine fumigation against insect pests in wheat storage

Methyl bromide (MBr) fumigant has been phased out globally honouring ‘Montreal Protocol’. However, MBr is still used in India in various commodities for controlling pests as well as international trade requirements. Reports on phosphine fumigant efficacy under different ecological zones in India are scanty. In the present study fumigation trials were conducted in warehouses on 5 Metric-Tons of wheat stacks per replication of a treatment for testing phosphine efficacy against laboratory cultured and warehouse resident population of Tribolium castaneum (Herbst), Sitophilus oryzae (Lin), and Rhyzopertha dominica (Fab). The trials were organized in triplicate including untreated control at FCI warehouses at two locations, Pithoragarh in Uttrakhand and New Delhi, with varying climates. The conventional 56% Aluminium phosphide (AlP) tablet at 2 and 3 tablet/MT, and gas derived from on-site phosphine generator using 77.5% granular formulation at 1.0 and 1.5 g phosphine/m3 was tested at these warehouses against test insects for 7 and 10-days exposure periods for each dosage. Phosphine concentration was monitored every 24 h till end of the exposure periods using gas monitors. No emergence of insects was observed until 60 days after treatment in both the exposure periods using all dosages of phosphine indicating mortality of all life stages of laboratory cultured insects and resident population at both the locations. Phosphine at 1.5 g/m3 was observed as an effective alternative to methyl bromide fumigant for controlling S. oryzae, R. dominica and T castaneum at 250–27 °C and humidity 38–45% with an exposure period of 7-days, with a terminal phosphine concentration of 500–600 ppm. Locational effect was observed for gas loss and phosphine gas concentration. During fumigation, phosphine gas loss was observed to be inversely related with grain moisture and directly related with Ct values.

Effect of Aluminium Phosphide on Some Nutrients and Anti-Nutritional Factors in Arachis hypogaea

Aims: To comparatively study the effect of aluminium phosphide preservative on some nutrientional and anti-nutritional factors in Arachis hypogaea.
 Study Design: Randomized design
 Place and Duration of Study: Department of Biochemistry and Molecular Biology Laboratory, Nasarawa State University, Keffi between May and August, 2019.
 Methodology: Two portions of A. hypogaea weighing 500g each, were obtained, one portion preserved with Aluminium phosphide tablet while the second portion was without any preservative. The preservation lasted for 30 days after which the A. hypogaea was blended using a mechanical blender before analysis for nutritional and anti-nutritional compositions.
 Result: The proximate compositions were significantly (p<0.05) higher in the NAPP than APP except the fiber (03.01±0.06 mg/100 g; 03.80±0.06 mg/100 g) and ash (01.00±0.06 mg/100 g; 02.23±0.06 mg/100 g). Carbohydrates (07.40±0.06 mg/100 g; 03.48±0.06 mg/100 g), protein (19.93±0.06 mg/100 g; 14.94±0.06 mg/100), fat (74.60±0.06 mg/100g; 68.08±2.75 mg/100 g), and moisture content (06.40±0.06 mg/100 g; 3.00±0.06 mg/100 g). Exception of phosphorus (65.00±0.06mg/100g; 63.00±0.06mg/100g), the minerals concentration was significantly(p<0.05) higher in NAPP compared to APP. Iron (76.20±0.06 mg/100 g; 62.00±0.06 mg/100 g), potassium (38.01±0.06mg/100 g; 26.20±0.06mg/100g), manganese (26.02±0.06mg/100g; 15.10±0.06 mg/100 g), magnesium (11.00±0.06mg/100g; 06.00±0.06 mg/100 g), calcium (82.10±0.06 mg/100 g; 72.00±0.06 mg/100 g) and zinc (25.01±0.06 mg/100 g; 14.01±0.06 mg/100 g).The anti-nutritional factors showed significant difference (p<0.05) higher in tannin (9.33±0.69 mg/100 g; 1.90±0.02 mg/100 g), oxalate (32.50±0.60 mg/100 g; 42.50±.60 mg/100 g), phytate (16.72±0.60 mg/100 g; 5.48±0.60 mg/100 g), alkaloid (16.72±0.60 mg/100g; 5.48±0.60 mg/100 g) and saponins (40.74±0.60 mg/100 g; 38.20±0.60 mg/100 g) except cyanide (0.02±0.00 mg/100 g; 0.02±0.00 mg/100 g).
 Conclusion: The study showed that aluminium phosphide negatively affected the nutritional profile of A. hypogaea. Thus, the effect of aluminium phosphide should be further investigated in vivo.

Locational dynamics of concentration and efficacy of phosphine against pulse beetle, Callosobruchus maculatus (Fab)

Phosphine is considered as an effective substitute to methyl bromide (MB), an ozone depleting fumigant which was phased out honouring ‘Montreal Protocol’. Limited field studies are available on phosphine toxicity against storage insects of pulses under different climatic conditions in India. In the present study phosphine efficacy was investigated against laboratory cultured and field populations of Callosobruchus maculatus by organising field fumigation trials of 5 MT pulse stacks, each in triplicate, under varied climatic conditions. The trials were conducted at three locations, Jaipur for Cicer arietinum (chickpea), Cuttack for Vigna radiata (green gram) and Mumbai for Lathyrus aphaca (yellow pea) using conventional 56% Aluminium phosphide (AlP) tablets (2 tab/MT and 3 tab/MT) application; and gas derived from on-site phosphine generator with 77.5% granular (1.0 g and 1.5 g phosphine/m3) formulations for two exposure periods (7 and 10-days) for each dosage including untreated control. Phosphine gas concentration was monitored daily until the exposure periods using gas monitoring equipment. No emergence of adults was observed until 60 days after treatment indicating 100% insect mortality of both populations (laboratory and field) for both exposure periods using all dosages. The minimum effective phosphine gas concentration for controlling C. maculatus was observed as 300–500 ppm for 7-days exposure using 1.5 g phosphine/m3 depending on climatic conditions. A significant variation was observed in gas concentration monitored during fumigation of pulses at different locations. Average concentration-time (Ct) product for green gram was higher than that of chickpea and yellowpea. The loss of gas concentration was found to be significantly low in yellowpea treated with phosphine at moderately hot and humid climate.

Preparation and antimicrobial effect of a cinnamaldehyde-based sustained release fumigant tablet for grain storage

Currently, aluminum phosphide tablets have been extensively used as fumigant for grain storage because they could release phosphine that shows highly efficient anti-microorganism. However, phosphine is highly toxic and flammable which usually causes production accidents. Therefore, this study aimed to develop a novel fumigant based on cinnamaldehyde and study its antimicrobial efficacy for grain storage. The novel fumigant tablet was composed of cinnamaldehyde, silica, citric acid and sodium bicarbonate. Results showed that mesoporous silica with ultra-high specific surface area (1036.5 m2/g) served as carrier for cinnamaldehyde. The mixture of citric acid and sodium bicarbonate reacted with moisture to generate carbon dioxide which was helpful to release cinnamaldehyde. As expected, the fumigant tablet displayed a sustained release effect. The in vitro culture experiments showed that cinnamaldehyde had high antimicrobial effect against five fungi including Aspergillus flavus, Aspergillus candidus, Aspergillus niger, Fusarium and Penicillium. In the accelerated mildew simulation experiment (temperature: 35 °C, humidity: 98%), the blank group without mildew preventive began to go mouldy after five days, the control group with only cinnamaldehyde became mildew one week later, whereas there was no visible mildew growth in the experimental group with the fumigant tablet after one week. The number of fungal colonies in the blank group and the control group after one week was 8.3 × 104 and 6.5 × 103 CFU/g, respectively, while there were no fungi detected in the experimental group. This cinnamaldehyde-based fumigant tablet is a green and safe mildew preventive, which provides an alternative solution to aluminum phosphide tablet for grain storage.

Clinical Symptoms and Para-Clinical Findings among the Deceased Patients Due to Aluminum Phosphide Poisoning in Ardabil, Iran, From 2009 To 2017

Introduction: Aluminum phosphide or rice tablet is one of the most common pesticides and insecticides used in agriculture to protect crops, cereals, and rice. Recently, this substance has been increasingly used as a method for committing suicide among people in society. This study aimed to evaluate the clinical symptoms and para-clinical findings of deceased patients due to Aluminum phosphide poisoning in Ardabil province, Iran. Materials and Methods: This descriptive cross-sectional study was conducted on 97 hospitalized patients who died due to Aluminum phosphide poisoning in Ardabil province, Iran, from 2009 to 2017. The data were collected using a checklist and then analyzed in SPSS software (version 19) through descriptive and analytical statistics Results: The mean age of all patients was 34.3±15.8 years, and the majority of the cases (77.3%) were female. The most important symptoms were nausea and vomiting in males (92%) and females (100%). Moreover, the patients had a mean recovery time of 5.89 h. Of all the deceased patients, 22 and 75 cases took two and one tablets, respectively. Furthermore, 92.7% of the patients had taken the rice tablets orally. The amount of Glasgow Coma Scale (P=0.001), systolic blood pressure (P=0.001), PH (P=0.001), heart rate (P=0.001), respiratory rate (P=0.001), bicarbonate (P=0.001) and white blood cell (P=0.009) in died patients in more than 24 hour significantly difference with died patients in less than 24 hour. The females obtained a significantly lower systolic blood pressure (P=0.01) and lower pH (p=0.045), but the higher partial pressure of oxygen (P=0.01), compared to males. Conclusion: The results of this study showed that the frequency of deaths due to rice pill poisoning was much higher in males than females; moreover, this value was higher in middle-aged groups, compared to other age groups.

Induced Abortion by Vaginal Use of Aluminum Phosphide in a 44-Year-Old Woman: A Case Report

Aluminum phosphide (AlP) is an efficient and toxic pesticide that is easily available in many Asian countries such as Iran. Many cases of unintentional or suicidal use of AlP have been reported in these countries, and these statistics are rising rapidly. We aim to present a case of abortion induced by vaginal use of AlP. We report a 44-year-old gravid woman who self-administered one-quarter of a 3-g AlP tablet intravaginally. Ultrasound at 6 hours post-admission showed no fetal movement or heart motion. Intravaginal administration of AlP can lead to fetal death and abortion. There is concern about the spread of vaginal use of these agents in pregnant women, as the number of illegal abortions is increasing.

BLOOD LACTATE AND LACTATE PYRUVATE RATIO AS PROGNOSTIC BIOMARKERS OF OUTCOME IN ACUTE ALUMINUM PHOSPHIDE POISONING

Aluminium phosphide (AlP) is a toxic pesticide accompanied by a high mortality rate after acute exposure from different routes. Objectives: evaluation of blood level of lactate, pyruvate and lactate/pyruvate (L/P) ratio as outcome predictors of AlP poisoning. Methodology: All patients with a confirmed diagnosis of acute AlP poisoning who admitted to Poison Control Center- Emergency Hospital-Tanta University, Tanta, Egypt, from October 2019 to end of November 2019 were included. All studied patients (46) underwent thorough history taking, physical examination and routine laboratory investigations. Three mL of blood were used for determination of lactate and pyruvate levels. Results: The predominant manner of poisoning was suicidal due to ingestion of AlP tablets. The mortality rate was 73.9%. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded with statistical significant difference between both studied groups. Oxygen saturation, pH, HCO3, PO2, mean blood hemoglobin, potassium (K) and magnesium (Mg) were statistically reduced in non- survival group compared with survival group. Lactate and L/P ratio showed significant rise in non-survived patients, while pyruvate presented statistically non-significant difference between the studied groups. The blood pH had the highest discriminatory power as regards mortality, followed by DBP on admission, then SBP on admission, lactate, L/P ratio, respiratory rate and pyruvate. The blood lactate and L/P ratio had 100% sensitivity and 66.7% specificity. Conclusion: Blood lactate level was indicated as an outcome biomarker of acute AlP poisoning.

Hemoptysis and Upper Gastrointestinal Bleeding In Two Patients Presenting With Aluminum Phosphate Intoxication (Oral and Inhaled): A Case Study

Introduction: The inhalation of aluminum phosphate and ingestion of aluminum phosphate tablets lead to clinical toxicity with different and nonspecific clinical symptoms. Two patients referred to Imam Reza Hospital Poisoning Emergency Center of Mashhad, Iran, one of whom was a 28-year-old male with oral consumption of four aluminum phosphide tablets, and the second case was a 29-year-old woman who was poisoned by inhalation. Both cases had symptoms of pulmonary and upper gastrointestinal bleeding during the brief hospitalization that resulted in their mortalities. Case Report: The first case is a 29-year-old man who consumed four oral tablets about 1.5 h before referral. He was intubated with the evidence of hemoptysis and upper gastrointestinal bleeding after about 4 h. The second patient is a young woman who had abdominal pain, nausea, and vomiting since the day before referral, and she told that she did not have any underlying diseases. During stabilization and patient evaluation, she suddenly became unresponsive with asystole. The CPR started with the evidence of hemorrhage within the intubation tube. Conclusion: There are currently no studies or reports of hemorrhagic complications in patients. In these two cases, there was no evidence of pulmonary hemorrhage and upper gastrointestinal bleeding which warrants further investigation and evaluation considering that these patients were young and with no underlying disease.

Influence of relative humidity on phosphine concentration during aluminium phosphide (ALP) fumigation¬ in pigeon pea

Phosphine fumigant is widely used to control stored insect pest infestation in grains. The study on Aluminium Phosphide (ALP) fumigation was conducted to find out the effect of relative humidity on concentration of phosphine. Aluminium phosphide (tablet) 56% formulation was used for fumigation of two stacks of pigeon pea grains, each of 4 MT capacities. During fumigation first stack the humidity was ranged 60 to 70% and another stack the humidity was between 50 to 60%. Fumigation procedure carried out as per National Standards of Phytosanitary Measures (NSPM) with dose rate of 3 tablets / MT for 10 days exposure period. Phosphine concentration was monitored in both stacks from 1 to 10 days after fumigation. After 24 hrs (1 day) of treatment the average phosphine concentration was 340 ppm in stack with higher humidity and terminal concentration (after 10 days) was 315 ppm, whereas in stacks with lower humidity the concentration was 309 ppm and 184 ppm after 24 hrs and 10 days respectively. The results revealed that concentration of phosphine was directly proportional to the humidity.

Early L-carnitine Therapy in Severe Acute Aluminum Phosphide Poisoning: A Randomized Controlled Clinical Trial

Introduction: Aluminum phosphide (AlP) is a common solid fumigant pesticide used for agricultural and nonagricultural purposes. In Egypt, AlP tablets are frequently used to commit suicide, and AlP poisoning constituting a frequent cause of admission and mortality in poison control centers. Current management of AlP poisoning is limited to supportive care; as there is no specific antidote. Objectives: to evaluate the therapeutic effect and safety of early L-carnitine administration, as an antioxidant, in treatment of severe acute AlP poisoning. Material and methods: This study was a randomized controlled clinical trial. It was conducted in Tanta Poison Control center (Emergency Hospital, Tanta University). Fifty acute AlP intoxicated patients were randomly allocated into two equal groups A and B using the sequentially numbered, opaque sealed envelopes method. Group A received only the routine treatment. Group B received L – Carnitine therapy as follow: 9 ampoules (9 gm) of L- Carnitine in 500 ml of 0.9% normal saline given as continuous IV infusion, until improvement or death in addition to the routine treatment. Complete physical examination, routine laboratory investigations and oxidative stress markers; malondialdehyde (MDA), total antioxidant capacity (TAC) and reduced glutathione (GSH) were assessed for each patient. Results: Comparison between groups A and B 12 hrs after admission revealed significant reduction of the mean MDA levels in group B than group A (7.54± 1.74 and 16.22± 2.95 respectively, p 0.05). Conclusion: Early administration of L-carnitine IV infusion was effective and safe as an adjuvant treatment of AlP poisoned patients.

Acute Myocardial Injury and Electrocardiogram Changes in a Case of Aluminum Phosphide Poisoning

Aluminum phosphide (AIP) poisoning is one of the major causes of mortality among toxic substances. The symptoms and signs of toxicity are nonspecific and related to dose and route of exposure. A 20-year-old woman was admitted to the emergency department due to the consumption of one AIP tablet. ECG was normal at 2 hours post-ingestion and echocardiography revealed LVEF of 55-60% at 4 hours post admission. ECG abnormalities in this patient included VT and VF on the second night. She experienced an unusual rhythm disturbance in term of LBBB and Brugada pattern besides low ejection fraction of left ventricue (about 20-25%) on the third day. The main emphasis for AIP poisoning cases is on a timely, precise and prompt symptomatic treatment.