Cholinesterase Concentration Research Articles

The association between preoperative serum cholinesterase and all-cause mortality in geriatric patients with hip fractures: a cohort study of 2387 patients

ObjectiveThis study is to evaluate the association between preoperative cholinesterase levels and all-cause mortality in geriatric hip fractures.MethodsElderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between preoperative cholinesterase levels and mortality in these patients. Analyses were performed using EmpowerStats and the R software.ResultsTwo thousand three hundred eighty-seven patients were included in this study. The mean follow-up period was 37.64 months. Seven hundred eighty-seven (33.0%) patients died due to all-cause mortality. Preoperative cholinesterase levels were 5910 ± 1700 U/L. Linear multivariate Cox regression models showed that preoperative cholinesterase level was associated with mortality (HR = 0.83, 95% CI: 0.78–0.88), P < 0.0001) for every 1000 U/L. However, the linear association was unstable, and nonlinearity was identified. A cholinesterase concentration of 5940 U/L was an inflection point. When preoperative cholinesterase level < 5940 U/L, the mortality decreased by 28% for every 1000 U/L increase in cholinesterase (HR = 0.72, 95%CI: 0.66–0.79, P < 0.0001). When cholinesterase was > 5940 U/L, the mortality was no longer decreased with the rise of cholinesterase (HR = 1.01, 95%CI: 0.91–1.11, P = 0.9157). We found the nonlinear association was very stable in the propensity score-matching sensitive analysis.ConclusionsPreoperative cholinesterase levels were nonlinearly associated with mortality in elderly hip fractures, and cholinesterase was a risk indicator of all-cause mortality.Trial registrationThis study is registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323) (08/03/2022).

Dietary Supplementation with Rumen-Protected Arginine or N-Carbamylglutamate Enhances Fetal Liver Development in Nutrient-Restricted Pregnant Hu Ewes.

This study was conducted in nutrient-restricted pregnant Hu ewes to determine whether rumen-protected arginine (RP-Arg) or N-carbamylglutamate (NCG) supplementation affects fetal liver growth and development. From 35 d to 110 d of gestation, 32 Hu ewes were randomly divided into four groups: a control group (100% of the National Research Council (NRC) requirements), a nutrient-restricted group (50% of the NRC requirements), and two treatment groups (ARG and NCG, 50% of the NRC requirements, supplemented with 20 g/day RP-Arg or 5 g/day NCG, respectively). Fetal body weights, fetal liver growth performance, the capability of antioxidation, and the expression of the mRNA and proteins of apoptosis-related genes in the fetal liver were determined and analyzed at 110 d of gestation. The dry matter, water, fat, protein, and ash components of the fetal livers in the RG group were found to be lower than in the CG group, and these components were significantly higher in the NCG group than in the RG group (p < 0.05). A decrease in DNA, RNA, and protein concentrations and contents, as well as in protein/DNA ratios, was observed in the RG group in comparison to the CG group (p < 0.05). Compared with the RG group, the NCG group had higher concentrations of DNA, RNA, and protein, as well as higher protein/DNA ratios (p < 0.05). The RG group had lower concentrations of cholinesterase, nitric oxide, nitric oxide synthase, superoxide dismutase, alanine aminotransferase, and total protein than the CG group (p < 0.05). The RG group had higher levels of glutathione peroxidase, maleic dialdehyde, and aspartate aminotransferase than the CG group (p < 0.05). In the RG group, the mRNA and protein expression of p53 and Bax was significantly increased (p < 0.05) compared with the CG group, and the gene expression of FasL and Bcl-2, the ratio of Bcl-2 to Bax, and the protein expression of Bcl-2 in the RG group were lower (p < 0.05) than in the CG group. It appears that RP-Arg and NCG supplementation during pregnancy could influence fetal liver growth and development. A nutrition-based therapeutic intervention to alleviate reduced fetal growth can be developed based on this study, which has demonstrated that maternal undernutrition during pregnancy induces the maldevelopment of the fetal liver.

Caffeine affects the neurobehavioral impact of sodium benzoate in adolescent rats

The continuous high intake of caffeinated products may harm CNS. Sodium benzoate (SB), broadly used for food preservation, may also have an impact. The current research studied the influence of caffeine and two doses of SB during adolescence period on behavior and brain alterations. Adolescent rats (90–120 gm) were exposed to vehicle, SB 100 and 400 mg/kg, p.o, caffeine (30 mg/kg, i.p), SB 100 or 400 + caffeine for 28 days. Locomotor performances were assessed by the open field, learning and memory were considered with novel object and y-maze, while anxiety was evaluated by light and dark as well as successive allays tests. The results showed that the motor activity of adolescent rats increased with each single treatment. Recognition memory was improved by SB100 and its combination with caffeine while working memory was reduced by SB (100 or 400) combination with caffeine compared with caffeine group. The anxiolytic effect of caffeine was reduced by SB co-treatment in either dose. Concerning biochemical study in the frontal cortex and hippocampus, oxidative biomarkers as well as Cholinesterase content were elevated due to SB400 + caffeine. Dopamine content was almost elevated by all treatments in both regions while GABA content was increased in the frontal cortex only. The obtained results pointed to histopathological changes as a result of brain oxidative stress and undesirable working memory consequences due to caffeine administration with SB, mostly the large dose. The outcomes propose new recommendations to evade the consolidation between processed nourishment and caffeinated beverages during adolescence.

Evaluation of the performance of an handheld device for measuring cholinesterase activity, in order to use in cases of organophosphate poisoning

Cholinesterase activity monitoring during the organophosphorus pesticides poisoning is still a challenge in the remote areas. The objective of this study was to evaluate the performance of the Test-mate Model 400 EQM® for the determination of cholinesterase. This is a cross-sectional analytical study conducted with two different levels of quality control sera (QCs) and 40 sera of different cholinesterase concentrations from patients samples. The coefficient of variation obtained for repeatability was compared to the supplier's values. Spearman's coefficient and kappa coefficient (ĸ) were used to examine correlation and assess agreement between measurements obtained with the handheld device and the INDIKO analyzer, used as a reference test. For repeatability of EQM Test-mate ChE®, coefficients of variation was 5.5% and 6% for the normal and pathological control sera respectively, that is lower than 7.5% as recommended by the supplier. A Spearman correlation coefficient of r=0.7451 (p&lt;0.0001) was obtained and a good agreement between the measurements ( ĸ=0.7253 (95%CI: 0.655- 0.841)). This handheld device is repeatable and showed a good correlation and agreement with the INDIKO® analyzer. It would therefore be suitable for determining cholinesterase activity in remote areas in case of organophosphate poisoning.

Serum cholinesterase as a new nutritional indicator for predicting weaning failure in patients.

The objective of this study is to examine the correlation between patient serum cholinesterase (SCHE) concentration and weaning failure in the context of invasive mechanical ventilation (IMV), as well as to identify predictors of ventilator weaning failure. Additionally, this study investigates the potential relationship between SCHE and nutritional risk for developing more effective weaning strategies. A retrospective observational study was conducted. The sample was collected from 227 patients with IMV over 48 h who underwent SBT before weaning. Relevant experimental samples and data collection were analyzed at the time of patient admission and before the initiation of the SBT. The correlation between SCHE and weaning failure was determined by multifactorial logistic regression and propensity matching scores. Weaning was successful in 127 patients and failed in 100 patients. Depending on the difficulty of weaning, 55 of these patients had difficulty in weaning and 45 had long-term weaning. In the crude cohort, experimental data collected on the day of SBT showed that SCHE concentrations were higher in patients with successful weaning than in those with failed weaning (4,514 u/l vs. 3,190 u/l p < 0.01). The critical value for predicting weaning failure was SCHE 3,228 u/l (p < 0.01). Ventilator weaning failure was predicted by multifactorial logistic regression analysis of SCHE, heart rate, and PaO2 before SBT, with SCHE predicting ventilator weaning failure (AUC 0.714; 95% CI 0.647-0.782) better than heart rate (AUC 0.618; 95% CI 0.545-0.690), PaO2 (AUC 0.59; 95% CI 0.515-0.664). After propensity-matched scores, SCHE remained an independent predictor of weaning failure (p = 0.05). And the SCHE concentration was strongly correlated with the patient's weaning difficulties (p < 0.01). The Nutrition Risk in Critically Ill (NUTRIC) score was also significantly correlated with SCHE according to Spearman's correlation analysis (p < 0.01). Our study revealed that the patients who experienced weaning failure exhibited lower SCHE values compared to those who successfully underwent weaning. Before spontaneous breathing trial (SBT), SCHE, heart rate, and PaO2 were identified as independent predictors of weaning failure. Following propensity score matching (PSM), SCHE and heart rate remained independent predictors. Patients with SCHE levels below 3,228 u/l should undergo careful evaluation before weaning. Our findings suggest that malnutrition may be a contributing factor to weaning failure in patients.

Serum alkaline phosphatase was independently associated with depression in patients with cerebrovascular disease.

Blood markers have important value in the diagnosis of depressive disorders. Serum alkaline phosphatase (ALP) not only predicts stroke recurrence and poor functional prognosis in cerebrovascular disease (CVD) patients but also increases significantly in middle-aged women with depression. Thus, it has not been reported whether serum ALP is associated with the development of depression and/or vascular depression (VDe) in CVD patients. This was a cross-sectional study of 353 CVD patients (stroke patients, n = 291; cerebral small vessel disease (CSVD) patients, n = 62). Baseline demographic information, fasting blood markers (such as blood counts, liver function, kidney function and lipids), and brain CT/MRI scans were collected. CVD patients were divided into non-depression, suspected vascular depression (SVD), and positive vascular depression (PVD) groups according to their Hamilton Rating Scale for Depression (HAMD) scores. Univariate analysis of baseline data, blood markers, and the prevalence of lesions (> 1.5 cm) was performed. Subsequently, the diagnostic performance of the univariate and combined variables for SVD and PVD was analyzed using binary logistic regression. The diagnostic value of the multivariate model for VDe was analyzed by ordinal logistic regression. (1) Serum ALP (p = 0.003) and hypersensitive C-reactive protein (hs-CRP, p = 0.001) concentrations increased as HAMD scores increased, and the prevalence of brain atrophy (p = 0.016) and lesions in the basal ganglia (p = 0.001) and parietal (p = 0.001), temporal (p = 0.002), and frontal lobes (p = 0.003) also increased, whereas the concentrations of hemoglobin (Hb, p = 0.003), cholinesterase (ChE, p = 0.001), and high-density lipoprotein cholesterol (HDL-C, p = 0.005) declined. Among these variables, hs-CRP (r = 0.218, p < 0.001) had a weak positively association with HAMD scores, and ChE (r = -0.226, p < 0.001) had a weak negative association. (2) The combination of Hb, hs-CRP, ChE, ALP, and HDL-C improved diagnostic performance for VDe [AUC = 0.775, 95% CI (0.706, 0.844), p < 0.001]. (3) Hb (OR = 0.986, p = 0.049), ChE (OR = 0.999, p = 0.020), ALP (OR = 1.017, p = 0.003), and basal ganglia lesions (OR = 2.197, p < 0.001) were important factors impacting VDe development. After adjusting for Hb, hs-CRP, ChE, HDL-C, lesions in the above mentioned four locations, sex, age and the prevalence of CSVD and brain atrophy, ALP [OR = 1.016, 95% CI (1.005, 1.027), p = 0.004] was independently associated with VDe. Hb, hs-CRP, ChE, ALP, and HDL-C concentrations are potential blood markers of depression in CVD patients and, when combined, may improve diagnostic performance for VDe. Serum ALP was independently associated with VDe in patients with CVD.

PENGGUNAAN PESTISIDA DAN KADAR CHOLINESTRASE PADA PETANI PENYEMPROT

Using pesticides can decrease the population of organisms in plants. A pesticide which the work of cholinesterase enzyme in the body is oregano phosphate; it also has a side effect on the decrease in cholinesterase content. The research used a cross-sectional design which was aimed to find out the influence of using pesticides on the decrease in blood cholinesterase content in farmers who spray their plants with pesticides at Desa Cikaok, Kecamatan Sitellu Talli Urang Julu, Kabupaten Pakpak Bharat. The samples were farmers who sprayed their plants with pesticides. Chi Square statistic test was used to find out the variables which probably decrease in cholinesterase content at p,0,05. It was found that 26,7% of the respondents underwent a normal decrease in cholinesterase content, and 73,3% of the respondents underwent an abnormal decrease. Statistically, there was a significant correlation between the length of spraying pesticides with the decrease in cholinesterase content in the blood of farmers who sprayed their plants with pesticides at Desa Cikaok at p-value = 0,678. It is recommended that the farmers lessen the duration of spraying in order to reduce the risk of exposure to pesticides and use personal protective devices such as gloves, hats masks, glasses, uniforms, and shoes. The regional government should provide protection, counseling, and training about the procedure of using pesticides in order to forestall the incidence of illness in the farmers who sprayed their plants with pesticides.

Nutritional Status and Body Composition in Wilson Disease: A Cross-Sectional Study From China.

Background: Abnormal nutritional status is frequently seen in patients with chronic diseases. To date, no study has investigated the detailed characteristics of abnormal nutritional status among Wilson's disease (WD) patients in the Chinese cohort. This study aimed to describe the nutritional status of WD patients, with a particular focus on the differences between patients with different phenotypes.Methods: The study subjects comprised 119 healthy controls, 129 inpatients (hepatic subtype, n = 34; neurological subtype, n = 95) who were being treated at the affiliated hospital of the Institute of Neurology, Anhui University of Chinese Medicine. All of the subjects were assessed for body composition by using bioelectrical impedance analysis. All WD patients received anthropometry, nutritional risk screening 2002 (NRS2002), and laboratory test (hemocyte and serum biomarkers) additionally.Results: Compared with healthy controls, the fat mass and rate of total body and trunk were significantly higher in WD patients (P < 0.001), the muscle and skeletal muscle mass of total body and trunk were significantly lower in WD patients (P < 0.001). Compared with hepatic subtype patients, the fat mass and rate of total body, trunk, and limbs were significantly lower in neurological subtype patients (P<0.01); while there were no significant differences in muscle and skeletal muscle between these two subtypes. The overall prevalence of abnormal nutritional status in WD patients was 43.41% (56/129). The prevalence of high-nutritional risk and overweight in WD patients was 17.83% (23 of 129) and 25.58% (33 of 129), respectively. Compare with patients with high nutritional risk, macro platelet ratio, alkaline phosphatase, the basal metabolic rate (p < 0.05), creatinine, trunk fat rate (p < 0.01) and appendicular skeletal muscle mass (p < 0.001) were significantly higher in patients without nutritional risk (p < 0.001). Patients with a high nutritional risk tend to have a lower cholinesterase concentration (x2 = 4.227, p < 0.05).Conclusion: Both patients with H-subtype and N-subtype are prone to have an abnormal nutritional status. Longitudinal studies are required to investigate if nutritional status and body composition could reflect prognosis in WD patients, and which of these body composition indexes contribute to malnutrition and worse prognosis.

Pesticides use and health impacts on farmers in Thailand, Vietnam, and Lao PDR: Protocol for a survey of knowledge, behaviours and blood acetyl cholinesterase concentrations.

Pesticides use in Southeast Asia has increased steadily, driven by the growth of large-scale commercial farming, as well as a desire to maximise food production in rural subsistence economies. Given that use of chemical pesticides, such as organophosphates and carbamates, has known potential health impacts, there are concerns about the safety of agricultural workers, and a need for a better evidence base to underpin regulation and worker education. This study, undertaken in 9 districts in Lao PDR, Thailand and Vietnam, will interview agricultural workers to investigate how they use pesticides, their knowledge of risks and self-protective practices, and their self-reported illness symptoms. In each district researchers will recruit and interview 120 participants engaged in vegetable farming, who have recently used pesticides, making a total of 1080 subjects divided equally between the three study countries. Workers’ degree of pesticides exposure will be determined from acetyl cholinesterase concentrations in capillary blood samples collected using field test kits, and these data will be analysed together with the interview findings. Country findings will be compared and contrasted, and general patterns noted. Knowledge gained about risky behaviours, self-protective practices and degree of association with serious pesticides exposure will assist policy makers and inform health improvement programmes.

ORGANOPHOSPHATE EXPOSURE, ASSOCIATED RISK FACTORS AND EXPOSURE RISK ASSESSMENT AMONG VEGETABLE FARMERS IN SABAH, MALAYSIA

Uncontrolled use of pesticides in agriculture may result in increased health risks. Organophosphate (OP) pesticides are widely used among vegetable farmers to control pests and increase productivity. The aim is to determine the organophosphate exposure, associated risk factors, and exposure risk assessment among vegetable farmers in Sabah. A cross-sectional study design in Kundasang, Sabah, Malaysia. We took a blood sample from participants for blood cholinesterase concentration measurements of pesticide exposure using the rapid test kit model Lovibond AF267. A validated questionnaire was used to collect the associated risk factors of vegetable farmers. The Hazard Identification, Risk Assessment, Risk Control (HIRARC) guidelines were used for exposure risk assessment of OP exposure. The response rate was 91.1%. About 23.3% (38 out of 163) have abnormal blood cholinesterase. The significant associated risk factors were age [aOR=1.07, 95%CI (1.02,1.13)], Body Mass Index [aOR=8.60, 95%CI (2.80,26.51)], frequency of exposure a month [aOR=5.99, 95%CI (1.29,27.76)], had not attended pesticide safety training [aOR=9.08, 95%CI (2.97,27.74)], no designated pesticide storage [aOR=6.92, 95%CI (1.70,28.25)] and low practices scores on pesticide handling [aOR=6.01, 95%CI (1.97,18.36)]. The exposure risk assessment level for vegetable farmers was at low-medium risk. Organophosphate exposure among the vegetable farmers in Kundasang was higher than in other settings. The risk factors associated with organophosphate exposure were related to inadequate compliance to the standard occupational safety and health practices in agriculture. Exposure assessment revealed the opportunity for improvement by implementing the recommended control measures. Vegetable farmers need continuous support from relevant authorities. Further research is required to understand better the health risks among vegetable smallholder farmers in Sabah.

Application Enzymatic Method for Analysis Vaginal Tabletas “Fluomizin”

Introduction: Development of a new enzymatic kinetic-photometric method for analysis of Dequalinium chloride, based on the use of enzymatic hydrolysis of acetylcholine, for determine the amount of Dequalinium chloride in the vaginal tablets “Fluomizin” No 6.&#x0D; Method: The amount of Dequalinium chloride (DCh) was determined by the degree of inhibition of the enzymatic reaction, which was evaluated by the residual unreacted substrate - acetylcholine. Determination of the residual amount of acetylcholine in the reaction mixture was performed by a kinetic-photometric method using an indicator oxidation reaction of p-phenetidine with peracetic acid, which is formed during the auxiliary reaction of perhydrolysis with addition of excess hydrogen peroxide in the reaction mixture over a period of time.&#x0D; Results: Optimal conditions were determined: pH 8.35 was selected, influence of nature of buffer solution, concentration of acetylcholine (0.05 mg / ml), cholinesterase (0.4 mg / ml), hydrogen peroxide (10,0%) and p-phenethedine (1 %), the incubation time (10 min).&#x0D; Conclusions: The procedure for determination of Dequalinium chloride content in the vaginal tablets “Fluomizin” No 6 was developed. The kinetic parameters Km (Michaelis–Menten constant) and Vmax (maximal velocity) were determined.

Pomelo polysaccharide extract inhibits oxidative stress, inflammation, and mitochondrial apoptosis of Epinephelus coioides

Although the production of pomelo, a citrus fruit, has recently increased considerably in China, the therapeutic potential of the fruitlets on aquatic animals has not been widely studied. Thus, in this study, we aimed to evaluate the protective effects of the crude polysaccharide extracted and purified from pomelo fruitlet (YZW-A), on oxidative stress, inflammation, and mitochondrial dysfunction-mediated apoptosis. For this, we added YZW-A (0, 100, 200 and 400 μg/mL) to Epinephelus coioides spleen (GS) cells before incubation with 0.8 mM of H2O2. Morphological indices showed significant deterioration when exposed to H2O2 (P < 0.05), whereas this was did not observed in the cells exposed to YZW-A. Administration of YZW-A (100 and 200 μg/mL) substantially mitigated the H2O2-induced oxidative stress, as shown by the elevated activities of the mitochondrial respiratory complexes and antioxidative enzymes, including superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR) and glutathione peroxidase (GSH-Px) (P < 0.05). NF-κB derived inflammation was also significantly attenuated by the diminished gene expression of the NF-κB regulated proinflammatory cytokines (TNF-α, IL-β and IL-6) (P < 0.05). In addition, apoptosis-related indicators (Bax, Bcl-2, and caspase-3, −8, and − 9) and the cell apoptosis rate showed that mitochondrial dysfunction-mediated apoptosis was alleviated due to the decreased oxidative stress. Pretreatment with the NF-κB inhibitor, BAY11–7082 (20 μM), dramatically reduced the expression of the downstream genes of NF-κB, including the proinflammatory genes, IL-β and IL-6 (P < 0.05), and the proapoptotic genes, Bax, caspase 3, and caspase 9 (P < 0.05), which confirmed that the NF-κB signaling pathway is involved in the mechanisms of inflammation and apoptosis. In support of the results in vitro study, we further added YZW-A at the doses of 0, 200, 400, 800 and 1600 mg/kg in the diet for 56 days prior to the treatment of H2O2 or saline. The results demonstrated that administration of YZW-A significantly ameliorated H2O2-induced liver injury as evident by the decline of Serum albumin (ALB), alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST), and cholinesterase (CHE) content in the groupers. Furthermore, the changes on the activities of the antioxidative enzymes and the mRNA expression of the apoptosis-related indicators and the proinflammatory cytokines corresponded well with that of in GS cells. In addition, YZW-A treatment repressed the enhancement of enzymic activities of the proinflammatory cytokines induced by H2O2. In summary, these findings showed the therapeutic potential of YZW-A on H2O2-induced oxidative stress, and further mitigated the NF-κB regulated inflammation and apoptosis.

Cholinetrase concentration in the blood of three types of cattle raised on land exposed to Organophosphates

Organophosphate pesticides are one of the causes of contamination in animal feed. The cholinesterase enzyme test is used to diagnose toxic exposure due to organophosphate pesticides. Quantitative research with survey design using cross sectional design using 35 samples of cows. The study was conducted in March - September 2020. Concentration measurement on cholinesterase enzyme concentrations of blood plasma used the biosystem A15 DGKC-Colorimetric Kinetic method. This study aims to evaluate the concentration of the enzyme cholinesterase as a marker of organophosphate poisoning in cattle. Blood samples were collected from the ventrolateral neck veins of male and female cattle aged 1-7 years and collected from local cattle in the Ogan Ilir area. The results showed that the cows raised in breeders were exposed to organophosphate pesticides as indicated by a decrease in the concentration and levels of the cholinesterase enzyme in the plasma of female cows. Cholinestrase enzyme levels in female cows were 0.20 ± 0.067 U / ml and bulls were 0.27 ± 0.183 U / ml. The highest concentration of cholinesterase enzyme levels occurred in cows aged 2 years, namely 0.25 ± 0.34 U / ml and the lowest was in cows aged 7 years, namely 0.12 ± 0.04 U / ml.

Cholinesterase in different types of the muscle tissue during the early postmortem period for diagnosis of death coming

The purpose of the research: consisted in study of postmortem regularities in the content of cholinesterasein different types of muscle tissue (MT) for improving accuracy of determination of the prescriptionof death coming PDC.&#x0D; Materials and methods: The activity/level of cholinesterase was determinedin homogenates of the myocardial (MMH), oesophageal (OMH), diaphragm (DMH) and intercostalmuscles (IMH)within the early PMP (3-13 hours after the coming of death) on 30 human corpses. MTwas sampled in conditions of postmortem biopsy with use of special instruments; MT homogenateswere prepared following the standard technique with subsequent determination of cholinesterase content in MT homogenates.&#x0D; Results and discussion: The analysis of postmortem changes in the content ofcholinesterase in MT depending upon PDC revealed that after 3 hours from the moment of death comingits highest content was in muscles of the oesophagus, the least one being in MT of the intercostal muscles(respectively, (2,717.1±37.1) and (883.5±6.2) U/g, р&lt;0.001). Levels of cholinesterase content in MT ofthe myocardium and diaphragm were rather close, though they differed (respectively, (1,213.8±8.8) and(1,512.8±11.5) U/g, р&lt;0.05), and occupied an intermediate place between the corresponding values of MTof the intercostal muscles and oesophagus.A common pattern for the content of cholinesterase in differenttypes of MT was characterized by a decrease of this content with an increase in PDC terms; besides, thedynamic lines of its changes, that we obtained, became basic ones for substantiating quantitative timedependencies and construction of relevant nomograms for forensic diagnosis of PDC by cholinesterase content in MT.&#x0D; Conclusions: It was proved that the content of cholinesterase in all MT homogenates,which we studied, changed regularly (and nonlinearly), but the initial and final levels of cholinesterasecontent differed depending upon the type of MT. Besides, the dynamics in changes of the content ofcholinesterase within the time period of 3÷13 hours from the moment of death coming differed uponthe type of MT too. Advantages of the technique consist in theintegrity of biochemical examinationof different types of MT and simplicity in interpretation of findings. The application of the nomogramtechnique for assessing PDC by cholinesterase content in MT makes it possible to improve the accuracyof diagnosis for terms of the coming of death up to 60 minutes.&#x0D; Bangladesh Journal of Medical Science Vol.20(1) 2021 p.95-100

Study of biochemical parameters in farmers exposed to pesticides used in cotton growing around the Bala hippopotamus pond

Repeated exposure to pesticides can cause a variety of human health problems, particularly among farmers. This work consisted in studying biochemical parameters and their evolution in cotton farmers exposed to pesticides. A longitudinal study was conducted during and after the 2018/2019 cotton season on a cohort of cotton farmers around the Bala hippopotamus pond in the department of Satiri. Biochemical parameters were measured during and after the crop year on the Architect ci 4100. The majority of the farmers had high uric acid (UA) and low blood sugar (Gluc) concentrations. A few had concentrations of Cholinesterase (ChE) (6.19%); Direct Bilirubin (BilD) (23.01%); Gamma Glutamyl Transferase (GGT) (8.85%); Alkaline Phosphatase (ALkP) (4.42%); Cholesterol (Chol) (4.42%); triglycerides (Trig) (4.42%); aspartate aminotransferase (AST) (4.42%) higher than normal and lower than normal albumin (Alb) (13.27%) and total protein (TP) (13.27%) concentrations. Analysis of the evolution of biochemical parameters showed that none of the producers had higher than normal ChE and TP concentrations. After the campaign, the number of producers with lower than normal values increased for AST, AlkP, Alb and Urea while those with higher than normal values increased for GGT, UA, Gluc, Chol, Trig and BilD. Also, a significant decrease in AST, ALT and creatinine (CreaC) concentrations and a significant increase in GGT and BilD concentrations were observed. The existence of some disturbances of biochemical parameters in farmers should encourage to test the hypothesis of a link between pesticide exposure and the appearance of biochemical disorders in clinical trials.

Association between ECG Alterations and Outcomes of Patients with Acute Organophosphate Poisoning

Background: Organophosphate (OP) poisoning leads to atrioventricular node blockade, alterations in ST segment, prolongation of QT interval, alterations in P wave, lethal arrhythmias, and cardiac arrest through the inhibition of acetylcholinesterase and consequent accumulation of free synaptic acetylcholine level. So the present study was aimed to investigate the role of electrocardiographic (ECG) monitoring combined with the introduction of anti-arrhythmic interventions on OPs poisoning outcomes. Methods: 41 patients with OPs poisoning were included. Patients with history of heart or liver diseases, cholinesterase deficiency, anemia, and poisoning with other toxins were excluded. Demographic characteristics, the time elapsed between OP ingestion and hospital admission, need for mechanical ventilation, and serum cholinesterase level were recorded. ECG of patients was analyzed for rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals. Study outcomes were measures of morbidity and mortality. Results: Of 41 patients, with mean age of 34.76±13 years, 19 were male. For 68.3% of the patients, the time elapsed between ingestion and hospital admission was 3-6 hours. Eight patients were treated with mechanical ventilation. There was a significant correlation between ST segment alterations and poisoning outcomes including uncomplicated discharge, complicated discharge, and death (P=0.02). Thirty one patients were discharged without any complication, 8 with morbidity and 2 expired. ST segment changes were seen in 4 patients. Two percent had PR interval greater than 0.21s and 3% had QT interval longer than 0.45s. The mean serum cholinesterase concentration was 3011.56 U/L. Conclusion: Due to lethal cardiac arrhythmia caused by OP poisoning, continuous monitoring, managing, and preventing irreparable effects of OP poisoning is highly emphasized.

Admission serum cholinesterase concentration for prediction of in-hospital mortality in very elderly patients with acute ischemic stroke: a retrospective study.

Cholinesterase as a sensitive biomarker for prognosis in a variety of conditions but it is rare in stroke studies. The very elderly (≥ 80years of age) represent the most susceptible group of ischemic stroke. We aimed to determine whether admission serum cholinesterase concentration had any effect on clinical outcome in very elderly patients (individuals aged ≥ 80years) with acute ischemic stroke. A retrospective record review was conducted in two tertiary university hospitals. Elderly patients aged ≥ 80years admitted with a diagnosis of acute ischemic stroke from January 1, 2014 to November 30, 2019, who had a cholinesterase concentration drawn, were included. The patients were grouped based on the inflection points of the locally weighted regression and smoothing scatterplot (LOESS) curve between cholinesterase levels and in-hospital mortality (study outcome) with lower concentration as reference group. A total of 612 patients were admitted with a diagnosis of acute ischemic stroke, and 569 met the inclusion criteria. A threshold effect was identified using regression smoothing scatterplot (LOESS), with one cutoff point of 4.0 KU/L. There was a significant difference in-hospital mortality was observed (P < 0.001). After adjusted demographic and clinical features, the OR of cholinesterase for mortality was 0.43 (95% CI 0.34-0.54, P < 0.001), suggesting that lower admission cholinesterase level was an independent risk factors for all-cause mortality among patients with AIS. We have demonstrated a significant association between admission cholinesterase concentration and in-hospital mortality in very elderly patients with AIS.

A prospective evaluation of correlation between cholinesterase level and severity of organophosphorus poisoning

Background: Organophosphorus compounds are anticholinesterases by inhibiting cholinesterase it protects acetyl chorine from hydrolysis. So, acetylcholine accumulates at the synapses, and all the clinical manifestation are due to that. So, this study has been designed to establish the reactive between level of serum and prognosis of op poisoning patients.Methods: Patient with history of organophosphorus poisoning admitted into the emergency department with following exclusion and inclusion criteria were included in this study. All patients were managed as per standard treatment protocol of op poisoning. Various parameters like demography of the patients, sign and symptoms, severity of intoxication, clinical and lab parameter manoring, Serum cholinesterase was measured every alternate day.Results: 22(47.84%) patients have mild symptom out of that 20 patient’s serum cholinesterase was more than 2000 IU/L, and 2(4.3%) patients serum cholinesterase was between 1000-2000 IU/L. In eighteen patient’s severity as per POP scale was moderate, out of that 2(4.3%) patients have serum cholinesterase was below 1000 IU/L, 8 having serum cholinesterase between 1000 to 2000 IU/L, and remaining eight having serum cholinesterase above 2000 IU/L.Conclusions: Serum cholinesterase was less in patient with high severity score or low serum concentration of cholinesterase was associated with high severity score. Serum cholinesterase was improved as days passes.

Development and validation of the enzymatic kinetic photometric procedure for determination of residual quantities of dequalinium chloride on the surface of the pharmaceutical equipment

Aim. To develop and validate the new enzymatic kinetic photometric procedure for analysis of dequalinium chloride based on application of enzymatic acetylcholine hydrolysis to determine the residual quantities of dequalinium chloride while monitoring the completeness of cleaning of the pharmaceutical equipment.Results and discussion. The optimal conditions for the enzymatic reaction course were determined – the order of mixing and the concentration of acetylcholine (0.05 mg/mL), cholinesterase (0.4 mg/mL), hydrogen peroxide (10 %) and p-phenetedine (1 %), the time of the reaction mixture maintaining (20 min), pH (8.35), the effect of the nature of the buffer solution. Validation of the procedure developed was carried out – the application range of the procedure was proposed (40–160 % in the normalized coordinates, the maximum acceptable concentration of dequalinium chloride in washes from the pharmaceutical equipment хcrit = 0.5 μg/mL), the number of concentration levels (n = 7); the order of their location within the application range, taking these data into account the maximum acceptable uncertainty of the procedure (maxΔx = 3.05 %) and the acceptability criteria for linear dependence parameters, systematic and random errors were calculated. The validation characteristics of the procedure developed were shown to correspond to the acceptability criteria calculated. The degree of extraction of dequalinium chloride from swabs with flushing from the pharmaceutical equipment was determined.Experimental part. The residual quantities of dequalinium chloride on the surface of the pharmaceutical equipment were determined by the degree of inhibition of the enzymatic reaction assessed by the unreacted residue of the substrate of the biochemical reaction, such as acetylcholine. The residual quantities of acetylcholine in the reaction mixture was determined by the kinetic photometric method by the indicator reaction of p-phenetidine oxidation with peracetic acid (formed during the auxiliary perhydrolysis reaction when adding an excess of hydrogen peroxide to the reaction mixture) in the way of registering the light absorbance of the resulting reaction product – azoxifenetole (λmax = 358 nm) for a definite period of time.Conclusions. The enzymatic kinetic photometric procedure has been developed to determine the residual quantities of dequalinium chloride on the surface of the pharmaceutical equipment after its cleaning. The procedure developed has been validated by such parameters as linearity, accuracy, precision and the limit of quantification

Prognostic significance of serum cholinesterase in patients with acute decompensated heart failure: a prospective comparative study with other nutritional indices

Nutritional status is associated with poor outcomes in patients with heart failure. Serum cholinesterase (CHE) concentration, a marker of malnutrition, was reported to be a prognostic factor in patients with chronic heart failure. The geriatric nutritional risk index (GNRI), the controlling nutritional status (CONUT) score, and the prognostic nutritional index (PNI) are established objective nutritional indices. The aim of this study was to clarify the prognostic significance of CHE concentration and to compare it with other well-established objective nutritional indices in patients with acute decompensated heart failure (ADHF). We prospectively enrolled 371 consecutive patients admitted for ADHF with survival discharge. Laboratory data including CHE and the objective nutritional indices were obtained at discharge. The primary endpoint of this study was all-cause mortality. During a mean ± SD follow-up period of 2.5±1.4 y, 112 patients died. CHE concentration was significantly associated with all-cause mortality independently of GNRI, CONUT score, or PNI, after adjustment for major confounders including other nutritional indices, such as age, sex, systolic blood pressure, BMI, left ventricular ejection fraction, history of hypertension, diabetes mellitus, dyslipidemia, prior heart failure hospitalization, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, β-blocker use, statin use, hemoglobin, sodium, blood urea nitrogen, albumin, C-reactive protein, and brain natriuretic peptide concentrations via multivariable Cox analysis. Kaplan-Meier analysis revealed that the risk of all-cause mortality significantly increased in accordance with CHE stratum [lowest tertile: 53%, adjusted HR: 6.92; 95% CI: 3.87, 12.36, compared with middle tertile: 28%, adjusted HR: 2.72; 95% CI: 1.45, 5.11, compared with highest tertile: 11%, adjusted HR: 1.0 (reference), P<0.0001]. CHE showed the best area under the curve value (0.745) for the prediction of all-cause mortality compared with the other objective nutritional indices. Net reclassification improvement afforded by adding CHE to the fully adjusted multivariable model was statistically significant for all-cause mortality (0.330; 95% CI: 0.112, 0.549, P=0.0030). CHE is a simple, strong prognostic marker for the prediction of all-cause mortality in patients with ADHF.