Pseudocholinesterase Research Articles

Organophosphate Pesticide Exposure: Effect on Farmers’ Sperm Quality in the Mekong Delta, Vietnam

ABSTRACT Objectives Using pesticides in the An Giang province is widespread. However, studies on the health effect of organophosphate pesticide have not been updated within the past 12 years. This study aimed to assess exposure to organophosphate pesticides and their effects on sperm quality among farmers in the An Giang Province, Mekong Delta, Vietnam. Methods During the winter – spring crop season of December 2021 to February 2022, a cross-sectional study was conducted on farmers aged 18 to 60 years-old based on seven communes’ health checkup programs. The pesticide spray group included farmers who had sprayed pesticides in the previous week and had a history of working in agriculture for more than 2 years. The control group was defined as those who lived in the same community, had not worked in agriculture, and had never sprayed pesticides. Demographic characteristics and blood, urine, and semen samples were collected and analyzed. Results Data for 184 eligible participants were analyzed, including 116 farmers in the pesticide spray group and 68 non-farmers in the control group. Pesticide spray contributed to a decrease in the sperm quality index of 6.253 units (95% CI, 4.472–8.749). Increasing each pseudocholinesterase (PChE) unit (kIU/L) was associated with an increase of 1.181 units in the sperm quality index (95% CI, 0.757–0.947). Conclusions Preventive methods for organophosphate pesticide exposure, such as administrative controls, engineering controls, substitution, and personal protective equipment should be applied to control health risks. In the An Giang setting, personal protective equipment is feasible, but most types of equipment are not used. The immediate priority is to determine the cause of personal protective equipment not being used and to find solutions to encourage people to use them.

Organophosphorus poisoning: A retrospective study on clinical profile and outcomes in ICU

Background: Organophosphorus (OP) compounds are widely used in India as insecticides and contribute to both acute and chronic poisoning. Several parameters have been analyzed to evaluate the severity of poisoning and to prognosticate the outcome but contradictory results have been obtained from studies for example for the relationship between hypokalemia and outcome, pseudocholinesterase (PChE) levels, and outcome. Aims and Objectives: The objectives of this retrospective study were to explore the epidemiological characteristics and clinical profile of patients admitted to intensive care unit with OP poisoning and to evaluate the outcomes including complications, in hospital mortality, and the predictors of mortality. Materials and Methods: All the patients above 18 years admitted with a history of ingestion of OP poisoning during the study period were included in the study. Data were collected from case records. Results: The mean age of the patients was 34±13.54. Fifty-four patients were male (69.2%) and 24 were female (30.8%). The correlation coefficient between intubation and PChE levels was 0.266. The mean period of ventilation was 4.16 days±2.41 days. About 80% (n=20) put on ventilator survived. Correlation of hypokalemia with patients getting ventilator support was 0.26 and that with mortality was 0.038. Conclusion: OP poisoning cases were primarily noted in the younger male group with the intent to self-harm. Chlorpyrifos was the most common compound consumed. Early admission and appropriate treatment can reduce mortality and complications as there is no single factor which can be used to predict the outcome in these patients.

A STUDY ON THE PREDICTORS OF MORBIDITY AND MORTALITY IN ORGANOPHOSPHORUS POISONING

Background: Poisoning from organophosphorus (OP) pesticides can occur as a result of occupational, accidental, or purposive exposure.Cholinergic syndromes,central nervous system (CNS) disorders,and cardiovascular disorders are some of the clinical manifestations.The most common causes of death are cardiovascular and respiratory failure.Aim:To assess various parameters that can predict the outcome of patients suffering from OP poisoning. Materials and Methods: A prospective study was conducted at Government general hospital vijayawada Over a one-year period of time.The clinical history of OP compound exposure and low blood levels of pseudo cholinesterase were used to make the diagnosis of OP poisoning.Results:The current study enrolled 133 patients, 98.5% of whom were suicidal and only 1.5% were exposed accidentally.The majority of cases involved young males,with an F/M ratio of 1:3.2.Younger people and patients who required prolonged ventilator support had a higher mortality rate.The death rate was proportional to the amount of poison consumed. Lag time,organ failure (Acute Renal Failure),and plasma pseudocholinesterase levels are all factors to consider. Acute complications were frequently observed and treated. There was no clear link found between liver dysfunction, electrolyte imbalance, and clinical outcome. Conclusion: According to this case study, mortality is directly proportional to the lag time, amount of OP substances consumed, and clinical severity.Acute renal failure, severity, pseudocholinesterase levels, and duration of ventilatory support are all factors to consider.This study emphasises the importance of prompt diagnosis and the initiation of early and effective treatment, which may result in fewer complications and lower mortality rates

A Comparative Study of the Triglycerides/HDL Ratio and Pseudocholinesterase Levels in Patients with Bladder Cancer.

Background: Lipid alterations may serve as potential tumour biomarkers. The ratio of triglycerides to HDL cholesterol (TG/HDL ratio) is associated with various cancers. Pseudocholinesterase (PChE) activity, involved in TG hydrolysis, plays an important role in the metabolism of lipoprotein. There is scarce data assessing the reliability of both the TG/HDL ratio and PChE levels in correctly classifying patients suffering from bladder cancer. Methods: Three hundred and ninety-six patients undergoing cystoscopy or transurethral resection of the bladder (TURB), broken into two major groups, i.e., patients with histologically confirmed, non-metastatic bladder cancer (n = 208) and without bladder cancer (no bladder cancer, n = 188), formed the study population. The last group was split into two subgroups consisting of a cohort of patients never suffering from bladder cancer but with other bladder diseases (no CaBD, n = 100) and another cohort formed by patients characterised by eradicated bladder cancer after TURB with no recurrence during a three-month follow-up (previous bladder cancer, n = 88). Pieces of information by both metabolic derangement (the presence of type 2 diabetes mellitus), hypertension and lipid profile were retrieved from patient records upon entry to the study. Sensitivity, specificity, areas under the ROC (AUROC) of the TG/HDL ratio, and PChE levels were used in diagnostic decision making. Results: The TG/HDL ratio as well as PChE concentrations of bladder cancer patients were significantly different when compared to those with previous bladder cancer and the no CaBD patients (p = 0.023 and 0.0004, respectively). There was an independent role of both the TG/HDL ratio and PChE levels in predicting the presence of bladder cancer (OR: 1.22 and 0.99, respectively), but the reliability of the TG/HDL ratio (AUROC: 0.587) was superior to that of PChE levels (AUROC: 0.374). The AUROC of a new parameter resulting from the combination of the TG/HDL ratio with PChE levels showed a further increment in the discriminant power of the bladder cancer presence (0.6298), interestingly with a negative predictive value (89%) according to the Bayesian approach. The cut-off of the TG/HDL ratio, the main marker of the present study that better distinguishes bladder cancer from no bladder cancer patients, was 2.147. Discussion and Conclusions: The reliability of the TG/HDL ratio is based on the fact that this parameter likely mirrors the insulin resistance (IR) underlying bladder cancer patients. Furthermore, PChE levels evidence both IR and the associated non-alcoholic fatty liver disease. The TG/HDL ratio and PChE levels as well as their combined use could help physicians to assess/confirm the presence of this very common cancer, where early detection is important to ensure the best therapeutical approach.

Hyperglycemia, Glycosuria, Ketonuria and their Association with Severity of Organophosphate Poisoning- A Cross-sectional Study

Introduction: Organophosphate Poisoning (OP) is very common in India and presents with features of cholinergic excess. Timely diagnosis and prompt treatment helps in prevention of complications like aspiration pneumonitis, respiratory failure etc. Due to non availability of Pseudo cholinesterase measuring facility at many rural areas and subcentres and as hyperglycemia, glycosuria and ketonuria are commonly seen in OP poisoning, the study of association of these three parameters with OP poisoning is of utmost importance. Aim: To study the association of hyperglycemia, glycosuria and ketonuria with severity of OP. Materials and Methods: This was a cross-sectional study with a sample size of 120 patients of OP poisoning, who reported to Karnataka Institute of Medical Sciences Hospital, Hubli, during December 2017 to November 2018. Adults >18 years of age with OP poisoning with no pre-existing diabetes were included. Clinical features with Peradeniya Organophosphate Score (POP Score), Complete Blood Count (CBC), Pseudo cholinesterase level, serum amylase, Gylcated Haemoglobin (HBA1c), Random Blood Sugar (RBS), urine ketones, urine glucose levels were obtained. The data was analysed using Chi-square test, ANOVA, paired t-test, Pearsons and Spearman's correlation. Results: Majority of the study population belonged to age group of 20-40 years (57.5%). Mean RBS at presentation was 200.58±110.31 mg/dL. Mortality was associated with higher RBS at presentation and RBS after 12 hours. There was significant association between RBS and outcome. Increasing RBS levels had direct correlation with mean duration of AMBU ventilation, mechanical ventilation, ICU stay duration, hospital stay duration and mortality rate. Deaths in cases with RBS <150 mg/dL was 2 and in >250 mg/dL is 22. Among the study population, eight cases had glycosuria and six had ketonuria at presentation. Mean POP score was also higher among these subjects with hyperglycemia, glycosuria and ketonuria. Conclusion: Blood sugar levels, urine analysis for glucose and ketones are useful, simple and cheap markers for identifying the severity of OP. Their presence indicates patient is at higher risk of developing complications and patient may be planned for referral to higher centre from non equipped centres. Hyperglycaemic state is a poor prognosticating factor.

Anaesthetic Management of a Patient with Parotid Abscess with Concomitant Organophosphorous Compound Poisoning

Introduction: Organophosphorous compounds are chemical agents in wide spread use throughout the world in agricultural industries. This poses a major challenge to an anesthesiologist; there is accumulation of acetylcholine causing overstimulation of muscarinic and nicotinic receptors disruption of transmission of nerve impulses in both peripheral and central nervous system. Case Report: A 47 year old male presented with alleged history of OP compound consumption with complaints of pain and swelling on the left cheek. On examination Diffuse swelling with warmth and tenderness was present. A diagnosis of parotid abscess was made. Systemic examination - CNS - GCS-E4M5V4 with bilateral pupil -2mm reacting to light. Pseudo cholinesterase was 380. Anaesthetic Management: Preloaded with 500ml RL. Monitors connected. Patient wason continuous Atropine infusion, Inj Midazolam and Inj fentanyl. Preoxygenated with 100% oxygen. Induced with Inj Propofol. Laryngeal mask airway(LMA) number 5- Proseal was inserted. Anaesthesia maintained with 50% nitrous oxide in oxygen, IV propofol with intermittent positive pressure ventilation. Inj Atropine infusion was continued at 3ml/hr and titrated according to heart rate. The haemodynamic parameters remained stable throughout the procedure. The patient was extubated, Postoperative recovery was uneventful. Conclusion: The use of muscle relaxants can produce bradycardia and prolong the motor recovery.Volatile anesthetics can also cause bradyarrythmias. In this case report we found that patient with OP compound consumption can safely be managed under general anaesthesia with IV propofol, without muscle relaxant and inhalational volatile anaesthetics.

Red cell distribution width as a predictor of severity and outcome of acute organophosphorus poisoned cases admitted to Poison Control Center Ain Shams University Hospitals (A prospective study)

Background: Organophosphates are highly toxic compounds for human beings. Organophosphate compounds (OPCs) poisoning by unintentional or suicidal ingestion is associated with high morbidity and mortality, particularly in developing countries. Aim of the study: Assessing the prognostic value of red cell distribution width (RDW) and white blood cells (WBCs), hemoglobin and platelet count on severity and outcome in patients with acute organophosphate poisoning in conjunction with clinical signs using the Peradeniya Organophosphorus Poisoning (POP) score. This is in addition to evaluation and comparison between RDW with pseudo choline esterase (PChE) level as early OPCs poisoning predictor. Methods: A prospective cross-sectional study was done on 100 acutely OPCs intoxicated patients admitted to Poison Control Center Ain Shams University Hospitals (PCC-ASUHs) from June 2019 till December 2019. All cases were clinically evaluated. RDW was done on admission and after 24 hours while WBCs, hemoglobin, platelets, PChE level and arterial blood gases (ABG) were estimated immediately after admission prior to treatment. Results: High RDW values indicated poor prognosis. There was a highly significant correlation between RDW values and the need for mechanical ventilation (MV). There was a significant correlation between high WBCs count, severity of OPCs poisoning and the need for MV. Lower mean pH, higher mean PCO2, lower mean HCO3, lower mean PChE levels, and higher mean WBCs count were noted in patients on MV compared to patients without MV. Conclusion: RDW values on admission can be a reliable predictor of severity and outcome in contrast to PChE levels which showed nonsignificant correlation with severity. Additionally, there was a significant correlation between WBCs with the need of MV. RDW on admission can predict the need for mechanical ventilation with sensitivity (58.97%), specificity (83.61%) at cutoff value more than 14.4. RDW on admission had a sensitivity of 75% and specificity of 73.75% with a cut-off value of 14.3 in predicting mortality in patients with OPCs poisoning. Recommendations: RDW is a simple parameter that could be used in assessing the prognosis of acute organophosphorus poisoning. WBCs count could also be used in those patients to predict the need of MV.

True and Pseudo Cholinesterase levels in short and long-term of pesticides exposures

The present study is aimed to study and analyze the true and pseudo Cholinesterase levels in the subjects exposed to pesticides during short term by intentional or accidental intake and long term exposure due to their occupation were studied at Department of Biochemistry, SVS medical college and hospital mahbubnagar district. Whole blood cholinesterase levels and Pseudo cholinesterase levels were estimated. 150 people were taken as controls who had no medical illness and a total number of 300 cases of pesticide poisoning were selected, aged between 20 to 55 years, which consist of 150 acute poisoning and 150 chronic poisoning subjects in Mahbubnagar district, were taken as case study, the detailed case history and the type of organophosphorus pesticide taken were recorded. Mean and standard deviation (S.D) of all variables were calculated and compared with those of controls. Statistical significance was assessed and P-value <0.05 were considered significant.
 During acute poisoning the mean value of Whole blood cholinesterase/True cholinesterase (U / L) in acute poisoning cases on first day was 1.267± 0.612 on 3th day was 1.651±0.647, on 7th day was 2.221±0.684 and at the end of 6 months was 3.970±0.404.The difference between the study group and control group (4.0 ± 0.39) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in acute poisoning cases on first day was 2213.05 ± 1749.81, on 3th day was 2862.3 ± 2025.6, on 7th day was 4008.4 ± 2355.9 and at the end of 6 months was 7708.34 ± 880.72.The difference between the study group and control group (7991.97 ± 1276.5) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months.
 During chronic poisoning (exposure) the mean value of Whole blood cholinesterase (U/L) in controls is 4.0 ± 0.39 as compared to 3.019 ± 0.848 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in controls was 7991.97 ± 1276.5 as compared to 6214 ± 1189 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant.

Study of serum creatinine phosphokinase and serum lactate dehydrgenase as prognostic markers in organophosphorus poisoning

Background: Organophosphorus (OP) compounds are insecticides which are widely used in agriculture. Acute organophosphorus poisoning is an important cause of morbidity and mortality in developing countries like India. In a limited resourced country like India, we need cheap and easily measurable biomarkers for predicting prognosis.Objective was to estimate creatinine phosphokinase and serum lactate dehydrgenase as prognostic markers in acute organophosphorus poisoning.Methods: Total 94 cases of OP poisoning admitted to KIMS Hospital, Hubbali between January 1st 2017 to December 31th 2017 were studied. Detailed history, clinical examination and lab investigations like pseudo cholinesterase, serum LDH and serum CPK were carried out. Peradeniya OP poisoning scale was applied to all study subjects and the severity of OP poisoning was graded as mild, moderate, severe. Data obtained was analysed by different statistical methods.Results: OP poisoning is more common in adults of age group between 20 - 30 years, Incidence is was more in male patients, Mortality rate is 12.8%. Mean values of serum LDH, serum CPK were negatively correlated with pseudcholinesterase levels and it was statistically significant. Correlation between the severity of OP poisoning (based on Peradenyia score) and biochemical parameters like serum CPK, serum LDH, was statistically significant.Conclusions: The correlation between the severity of OP poisoning and biochemical parameters was statistically significant and they are usefull in predicting development of respiratory failure.

Pseudocholinesterase Enzyme Deficiency in Adıyaman City Area.

Pseudocholinesterase (PChE) is an enzyme responsible for the hydrolysis of succinylcholine. In case of its deficiency, the effect of succinylcholine that is approximately 5-10 min is prolonged up to few hours. The use of succinylcholine has been declined recently. However, it is still actively used in some special conditions and in developing countries. In this study, incidence of PChE enzyme deficiency around Adiyaman city was investigated and presented with the literature review. After obtaining an approval from the investigational board of our hospital (Adiyaman University Medical School, Biomedical Research Ethics Board, 30.12.2012, Nr: B.30.2.ADY.0.20.00-600/51), patients undergoing any elective operation under general anaesthesia in the Adiyaman University Medical School Hospital between March and December 2013 were recruited for the study. After obtaining the patients' written consents, blood PChE, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, creatinine, international normalisation ratio (INR) and activated partial thromboplastin time (aPTT) values of the patients were analysed. Possible association of the PChE deficiency with other values was also investigated. The normal value of PChE was taken as 4260-11250 for females aged 16-40 years and 5320-12920 U L(-1) for other patients. The study was completed with 964 patients, 702 (72.8%) of whom were females. PChE enzyme levels were under the normal in 7.2% of the patients. There were no correlation between patient group, ALT, INR, aPTT and creatinine elevation with PChE deficiency (p>0.05), whereas AST and urea level elevation was significantly associated with PChE deficiency (p<0.05). The risk of PChE deficiency was 4.5 and 9 times higher in the patients with the elevation of AST and urea levels, respectively. Pathological elevations of AST and urea that are a part of normal pre-operative biochemical analysis of blood will indicate the possible deficiency of PChE enzyme.

Predictors of the need for Intensive Care Unit admission in acute organophosphorus poisoning: One year prospective study

Background: Organophosphorus (OP) poisoning is a very serious condition that needs rapid intervention and treatment. It can result from occupational, intentional or accidental exposure. Clinical manifestations include muscarinic, nicotinic and central effects which may be life threatening increasing the need for intensive care unit (ICU) management. Aim: The present study aims to identify the predictors which help in making timely decisions regarding transferring the patients for intensive care managements in acute organophosphorus poisoning. Material & Methods: A prospective study included all 404 organophosphorus poisoning cases that were admitted to Menoufia Poison Control Center; Menoufia University Hospitals within the period from the beginning of January 2018 till the end of December 2018. Diagnosis of OP poisoning was based on history of exposure to OP compounds, characteristic clinical manifestations, low serum pseudo cholinesterase levels and detection of OP in the biological fluids by thin layer chromatography. Results: Organophosphorus poisoning was the 2nd common cause of poisoning (15.02% - 404 cases out of 2689) among cases admitted to Menoufia Poison Control Center during the period of the study. Majority of the cases managed at MPCC department while 83 patients (20.54%) needed ICU admission. Most of the cases were suicidal and 94.31% were by oral exposures. 51.98% of the cases were poisoned by the liquid form of OP. Females outnumbered males. The majority of the cases were young students and single. There was statistically significant relation between pseudo cholinesterase activity and severity of the case according to POP classification (p value < 0.001), the more the severity of poisoning the more suppression of pseudo cholinesterase level in the serum. Severe degree of POP classification, presence of hypoxia (< 50 mmHg), convulsions, and severe affection of serum cholinesterase activity were significantly predictors for patients who needed ICU admission. Conclusions: Severe degree of POP classification, presence of hypoxia, convulsions, and severe affection of serum cholinesterase activity are important predictors for ICU admission in OP poisoning.

Prognostic Value of Insecticide Type and Enzymatic Activities on Severity of Acute Insecticides Poisoning

Background: Insecticides poisoning is a major problem worldwide, especially in developing countries. The most extensively utilized types are pseudocholinesterase (PChE) inhibitors, predominantly organophosphorus compounds and carbamates. They are metabolized by microsomal oxidases to oxygen analogues, which are active neurotoxic metabolites. These oxygen analogues are further hydrolyzed by the serum arylesterase; paraoxonase (PON1), which appears to play a pivotal role in their detoxification. Objectives: This study aimed to 1-Identification and quantitation of common insecticides in acutely poisoned patients presented to Assiut University hospitals. 2- Detection of paraoxonase and cholinesterase levels in poisoned patients. 3- Evaluate the prognostic value of pesticide type and enzymes level in relation to the severity of insecticidal poisoning. Methods: This case-control study was conducted on 50 patients who have been admitted to the Emergency Unit and Intensive Care Units in Assiut University Hospitals along with 50 controls. Age, residence and sex were matched. History and clinical data and other related laboratory investigations were gathered for each patient. Blood plasma samples (5ml) were collected from patients on admission alongside controls then analyzed for level of pseudocholinesterase (PChE) and paraoxonase (PON1) enzymes activity by a spectrophotometer. The insecticide types were identified using Gas Chromatography/Mass spectrometry (GC-MS). Results: The patients were mostly males, of young age group and residing in rural areas. The mode of poisoning was mainly accidental by oral route (66%). Tachycardia, tachypnea and hypotension were most commonly presenting muscarinic signs. The detected insecticides were mainly of the organophosphate types specifically malathion. A highly significant decrease in PChE and PON1 level were detected in patients compared to controls that the decline in their levels was also significantly associated with the severity of acute poisoning. A positive correlation was also observed between PChE and PON1 levels. Conclusion: the present study identified more than one type of pesticides mainly of organophosphate category among acutely poisoned patients. Furthermore, it pointed to those persons with higher paraoxonase activity and less cholinesterase inhibition may have a better chance of toxic effects amelioration

Stoichiometry and Kinetics of Sequential Dimethacrylate Enzymolysis

The increasing use of methacrylate-based materials in tissue engineering and dental restorations demands detailed evaluation of enzymolysis of these materials due to toxicity, durability, and biocompatibility concerns. The objective of this study is to develop tools for assessing and ranking the enzymolysis kinetics of dimethacrylate (DMA) compounds. Triethyleneglycol DMA and diurethane DMA are employed as model DMAs for kinetic studies of 2-step enzymolysis by 2 esterases, pseudocholine esterase and cholesterol esterase. In addition, the intermediate hydrolysis products, mono-methacrylates (mono-MAs), are prepared via esterases. The kinetics of DMA enzymolysis are evaluated per the concentrations of DMA. The enzymolysis products are quantified by high-performance liquid chromatography. Additionally, stoichiometric analysis and a Berkeley Madonna model are employed to compare the efficacy of esterases in DMA enzymolysis. The chemical structure of mono-MAs is verified by proton and heteronuclear single quantum coherence (2D 1H-13C) nuclear magnetic resonance spectroscopy and mass spectrometry. In evaluating the ratio of sequential and simultaneous degradations of DMA and mono-MA, the stoichiometric analysis draws the same conclusions without using [mono-MA] as the experimental observation using [mono-MA]. The majority of the 4 esterase-DMA combinations undergo the sequential enzyme-catalyzed hydrolysis, from DMA to mono-MA to diol. However, cholesterol esterase is more effective than pseudocholine esterase in maintaining sequential degradation until >90% of DMA is decomposed. Both enzymolysis steps are first-order reactions. The mono-MAs are more hydrolysis resistant than DMAs. Moreover, esterase efficacy and selectivity on DMA enzymolysis are presented. The stoichiometric analysis provides valuable tools in assessing DMA enzymolysis when mono-MA is difficult to be obtained. The resistance of mono-MAs to enzymolysis suggests a need for thorough toxicity evaluations of these intermediate compounds. It also advocates the alternative approaches in designing and developing durable and biocompatible materials.

The use of the Electrometric Method in Measuring the Activity of Cholinesterase in Local Female Buffalo in north of Iraq

The aim of present study, was desigen to measurement of cholinesterase (ChE) activity by electrometric method in normal blood of adult Female buffalo, Cholinesterase was used in red blood cells (RBCs)to determine the linear relationship between incubation time and cholinesterase activity. The change in pH of RBCs cells reaction mixture (0.21 to 0.47) agreed with increased incubation time of 10 - 50 minutes and the pH change red blood cells reaction mixture (0.31 to 0.46) was associated with increased incubation temperature of 25-40C. recorded the highest activity of natural ChE the change in pH / 40 C° minutes in the red blood cells (0.46), whole blood (0.42) and least in the blood plasma (0.076). To illustrate the accuracy of the way the coefficient of variation in red blood cells and blood plasma and the whole blood (1.65%, 6.97% and 4.12%), respectively, this was done using 0.1 ml acetylcholine iodide 7.5% as the basis of the combination interaction of the current study. Quinidine sulfate specifically inhibited pseudo ChE in the RBC and whole blood, and it was estimated to be (6.5%,16.7%), where as true ChE activity was (93.5%, 83.3%). Monocrotophos at concentration (0.5, 1 µM) and carbaryl at (5, 10 µM) significantly inhibited RBCs ChE in vitro. These results indicate that the used of modified electrometric method its simple, precise, efficient and have the validity for measurement of ChE activities in adult Female of buffalo.

GENETIC VARIANTS OF HUMAN BUTYRYLCHOLINESTERASE AND ITS POTENTIAL IMPACT ON EGYPTIAN FARM WORKERS ACUTELY EXPOSED TO ORGANOPHOSPHATE PESTICIDE

Introduction: Organophosphate compounds (OPs) are potent and effective insecticides widely used in human practice. They are irreversible cholinesterase inhibitors causing accumulation of acetylcholine at cholinergic synapses with over-stimulation of muscarinic and nicotinic receptors. In Egypt, little is known about susceptibility to toxic effects of OPs during pesticide application. Aim of work: To study the genetic variation in Butyrylcholine esterase (BChE) among workers presented to the National Egyptian Centre of Toxicological and Environmental Research (NECTR) with acute toxicity during spraying of organophosphorus pesticide and having occupational history of chronic exposure. Materials and methods: It is a case–control study to assess BChE genotype and enzyme activity in 65 workers presented to NECTR at Cairo, Egypt, during the period from January 2014 to July 2016. Comparison with 55 matched control subjects was performed; to identify those workers at risk to potential adverse health effects of OP compounds. The studied group answered a predesigned questionnaire with detailed personal medical and occupational histories. Full physical examination was done. Laboratory investigations included: liver and kidney functions, analysis of pseudo choline esterase and DNA. Results: The study revealed that 73.8 % of the total cases was carrying JK variants (named in honor of James and Kalow respectively) in heterozygote state with the A (Atypical) variant an d 13.8 %in heterozygote state with the U (Usual) variant, these workers showed reduction in the level of BChE enzyme . Conclusion: BChE genetic variations could be a concern in farm workers exposed to organophosphorus pesticides in agriculture and could be useful in assessing the risk of pesticide exposure. Safety regulations concerning products use, training of occupational workers for the safe application of potentially harmful pesticides are highly recommended.

A study of acute organophosphorus compound poisoining in a rural hospital with reference to pseudocholine esterase levels

A study of acute organophosphorus compound poisoining in a rural hospital with reference to pseudocholine esterase levels

Evaluation of salivary acetylcholinesterase and pseudocholinesterase in patients with Alzheimer's disease: A case-control study.

The aim of this study was to evaluate acetylcholinesterase (AChE) and pseudocholinesterase (PChE) in whole saliva in patients with Alzheimer's disease (AD) and in healthy subjects. Saliva has a high potential for keeping track of general health and diseases. AD is a type of dementia with reduction in brain cholinergic markers that causes memory, thinking, and behavior problems. Up to 90% decrease in AChE activity has been observed in AD. Thirty healthy subjects and 30 patients with AD participated in this study. Saliva samples were collected from 8 to 10am. AChE and PChE of saliva were assessed by the Ellman method. Statistical comparison was performed using SPSS 16 for t-test. The activity of AChE and PChE significantly increased in the group with AD compared to the healthy subjects. Sex had no effect on the activities of these enzymes. No correlation existed between the duration of illness and enzymatic activity. The enzyme levels reduced with age. AChE and PChE levels were increased in saliva samples of patients with AD. Therefore, saliva has the potential for being used for the purpose of biomarker evaluation to replace cerebrospinal fluid in patients with AD.

English

Organophosphorus (OP) poisoning is a major common cause of mortality and morbidity in most countries. Some clinical cases developed renal injury after acute OP poisoning. The aim of our study is to evaluate the levels of kidney injury molecule-1(KIM-1) and interleukin -18(IL-18) in acute OP poisoned patients as early predictors of OP induced nephrotoxicity. Over a period of one year, the observational cross sectional study was conducted at the Poison Control Center, Zagazig University hospitals, Zagazig, Egypt. The study group consisted of 95 patients who fulfilled the inclusion criteria; the patients were categorized according to Peradeniya organophosphorus poisoning (POP) scale. The serum pseudocholine esterase enzyme (PChE), serum creatinine, urinary KIM-1 and IL-18 were assayed at 0, 12, 24 and 48 h after admission. There were progressive increases in the mean values of KIM-1 and IL-18 at different time intervals especially in severe poisoned patients compared to the increased levels of serum creatinine. The cutoff values of urinary KIM-1 and IL-18 that determined patients with potential AKI were 2.8 ng/ml creatinine (86.9% sensitivity, 94.6% specificity and 0.859% area under curve) and 59 pg/dl creatinine (90% sensitivity, 92% specificity and 0.946&amp; area under curve), respectively. A positive correlation was observed between KIM-1 and IL-18 and serum creatinine. Moreover, KIM-1 is positively correlated with IL- 18. Urinary KIM-1 and IL-18 may be considered as valid markers for prediction of acute kidney injury among acute OP poisoned patients. Key words: Organophosphorus poisoning, IL-18, KIM-1, acute kidney injury. &nbsp; &nbsp

Severe pseudocholinesterase deficiency and ECT: a case report

Pseudocholinesterase (PCE) deficiency is an inherited condition in which recovery from anesthetic agents like succinylcholine and mivacurium is slow and is complicated with prolonged paralysis of respiratory muscles in susceptible patients. We present a very rare case that we encountered in our practice; the patient is a 29-year-old woman with a 15-year history of schizophrenia with pseudocholinesterase deficiency. Since the detection of PCE levels of all patients eligible for ECT is part of our pre-ECT assessment procedure, we could detect the deficiency before the ECT procedure. We performed modified ECT with propophol and rocuronium instead of succinylcholine as usual. Sugammadex was used for fastening the recovery. Response to treatment which is measured with Positive and Negative Symptom Scale was good and we completed 9 ECT sessions without complication. We suggest further investigation of this topic because screening for PCE levels in pre-ECT assessment may reduce complications of modified ECT with anesthesia.

PSEUDOCHOLINESTERASE AS A PREDICTOR MARKER IN HYPOTHYROID PATIENTS

Introduction: Hypothyroidism is due to decreased circulating levels of Thyroid hormones and is caused by inadequate functioning of thyroid gland. Pseudocholinesterase (PCHE) is a nonspecific cholinesterase enzyme that hydrolyses choline based esters in plasma. The purpose of this study was to evaluate the serum level of PCHE in hypothyroid patients. Methodology: The present study was conducted on 100 newly diagnosed hypothyroid patients attending the Medical OPD. The results of patients were compared with 100 healthy controls of either sex of similar age group. Anthropometric measurements, T3, T4, TSH, PCHE &amp; Cholesterol estimations were performed. Results: The mean serum PCHE (decrease) level was observed statistically highly significant (p&lt;0.001) in hypothyroid patients as compared with healthy control subjects. A highly significant positive correlation between PCHE with T3 &amp; T4 (p&lt; 0.001) in hypothyroid cases. Conclusion: Serum Pseudocholinesterase may be helpful as biomarker in screening test for hypothyroidism along with thyroid stimulating hormone.