Serum Acetylcholinesterase Levels Research Articles

Chrysin-loaded PEGylated liposomes protect against alloxan-induced diabetic neuropathy in rats: the interplay between endoplasmic reticulum stress and autophagy

BackgroundDiabetic neuropathy (DN) is recognized as a significant complication arising from diabetes mellitus (DM). Pathogenesis of DN is accelerated by endoplasmic reticulum (ER) stress, which inhibits autophagy and contributes to disease progression. Autophagy is a highly conserved mechanism crucial in mitigating cell death induced by ER stress. Chrysin, a naturally occurring flavonoid, can be found abundantly in honey, propolis, and various plant extracts. Despite possessing advantageous attributes such as being an antioxidant, anti-allergic, anti-inflammatory, anti-fibrotic, and anticancer agent, chrysin exhibits limited bioavailability. The current study aimed to produce a more bioavailable form of chrysin and discover how administering chrysin could alter the neuropathy induced by Alloxan in male rats.MethodsChrysin was formulated using PEGylated liposomes to boost its bioavailability and formulation. Chrysin PEGylated liposomes (Chr-PLs) were characterized for particle size diameter, zeta potential, polydispersity index, transmission electron microscopy, and in vitro drug release. Rats were divided into four groups: control, Alloxan, metformin, and Chr-PLs. In order to determine Chr- PLs’ antidiabetic activity and, by extension, its capacity to ameliorate DN, several experiments were carried out. These included measuring acetylcholinesterase, fasting blood glucose, insulin, genes dependent on autophagy or stress in the endoplasmic reticulum, and histopathological analysis.ResultsAccording to the results, the prepared Chr-PLs exhibited an average particle size of approximately 134 nm. They displayed even distribution of particle sizes. The maximum entrapment efficiency of 90.48 ± 7.75% was achieved. Chr-PLs effectively decreased blood glucose levels by 67.7% and elevated serum acetylcholinesterase levels by 40% compared to diabetic rats. Additionally, Chr-PLs suppressed the expression of ER stress-related genes (ATF-6, CHOP, XBP-1, BiP, JNK, PI3K, Akt, and mTOR by 33%, 39.5%, 32.2%, 44.4%, 40.4%, 39.2%, 39%, and 35.9%, respectively). They also upregulated the miR-301a-5p expression levels by 513% and downregulated miR-301a-5p expression levels by 65%. They also boosted the expression of autophagic markers (AMPK, ULK1, Beclin 1, and LC3-II by 90.3%, 181%, 109%, and 78%, respectively) in the sciatic nerve. The histopathological analysis also showed that Chr-PLs inhibited sciatic nerve degeneration.ConclusionThe findings suggest that Chr-PLs may be helpful in the protection against DN via regulation of ER stress and autophagy.Graphical

The serum acetylcholinesterase (AChE) levels as an alternative diagnostic tool in pre-operative Hirschsprung's disease

Background: The golden standard of Hirschsprung's disease diagnosis is through a histopathological examination of the aganglionic site. The significance of serum acetylcholinesterase (AChE) immunohistochemistry for diagnosing Hirschsprung's disease has been widely accepted. However, the study of serum AChE levels in Hirschsprung's disease patients is still scarce. We aimed to examine the serum levels of AChE in individuals with Hirschsprung's disease. Methods: An analytical observational study with a cross sectional design was conducted on 29 patients with Hirschsprung's disease. We divided the patients into two groups: 14 in Hirschsprung's disease group and 15 in the control group. Serum AChE level was measured using the enzyme-linked immunosorbent assay (ELISA) method. The optimal cut-off value for detecting Hirschsprung’s disease was determined using the ROC analysis. Results: The prevalence of Hirschsprung was higher in males than in females. The average AChE level in the Hirschsprung group was 95.89 ± 51.11 Units/mL, while the average level of AChE in the control group was 44.45 ± 33.40 Units/mL. The optimal cut-off value was 46.615 Units/mL. We found that this study's sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values ​​were 83.3%, 70.6%, 66.7%, 85.7%, and 75.9%, respectively. There was a significant relationship between serum AChE levels and Hirschsprung's disease (p=0.004). Conclusion: The AChE levels in blood serum can be used as an alternative diagnostic parameter for Hirschsprung's disease. Patients with Hirschsprung's disease had higher serum AChE levels than patients without Hirschsprung's disease.

Organophosphorus Poisoning among Patients Admitted to the Intensive Care Unit of the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Organophosphates are potent cholinesterase inhibitors that when ingested in excessive amounts can be fatal. Organophosphorus poisoning has become an important clinical problem with increased mortality in the country from accidental or intentional ingestion of, or exposure to the pesticide. This study aimed to find out the prevalence of organophosphorus poisoning among patients admitted to the Intensive Care Unit of the Department of Internal Medicine in a tertiary care centre. A descriptive cross-sectional study was conducted among patients admitted to the Intensive Care Unit of the Department of Internal Medicine of a tertiary care centre after receiving ethical approval from the Institutional Review Committee (Reference number: 2003202205). The study was conducted between 1 February 2021 and 1 February 2022 using hospital records. Convenience sampling was done among the patients who met the eligibility criteria. The diagnosis of organophosphorus poisoning was made based on the patient's history, clinical examination and the measurement of serum acetylcholinesterase levels. Point estimate and 95% Confidence Interval were calculated. Among 1108 patients admitted, organophosphorus poisoning was seen in 50 (4.15%) (3.29-5.73, 95% Confidence Interval). Our study found that the prevalence of organophosphorus poisoning was lower when compared to similar studies done in similar settings.

Distinct CholinomiR Blood Cell Signature as a Potential Modulator of the Cholinergic System in Women with Fibromyalgia Syndrome.

Fibromyalgia syndrome (FMS) is a heterogeneous chronic pain syndrome characterized by musculoskeletal pain and other key co-morbidities including fatigue and a depressed mood. FMS involves altered functioning of the central and peripheral nervous system (CNS, PNS) and immune system, but the specific molecular pathophysiology remains unclear. Anti-cholinergic treatment is effective in FMS patient subgroups, and cholinergic signaling is a strong modulator of CNS and PNS immune processes. Therefore, we used whole blood small RNA-sequencing of female FMS patients and healthy controls to profile microRNA regulators of cholinergic transcripts (CholinomiRs). We compared microRNA profiles with those from Parkinson’s disease (PD) patients with pain as disease controls. We validated the sequencing results with quantitative real-time PCR (qRT-PCR) and identified cholinergic targets. Further, we measured serum cholinesterase activity in FMS patients and healthy controls. Small RNA-sequencing revealed FMS-specific changes in 19 CholinomiRs compared to healthy controls and PD patients. qRT-PCR validated miR-182-5p upregulation, distinguishing FMS patients from healthy controls. mRNA targets of CholinomiRs bone morphogenic protein receptor 2 and interleukin 6 signal transducer were downregulated. Serum acetylcholinesterase levels and cholinesterase activity in FMS patients were unchanged. Our findings identified an FMS-specific CholinomiR signature in whole blood, modulating immune-related gene expression.

CRP COMPARISON WITH RDW AS A PROGNOSTIC MARKER FOR OUTCOME OF OP POISONING

Background: Organophosphate (OP) compounds are frequently used as pesticides in countries. This ease of availability of the OP compounds has resulted in a gradual increase in unintentional and 1 suicidal poisoning, mainly in developing countries . Elevated RDW is associated with systemic inammation and oxidative stress More severe poisoning means more production of free radicals and more oxidative stress. In AOPP, toxins may cause 2,5 lesions in tissues and organs in the body, leading to increased plasma CRP levels . Aim: 1-To measure CRP, serum acetylcholinesterase, red cell distribution width, in acute organophosphorus poisoning.2- To analyze the correlation between these biochemical parameters and serum acetylcholinesterase levels. 3-To analyze the validity of these biochemical parameters in prediction of severity and prognosis in op poisoning. Hospital based Methods: prospective study was conducted from OP compound consumption patients attending casualty and admitted patients in S. Nijalingappa Medical College Hospital and Research center, BAGALKOT. Patients less than 18 years, Co-ingestion of organophosphorus with other agents, Pre hospital cardiac arrest, Prior history of Iron deciency anemia, Vitamin B12 deciency and folate deciency anemia, Recent hemorrhage, Chronic liver disease, Prior chemotherapy, Patient on oral contraceptive pills, Patient on estrogen therapy is excluded. Results: a total of 60 patients who diagnosed with history of poisoning were involved in the study among them 29 (48.3%) were male and 31 (51.7%) were female. 75% of study population has attempted suicide by taking the poisoning and 10% of study population had accidental consumption of poisoning, and 5% of study population had occupational exposure. There is negative correlation between the cholinesterase, RDW and CRP as cholinesterase in Conclusion: creases RDW and CRP decreases and severity of poisoning decreases and as cholinesterase decreases RDW and CRP increases and severity of op poisoning increases and morbidity and mortality increases.

Is Serum Creatine Phosphokinase Level Useful to Predict the Severity of Organophosphate Poisoning?

Organophosphate poisoning is a global health burden due to intentional and occupational exposure, particularly in Asian countries. Patients are usually monitored through serum acetylcholinesterase levels. Still, it is non-specific, does not correlate well with the severity of poisoning, and is not widely available in laboratory settings in developing countries. This study aims to assess serum baseline creatine phosphokinase (CPK) levels as a prognostic biomarker in acute organophosphate poisoning. We recruited all patients older than 12 years who were admitted to the wards of the Indoor Medicine Ward in Burdwan Medical College and Hospital in West Bengal (India) because of ingestion or inhalation of organophosphorus compounds within the previous 12 hours between May 1, 2019, and November 1, 2020. Clinical severity was categorized according to Peradeniya organophosphorus poisoning (POP) scale. Serum CPK, pseudocholinesterase levels, and pH were measured. Levels were reassessed on days three and seven, and patients were followed-up until death or discharge. 100 patients (68 men and 32 women) were included in the study. Most of them presented with miosis (98%), followed by abdominal pain (96%), diarrhea (78%), and vomiting (52%). In the multivariate analysis, the patients with a higher risk of being intubated were younger. Of the analytical levels, the one that showed a better relationship with the risk of intubation was the pseudocholinesterase level, although without statistical significance. Initial CPK levels, time of admission, or stratification on the POP severity scale, offered poor performance after adjustment. The analytical values of CPK or the POP severity scale at the time the patient presents in the emergency room have limited value to predict the final severity of the picture. The amount of the poison consumed should be collected for future studies to elucidate these differences.

Ameliorative effects of olibanum essential oil on learning and memory in Aβ1-42-induced Alzheimer’s disease mouse model

Purpose: To study the effect of olibanum essential oil (OEO) on learning and memory in Alzheimer’s disease (AD) mouse.Methods: Mice were administered the 42-amino acid form of amyloid β-peptide (Aβ1-42) to induce AD and then treated with OEO at 150, 300, and 600 mg/kg, p.o. for two weeks. Following treatment, the AD mice were assessed by step-down test (SDT), dark avoidance test (DAT), and Morris water maze test (MWM). Blood and brain tissues were collected for biochemical assessments. Gas chromatographymass spectroscopy was used to analyze the main constituents of OEO.Results: The main constituents of OEO were limonene, α-pinene, and 4-terpineol. Treatment with OEO prolonged t latency in SDT and DAT, but decreased error times. Escape latency decreased and crossing times were rose in the MWM following OEO treatment (p < 0.5). Treatment with OEO also enhanced the acetylcholine levels and decreased the acetylcholinesterase levels in serum and brain tissue (p < 0.5). Additionally, OEO reduced amyloid plaques in the hippocampus and protected hippocampal neurons from damage. Furthermore, OEO decreased c-fos expression in hippocampus tissues from AD mice (p < 0.5).Conclusion: OEO has significant ameliorative effect AD-induced deterioration in learning and memory in AD mouse induced by Aβ1-42. The mechanisms of these effects are related to increased acetylcholine contents, reduction of amyloid plaques, protection of hippocampal neurons, and downregulation of c-fos in brain tissues. The results justify the need for further investigation of candidate drugs derived from OEO for the management of AD.
 Keywords: Olibanum, Essential oil, Learning, Memory, AD

Pesticide Use and Serum Acetylcholinesterase Levels among Flower Farm Workers in Ethiopia-A Cross-Sectional Study.

The flower industry in East Africa has grown in recent years, especially in the production and export of roses. The aim of this study was to assess pesticide use on selected flower farms in Ethiopia. Serum cholinesterase levels in workers were used as a marker of pesticide exposure. This study was a cross-sectional study involving 588 workers from 15 different flower farms. It had a response rate of 95.5%. The participants included 277 males (mean age 26 years; 148 pesticide sprayers and 129 non-sprayers) and 311 females (mean age 25 years; 156 working in greenhouses and 155 working outside the greenhouses). The researchers undertook structured interviews, blood sampling, and walkthrough surveys. Descriptive statistics and Poisson regression were used in the statistical analyses. A total of 154 different trade names of pesticides were found. Of them, 31 (27%) were classified as moderately hazardous by the WHO, and 9% were organophosphates. Serum levels of cholinesterase deviating from 50–140 Michel units were considered abnormal. Abnormal serum cholinesterase levels (above 140 Michel units) were found in 97 participants (16.5%, 95% confidence interval 13.7–19.7%). There were no differences between the four job groups regarding cholinesterase levels. The high prevalence of abnormal serum cholinesterase levels might indicate the presence of pesticide intoxication. Thus, there is a need for routine monitoring of all workers exposed to pesticides, not only sprayers.

Carnosic acid alleviates chlorpyrifos-induced oxidative stress and inflammation in mice cerebral and ocular tissues.

Chlorpyrifos is an organophosphate pesticide whose exposure leads to inhibition of acetylcholinesterase (AChE) enzyme and induces oxidative stress, inflammation, and neurotoxicity. The current study was designed to evaluate the efficacy of carnosic acid (CA) in ameliorating CPF-induced cytotoxicity in mice brain and eye tissues. We allocated 40 male Swiss albino mice to receive DMSO 1% solution, oral CA 60mg/kg/day bw, CPF 12mg/kg/day bw via gastric gavage, or CPF plus CA at 30 and 60mg/kg/day bw. Carnosic acid was administered once/day for 14days, while CPF was administered in the last 7days of the experiment. Biochemical analysis showed that CPF administration was associated with significant increases in the serum concentrations of interleukin-1β, IL-6, and tumor necrosis factor-α, while it was associated with significant reductions in serum AChE levels in mice. Moreover, CPF-intoxicated mice exhibited significantly higher levels of malondialdehyde and nitric oxide in the brain and eye tissues. However, they had significantly lower levels of reduced glutathione, glutathione peroxidase, superoxide dismutase, and catalase in comparison with normal controls. Pretreatment with CA at 30 and 60mg/kg/day bw for 14days significantly alleviated all the aforementioned CPF-induced alterations in a dose-dependent manner; more frequent restorations of the normal control ranges were observed in the higher dose group. In conclusion, CA offers a neuroprotective effect against CPF-induced oxidative stress and inflammation and should be further studied in upcoming experimental and clinical research.

Correlation of Clinical Score and Serum Acetylcholinesterase Level as a Predictor of Outcome among Patients with Acute Organophosphate Poisoning Admitted in Emergency Ward of a Tertiary Hospital

Background: Monitoring a patient's serum acetylcholinesterase (AChE) status after clinical score of organophosphate poisoning enables the verification of exposure to anticholinesterase agents.
 Methods: A cross-sectional study was conducted among the patients fulfilling the inclusion criteria and was categorized according to POP (Peradeniya Organophosphorus Poisoning) score. The study was conducted at a tertiary hospital for one year in the period of Jan 2016 to Dec 2016. POP score was applied and serum acetylcholinesterase level was determined in the lab. Spearman’s rho coefficient method was applied for correlation.
 Results: Seventy four patients survived in emergency ward who presented within (4.1 ± 2.9; 95% confidence interval [CI], 3.43- 4.80; P= 0.021) hours of ingestion of OP compounds, POP score 3 (Q1, Q3, 2, 4), serum AChE 2221 (Q1, Q3, 768.5, 4703.5) IU/L with 9 ( Q1,Q3, 8.75, 34.75) mg of atropine used, 94% received PAM for 5 (Q1, Q3, 3, 7) days of hospital stay.
 Four patients died within (7.5 ± 5.4; 95% CI, -1.16- 16.16; P= 0.021) hours of presentation, POP score of 4 (Q1, Q3, 4, 7.75), serum AChE 588 (Q1, Q3, 173, 1912) IU/L, atropine used 170 (Q1, Q3, 152.5, 297) mg, 5.1% received PAM for 3.5 (Q1, Q3, 1, 11.25) days of hospital stay.
 Spearman’s rho coefficient showed well correlation between POP score and serum AChE level (coefficient -0.356; P= 0.001), POP score for the need of atropine (coefficient= 0.536; P= 0.001).
 Serum AChE also correlated with the length of hospital stay (coefficient= 0.414; P= 0.001) compared to POP score (coefficient= 0.420; P= 0.001).
 Conclusions: The higher degree of POP score correlated to higher degree of serum acetylcholinesterase derangement, need for atropine, PAM and length of hospital stay. Thus, it enhances in the prediction of outcome among patients with acute organophosphate poisoning at index visit.

Knowledge, Attitude, Practice and its Impact on Acetylcholine Esterase Level among Organophosphate Pesticide Applicators in South India

Aim: To assess knowledge, attitude, practice and its impact on acetyl cholinesterase (AChE) level among 100 male Organophosphate pesticide applicators in South India. Methods/Statistical Analysis: A cross sectional study was performed among pesticide applicators in Theni district, Tamil Nadu. They were interviewed using a standard questionnaire on knowledge, attitude and practice. Blood samples were collected for serum AChE level. The results were analyzed using R studio. Pearson correlation coefficient was used to determine relationships between variables. The P value uses lower than 0.05 were considered statistically significant. Findings: Applicators reported high levels of knowledge on the name of the pesticide used in the agriculture field. The common symptoms felt by the applicators include eye and skin irritation and headache. Regarding Personal Protective Equipment (PPE) long pants and long sleeved shirt (78%) were considered as most effective tool in controlling pesticide exposure. About 98% of the respondents were strongly agreed that pesticides are harmful to human health and environment and expensive chemicals are effective to control pest better than the cheaper chemicals. Blood results showed that 20% of participants’ AChE levels were normal and remaining 80% of the participants’ had an abnormal AChE levels. Knowledge was statistically significant with acetylcholine esterase level among organophosphate pesticide applicators. Conclusions: Knowledge shows a significant correlation with the AChE level. The applicators’ AChE levels were found to be lower than the normal standard because of their pesticide exposure. Keywords: Acetyl Cholinesterase (AChE), Attitude and Practice of Pesticide Use, Knowledge, Organophosphate Pesticides, Personal Protective Equipment’s, Pesticide Applicators

Prevalence of Abnormal Serum Cholinesterase and Associated Symptoms from Pesticide Exposure among Agricultural Workers in the South of Thailand

ABSTRACTObjective: To determine prevalence of abnormal serum acetylcholinesterase (AChE) and behavioral risks associated behaviors from pesticide exposure.Methods: Cross-sectional data were collected from agriculture workers in Trang Province, Thailand in 2013–2014. Agricultural workers in Trang Province filled out questionnaires provided by the Ministry of Public Health and gave blood samples. Risk scores were calculated based on questionnaire responses and a reactive-paper finger-blood test was used to evaluate AChE levels.Results: A total of 6,222 agricultural workers filled out questionnaires and 3,431 workers gave blood samples. The prevalence of abnormal AChE results was 12.5%. Females had a higher prevalence of abnormal serum AChE levels (15.2%) than males (10.2%). The most common self-reported symptoms were coughing (5.7%), being tired (5.4%), dizziness (5.1%), and dry skin and irritation (4.8%). However, those with abnormal serum AChE levels were most likely to report dizziness (12.4%) as their main symptom. Male agricultural workers had significantly higher risk than female farmers after adjusting for sex and risk level (OR = 1.56, P < 0.05).Conclusions: Abnormal serum AChE levels associated with pesticide exposure are associated with AChE levels and symptoms such as coughing, being tired, dizziness, and dry skin and irritation. Educating farmers about the effects of pesticide use and encouraging better personal protective equipment practices could also assist in reducing pesticide exposure.

Taurine alleviates malathion induced lipid peroxidation, oxidative stress, and proinflammatory cytokine gene expressions in rats

The present study was considered to evaluate the protective effect of taurine on malathion-induced toxicity in rats. Totally, 48 male rats were divided into 6 equal groups: 0.5ml physiological salt solution was given orally to control rats. 0.5ml corn oil was given orally to rats in corn oil group. Malathion at dose of 27mg/kg (1/50 of LD50) was dissolved in 0.5ml corn oil and given to orally rats in malathion group. The other groups; malathion (27mg/kg) and taurine (dissolved in 0.5ml physiological salt solution) at dose of 50, 100, and 200mg/kg were given orally to rats for 30days, respectively. Malathion treatment decreased acetylcholinesterase levels in serum (30%) and liver (25%) compared to the control group. Malathion resulted in a significant increase in malondialdehyde levels whereas decreased glutathione levels, superoxide dismutase, and catalase activities in rats. Also, IF-γ, IL1-β, TNF-α, and NFĸB mRNA expression levels were found to be increased 5, 1.7, 2.3, and 2.5 fold in malathion treated rats compared to control, respectively. However, treatment of taurine, in a dose-dependent manner, resulted in a reversal of malathion-induced lipid peroxidation, antioxidant enzyme activities, and mRNA expression levels of proinflammatory cytokines. Moreover, taurine demonstrated preventive action against malathion-induced histopathological changes in rat tissues. In conclusion, taurine exhibited a protective effect in rats against malathion-induced lipid peroxidation, besides it ameliorated antioxidant status, decreased mRNA expression levels of proinflammatory cytokine and repaired rat tissues.

Biochemical abnormalities in OPC poisoning and its prognostic significance

BACKGROUND: Organophosphorus insecticides are arguably one of the commonest causes of morbidity and mortality due to poisoning worldwide, especially in developing countries like India due to its easy availability. Though Serum cholinesterase can be a useful tool in the diagnosis of OP poisoning, its role in prognostication is very minimal. Our study was conducted to other biochemical abnormalities to predict the severity and prognosis in OP poisoning patients. AIMS AND OBJECTIVES: (1)To measure serum electrolytes, liver enzymes, amylase, CPK, CPK-MB, and Troponin I in acute organophosphorus poisoning (2) To analyse the correlation between these biochemical parameters and serum acetylcholinesterase levels (3) To analyse the validity of these biochemical parameters in prediction of severity and prognosis in op poisoning. MATERIALS AND METHODS:This study was conducted over a period of 1 year in Mahatma Gandhi Memorial Government Hospital attached to K.A.P.V Govt Medical College, Trichy wherein 50 OP poisoning patients were selected using inclusion and exclusion criteria and their blood samples were collected on admission and analysed for the above said biochemical parameters. RESULTS: 74% of the patients were male, and 62% of the patients fall in the age group of 20 to 30 years. Statistically significant elevation of ALT, CPK, CPK-MB and Troponin I were noted in the study group. A significant fall in serum potassium level in also noted. Most of the patients in the study had a cholinesterase level of 20% to 50%. CONCLUSION: AST, ALT, ALP, and Amylase increase in acute OP poisoning. Rise in CPK, CPK-MB, Troponin I and ALT indicate the severity of OP poisoning and is also statistically significant to predict the prognosis of the patient. Hypokalaemia and associated low cholinesterase levels indicate the requirement of ventilator support and also the poor prognosis of the patient. These findings can assist health professionals to better evaluate patient’s prognosis and improve their treatment plan.

Effect of Commiphora molmol extract (Mirazid) on the tegument of Schistosoma mansoni and serum acetylcholinesterase activity in infected mice

Context: Scanning electron microscopy (SEM) has become a useful tool for the study of the ultrastructural changes of the surface of the Schistosoma worms in response to chemotherapy as well as evaluation of serum acetylcholinesterase (AChE) determine safety of the drug on cholinergic function. Aims: The aim was to study the effect of Mirazid (MZD) on the teguments of Schistosoma mansoni worms recovered from infected mice and its effect on the cholinergic function of treated animals compared to praziquantel (PZQ). Materials and Methods: Forty albino mice were enrolled in four groups of ten mice each: Group 1: normal group; Group II: infected control given only the vehicle; Group III: infected mice treated orally with MZD in a dose of 500 mg/kg for 5 days at 7-week postinfection; and Group IV: infected mice treated orally with PZQ 500 mg/kg for 2 days. Two-week posttreatment, mice were sacrificed and Schistosoma worms were examined by SEM and blood samples were taken for estimation of serum AChE. Statistical Analysis Used: The data of serum AChE level were analyzed using Student's t -test for comparison of means. Results: PZQ caused extensive tegumental damages in male and female worms in the form of rupture of tubercles and loss of spines in male worms and ulceration in female worms. MZD showed tegumental damages with shrinkage of the outer surface of male tubercles with marked loss of spines and mild ulceration in female worms. The two drugs showed nonsignificant effect on serum AChE compared to the normal mice. Conclusions: MZD showed potent antischistosomal activity but lower than that of PZQ and the two drugs had no effect on cholinergic function at the studied dose.

Erum Enzymes in Organophosphorous Poisoning

Organophosphorus compounds have been widely used for a few decades in agriculture for crop protection and pest control. In India Organophosphorus poisoning is the most common. Acetylcholinesterase is an enzyme that breaks down the neurotransmitter acetylcholine results in a lowered level of acetylcholine, and ultimately the termination of nerve impulses. Organophosphorous compounds covalently block the active site of serine residue of acetylcholinesterase this irreversible inactivation leads to an excess accumulation of acetylcholines in the peripheral and central nervous system causing cholinergic manifestations. We have estimated the serum enzymes such as acetylcholinesterase, lactate dehydrogenase, creatine kinase, amylase and lipase in organophosphorus poisoning patients and healthy controls. We found significantly decreased acetylcholinesterase (p<0.001) and significantly increased lactate dehydrogenase, creatine kinase, amylase and lipase in patients with organophosphorus poisoning as compared to controls (p<0.001). Serum acetylcholinesterase level was estimated only at the time of admission. Daily estimation of acetylcholinesterase and amylase levels may provide more informative in prediction the prognosis or severity of poisoning and to monitor the effectiveness of therapy.

Increased risk of deep vein thrombosis and pulmonary thromboembolism in patients with organophosphate intoxication: a nationwide prospective cohort study.

Organophosphate (OP) poisoning is a critical cause of morbidity and mortality worldwide. We conducted a nationwide longitudinal cohort study to investigate the development of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) among patients admitted with OP intoxication.We identified patients with OP intoxication by using the Taiwan National Health Insurance Research Database and enrolled 9223 patients who were hospitalized for OP intoxication between 2000 and 2011. OP intoxication was diagnosed based on a clinical assessment and serum acetylcholinesterase levels at the time of hospital admission. Each patient in the OP intoxication cohort was randomly frequency matched with 4 patients without OP intoxication based on their age, sex, and index year (36,892 patients as control cohort), and all patients were observed from the index date until the appearance of a DVT or a PTE event, or until December 31, 2011. We analyzed the risks of DVT and PTE by using Cox proportional hazards regression models that included the demographic variables of sex, age, and comorbidities (eg, hypertension, diabetes, cerebral vascular disease, heart failure, all cancer types, and lower leg fracture or surgery).The results revealed a significantly increased risk of developing DVT among patients with OP poisoning (adjusted hazard ratio [HR] = 1.55; 95% confidence interval [CI] = 1.03–2.34) but not PTE (adjusted HR = 1.44; 95% CI = 0.83–2.52). Among the patients without comorbidities, the OP poisoning patients compared with controls had a higher adjusted HR of 2.12 (95% CI = 1.21–3.71) for DVT.The results of this nationwide cohort study indicate that the risk of developing DVT is markedly higher in patients with OP intoxication compared with that of the general population.

A retrospective analysis of serial measurement of serum cholinesterase in acute poisoning with organophosphate compounds

Objectives:Retrospective analysis of the utility of serial measurements of serum acetylcholinesterase (AChE) in predicting the duration of stay in the intensive care unit (ICU), duration of mechanical ventilation (MV) and outcome of the patient from MV in organophosphate (OP) compound poisoning patients.Materials and Methods:The medical records of patients who presented to tertiary care hospital with symptomatic insecticidal poisoning from January 2009 to December 2010 were utilized for the study purpose. Forty four patients with history of poisoning were admitted during this period. Out of these 37 patients with history of OP poisoning, without any underlying diseases and whose serial AChE activity levels were available were included in the study. Data regarding clinical manifestation at presentation, AChE activity results and its interpretation, details of patient management and data on outcomes of patients were noted.Results:Serum acetycholinesterase levels below 1,250IU/L, 1,789IU/L and 2,764IU/L on day three, day four and five respectively indicates longer duration of stay in the ICU. Patients with serum AChE levels below 975IU/L, 876IU/L, 1,245IU/L, 1,395IU/L and 1,875IU/L on day one, two, three, four and five respectively take a longer time to be out of mechanical ventilation. Levels below 870IU/L, 1,110IU/L, 1,020IU/L and 885IU/L on day two, three, four and five respectively indicate poor prognosis of the patient and mortality.Conclusion:We conclude that the serial measurements of serum acetylcholinesterase levels can be useful in predicting the length of ICU stay, duration of mechanical ventilation and the prognosis of the patient with OP poisoning.

Organophosphate Poisoning Due to a Wheat Bagel

Organophosphate compounds are possibly the most widely-used insecticides worldwide. Organophosphate compounds cause poisoning, inhibiting acetylcholinesterase at the cholinergic synapses. Civilian casualties resulted from a terrorist attack with sarin in a Tokyo subway. Recent terrorist activities have also raised concerns that organophosphate or nerve agents may be used as a weapon of terror or mass destruction. In this study, an extraordinary type of mass poisoning was evaluated. Especially by focusing on the way of poisoning, the demographic features and clinical findings of patients were analyzed. After eating a wheat bagel, 13 patients with organophosphate poisoning were admitted to our emergency department. Seven were males and 6 were females. The mean age of the patients was 26 +/- 13.9. The mean serum acetylcholinesterase level was 2945.1+/-2648.9 U/L. Nine patients who had supportive treatment and who were given atropine and pralidoxime were hospitalized approximately 6.8+/-6.5 days. All of the patients recovered after the treatment and no deaths occurred. If organophosphate poisoning is not diagnosed and treated in time, it may be fatal. When cases of food poisoning are admitted to the hospital, attention must be taken especially if it is a mass poisoning.

Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan

Poisoning due to organophosphate pesticides is an important cause of morbidity and mortality worldwide. Although standard treatments involving the administration of atropine and oximes have been used, there remain many controversial areas concerning organophosphate poisoning (OPP). Herein, we present our 10 years of experience in assessing the severity of OPP in southern Taiwan. A retrospective study was performed on patients admitted with OPP. A total of 75 patients (50 males and 25 females) were studied between January 1996 and December 2005. Diagnosis was based on a clinical assessment and serum acetylcholinesterase (AChE) level at the time of hospital admission. The severity of OPP was assessed using the grading system of Bardin et al. The duration and dosage of atropine and palidroxime were recorded. All the biochemical data were analyzed. Sixty-one of the patients had attempted suicide and 14 patients had accidental exposure. The overall mortality rate was 8%. Muscarinic effects were observed in 66 (88%) of the OPP patients and the most frequent symptom was bronchial hypersecretion (52%). Among these three different severity groups, prolonged length of stay, higher infection rates, and higher mortality were found in the life-threatened group. The initial serum C-reactive protein (CRP) level was strongly correlated to the severity grading of the OPP. Nearly half of the patients were admitted to the intensive care unit (ICU) and, of this, 21 patients developed respiratory failure within 72 hours. Low serum AChE levels support the diagnosis of OPP, but no significant association was found between the severity of OPP and serum AChE levels. The grading system of Bardin et al is very helpful for physicians to facilitate the recognition of seriously poisoned subjects, and to permit their early admission to an ICU. Initial serum CRP, an acute phase reactant, had significant value in assessing the severity of the OPP. Although the management of acute OPP is supportive and the recovery rate is high, anti-cholinergic therapy should be used as soon as possible to counteract muscarinic effects. Physicians must be aware of the potential dangers of respiratory failure, which could occur within 72 hours of OPP.