Serum Cholinesterase Activity Research Articles

The Role of Brain Methamidophos in Acephate Poisoning in Mice.

We gave mice a 540 mg/kg dose of LD50 acephate, followed by an assessment of acephate, methamidophos (MP), and choline esterase (ChE) activity for up to 4 hours (hr) in order to investigate the time course of acephate intoxication. At 1 hr, the blood acephate and MP levels were 428 ± 90 µg/ml (mean ± SEM) and 4.2 ± 0.4 µg/ ml, respectively. The liver acephate levels were similar to those in the blood, but the liver MP levels were approximately 3.5 times that of the blood at 1 hr. The brain MP level tended to be higher than the blood MP at 1 hr. These levels decreased gradually over 4 hr, but the brain acephate and MP levels surpassed the blood levels significantly at 4 hr, and after 2 hr, respectively. Serum, liver, cerebrum, cerebellum, and brainstem cholinesterase activity (ChE) were inhibited at 1 hr, and remained inhibited in all but the cerebellum until the end of the experiment. The obtained data were applied to previously reported autopsy cases of acephate intake. Experimental data suggest that brain MP is involved in acute acephate-induced poisoning, even after a reduction in blood acephate. In autopsy cases with suspected acephate poisoning, the MP level in the brain should be considered in addition to the ChE activity to diagnose the cause of death.

Factors affecting the recovery of cholinesterase activity in patients with acute chlorpyrifos poisoning

Objective: To investigate the related factors affecting the recovery of cholinesterase (ChE) activity in patients with acute chlorpyrifos poisoning. Methods: In February 2020, the clinical data of acute chlorpyrifos poisoning patients admitted in our hospital from January 2016 to December 2019 were retrospectively analyzed. The outcome variable was the time of ChE activity recovered to 50% lower limit of normal value, and multivariate linear regression analysis was performed to explore its influencing factors. Results: A total of 78 patients, 43 males and 35 females, with an average age (39.58±14.77) years were enrolled in this study. The average time of serum ChE activity recovered to 50% lower limit of normal value was (24.45±2.64) days. There was a correlation between hemoperfusion (r=-0.644) , atropine dosage (r=0.498) , chlorophosphorus dosage (r=0.432) and the time of serum ChE activity recovered to 50% lower limit of normal value, in which hemoperfusion was significantly negatively correlated with the time of serum ChE activity recovered to 50% lower limit of normal value (β=-4.222, P<0.05) . Conclusion: The recovery of serum ChE activity in patients with acute chlorpyrifos poisoning is very slow. Hemoperfusion can quickly remove chlorpyrifos, its metabolites and inflammatory mediators in the blood, thus effectively promoting the recovery of ChE activity.

Sensitive detection of butyrylcholinesterase activity based on a separation-free photothermal assay

Butyrylcholinesterase (BChE), a regulator for the cholinesterase activity in serum, is an important index for clinical diagnosis of organophosphorus poisoning and liver related disease. However, the assays for BChE activity are highly dependent on expensive and bulk equipment and professional operators, which limits its straightforward and portable detection. In this work, we proposed a straightforward and sensitive photothermal assay for the detection of BChE activity, avoiding the use of expensive instrument, professional operators, and separation process. Polydopamine (PDA) nanoparticles can be produced through the oxidation of dopamine by MnO2 nanosheets, which show a rather strong photothermal features. Hydrolyzation of substrate into thiocholine and butyrate happens after introducing BChE. The generated thiocholine and butyrate inhibit the formation of PDA nanoparticle through reducing MnO2 into Mn2+ and creating an acidic environment, respectively. Those effects lead to the decreasing of photothermal efficiency of the reaction system, resulting in the decreasing on temperature change. Quantitative detection of BChE activity is achieved by recording the temperature change of system, using a common device, with a limit of detection of 40.65 U/L calculated. The presented results provide a clue for developing straightforward and portable photothermal assay for BChE, which shows great potential for their clinical applications.

Impacts of Titanium Dioxide Nanoparticles on Serum Parameters and Enzyme Activities of Clarias gariepinus.

Impacts of titanium dioxide nanoparticles (TiO2 NPs) on serum glucose, albumin, total protein, cholesterol, triglyceride, sodium (Na+), potassium (K+), and chloride ion (Cl-) levels and serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and cholinesterase (ChE) activities of Clarias gariepinus were determined after exposing the fish to 1, 5 and 10mg/L titanium applied as TiO2 over 1, 4 and 7days. No mortality was observed during the experiments. Serum glucose and albumin levels increased while serum total protein, cholesterol and triglyceride levels decreased compared to control at the end of the 7th day. Serum Na+, K+ and Cl- levels of C. gariepinus decreased after 7days of exposure to 10mg/L TiO2 NPs. ChE activity decreased and AST, ALT, ALP activities increased at all exposure concentrations and LDH activities increased compared to control after 4 and 7days of exposure to TiO2 NPs in C. gariepinus.

The value of sepsis biomarkers and their kinetics in the prognosis of septic shock due to bacterial infections.

In this study, we aim to explore the value of procalcitonin (PCT), C-reactive protein (CRP), and serum cholinesterase (SChE) activity kinetics as useful predictors of mortality in patients with septic shock admitted to the intensive care unit (ICU). We conducted aprospective single-blinded study in the ICU of auniversity hospital during aperiod of 1 year. Were included all patients 18 years of age or older, with confirmed septic shock. For all included patients, blood samples of septic biomarkers (PCT, SChE activity, and CRP) were obtained. Serum was collected at the day of ICU admission (day 0), the day of septic shock (day 1), then 3 and 5 days after the septic shock development. During the study period, 60 patients were included. The mean age (± SD) was 47.7 ± 19 years. There were 46 male (74%) and 14 female (26%) patients. Mean SAPSII on ICU admission was 40.7 ± 16 (median: 37), and mean SOFA score on ICU admission was 16 ± 4 (median: 7). During their ICU stay, out of the 60 included patients, 37 patients died (61%). The comparison between the 2 groups (deaths and survivors) showed that the factors associated with poor outcome were age, SOFA score on ICU admission, and the need for invasive mechanical ventilation. The day of septic shock, there was no difference in the mean concentrations in those of plasma SChE activity or in the PCT and CRP plasma between survivors and non-survivors. However, the comparison of mean plasma SChE activity, and PCT and CRP plasma concentrations (on day 3 and day 5) between survivors and non-survivors, showed asignificant difference between the 2 groups. Our study suggests that, in agroup of critically ill patients with severe septic shock, arise or no change in procalcitonin and/or CRP level, and/or adecrease or no change in SChE activity should warn the clinician about the insufficiency and/or inadequacy of the therapy. However, afall in procalcitonin and/or CRP levels, and/or arise in SChE activity were associated with afavourable prognosis. Based on our study and some other data detailed above, we recommend that an estimation of SChE acti-vity, procalcitonin, and CRP on the day of septic shock, followed by estimation within the next 72-120 h, could help the prognostic assessment of critically ill patients with septic shock. Further studies are needed to define the critical values related to mortality.

Decreased Serum Cholinesterase Activity- A Reliable Diagnostic Aid for Tuberculosis

Introduction: Siderophore, the low molecular weight ferric iron chelator, is secreted extracellularly by Mycobacterium tuberculosis, an obligate aerobe. The pathogenic mycobacteria need iron as co-factor for the extracellularly secreted enzyme Superoxide Dismutase (SOD) for its pathogenicity as well as it requires iron for its metabolic functions like reduction of oxygen for synthesis of Adenosine Triphosphate (ATP), etc. The termination of impulse conduction is endorsed by the rapid hydrolysis of Acetylcholine (ACh) by Acetylcholinesterase (AChE) in the central as well as peripheral nervous system (cholinergic pathway). The inhibitors to Cholinesterase (ChE) might lead to accumulation of ACh, hyper stimulation of nicotinic and muscarinic receptors and also disruption of neurotransmission. Possibility of an inhibitor substance for AChE in Tuberculosis (TB) patients interestingly correlates with the symptom of night sweating in those subjects. Aim: To assay the level of serum ChE in normal control, lung disease control and tubercular subjects;circumvent the serum ChE level as a diagnostic potential in TB at an early stage. Materials and Methods: The study was conducted on total 124 subjects, and were divided into three groups: Group 1: normal control (n=31), Group 2: lung disease control (n=31) and Group 3: patients suffering from TB {3A: pulmonary TB (n=31) and 3B: extrapulmonary TB (n=31)}. Serum ChE activity for all the subjects were measured according to the method of Hestrin S. Serum ChE level was assayed for group 3 subjects after additional one month’s anti-TB drug treatment and also for group 2 subjects after one month with usual treatment. The level of significance was assessed using Student’s t-test. Results: There was a significant inhibition of serum ChE activity in both pulmonary and extrapulmonary TB patients in comparison to that of in normal control as well as lung disease control subjects (p&lt;0.01). With the anti-tubercular drug therapy for one month, there was significant recovery in the serum ChE activity in pulmonary as well as extrapulmonary tubercular subjects (p&lt;0.01). Conclusion: It appears that the high level of hydroxamate type of siderophores (secreted by Mycobacterium tuberculosis for acquiring iron) might form ACh ferric hydroxamate complex binding more strongly with serum ChE resulting in inhibition of serum ChE activity in tubercular subjects. With anti-tubercular drug therapy, there was decrease in serum ACh ferric hydroxamate complex level resulting in recovery of serum ChE activity.

Outbreak of organophosphorus compound-induced delayed neurotoxicity in water buffaloes

ABSTRACT: Forty 1-2-y-old water buffaloes were simultaneously treated with trichlorfon and chlorpyrifos products in the recommended dose for cattle. After a week, 19 animals started presenting clinical signs characterized by apathy, diarrhea, aggressiveness, dehydration, and motor incoordination, followed by flaccid paralysis and permanent lateral recumbency. All affected buffaloes died after a clinical course of 1-4 days. Reduction of serum cholinesterase activity in three cases was indicative of significant exposure to organophosphorus compounds (OPs). Pathological examination of three buffaloes revealed no gross and histological lesions. By thin layer chromatography, chlorpyrifos residues and trace of trichlorfon residues were detected in fresh tissue samples. The epidemiological, clinical, pathological, and toxicological findings were highly compatible with OPs-induced delayed neurotoxicity, a neurological manifestation rarely described in domestic animals.

Токсикодинаміка за сумісної дії хлорпірифосу та івіну при тривалому надходженні до організму

The combined action of pesticides is one of the problems of toxicology, because in comparison to individual active substances, their mixtures can increase toxicity and delayed action effects, which is a risk to human health. It is known that plant growth regulators (PGR) when applied together with pesticides help to reduce the quantitative rates of pesticides applied, the accumulation of pesticides and heavy metals in plants, reduce the acute toxicity of xenobiotics. The combined effect of the prolonged admission of PGRs and pesticides is an unexplored area, and it is an important issue in preventive toxicology. The Aim of the Research. Determination of the nature of toxic effects of Chlorpyrifos and “Ivin” combined action at subchronic oral admission. Materials and Methods. Chlorpyrifos and PGR “Ivin” (2.6-dimethyl-N-pyridine oxide) combined action was studied on male Wistar Han rats. Substances were administered orally, via a feeding tube for 13 weeks; Chlorpyrifos was administered in the form of an aqueous emulsion with an auxiliary material OP-10 at a dose of 5 mg/kg (1/15 LD50), “Ivin” — in the form of an aqueous solution at a dose of 13 mg/kg and 0.013 mg/kg (1/100 and 1/100000 LD50 respectively), the control group of rats was given water with an auxiliary material OP-10. Signs of intoxication were recorded, body weight was measured in 4, 9 and 13 weeks, biochemical indicators of blood serum were determined (the activity of ALT and AST enzymes and alkaline phosphatase; the content of crude protein, urea, cholesterol, triglycerides and glucose were determined using kits of reagents by BioSystems (Spain); cholinesterase (ChE) activity in serum, red blood cells and brain tissue was determined with the use of methodology by Hesrtin S. using a kit of reagents produced by LLC NPP Filisit-Diagnostics (Ukraine). Results. No clinical signs of intoxication were detected in the experimental groups of rats. Under the isolated use of Chlorpyrifos a significant decrease in body weight, ChE inhibition activity in all bio substrates, with the greatest effect in the brain (by 48.8%); increase (after 9 and 13 weeks) in the activity of ALT and AST by 26.7–32.6%, 12.5–12.0%; a slight but a significant increase in the level of urea and glucose in blood serum to 17.3% and 17.6 %, respectively was detected. Under the combined action of Chlorpyrifos and “Ivin” in specified doses the body weight of rats was at control level, decrease of ChE activity was observed in all biological substrates and was at nearly the same level with the isolated use of Chlorpyrifos. There was a tendency towards the decline in ChE inhibition activity in brain tissue, and under the combined action of Chlorpyrifos with “Ivin” at higher doses after 4 weeks this effect was a significant (22.15%, p &lt; 0.05). Conclusions. Chlorpyrifos under the isolated oral admission for 13 weeks has a weak hepatotoxic effect, as evidenced by the increase in cytolysis enzymes and urea levels in serum and causes a moderate anticholinesterase effect. “Ivin” under combined with Chlorpyrifos admission to the organism eliminates the hepatotoxic effects of Chlorpyrifos and reduces its anticholinergic effects in brain, which contributes to a less severe intoxication. Key Words: Chlorpyrifos, Ivin, hepatotoxic effect, anticholinesterase effect.

Point-of-care measured serum cholinesterase activity predicts patient outcome following severe burns

Risk stratification is of utmost importance in burn therapy. However, suitable bedside biomarkers to evaluate the emerging inflammatory response following burn injuries are missing. Serum cholinesterase (butyrylcholinesterase, BChE) has been shown to be a clinically relevant biomarker in acute inflammatory diseases including burns.In this observational cohort study BChE activity was measured by using point-of-care testing (POCT), a novel method in acute burn care. POCT measurements were performed at emergency room admission (ERA) of 35 patients and repeated 12, 24 and 48 h later. All patients or their legal designees gave informed consent.Patients with burn injuries showed sustained BChE activity reduction following hospital admission. BChE activity correlated negatively with burn injury severity, organ failure severity and intensive care unit resource requirements. BChE activity measured at ERA and 12 h later identified survivors and predicted 28-day patient outcome with noninferior efficacy compared to the abbreviated burn severity index (ABSI) scoring. Finally, POCT-measured BChE activity might complement ABSI scoring and possibly improve early risk stratification in acute burn care therapy.

The Cholinergic Profile as a Target for Rational Therapy of Central Nervous System Diseases and Injuries

Objective. To conduct a comparative analysis of the clinical efficacy of cholinergic drugs and acetylcholinesterase inhibitors and their combinations in the complex therapy of cerebrovascular pathology and the sequelae of closed craniocerebral trauma (cCCT) using clinical, instrumented, and laboratory follow-up investigations. Materials and methods. A total of 90 patients with cerebrovascular pathology (chronic cerebral ischemia grade 2 (I67; 45 patients) and the sequelae of cCCT (T90; 45 patients) were studied. Groups were divided into three subgroups each of 15 patients. Complex treatment included basal and specific therapy: subgroup 1 received the drug Neuromidin, group 2 received Gliatilin, and group 3 received Neuromidin plus Gliatilin. Treatment duration was two months. All patients underwent complex clinical, neurophysiological, and laboratory investigations before treatment and at one and two months from treatment initiation: plasma cholinesterase activity was estimated, patients were tested on the Mini Mental State Examination (MMSE) and the Hamilton scale, and patients underwent transcranial magnetic stimulation with assessment of the central motor conduction time and evaluation of somatosensory evoked potentials with determination of the central afferent conduction time. Results. Before treatment, a strong positive correlational relationship was found between patients’ age and serum cholinesterase activity (Rs = 0.77; p = 0.0001). On the background of treatment, all study parameters showed significant (p < 0.05) improvements with the exception of the MMSE, which showed only a trend to improvement) in subgroups 1 and 3 of each group as compared with values obtained in subgroups 2 of the corresponding groups. In addition, at two months from treatment initiation, there were significant decreases in serum cholinesterase activity in patients of subgroups 1 and 2. Conclusions. Assessment of deviations in the “cholinergic profile” (blood cholinesterase activity) in patients with cerebral pathology and the strategy of using cholinergic drugs and acetylcholinesterase inhibitors and their combination to correct psychoneurological disorders is among the most important directions in optimizing the combined treatment of patients of this category.

In Situ Generation of Prussian Blue by MIL-53 (Fe) for Point-of-Care Testing of Butyrylcholinesterase Activity Using a Portable High-Throughput Photothermal Device.

Butyrylcholinesterase (BuChE), the primary source of serum cholinesterase activity, is an indispensable biochemical marker for clinical diagnosis of liver function and organophosphorus poisoning. The requirement for bulky and expensive instruments represents a huge hindrance for point-of-care testing (POCT) of BuChE, especially in resource-limited settings. Herein, an easy-operated, economic, and portable photothermal (PT) biosensing platform for high-throughput BuChE detection was rationally designed. BuChE could "light up" the PT signal through in situ generation of Prussian blue (PB) by MIL-53 (Fe), which allowed us to translate biological signals into temperature signals. Such temperature change signals could be monitored at high throughput (six samples for a single measurement) by a miniature self-made integrated PT device via combining separable 96-well plates, a three-dimensional (3D) printed sample bracket, 808 nm lasers, and thermometers, satisfying the requirement for rapid on-site detection in a large batch with low cost. In addition, the large specific surface area, 3D network structure, and high porosity of MIL-53 (Fe) offered a beneficial platform for its reaction with enzymatic hydrolysate, resulting in high sensing sensitivity and low detection limit (0.3 U L-1), which was at least 20 000 times lower than the normal human serum BuChE activity. This facile, affordable, and broad applicability PT sensing platform provides a beneficial reference for the rational design of other disease diagnostic approaches suitable for POCT.

Blood acetylcholinesterase activity is associated with increased 10 year all-cause mortality following coronary angiography

Background and aimsParasympathetic dysfunction is associated with increased risk for major adverse cardiovascular events (MACE). However, clinically validated biomarkers that reflect parasympathetic activity are not yet available. We sought to assess the ability of serum cholinesterase activity to predict long term survival in patients undergoing coronary angiography. MethodsWe prospectively followed 1002 consecutive patients undergoing clinically indicated coronary angiography (acute coronary syndrome or stable angina). We measured blood acetylcholinesterase (AChE) activity using the acetylcholine analog acetylthiocholine. Mortality rates were determined up to 10 years of follow-up. We divided our cohort into 3 groups with low, intermediate and high AChE activity by a Chi-square automatic interaction detection method (CHAID). ResultsPatients with lower than cutoff levels of AChE (<300 nmol/min/ml) had higher mortality rates over 10 years of follow-up, after adjusting for conventional risk factors, biomarkers, clinical indication, and use of medications (HR = 1.6, 95% CI 1.1–2.5, p = 0.02). Patients with intermediate levels of AChE (300–582 nmol/min/ml) were also at increased risk for death (HR = 1.4, 95% CI 1.1–1.9, p = 0.02). AChE was inversely correlated with C-reactive protein, troponin I, fibrinogen and neutrophil/lymphocyte ratio levels. ConclusionsPatients presenting for coronary angiography with low levels of serum AChE activity are at increased risk for death during long term follow-up.

CYP2D6 (G1934A) Gene Polymorphism in Rice Farmers with Long-term Pesticide Exposure, Suphan Buri, Thailand

CYP2D6 G1934A (rs 3892097) gene polymorphism in coding region is leads to catalytic rate of cytochromeP450 enzyme activity toward xenobiotic, including insecticide. Study was aimed to investigate CYP2D6(G1934A) gene polymorphism in rice farmers along with occupational health risks and behaviors; and toevaluate the relationship of gene polymorphisms and serum cholinesterase (SChE) levels. Cross-sectionalstudy was carried out from June 2019 to February 2020. Data had collected from health service programby U-Thong district health promoting hospital. Gathered information concerning of pesticide exposuresfrom 50 rice farmers and 50 control respondents was conducted by questionnaire interviewing. Eachserum sample was determined SChE activity test by paper test and automatic analyzer; and EDTA bloodwas analyzed genotyping by PCR-RFLP. Chi-square was used to analyze on the different of personalinformation; and of polymorphism. Person correlation was evaluated relationship between SChE level andgenotypes. 60% of rice farmers were used pesticide over 10 years. Means of SChE level of both groupswere within reference value and significantly different (p = 0.033). Polymorphisms were included wild type(GG), heterozygote (GA) and homozygote (AA); and were significantly different between rice farmers andcontrol (p = 0.0001). GA genotype in rice farmers was more frequent and AA genotype was not detected.Relationship of polymorphism and SChE level were negative correlated (r = -0.258; p = 0.009). CYP2D6gene polymorphism may useful biomarker for duties assignments in agricultural workers especially riskgroup (GA genotype).

PON1 Q192R Gene Polymorphism and Pesticide Exposure Status of Rice Farmers, Suphan Buri, Thailand

PON1 Q192R (rs662) polymorphism in coding region is conveying differential catalytic activity oforganophosphate. Study was aimed to investigate PON1 Q192R gene polymorphisms in rice farmers alongwith pesticide knowledge and practices; and to evaluate the relationship of gene polymorphisms and serumcholinesterase (SChE) levels. Information of pesticide exposure, knowledge and practices were collectedfrom 50 rice farmers and 50 control respondents by questionnaire interviewing. Each blood sample wasobtained by venipuncture and prepared to serum for SChE activity test by paper test and automatic analyzer;to EDTA blood for genotyping by PCR-RFLP. Exposure status, knowledge and practices on pesticide usewere represented as frequency. Chi-square was used to analyze on the different of personal information;and of polymorphism. Independent t-test was used for comparison of SChE levels. Person correlation wasevaluated relationship between SChE level and genotypes. 60% of rice farmers were used pesticide over10 years. Rice farmers were long-term pesticide exposure with good on pesticide knowledge, howeverpoorly practice. Means of SChE level of both groups were within reference value and significantly different(p = 0.033). Polymorphisms were included wild type (QQ), heterozygote (QR) and homozygote (RR);and were significantly different between rice farmers (high frequency of RR genotype) and control (p =0.02). Relationship of polymorphism and SChE level were negative correlated (r = -0.261; p = 0.031). Thispolymorphism may useful biomarker for chronic pesticide exposure in Thai rice farmer and corresponded todecline of serum cholinesterase; and RR genotype was high risk group.

Simple Colorimetric Method for Cholinesterase-inhibitor Screening in Gastric Content by Using Phytoesterase Enzyme from Kidney Bean.

Diagnosis of cholinesterase inhibitor insecticide ingestion is based on clinical suspicious and should be confirmed by cholinesterase essay. However, serum cholinesterase activity test requires specific instruments and procedure. This study aimed to develop simple colorimetric test to detect cholinesterase inhibitors in the gastric content, using phytoesterase and alpha naphthyl acetate as a chromogenic substrate. Methomyl and chlorpyrifos were selected for the phytoesterase enzyme inhibition assay. The experiment was conducted using pooled insecticide-free gastric content sample from ten cadavers. The gastric content samples were prepared by simple filtration procedure or liquid-liquid extraction procedure with dichloromethane or ethyl acetate. The inhibitor concentrations measured by the developed phytoesterase enzyme inhibition assay were compared with those analyzed by the LC-MS/MS and the GC-FPD. Different sample preparation procedures, sensitivity and specificity and specificity of the test were investigated. Sample extracted with dichloromethane reduced the effect of matrix in gastric content as same as ethyl acetate. The developed color test method of detection showed 56.52% sensitivity and 100% specificity for methomyl, 100% sensitivity and 96.30% specificity for chlorpyrifos. The limit of detection of the assay was 422.6 ng mL-1 for methomyl and was 339.8 ng mL-1 for chlorpyrifos. This developed method could be used an alternative diagnostic test for methomyl and chlorpyrifos self-ingestion.

Effects of paper wasp (Polistes flavus) venom toxins on lactic dehydrogenase (LDH) and acetyl cholinesterase (AChE) activity in blood serum, liver and muscles of albino mice

In the present investigation, in vivo effects of wasp toxin were evaluated on lactic dehydrogenase (LDH) and acetyl cholinesterase (AChE) enzyme activity in serum, liver and gastrocnemius muscles of albino mice. A significant elevation was observed in LDH activity in serum, liver and muscles, while the activity of AChE was decreased in serum, liver and gastrocnemius muscles of albino mice after injected the sub lethal dose of Polistes flavus venom. Increase in the activity of LDH shows liver damage, massive disintegration and necrosis of hepatic cells and leakage of the enzyme into the circulation. High LDH level causes intense stress and hypertension and did a significant increase in the rate of oxidation in animals. Therefore, elevation in LDH level increases the glucose catabolism for energy production especially in anaerobic condition. Besides this, increased level of LDH in muscle and liver cells shows insufficient oxygen supply. In experimental animals accumulation of acetylcholine may lead to prolonged activation of acetylcholine receptors and a permanent stimulation of nerves and muscle cells resulting in muscular paralysis and finally imposed death in experimental animals. Contrary to this, in vitro study of wasp venom toxins directly affected the lactic dehydrogenase activity while the venom toxin of the Polistes flavus not directly affects the acetyl cholinesterase in the serum of the albino mice.

Effects of paper wasp (Polistes flavus) venom toxins on lactic dehydrogenase (LDH) and acetyl cholinesterase (AChE) activity in blood serum, liver and muscles of albino mice

Effects of paper wasp (Polistes flavus) venom toxins on lactic dehydrogenase (LDH) and acetyl cholinesterase (AChE) activity in blood serum, liver and muscles of albino mice

Nerve conduction study as a diagnostic tool in atypical presentation of accidental organophosphorus poisoning

Poisoning with organophosphorus (OP) compounds is a worldwide phenomenon. However, atypical presentation of OP toxicity, particularly when there is a paucity of muscarinic manifestations, can be a diagnostic challenge. We report a patient with atypical symptoms where exposure to OP poison was not clearly determined. Motor nerve conduction studies done to rule out acute motor neuropathy revealed that a single supramaximal stimulus-evoked repetitive compound motor action potentials. As this finding is the earliest and most sensitive indicator of acetylcholine esterase inhibition, OP poisoning was suspected. Decreased plasma acetylcholinesterase levels confirmed the diagnosis. The patient recovered completely with treatment. Although the diagnostic hallmark of OP poisoning is a reduction in serum and red blood cell cholinesterase activity, clinicians should be alert to recognize evidence of neuromuscular transmission failure seen on nerve conduction study to diagnose atypical or concealed cases of OP poisoning.

‘Role of Serum Cholinesterase and 5-Nucleotidase Enzyme Activity in the Diagnosis of Alcoholic and Non-Alcoholic Liver Disease and Compared With Healthy Subjects of Rajasthan’

‘Role of Serum Cholinesterase and 5-Nucleotidase Enzyme Activity in the Diagnosis of Alcoholic and Non-Alcoholic Liver Disease and Compared With Healthy Subjects of Rajasthan’

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.