Ingestion Of Substances Research Articles

The environmental impact on aging: Insights from buccal mucosa and molecular biomarkers

Buccal epithelial cells serve as a primary barrier against the inhalation and ingestion of harmful substances, working alongside immune system cells such as natural killer cells to protect the body from health-damaging factors. These epithelial cells can also be used as an alternative tissue source for monitoring the genotoxic effects of external factors such as chemical exposure. This assessment can be performed using molecular biomarkers of aging, which reflect biological age and indicate cellular aging acceleration due to internal and external damage factors, such as environmental hazards. In contrast to chronological age, which merely reflects the passage of time, biological age accounts for individual variation in aging processes. Molecular biomarkers are crucial for distinguishing between normal and pathological processes in the body and for identifying the effects of external factors such as chemical exposures. The identification of specific biomarkers enhances the ability to detect and monitor adverse biological responses and accelerated aging. This review aims to highlight the routes through which environmental hazards enter the body, the application of buccal epithelial cells in assessing genetic modifications, and the introduction of potential molecular biomarkers. However, further research is necessary to elucidate the roles of these biomarkers in determining aging rates and individual variability. Understanding their implications may also help identify new therapeutic targets for preventing premature aging, treating age-related diseases, and developing potential treatments.

Affect heuristics and peer effect on substance use among adolescents in Brazil

Significant changes are observed during adolescence with respect to health-related habits and risky behaviors. Among the behavioral changes, the consumption of substances such as alcoholic beverages, cigarettes, and illicit drugs, and social interactions are relevant factors for the intake of such substances. This study aims to analyze the relationship between the joint decisions of substance use by adolescents and their peers from the perspective of the affect heuristics. To this end, a multivariate probit model was estimated, based on microdata from the 2019 National School Health Survey. The results showed that substance use by adolescents was positively related to substance use by their peers; therefore, having friends who consume alcohol, illicit drugs, and cigarettes or having parents who consume alcohol or cigarettes increases the likelihood of an adolescent consuming these substances. The study also identified that the substance consumption decision was governed by an unobserved common factor compatible with the affect heuristic.

CHARACTERISTICS OF WORKPLACE AGGRESSION IN MEDICAL PRACTICE

Purpose: To study and analyze the presence of aggression in the workplace among medical professionals in emergency departments. Material/Methods: The study included 227 medical and non-medical personnel from emergency units in the Varna region. Documentary, sociological, and statistical methods are applied. The study was carried out in 2023. Results: A large proportion of emergency workers were the object of aggression from patients or their relatives during work (84.1%, n=191). The object of aggression is the employees in the age group of 51-65 years (35.2%, n=80). More often, aggression is verbal aggression. Doctors and nurses are the object of aggression more often than other categories of staff. Aggression leads to a decrease in the pace of work, intention to leave the workplace, etc. Negative emotional reactions to the intake of alcohol or narcotic substances are among the reasons leading to aggression of the patient or his relatives. Conclusion: The professional activity of medical specialists is related to mental and physical stress. Violence in the workplace is a prerequisite for stress and anxiety. It adversely affects workers.

Comparison of Clinical Observation and Upper GI Endoscopy in Corrosive Substances Ingestion: A Randomized Controlled Trial

Comparison of Clinical Observation and Upper GI Endoscopy in Corrosive Substances Ingestion: A Randomized Controlled Trial

Epidemiological Study of Pediatric and Adolescent Poisoning Cases in a Rural Tertiary Care Centre in South India

Pediatric poisoning covers the entire spectrum of cases from accidental ingestion in toddlers to intentional abuse in teenagers. Epidemiological surveillance of oral ingestion of poisonous substances in children and adolescents in a particular area is necessary to determine the extent and characteristics of the problem, according to which related preventive measures can be taken. This was a retrospective, observational study including all pediatric poisoning patients (between the age of 0 to 19 years) received at the Trichy SRM Medical college & Research Centre, Irungalur, Trichy during the 2 year period from May 2021 to April 2023. A total of 52 cases were received in the casualty department of our hospital during the study period. Out of this, Male patients were predominant (53.85%). Most of the cases belonged to the age group between 16- 19 Years . Most of the cases were from the Rural areas (82.69%).Accidental Poisoning (61.54%) is more common followed by suicidal poisoning (38.46%). The substances involved in Poisoning are Kerosene(19%),Rat Killer (10%), Paracetamol(10%), Oleander(8%), ant-killer (8%), Organo-phosphorus Poisoning(6%) among many others. Most of the time the poisoning happened inside Home(65%) followed by area surrounding home(17%). Oral route (88%) was the most common way of taking poison. Most cases took less than 4 hours (71%) to reach the hospital. Vomiting was the most common symptom in most of the cases. 23 cases (44%) were requiring intensive care of which only 8 cases (15%) needed more than 3 days of ICU care.

7886 Impact of Withania somnifera (Ashwagandha) Supplement on Androgen Signalling Pathways

Abstract Disclosure: I.S. Barata: None. J. Yakubu: None. T. Du Toit: None. A.V. Pandey: None. Supplements derived from plant extracts are often used as alternatives to pharmaceutical drugs. These products are often perceived as safe despite the absence of scientific evidence regarding their efficacy and safety and are less strictly regulated than pharmaceutical products. Winter cherry (Withania somnifera, commonly known as ashwagandha) is used as a testosterone booster supplement in multiple countries. Withania somnifera extract was found to increase testosterone and androgen precursors in a small clinical study. However, there is a lack of data regarding effects of Withania somnifera on the steroidogenic pathways. Steroidogenesis impacts not only sexual differentiation, reproduction, and fertility but also other physiological processes, including hypertension and obesity. Moreover, the modulation of hormone signaling is an important target in hormone-responsive pathogenesis, and overproduction of androgens has been implicated in the pathogenesis of prostate cancer (PCa) and polycystic ovarian syndrome (PCOS). In humans, testosterone is mainly produced in the testes after conversion of pregnenolone to 17-hydroxypregnenolone (17-OHPreg) and dehydroepiandrosterone (DHEA, the precursor of androgens) by adrenal CYP17A1, which catalyzes both the 17-hydroxylation of steroids for cortisol production and the breakage of 17,20 bonds (17,20 lyase) in 17-OHPreg to produce DHEA. The intake of substances that may increase androgen levels by people with PCa or PCOS or with predisposition to these conditions may trigger pathogenesis or worsen prognosis by accelerating disease progression. We investigated the effects of Withania somnifera in modulating the adrenal steroidogenic pathway and the possible consequences on the pathogenesis of androgen-responsive conditions, specifically PCa. Adrenal cells were treated with the extract of Withania somnifera to characterize its effect on adrenal steroid profile and CYP17A1 hydroxylase and lyase activities. Prostate cancer proliferation was assessed by direct incubation of prostate cancer cells with extracts as well as with conditioned media from adrenal cells treated for 48h, to simulate natural steroidogenesis. The results suggest that adrenal steroid hormone biosynthesis can be altered by the intake of Withania somnifera extract and that this supplement may affect proliferation of PCa cells. Moreover, the reported testosterone booster effect of Withania somnifera supplementation does not appear to be through increased adrenal androgen production. Presentation: 6/1/2024

7886 Impact of Withania somnifera (Ashwagandha) Supplement on Androgen Signalling Pathways

Abstract Disclosure: I.S. Barata: None. J. Yakubu: None. T. Du Toit: None. A.V. Pandey: None. Supplements derived from plant extracts are often used as alternatives to pharmaceutical drugs. These products are often perceived as safe despite the absence of scientific evidence regarding their efficacy and safety and are less strictly regulated than pharmaceutical products. Winter cherry (Withania somnifera, commonly known as ashwagandha) is used as a testosterone booster supplement in multiple countries. Withania somnifera extract was found to increase testosterone and androgen precursors in a small clinical study. However, there is a lack of data regarding effects of Withania somnifera on the steroidogenic pathways. Steroidogenesis impacts not only sexual differentiation, reproduction, and fertility but also other physiological processes, including hypertension and obesity. Moreover, the modulation of hormone signaling is an important target in hormone-responsive pathogenesis, and overproduction of androgens has been implicated in the pathogenesis of prostate cancer (PCa) and polycystic ovarian syndrome (PCOS). In humans, testosterone is mainly produced in the testes after conversion of pregnenolone to 17-hydroxypregnenolone (17-OHPreg) and dehydroepiandrosterone (DHEA, the precursor of androgens) by adrenal CYP17A1, which catalyzes both the 17-hydroxylation of steroids for cortisol production and the breakage of 17,20 bonds (17,20 lyase) in 17-OHPreg to produce DHEA. The intake of substances that may increase androgen levels by people with PCa or PCOS or with predisposition to these conditions may trigger pathogenesis or worsen prognosis by accelerating disease progression. We investigated the effects of Withania somnifera in modulating the adrenal steroidogenic pathway and the possible consequences on the pathogenesis of androgen-responsive conditions, specifically PCa. Adrenal cells were treated with the extract of Withania somnifera to characterize its effect on adrenal steroid profile and CYP17A1 hydroxylase and lyase activities. Prostate cancer proliferation was assessed by direct incubation of prostate cancer cells with extracts as well as with conditioned media from adrenal cells treated for 48h, to simulate natural steroidogenesis. The results suggest that adrenal steroid hormone biosynthesis can be altered by the intake of Withania somnifera extract and that this supplement may affect proliferation of PCa cells. Moreover, the reported testosterone booster effect of Withania somnifera supplementation does not appear to be through increased adrenal androgen production. Presentation: 6/1/2024

2,4-dinitrophenol intoxication and its morphological findings as an indication of substance intake

Lethal intoxications can only very rarely be recognized during an external examination of corpses, as poisoning does not leave any characteristic findings on the deceased. The present study is a retrospective review on 2,4-dinitrophenol (2,4-DNP) intoxications in human subjects from the beginning of the 20th century until today, as well as a case report on a fatal intoxication of a 50-year old obese man in Rostock (Germany) and an introduction for toxicological analysis in post-mortem specimens of the substance ingested in these rare cases.Via selective literature search, the information on occurrence and localization of abnormal pathomorphological external and/or internal findings in cases of 2,4-DNP ingestion/ intoxication was gathered. By 2021, a total of 13 case reports with information on morphological findings due to 2,4-DNP ingestion/intoxication were found. The external findings were dominated by yellowing of the skin, followed by exanthemas/rashes and yellowing of the sclera. The internal findings included yellowing of the internal organs, yellow color of the stomach contents, yellowing of the mucous membranes and an intense yellow color of the urine. Yellowish discoloration of the skin, sclera, mucous membranes, internal organs, sweat and/or an intensive yellow discoloration of the urine are not observed in every 2,4-DNP intoxication. However, when they do occur, they are a characteristic indication of 2,4-DNP ingestion and, if localized to the skin, indicate prolonged consumption. A fatal case from Rostock in 2016 due to prolonged intake of 2,4-DNP for weight loss is exemplified. A simple, fast and cost-effective workup combined with HPLC-DAD for post-mortem toxicology ultimately delivers reliable analysis results.

Development of an evaluation method for addictive compounds based on electrical activity of human iPS cell-derived dopaminergic neurons using microelectrode array.

Addiction is known to occur through the consumption of substances such as pharmaceuticals, illicit drugs, food, alcohol and tobacco. These addictions can be viewed as drug addiction, resulting from the ingestion of chemical substances contained in them. Multiple neural networks, including the reward system, anti-reward/stress system and central immune system in the brain, are believed to be involved in the onset of drug addiction. Although various compound evaluations using microelectrode array (MEA) as an in vitro testing methods to evaluate neural activities have been conducted, methods for assessing addiction have not been established. In this study, we aimed to develop an in vitro method for assessing the addiction of compounds, as an alternative to animal experiments, using human iPS cell-derived dopaminergic neurons with MEA measurements. MEA data before and after chronic exposure revealed specific changes in addictive compounds compared to non-addictive compounds, demonstrating the ability to estimate addiction of compound. Additionally, conducting gene expression analysis on cultured samples after the tests revealed changes in the expression levels of various receptors (nicotine, dopamine and GABA) due to chronic administration of addictive compounds, suggesting the potential interpretation of these expression changes as addiction-like responses in MEA measurements. The addiction assessment method using MEA measurements in human iPS cell-derived dopaminergic neurons conducted in this study proves effective in evaluating addiction of compounds on human neural networks.

Voluntary self-poisoning in children – a silent call for help

Introduction. Voluntary self-poisoning represents nowadays a public health issue, being one of the main causes of morbidity and mortality in pediatric patients. The psychological burden some children have to carry becomes heavier than their strength, fact that determine them to make their voices heard through self-hurting. Aim. The current study proposed to raise awareness upon the multiple cases of voluntary ingestions between children, to assess the reasons and, consequently, to find solutions to support our future generations. Materials and methods. This is an observational retrospective study performed by analyzing the medical data of the patients admitted to the Department of Pediatrics I, from the Clinical County Emergency Hospital Targu Mures, with the diagnostic of toxic substance ingestion, between 1st of January 2019 and 31st December 2022. The study group comprised of 204 children, who were exposed to harmful chemicals, 68 of them being voluntarily involved. Results. A slight increase in the number of cases have been observed during SARS-CoV-2 pandemic. Additionally, we identified that teenage girls were more prone to self-poison than pre-school boys, who were more susceptible to unintentionally ingest toxics. Low family income, abandon, scholar difficulties, use of alcohol and pregnancy were only some of the causes of producing emotional instability. Furthermore, the most preferable substances to consume were pharmaceuticals, especially psychotropics. Conclusion. The study is emphasizing the necessity to establish mental support systems for the children who struggle with past traumas. Founding trustful connections between the child and its family, school and health care professionals can help reduce the self-harm cases and even develop a much more emotionally stronger society.

To what extent does a high sugar diet affect obesity in China?

The aim of this dissertation is to provide an answer about to what extent does a high sugar diet affect obesity. The goal of answering this question is to find the substitution of sugar and the number of sugar intake that wont increase the risk of obesity. The dissertation will be separated into this part and uses the available literature to identify them. What is obesity and the impact of varying degrees of obesity on health. What is sugar and how sugar contribute to obesity. Comparing the amount of sugar in different substance and the limiting numbers of sugar intake to give advice about how many substances intake wont increase the risk of obesity. Exploring what is sweeteners and the potential hazard of them to determine whether the sweeteners is good substitution or not. Also, the article will find another factor affect obesity and explore the nature of them. Through this part, it is concluded that excess sugar intake increases the risk of obesity by convert glucose into fatty acid and the nature of the other factors that affect obesity is to stimulate people to take in more sugar. Meanwhile, sugar alcohol could be considered as the best sugar substitution and it is suitable for people to consume the amount of added sugar like white sugar which is lower than 36g. For fructose, it is suitable for people to consume lower than 50g.

Retrospective Evaluation of Adolescent Patients Presenting to the Emergency Department with Suicidal Attempt

Objective: Suicide attempts among adolescents are a major public health problem. It is important to understand the prevalence of suicide attempts in the adolescent population and the risk factors underlying the attempts so that the necessary precautions can be taken by health authorities. We therefore aimed to retrospectively evaluate the demographic and clinical characteristics of adolescent patients presented to the emergency department due to suicide attempts. Materials and Methods: This retrospective observational study included adolescent patients aged 10-19 years who presented to the emergency department for suicide attempt between August 01, 2018 and July 31, 2023. Ethics committee approval was obtained and data were collected from the hospital automation system through ICD codes. Demographic data, clinical characteristics, intervention methods, treatment processes and outcomes of the patients were analysed in detail. Results: Of the 126 patients included in the study, 80.2% were female, 19.8% were male, and the mean age was 184 months. 97.6% of the patients attempted suicide by ingestion of drugs or substances, and the rest of the patients preferred methods such as jumping from a height, firearm and sharp instrument use. Depression was the most common comorbid psychiatric disorder and was identified in 73.7% of the adolescents in the study. 42.1% of the patients presented to the emergency department with other complaints along with the suicide attempt. Treatments such as gastric lavage and activated charcoal were administered in the majority of admissions. Conclusions: This study reveals that suicide attempts are an important public health problem in the adolescent population and psychiatric disorders, especially depression, play a role in these attempts. It was observed that suicide attempts were more common among adolescent females. The findings emphasise the importance of early screening and interventions for the prevention and management of suicide attempts in adolescents. The findings of the study shed light on efforts to review and improve current management strategies and demonstrate the need for large-scale community-based studies.

Relating distractor suppression to problematic drinking behavior

BackgroundImpaired cognitive control has been linked to weakened self-regulatory processes underlying compulsive substance intake. Previous research has provided evidence for impaired task performance in substance-abusing groups during Stroop and Go/No-Go tasks. Mechanisms of distractor suppression in visual search might also involve overlapping regulatory components that support goal-directed behavior by resolving the attentional competition between distractors and the target of search. However, the efficiency of learning-dependent distractor suppression has not been examined in the context of drug abuse and a direct comparison between cognitive control and distractor suppression is lacking. MethodA total of 84 participants were assigned either to the heavy drinking group (ALC, n = 42) or the control group (CTL, n = 42) based on self-reported substance use. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and Barratt Impulsiveness Scale (BIS). After that, participants completed a computerized version of the Stroop task, Go/No-go task, and a visual search task measuring learning-dependent distractor suppression. ResultsThe Stroop effect and the frequency of no-go errors did not differ between groups. However, learned distractor suppression was significantly blunted in the ALC group compared to the control group. Across participants, performance on the Stroop and Go/No-go task were correlated, while the magnitude of distractor suppression was related to neither. ConclusionsOur findings support a divergence of mechanistic processes underlying cognitive control and attentional control, and demonstrate impaired learning-dependent distractor suppression in heavy drinkers relative to a control group. Impaired distractor suppression offers new insight into why drug cues can be difficult to ignore.

Determination of Some Minerals and Heavy metals in Raw Cow’s Milk

Milk is a healthy and nutritious food. Its ability to be consumed by all age groups and its easy accessibility increase the importance of milk in our diet. As technological developments increase, so does environmental pollution. As a result of this pollution, metals and metal mixtures reach animals and humans through the food chain. This situation negatively affects the health of living organisms. In addition, excessive intake of some mineral substances can also be toxic. The contamination of heavy metals in food occurs through various pathways. The risk of metals in the composition of the containers used in the production of acidic foods such as milk and cheese dissolving and passing into the product is more likely to occur than in other foods. For this purpose, in our research, 10 samples of raw cattle milk collected from different regions of Muş province were analyzed for the amounts of calcium, magnesium, sodium, potassium, zinc, iron, copper, manganese, and heavy metals lead and cadmium using Atomic Absorption Spectrometry device. The samples' lead, cadmium, iron, copper, and manganese contents were determined as 0.40±0.01-0.19±0.01, 0.38±0.00-0.20±0.00, 1.96±0.01-0.24±0.01, 0.50±0.00-0.11±0.00 and 0.20±0.00-0.12±0.00 mg/L, respectively. The highest levels of calcium (433.45±0.00 mg/L) and potassium (1146.25±0.02 mg/L) were detected in sample S10. The lowest levels of magnesium (197.81±0.00 mg/L) and sodium (661.17±0.01 mg/L) were found in sample S3. The zinc contents of the samples varied between 8.25±0.00-14.51±0.00 mg/L. The results obtained were evaluated considering the factors affecting the amount of mineral substances and heavy metal contamination in the milk.

Determination of Selected Metals and Metalloids in Different Types of Rice by Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES).

Pantanal is a unique biome located in Brazil, with diverse fauna and flora, being home to native species such as the rice types Oryza latifolia and Oryza rufipogon. Rice is a staple food for two-thirds of the population, with increasing consumption, especially in Asia, regions of Sub-Saharan Africa, countries in the Caribbean, and Latin America. The per capita rice consumption had an average consumption of 160g/day. However, rice consumption may lead to the intake of other harmful substances to health, such as toxic metals/metalloids. The determination of potential hazards in native species is crucial in maintaining the local population in good health. In this study, we determined the concentration of essential elements and potentially toxic elements in seven different types of Brazilian rice grains, including the two Pantanal native species O. latifolia and O. rufipogon, using ICP-OES to identify their nutritional richness or potential toxicity. The contaminant with the highest HQ levels was chromium, with an HQ above one only in the native species. All species (commercial and native) showed carcinogenic risk considering inorganic arsenic. Rice exhibits duality in its classification, providing nutritional content and leading people to potential risks of overexposure to toxic elements. While rice can be part of a healthy and nutritious diet, more studies should be conducted on avoiding or remedying contamination with toxic elements.

Phytosterols: Physiological Functions and Potential Application.

Dietary intake of natural substances to regulate physiological functions is currently regarded as a potential way of promoting health. As one of the recommended dietary ingredients, phytosterols that are natural bioactive compounds distributed in plants have received increasing attention for their health effects. Phytosterols have attracted great attention from scientists because of many physiological functions, for example, cholesterol-lowering, anticancer, anti-inflammatory, and immunomodulatory effects. In addition, the physiological functions of phytosterols, the purification, structure analysis, synthesis, and food application of phytosterols have been widely studied. Nowadays, many bioactivities of phytosterols have been assessed in vivo and in vitro. However, the mechanisms of their pharmacological activities are not yet fully understood, and in-depth investigation of the relationship between structure and function is crucial. Therefore, a contemporaneous overview of the extraction, beneficial properties, and the mechanisms, as well as the current states of phytosterol application, in the food field of phytosterols is provided in this review.

N-Ethylhexedrone: A very long and bad trip! A case series.

N-ethylhexedrone (NEH) is a new cathinone derivative with, currently, low toxicokinetic and toxicodynamic knowledge. We present three documented clinical cases of NEH intoxication with plasma and urine concentrations. A thorough search for metabolites was performed. The three patients were admitted to the emergency department, and two out of the three were hospitalized for an extended period. While recovering from the drug effects, 12-24 h after nasal intake of New Psychoactive Substance (NPS), the patients described the following disorders: anxiety, feelings of persecution, asthenia, anhedonia, abulia, psychomotor slowing and loss of consciousness. NEH was identified in all samples by liquid chromatography-high resolution mass spectrometry (LC-HRMS), and quantified by liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS). Quantitative analysis showed decreasing concentrations over time: for Case 1, from 97.2 (Day 1, D1) to 0.7 (Day 7, D7) µg/L for plasma, and from 724 (D1) to 0.5 (D7) µg/L for urine. NEH concentration of 7.9 µg/L was found in the plasma collected at admission for Case 2. For Case 3, concentrations ranging from 49 (D1) to 1.8 (D7) µg/L in plasma, and from 327.3 (Day 6, D6) to 116.8 (D7) µg/L in urine were found. NEH was no longer detected in the urine sample at Day 10. Elimination half-life was estimated at 19, and 28 hours in Patients 1 and 3, respectively. Four metabolites were identified in blood and urine: reduced NEH, dealkyl-NEH, reduced dealkyl-NEH and hydroxy-NEH. The cases presented highlight the long detectable lifetime of NEH. Characterization of the metabolites will allow better identification of the consumption of this drug. Serious adverse events can be observed after NEH consumption, as two out of the three patients required intubation and ventilation. A syndrome of inappropriate antidiuretic hormone secretion (SIADH) was also diagnosed. Two out of the three cases are notable because of the number of samples collected and because NEH was the only drug of abuse detected.

#3073 Should we expand the indications for hemodialysis in lithium intoxications beyond the EXTRIP recommendations?

Abstract Background and Aims EXTRIP Workgroup (EW) recommends renal replacement therapy (RRT) in lithium poisoning when serum lithium levels >4 mmol/l in cases of impaired kidney function, decreased consciousness, seizures or dysrhythmias, and suggests RRT in cases of serum lithium >5 mmol/l or when there is confusion or the expected time to obtain lithium levels <1 mmol/l with optimal management exceeds 36 hours. The aim of this study was to assess the benefit of RRT in the conditions recommended and suggested by the EW, and evaluate the benefit from RRT in other conditions of lithium poisoning. Method We conducted a retrospective mutli-centre observational study that included patients with a diagnosis of lithium poisoning from January 2006 to December 2022. Demographic data, kidney function and comorbidities, clinical presentation including neurologic, cardiac and renal manifestations, type of intoxication, previous poisonings or concomitant intake of other toxic substances and treatments used were registered. In patients receiving RRT, the type of RRT, duration and number of sessions were registered. Lithium levels during hospitalization were recorded, and time for lithium levels <1 mmol/l was calculated. The primary outcomes were death from lithium poisoning and persistent neurologic deficits (syndrome of irreversible lithium-effectuated neurotoxicity, SILENT). Results The study included 179 cases of lithium poisoning (62.6% chronic lithium poisoning, 34.6% acute on chronic and 2.8% acute poisoning),with a mean age of 56.3 ± 15.4 years, and patients were predominantly females (57%). 130 patients (72.6%) presented neurological manifestations, out of which 33 patients (18.4%) presented a decreased conscious level or generalized convulsions, and 40 patients (22.3%) presented confusion. 98 patients (54.7%) presented acute kidney injury (AKI) and 21 patients (11.7%) presented life-threatening dysrhythmias. 68 patients (38%) were treated with RRT. 31 patients (17.3%) developed persistent neurological deficits (SILENT) and only 2 patients (1.1%) died of lithium poisoning during hospitalization. Concerning patients in whom hemodialysis was recommended according to EW guidelines, only 34 out of 53 patients (64.2%) received RRT. In this group of patients, those who received RRT developed less frequently SILENT (11.8% vs 36.8%, p = 0.031) Regarding patients in whom hemodialysis is suggested according to EW, only 34 out of 106 patients (32.1%) received RRT. Overall, combining patients in whom dialysis is recommended or suggested according to EW, SILENT developed less frequently in those who received RRT (13.2% vs 20.4%) Beyond the recommendations by the EW, we found that patients with lithium levels > 2 mEq/l with AKI and any neurological manifestations presented less frequently SILENT when receiving RRT (7% vs 26%, p = 0.033). We also observed that patients who received RRT had a shorter in-hospital stay (3.3 [IQR 2-7] days vs 9.4 [IQR 5-11] days, p = 0.01). Conclusion Patients presenting with lithium poisoning and impaired kidney function or any neurological manifestations who received RRT presented less frequently persistent neurologic deficits (SILENT) after discharge, regardless of lithium levels or type of poisoning. We suggest that EXTRIP should recommend RRT in any patient with lithium poisoning who presents with neurological symptoms or impaired kidney function, regardless of lithium levels.

Prevalence and causes of substance abuse among Egyptian university students

Substance abuse is a global challenge with dangerous effects on health, wealth and security of nations, and individuals’ mental and physical health. This study was done to identify the prevalence and risk factor of drug abuse among university students and evaluate drug abuse use according to its type and problems encountered. Cross sectional study using self-administrated questionnaire conducted for one month in the academic year 2022-2023 to 600 university students at Beni-Suef University from grade 1 to grade 6 and postgraduates. The survey included all faculties in the university. Screening tests for drug abuse in the urine samples were performed by dipsticks and confirmed by auto-analyzer device. Most of the students were male (68.3%), their mean age was 22.05 ± 2.25 year. 58.3% of them were from urban, 84.7 % of them were single, with monthly pocket money 1205.73 ± 1260.02 Egyptian pounds while the mean of family income 5515.50 ± 9210.39. The urine samples were collected and analyzed by drug screening strips, 75.4% of the samples were negative and 24.6% were positive. Auto analyzer confirmed 31.8% of positive cases by drug screening strips and the most common drug was confirmed was combined drug abuse (59.6%). High significance relation of addiction with the mean age of the cases (P value=0.0001), males’ gender (P value=0.0001), high monthly pocket money (P value=0.0001), lower father and mother education (P value =0.0001). The problems faced by addicts were oppose the orders (51.4%), usual liar (48.6%), struggle with parents (44.6%), and psychiatric problems (33.8%) especially unstable psychological state. The most common cause of substance intake in the positive group was adolescent curiosity (56.8%) followed by be happy (48.6%) and active (40.5%). Most of the students were male (68.3%), their mean age was 22.05 ± 2.25 year. 25.7% had a history of substance abuse, the most common substance abuse was THC (34%). Age of students, single, higher family income and father occupation were the most predicted risk factors to substance abuse.

Content in the Red Cup: Perceived Implication of Substance Use in Nigeria Hip Hop Music Video Performance

Music is an essential part of mass communication that aids the stimulation of concrete information in a lighter mood. The current trend of cup usage by artist in Nigeria music video performance has presently increased the imitation among the upcoming artist and youth. Substance abuse can be referred to excessive use of psychoactive drugs. This study investigates use of red cup and perceived implication of substance abuse in Nigeria music video performance. The study made use of quantitative research approach. The research design for this study is survey method, questionnaires were used gather data needed for the study. Simple random sampling was adopted to select 200 respondents among students of the department of performing art and film studies and mass communication and media technology Lead City University, Ibadan. The result obtained were analysed and presented in percentage tables. The study found out that most of the red cups found in Nigeria Music Video contain drug substance. The study also revealed that use of substance during performance can lead to drug addiction and other related effects. The study concluded that the content in red cup of Nigeria music videos contain drug substance, this can lead to addiction and immoral imitation that can influence viewers and upcoming artist. The study recommends that artist should reduce the use of red cup as it sends negative signals to the viewers who see them as role model and mentor, also, artist should avoid intake of drugs substance and alcohol during performance in other to retain originality in their music performance.