Biomedical subjects

Salim Satar

Publications and source records attributed to Salim Satar.

15 recordsLinked to original sources

PubMed2005

Ultrastructural effects of acute organophosphate poisoning on rat kidney.

We investigated the ultrastructural effects of the organophosphate compound methamidophos and treatment with atropine and pralidoxime (2-PAM) on rat kidneys. Male Wistar albino rats were assigned to four groups. Group 1 received 30 mg/kg methamidophos, the LD50 for this compound in rats, via oral gavage. Group 2 received only physiologic saline. Group 3 rats received 30 mg/kg methamidophos and were treated with 2-PAM and atropine via intraperitoneal injection when cholinergic symptoms were noted. Group 4 served as a control, and received physiologic saline in equivalent volumes and routes to Group 3. Kidney tissues were prepared for electron microscopic studies. No ultrastructural changes were detected in Group 1 after acute poisoning with methamidophos and in Group 3 treated with antidotes after poisoning. Acute organophosphate poisoning and antidotal treatment in this model are not associated with histopathological changes in the rat kidney but the models with different organophosphate compounds, by administrating the different dosages, may be more illuminative in explaining the effects of these chemicals in kidney.

Acute Disease↗

PubMed2005

Prognostic value of thyroid hormone levels in acute myocardial infarction: just an epiphenomenon?

The purpose of this study was to investigate whether thyroid hormone levels have any predictive value for mortality in patients presenting to the emergency department with acute myocardial infarction (AMI). Three groups of patients admitted to the emergency department within the 11-month study period were considered eligible: 95 patients with chest pain and proven AMI, 26 patients with chest pain and no AMI, and 114 patients who served as controls with no evidence of any major disease. Cardiac enzymes and the following thyroid hormones were analyzed and compared between groups, regarding effects of historical and demographic factors: thyrotrophin, free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), and total thyroxine (TT4). Sixteen patients with AMI (16.8%) died within the study period. Troponin T and creatine kinase-B with an M-type subunit levels were significantly higher in the nonsurvivors when compared with survivors. Survivors in the AMI group had higher TT3, TT4, and lower FT4 levels, while the nonsurvivors in the AMI group had higher thyrotrophin and lower TT3, FT3 and FT4 levels than controls. In the AMI group, the nonsurvivors had lower TT3 and FT3 levels than the survivors. A history of diabetes mellitus and/or angina, TT3, or FT3 was an independent predictor of mortality. TT3 and FT3 appear to be independent prognostic factors in patients with AMI.

Aged↗

PubMed2005

Acute intoxication with doxazosin.

Experience with overdosage and toxicity with the alpha-adrenoreceptor antagonists remains very limited in the literature. In this paper, the second case in the literature with doxazosin overdosage is reported. Supportive treatment was given to the patient and the patient was discharged 48 hours after admission to the emergency department.

Adrenergic alpha-Antagonists↗

PubMed2005

An unusual localization of snakebite treated without antivenin: case report.

Snakebite is one of the commonest causes of morbidity and mortality in tropical regions. This paper focuses on the medical treatment of a patient who had been bitten by a snake on the vertex of his head. It was a severe envenomation with ensuing marked edema associated with coagulation abnormalities. Although the antivenin was extensively sought in various medical centers, it was unavailable. We observed and treated the patient, with special regard to his hematological findings and potential complications. Specifically, tetanus prophylaxis and intravenous fluids were administered, and the wound was cleaned and dressed. Fresh frozen plasma was also administered. The patient responded well, and was discharged on the fourth day of his admission, without any sequelae.

Adolescent↗

PubMed2005

Organophosphate poisoning associated with fetal death: a case study.

The increasing use of organophosphorus insecticides in agriculture and inside homes and schools, as well as its widespread existence in the environment, poses a potential health hazard. As the use of these agents increases, acute and chronic exposure has become more common. As with other organophosphates, chlorpyrifos kills insects and other animals, including human beings, because of its toxicity to the nervous system. Exposure of pregnant women to organophosphates is an important clinical entity because of its effects on two organisms--mother and fetus. There are few reports about fetal toxicity of organophosphates in the literature because of the relatively few cases reported. In this paper we report a case of intoxication from chlorpyrifos, an organophosphorus compound, during pregnancy, causing fetal death.

Adult↗

PubMed2005

Carbofuran poisoning among farm workers.

Accidental or intentional ingestion of carbofuran can produce a life-threatening syndrome that requires prompt diagnosis and treatment. This paper investigates unintentional carbofuran poisoning in farm workers. Thirteen patients were admitted to the emergency department with carbofuran poisoning between January 2002 and August 2004 (2 female, 11 male). The patients had been poisoned while mixing the liquid form of carbofuran with seeds. Their hands were red on admission. Complaints most commonly reported by the patients on admission were nausea, vomiting, headache, weakness, dizziness and blurred vision. The most commonly observed signs were tachycardia, tachypnea, salivation, miosis, elevated blood pressure, and fasciculation. Three patients were agitated and one was lethargic on admission. We reviewed the patients' medical charts retrospectively, as well as the demographic data, intoxication route, clinical and laboratory presentations, and outcomes. We made the diagnosis according to a compatible exposure history and clinical findings. The most commonly observed laboratory finding was hyperglycemia, which was found in 6 patients. Serum pseudocholinesterase level was low in only one patient. All the patients were cured and discharged from the hospital in good physical condition. Rapid onset, mild illness and quick recovery are typical characteristics of acute occupational carbofuran poisoning. We conclude that public health efforts should educate farm workers about the dangers of pesticide application so that its threat can be diminished.

Adult↗

PubMed2005

Frequency and mortality risk factors of acute adult poisoning in Adana, Turkey, 1997-2002.

OBJECTIVE: The purpose of this study was to evaluate the data on acute adult poisoning over a six-year period at a university emergency department in Turkey and identify the risk factors of mortality. MATERIAL AND METHODS: In this survey, data were collected from 2,229 adult patients admitted to the Emergency Department (ED) of Cukurova Medical Faculty, Adana, from January 1, 1997 to December 31, 2002. RESULTS: Of all emergency admissions during the six years, 1.6% were poisoned. Of the total poisoning cases, 725 (32.5%) were males and 1,504 were females. Mean age was 29.3 +/- 13.2 for males and 23.8 +/- 9.6 for females (p=0.001). A majority of the cases (76.4%) were attempted suicides. The attempted suicide ratio is higher for women (gender ratio: 2.4/1) and youths. Drugs were the most frequent cause of poisoning (59.0%) and pesticides were the second (26.4%). Psychoactive drugs were the most common agent (33.5%) among drugs, with their rate increasing each year. Eighty-seven patients died (3.9%): alcohol (methanol) was the most frequent cause of death (20.6%), followed by mushrooms (11.5%), carbon monoxide (10.3%) and pesticides (8.3%). More men than women died by poisoning (OR: 1.8 CI: 1.1-3.1). Gender, age, season, clinical status, initial emergency care and type of substance were significant risk factors for mortality. CONCLUSION: Poisoning by psychoactive drugs was increasing each year of the study, but many drugs are not a serious risk factor for mortality. However, organic phosphorus is a serious risk factor for poisoning and mortality in this area. Providing satisfactory public and emergency staff assistance and education on the subject may reduce the mortality rate.

Adolescent↗

PubMed2004

Ultrastructural changes in rat liver treated with pralidoxime following acute organophosphate poisoning.

We investigated the ultrastructural effects of methamidophos and the positive effects of 2-pralidoxime (2-PAM) on the liver. Male Wistar-albino rats were assigned to 4 groups and all were treated per os: Group 1 (n=10) received 30 mg/kg methamidophos; Group 2 (n=7) (serving as controls for Group 1) received physiologic NaCl; Group 3 (n=10) received 30 mg/kg methamidophos and was treated with 2-PAM and atropine when cholinergic symptoms were noted; and Group 4 (n=7) (serving as controls for Group 3) was treated with physiologic NaCl. Plasma cholinesterase was measured using radioimmunoassay. Liver tissues were prepared for electron microscopic studies. Methamidophos treatment of Group 1 led to serious changes in hepatocytes and organelles. These changes were not detected in Group 3. In Group 1, the chromatin content of some hepatocyte nuclei and cytoplasmic density increased; these cells also became vacuolar in appearance as a result of lysis in the mitochondrial matrices. In some cells, the lipid content constituted the majority of the cytoplasm. Furthermore, these cells were surrounded by glycogen accumulation. In some areas of the perisinusoidal zone, collagen fibers had increased to form bands. None of these changes were noted in Group 3. These findings suggest that acute organophosphate poisoning causes serious histopathological effects in rat liver, but that these changes are reversible with appropriate treatment strategies.

Acute Disease↗

PubMedDate not supplied

Analysis of acute adult poisoning in a 6-year period and factors affecting the hospital stay.

Case management of adult patients with acute poisoning in a university-based emergency department to determine the factors that affect duration of hospital stay was assessed. In this survey, data were obtained for the period between January 1, 1997 and December 31, 2002 at the emergency department (ED). Case analyses of 2229 patients older than 14 years of age were reviewed. Of all patients, 725 (32.5%) were male, 801 (35.9%) were younger than 20, and 540 (24.2%) were older than 30 years. Mean ages of patients were 29.3+/-13.2 for the males and 23.8+/-9.6 for the females (P<.001). During the study, the greatest number of patients were admitted in May (11.0%). Suicidal poisoning was the observed etiology in the majority of cases (76.4%). Moreover, the mortality rate due to poisoning was 3.9%. Drug ingestion was the most frequent means of poisoning (59.0%), followed by pesticides (19.0%). The rate of poisoning with multiple drugs has declined over time, whereas the rate owing to psychoactive drugs has increased markedly. The mean length of hospital stay was 2.9+/-1.8 days and the proportion of patients who stayed for longer than 2 days was 44.3%. The mean length of hospital stay was longer for males, those older than 30 years, those who had been poisoned unintentionally, and for confused and unconscious patients and those who had arrived to ED more than 2 hours after the event. This study suggests that morbidity for adult patients with poisoning varied by sex, age, and season. Length of hospital stay was affected by sex, age, arrival time to ED, mode of transport, severity of poisoning, and type of agent.

Adolescent↗

PubMedDate not supplied

Endocrine effects of organophosphate antidotal therapy.

To determine the endocrine effects of the treatment of organophosphate poisoning, this prospective study was conducted in a university-based emergency department among patients with a history and clinical findings compatible with those of organophosphate poisoning. Thyrotrophin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), progesterone (PRG), adrenocorticotropic hormone (ACTH), cortisol, and testosterone (TST) levels were analyzed before and after treatment with atropine and pralidoxime. The Wilcoxon's sign rank sum (nonparametric) test was used to compare dependent variables before and after treatment. A total of 44 patients (19 male; mean age: 28.5 +/- 12.6 y) were enrolled in the study. Patients were hospitalized for 5.4 +/- 1.3 days. Posttreatment ACTH, cortisol, PRL, FT3, FSH, and PRG levels were significantly lower than pretreatment levels (P < .05). The decrease in TSH, LH, and TST levels did not reach statistical significance, while FT4 levels increased following the treatment (P < .05). Six patients were diagnosed on admission with sick euthyroid syndrome, and 11 patients who were euthyroid on admission developed sick euthyroid syndrome following treatment. ACTH, cortisol, PRL, FT3, FT4, FSH, and PRG levels are affected by acute organophosphate poisoning. The change in hormone levels may result from the effects of neurotransmitters, from the direct effect of the toxic agent, or from stress associated with events leading to the poisoning incident.

Adolescent↗

PubMedDate not supplied

Thyroid storm induced by aspirin intoxication and the effect of hemodialysis: a case report.

Thyroid dysfunction is one of the serious consequences of an overdose of acetaminophen, aspirin, or nonsteroidal antiinflammatory drugs. The management of such consequences remains a medical challenge. A variety of thyroid abnormalities are common in clinical practice and can, in many cases, be accurately diagnosed and managed by the primary care physician. This case study covers an aspirin overdose causing thyroid storm that was treated successfully with hemodialysis.

Adult↗

PubMedDate not supplied

Unusual electrocardiographic changes with propranolol and diltiazem overdosage: a case report.

The therapeutic efficacy and safety of beta-adrenoreceptor-blocking drugs has been well established in patients with angina pectoris, cardiac arrhythmias, and hypertension and reducing the risk of mortality and nonfatal reinfarction on survival of acute myocardial infarction. The calcium antagonists are used for the treatment of patients with angina pectoris, long-term systemic hypertension, and the management of hypertensive emergencies and also for a multitude of other cardiovascular and noncardiovascular conditions. Because adverse cardiovascular effects can occur, however, patients being considered for combination treatment with propranolol and diltiazem must be selected carefully and observed closely. In this article, we present a suicidal case of drug overdose with propranolol and diltiazem with unusual electrocardiographic changes.

Adolescent↗

PubMedDate not supplied

Ingestion of caustic substances by adults.

Caustic products are responsible for the most serious cases of poisoning, which are always emergency cases. In this paper, we review demographic features and endoscopic results of the patients admitted to a university emergency department with a history of caustic substance ingestion between January 2000 and June 2003. Thirty-seven patients were included in this study. Twenty-one of the patients were female and 16 were male. The mean age of the patients was 30.9 +/- 14.7 years. The agents included sodium hypochlorite in 24 patients and hydrochloric acid in 13 patients. All the patients ingested these agents orally. The mean interval time of admission to emergency department after ingestion of caustic agent was 5.4 +/- 5.6 hours. Endoscopy was attempted in 37 patients. Endoscopic results were as follows: grade 0 in 8 (21.6%) patients, grade 1 in 17 (45.9%) patients, grade 2a in 5 (13.5%) patients, and grade 2b in 7 (18.9%) patients. We believe that early signs and symptoms after caustic substance ingestion are not consistent with the extent of damage, and endoscopy is the only reliable method to assess injury. It is important that efforts should be made to educate the public about the dangers of caustic substances so that their threat may be diminished.

Adolescent↗

PubMedDate not supplied

Emergency hemodialysis in the management of intoxication.

Management of intoxicated patients has many aspects in a wide spectrum, beginning with decontamination processes and basic supportive care. The most logical therapeutic approach is probably the specific antidotes, when available and/or applicable. On the other hand, many chemicals and drugs, can be removed from the body by means of hemodialysis or hemoperfusion while treating vital sign abnormalities and electrolyte and acid-base disturbances of the patient. In this paper, we describe 11 cases of intoxication, 6 with methyl alcohol, 3 with lithium, and 2 with salicylate, admitted to emergency department and treated with hemodialysis between January 1, 2002 and December 31, 2004. We review their medical charts and detailed demographic data, medical history, type of exposure, clinical and laboratory presentations, duration of hemodialysis performed, and the outcome.

Adult↗

PubMedDate not supplied

Effects of acute organophosphate poisoning on thyroid hormones in rats.

The aim of this study was to investigate the effects of organophosphate poisoning on thyroid hormones. In this study, male Wistar albino rats weighing 200-225 g were used. The rats were divided into 4 groups. Group 1 (n = 10) was administered 30 mg/kg lethal dose of methamidophos, whereas group 2 (n = 7) was treated with physiologic NaCl (SP). Group 3 (n = 10) was treated with 30 mg/kg of methamidophos. When cholinergic symptoms developed among the rats in group 3, they were treated with 40 mg/kg pralidoxime intraperitoneally (IP) and administered atropine IP until the cholinergic symptoms disappeared. Group 4 (n = 7) was treated with SP. After the cholinergic symptoms appeared among the rats in group 1, intracardiac blood samples were taken. In group 3, blood samples were taken after the cholinergic symptoms had disappeared. Then triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), and plasma choline esterase (PCE) levels were studied by RIA. The Kruskal-Wallis test and Mann-Whitney U test were used for comparison between groups. Bonferroni correction was applied when multiple comparisons were made. T3, T4, and TSH levels decreased in group 1 compared with group 2 (P < 0.01). When the results between groups 3 and 4 were compared, it was found that the T3 and T4 levels in group 3 decreased while the decreases in T3 levels were statistically significant (P < 0.01). When comparing the results of groups 1 and 3, the T4 level was lower in group 1 and the T3 level was higher in group 3 (P < 0.01). The TSH level increased in group 3 after treatment (P < 0.01). Thyroid hormones were affected after acute organophosphate poisoning. Hypothyroidism and sick euthyroid syndrome was observed during poisoning and after treatment. In serious poisoning, there may be a poor prognosis, but more extensive studies will illuminate the issue in depth.

Acute Disease↗