A tropán alkaloidok számos növénycsaládban előfordulnak, toxikus hatásuk következtében dózistól függően enyhe tüneteket, de akár halált is okozhatnak. Az emberi szervezetbe leggyakrabban ...szennyeződés, tévesztés vagy bódító hatásuk miatti szándékos visszaélés következtében kerülnek. Gabonafélék, hüvelyesek, egyéb szemes termények, de különösen a vegyszermentes termelésű biotermékek nem megfelelő tisztítása következtében általános közfogyasztásra szánt élelmiszerekben előfordulnak, esetenként dokumentált mérgezést okoznak. A 2021-ben megjelent európai uniós szabályozás a növényi alapanyagok viszonylag széles körére határozza meg a tropán alkaloidok megengedhető mértékét, így a rendelet következetes betartásával elérhető lesz a tropán alkaloid szennyeződésből eredő élelmiszerbiztonsági kockázat csökkenése, mindamellett, hogy az utóbbi évek élelmiszer-eredetű mérgezéses esetei felhívják a figyelmet a szabályozás alá eső élelmi anyagok köre bővítésének szükségességére.
•Mortality of OP poisoning was comparably high to underresourced regions.•Death occurred rather late and was related to non-poison specific complications.•BChE was suppressed earlier and more ...sustained in patients who ingested diethyl-OPs.•Severity of poisoning and outcome did not differ between dimethyl- and diethyl-OPs.•The calculated QTc-interval in the ECG was significantly prolonged in fatalities.
Organophosphate (OP) poisoning is still associated with high morbidity and mortality rates, both in resource-poor settings and in well-developed countries. Despite numerous publications dealing with this particular poison, detailed clinical data on more severe overdoses with these agents are relatively sparsely reported. A retrospective study was consequently conducted on 33 patients with OP poisoning admitted to our intensive care unit (ICU) to provide additional data on clinical features. We included moderate to severe poisonings between 2000 and 2012 who required admission to ICU.
Patients ingested dimethyl-OPs in 19 cases, diethyl-OPs in 8 cases and otherwise classified OPs in 6 cases. Death (5/33) occurred rather late and only one of these fatalities died during on-going cholinergic crisis. Of the survivors (28/33), 71% recovered fully while 29% showed predominantly neurological disabilities before being transferred to neurologic rehabilitation. Aspiration pneumonia predominated in 27/33 patients and one patient died in refractory acute respiratory distress syndrome (ARDS). The intermediate syndrome occurred twice and cardiopulmonary resuscitation had to be performed in 6/33 patients. Fatalities showed a higher Poison-severity-score, APACHE-II-score and SOFA-score on admission compared with survivors and they showed significantly longer QTc-time in the ECG, lower systolic blood pressure and heart rate, a lower pH and a lower base excess on admission. Patients with diethyl-OPs required intubation significantly earlier and showed lower and more sustained inhibited activity of the plasma-cholinesterase on admission compared with patients ingesting dimethyl-OPs. Treatment with atropine and obidoxime was comparable between these groups and severity of poisoning, outcome, hemodynamics on admission, duration of mechanical ventilation and length of stay in the ICU did not significantly differ between the involved group of dimethyl- and diethyl-OPs.
We conclude that the fatality rate in our patient cohort treated in a well-staffed and equipped ICU of a developed country is quite similarly high compared with the rate observed in developing countries. Patients died rather late when severe cholinergic crisis had mostly been overcome and death was therefore related to non-poison specific complications.
Abstract
Objective: To assess the incidence of seizures induced by cycloplegic ophthalmic drops.
Materials and methods: A survey among members of the American Association for Pediatric Ophthalmology ...and Strabismus yielded five patients who received cycloplegic eye drops between 1998 and 2010 and who consequently developed a seizure.
Results: The median age of the patients was 5 years (range 3 months to 12 years). Cyclopentolate hydrochloride 1% was the only causative agent. The seizure happened on average 12 min after the instillation of dilating eye drops. Three were generalized convulsions, and two patients had a focal seizure. Past medical history was unremarkable in four cases. In total, 16 previous cases of seizures induced by cycloplegic drugs were identified in reports published between 1890 and 2004, implicating atropine in nine reports, tropicamide and phenylephrine eye drops in one and cyclopentolate in six.
Discussion: A small amount of cyclopentolate drops could induce convulsions in young children after only minutes to less than an hour, while a larger dosage of atropine over the span of several hours could cause this rare and unpredictable complication. Predisposing factors were rare and those developing the seizures were healthy subjects. Generalized seizures were much more frequent than focal convulsions.
Conclusions: Seizures after instillation of cycloplegic drops are extremely rare.
Kemangi (Ocimum americanum L.) is a well known plant that contains essential oils with citral as a major compound. Citral is reported to have beneficial effect on intestinal motility. This reseach ...investigated the effect of essential oil of kemangi leaves (Ocimum americanum L.) on male DDY mices intestinal motility. Thirty mices were divided into six groups and each group was pretreated with 0,2 ml of 0,5% CMC (negative control), 1 mg/kg BW of atropine sulfate (positive control), 5 mg/kg BW of citral (comparative control), and three dose variation of volatile oil of kemangi leaves (25 mg/kg BW; 50 mg/kg BW; 100 mg/kg BW) orally. All mices were given charcoal meal suspension 0,2 ml orally, and the animals were sacrificed. The percentage ratio and inhibition were analysed by measure the intestinal transit of charcoal. The results showed that the essential oil of kemangi leaves dose 100 mg/kg BW significantly (p < 0.05) reduced intestinal transit in mice with the percentage inhibition value of 59,79%. This value is not significant different (p> 0.05) compared with citral and atropine sulfate. This research concluded that the essential oil of kemangi leaves has potential effect as antispasmodic agent.
Rhus semialata Murr. (Anacardiaceae) is a deciduous tree of north
eastern India. The fruit of this plant is traditionally used to control
diarrhoea and dysentery. The Present study was undertaken to ...evaluate
anti-diarrhoeal potency of methanol extract of fruits of R.
semialatalts indicated that the methanol extract of the fruits of R.
semialata possesses significant anti-diarrhoeal effect and
substantiated the use of this herbal remedy as a non-specific treatment
for diarrhoea in folk medicine.
The purpose of this study was to compare the topical anti-inflammatory effects of the nonselective cyclooxygenase (COX) inhibitor, ketorolac, with the selective COX-2 inhibitor, nimesulide, in an ...animal model of dry eye in albino rabbits. All animals were examined by the Schirmer test, tear break-up time (TBUT) and fluorescein corneal staining test. Dry eye model showed significant reduction in tear volume, TBUT, corneal staining and histopathological signs of dryness and inflammation. On treating dry eye model with nimesulide 0.1% eye drops and ketorolac 0.5% eye drops, there were improvements in Schirmer test values, TBUT and fluorescein corneal staining and histopathologically reduced inflammatory reaction, with signs of healing and regeneration. Both nimesulide and ketorolac ameliorate atropine sulphate induced dry eye in albino rabbits. The use of selective COX-2 inhibitor, nimesulide, is preferred to avoid local and systemic side effects which may occur with the use of the nonselective COX inhibitor, ketorolac.
Cilj istraživanja bila je usporedba topičkog protuupalnog učinka neselektivnog inhibitora ciklooksigenaze (COX), ketorolaka i selektivnog COX-2 inhibitora, nimesulida na animalnom modelu suhog oka u albino kunića. Na životinjama je proveden Schirmerov test, vrijeme prestanka suzenja oka (TBUT) i test bojenja rožnice fluoresceinom. U animalnom modelu suhog oka značajno je smanjen volumen suza, TBUT, bojenje rožnice i histopatološki simptomi suhoće i upale. Obradom suhog oka s kapima za oči koje sadrže 0,1% nimesulida, odnosno 0,5% ketorolaka, poboljšane su vrijednosti u Schirmerovom testu, TBUT i bojanje rožnice fluoresceinom, smanjena je upalna reakcija, a na oku su se pokazali simptomi ozdravljenja i regeneracije. I nimesulid i ketorolak smanjuju suhoću oka induciranu atropin sulfatom u albino kunića. Uporaba selektivnog COX-2 inhibitora, nimesulida, se preferira jer se izbjegavaju lokalne i sistemske nuspojave koje se mogu pojaviti uz uporabu neselektivnog COX inhibitora, ketorolaka.
Saraca indica Linn (Caesalpinaceae) ve Datura stramonium Linn (Solanaceae) bitkisinin aseton eksteresi; ve Allium sativum Linn
(Liliaceae) bitkisinin sıvı ekstresi in vitro olarak vibrosidal ...aktiviteleri çalışılmıştır. Bu ekstreler çoklu direnç gösteren insan
patojenlerine etkili bulunmuşlardır. Disk difüzyon yöntemi ile Vibrio cholerae, Vibrio parahaemolyticus ve 12 çoklu direnç gösteren
Vibrio cholerae non-O1 izolatlarına karşı önemli ölçüde konsantrasyon bağımlı antibakteriyal etkiler gözlenmiştir. Bitki ekstrelerinin
denenen bakterilere karşı inhibisyon zon çapları 7-27 mm arasında, MIC değerleri ise 2,5 ile 15 mg/ml arasında bulunmuştur. S.
indica ve D. stramonium bitkisinin aseton ekstresi su ve etanol esktresine gore en yüksek potansiyele (düşük MIC) sahip olmuştur.
Fakat, A. sativum bitkisinin su ekstresi en etkili bulunmuştur. Ekstrenin ince tabaka kromotografisi (TLC), biyootografi ve Yüksek
Performanslı Sıvı Kromotografi (HPLC) analizleri saponin, tannin, skopolamin, atrofin ve allisin bileşiklerinin varlığını ortaya
çıkarmıştır.
In vitro investigation of the vibriocidal activity of acetone extracts of Saraca indica Linn (Caesalpinaceae) and Datura
stramonium Linn (Solanaceae), and aqueous extracts of Allium sativum Linn (Liliaceae) showed that they have antibacterial activity
against multidrug-resistant human pathogens. Disc diffusion assay showed that there was significant concentration-dependent
antibacterial activity against standard strains of Vibrio cholerae, Vibrio parahaemolyticus, and 12 multidrug-resistant isolates of Vibrio
cholerae non-O1. The crude plant extracts had zones of inhibition in the range of 7-27 mm against 1 or more test bacteria, with
MIC ranging from 2.5 to 15 mg/ml. Acetone extracts of S. indica and D. stramonium, in most cases, had more potency (low MIC
value) than ethanol and aqueous extracts; however, the aqueous extract of A. sativum was the most effective. Thin layer
chromatography (TLC), bioautography, and high performance liquid chromatography (HPLC) analysis of the crude extracts revealed
that saponin, tannin, scopolamine, atropine, and allicin were the active constituents.
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