Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Forensic Medicine and Clinical Toxicology

Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine (NAC) on the survival time, hemodynamics, and parameters at various time intervals in all cases of ALP poisoning. Methods This research was a case{u2013}control study to evaluate 30 AlP poisoned patients during the period of 10 months from October 2018 to August 2019. They were admitted at national clinical toxicology and environmental center. They were treated with intravenous NAC plus conventional treatment & were considered as the case group and compared with patients who did not receive NAC. NAC infusion was administered to the case group at 300 mg/kg for 20 h. The data gathered included age, sex, heart rate, systolic blood pressure (SBP), creatine, SGPT and SGOT and ECG. Analysis of repeated measures was performed to check the variability of parameters over time. The severity of the patients assessed by clinical symptoms, signs and investigations. Results Most of the study population were moderately intoxicated. The most affected age group in the N-acetyl cysteine group studied patients was (67%) between 20 years and 25 years and (90%) in the control group. Female to male ratio was 0.8:1. 66.7% of the included patients belonged to Fayoum while 33.3% belonged to other areas.The mean time to presentation before admission was 5.3: 8.7 hours, there was significant difference as regards to time of presentation among cases presented by abdominal pain, and nausea. p-value (0.04) in nausea and abdominal pain. The investigations showed elevated liver enzyme in (14{u2105}) of patients. Arterial blood gases analysis showed metabolic acidosis in (50%) which were corrected in all patients except in one patient. ECG changes were found in 57% of patients, in the form of abnormal heart rate, irregular rhythm, right bundle branch block, ST-segment elevation and depression, PVCs. In this study, (64 %) recovered and recorded deaths in (36%)

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