الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
In Egypt and developing countries, anticholinesterase compounds are
among the most often utilized chemical substances due to their availability
and effectiveness. The WHO estimates that there are 3 million cases of
pesticide poisoning each year and up to 220,000 deaths in developing
countries. There is an annual increase in the number of acute
anticholinesterase poisoning cases in Eygpt whether suicidal or accidental.
These compounds act by inhibiting acetylcholine esterase enzyme causing
overstimulation of acetylcholine receptors. The clinical manifestations of
poisoning are mainly due to muscarinic, nicotinic, and central nervous
system (CNS) receptors overstimulation. Acute anticholinesterase
poisoning is associated with oxidative stress, lipid peroxidation, low
glutathione level, and damage to cell membranes resulting in cell death and
adverse effects on multiple systems in the body. Routes of exposure
involve
inhalation,
ingestion,
or
dermal
contact.
Peradynia
organophosphorus poisoning scale was proposed for evaluating the severity
of acute anticholinesterase poisoning cases.
Diagnosis of acute anticholinesterase poisoning is based on the history of
exposure, the presence of symptoms and signs, and the decrease in serum
pseudocholinesterase enzyme levels .
Caspases are a family of endoproteases that cut proteins at specific
sequences and play essential roles in inflammation and apoptosis. The
members of the caspase family are classified as inflammatory or apoptotic.
The caspases-1, 4, -5, and -11 are grouped as inflammatory caspases and
the caspases -2,-3,-6,-7,-8,-9, and – 10 are grouped as apoptotic caspases.
These apoptotic caspases are further subdivided into two groups: the
initiator caspases (caspase-2, -8, -9, and -10), which are the first to be activated in response to a signal, and the executioner or effector caspases
(caspase-3, -6, and -7) that carry out apoptosis and cell death .
Anticholinesterase compounds directly interact with cellular membranes
causing disturbances in their structure, mitochondrial dysfunction,
enhanced production of reactive oxygen species (ROS), and subsequent
lipid peroxidation. Lipid peroxidation is accompanied by an alteration of
the antioxidant defense system in different organs. The increase in the
activity of caspase biomarkers after acute exposure to anticholinesterase
compounds may be due to oxidative stress through releasing of cytochrome
C that activates them to induce apoptosis and cell death . The cause of
death in acute anticholinesterase poisoning cases is usually due to
respiratory failure, but may also be due to other complications such as
arrhythmia, pneumonia, pulmonary edema, pancreatitis, and renal failure .
Hence, this study aimed to assess the pattern and outcome of acute
anticholinesterase poisoning cases admitted to Menoufia Poison & Control
Center (MPCC) over one year, as well as to explore the potential role of
biochemical caspase markers in predicting the outcomes.