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Hurst, C.G., Newmark, J. and Romano Jr., J.A. (2012) Chemical Terrorism: Introduction. In: Longo, D.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Jameson, J.L. and Loscalzo, J., Eds., Harrison’s Principles of Internal Medicine, 18th Edition, McGraw-Hill, New York, 1779-1788.

has been cited by the following article:

• TITLE: Cardiotoxicity among Children Accidentally Exposed to Organophosphate Insecticides Coupled with Scorpion Bites in Gaza

  AUTHORS: Yasser El-Nahhal, Ibrahim El-Nahhal

  KEYWORDS: Component, Insecticides, Cardiotoxicity, Children, Scorpion Bites

  JOURNAL NAME: Health, Vol.13 No.9, September 22, 2021

  ABSTRACT: Insecticides are toxic chemicals used at homes for controlling insects of public health importance and controlling agricultural pests at home gardens. Their application may result in accidental poisoning. Four accidental insecticide-poisoning children coupled with a scorpion bitten child were brought to the main hospital in southern Gaza for medical treatment. Primary investigation showed severe breath shortness, low heartbeat, and low blood pressure (hypotension). These symptoms are indications of potential cardiotoxicity among children. Electrocardiograms were measured and indicated various heart complications between cases. Complete blood count (CBC) determination showed the highest white blood cells (WBC) in the scorpion-bitted child suggesting the development of immune defense system. Blood electrolyte (Na+, K+, Ca2+) concentrations indicated disturbances due to poisoning. An interesting outcome of the study is the dramatic alteration in blood glucose concentration. Additionally, activity of acetylcholinesterase (AChE) indicated normal activity in poisoning case 1, moderate inhibition in poisoning case 2 and case 3, normal activity in poisoning case 4 and severe inhibition in poisoning case 5. The levels of Aminotransferase (ALT) and Aspartate Aminotransferase (AST) were within the acceptable range whereas the level of Alkaline Phosphatase (ALP) was above the acceptable reference range suggesting potential Hepato-toxicity. Scorpion bitten child did not receive atropine whereas two poisoned cases were successfully cured by atropine injection. Additionally, alternative safe medical management may be used for cardiotoxicity using vitamin C, vitamin E, quercetin, and curcumin. These vitamins may be recommended as alternative medical treatments for cardiotoxicity.