1233 Can speckle tracking echocardiography predict outcome in hypoplastic left heart syndrome patients?

Funding Acknowledgements

EACVI Training Grant

Introduction

Children with Hypoplastic Left Heart Syndrome (HLHS) have a high mortality (up to 95%) and morbidity. Systemic right ventricle (RV) dysfunction plays a key-role in their outcome.

Purpose

The aim of this study is to evaluate the accuracy of speckle-tracking echocardiographic (STE) assessment of RV deformation and 2D standard echo parameters in predicting death and need for heart transplantation (HT) in HLHS patients.

Methods

31 patients with diagnosis of HLHS successfully completed Norwood (n = 29) or comprehensive Norwood stage II (n = 2) at our Institution between 2015 and 2019. Survival at 6 months was 90.32%, survival at 18 months was 85.72%. We studied 29 HLHS patients (17 male). Patients with HLHS variant (n = 2) were excluded. All the studied patients underwent in-hospital interstage stay. Serial echocardiographic assessment was performed in all the included patients (baseline, one month after Norwood, three months after Norwood, one week before bidirectional cavopulmonary anastomosis [BCPA] and two months after BCPA). From the apical view we measured: tricuspid annulus peak systolic excursion (TAPSE), fractional area change (FAC), longitudinal strain (LS) and strain rate (LSR).

Results

After a mean follow-up of 1.83 ± 1.16 years, 8 out of 29 of the included patients met the composite endpoint of death/HT. At pre-Norwood assessment, there was no statistical difference in echo measurements between survivors and patients who reached the endpoint. In death/HT group TAPSE and LS declined already at one-month after Norwood procedure evaluation. At one-month evaluation, a TAPSE ≤ 5 mm had a good sensitivity for death/HT (85.71%) and a moderate specificity (66.67%), with an area under the curve of 0.789. Always at one-month evaluation, a Δ LS ([{baseline LS – one-month post Norwood LS}/ baseline LS] *100) of 8.7% showed a 100% sensitivity and good specificity (80.95%) for death/HT, with an area under the curve of 0.888. Multivariate analysis showed that one-month-after-Norwood Δ LS was the best predictor of worse outcome (p = 0.02).

Conclusions

HLHS patients with Δ LS of > 8.7% at one-month after Norwood procedure had a high likelihood of death or HT. These data encourage the routine use of LS to monitor cardiac function in HLHS patients.

Abstract 1233 Figure. HLHS LS and trend of TAPSE and LS.

P312The acute impact of a high altitude ultra-trail race on the ECG

Background

Ultra-endurance competitions are becoming increasingly popular but the consequences of ultra-endurance sports activity on the heart rhythm is still a debated issue. Some authors demonstrated that athletes engaging in ultra-endurance sports show a transient rise in cardiac biomarkers and right ventricular dysfunction after a competition, suggesting the possibility of an adverse arrhythmic remodeling and an increased risk of sudden cardiac death. The aim of our study was to evaluate the effects on heart rhythm of an ultraendurance high-altitude race.

Methods

The study was performed during the 2018 North Face® Lavaredo Ultra Trail mountain run. We recorded the ECG with the FDA-approved MyDiagnostick device. Recordings were performed at baseline the day before the run and immediately after the run in the available athletes. The ECG was analyzed for heart rate, QRS duration, QT interval duration corrected according to the Bazett formula and presence of at least one beat of presumed ventricular origin (PVB).

Results

A total of 545 athletes (83% males, mean age: 40±9 years), 241 running the 120 Km race and 304 running the 50 Km race, were included in the study. At baseline, athletes showed a mean heart rate of 64±14 bpm and a mean QRS duration of 92±18 ms. Three (0.5%) showed at least one PVB. Analysis of QTc interval duration showed a mean value of 412±25 ms. After the race, athletes showed a higher heart rate (91±13 bpm, p<0.001), a similar QRS duration (94±16 ms, p=0.32) and a longer QTc interval duration (447±25 ms, p<0.001), as compared to baseline data. The number of athletes showing at least 1 PVB significantly increased to 18 (3.3%, p=0.004) as compared to pre-race evaluation. Athletes engaged in the 120 Km run showed a slightly longer post-run QTc interval (450±24 versus 444±25 ms, p=0.009) while the post-run QRS duration was similar between the two groups. The presence of PVBs after the race was not correlated with the duration of QTc interval.

Conclusions

In this study we found an increased number of PVBs and a prolonged QTc duration after an ultra-endurance competition. Increased ventricular ectopic activity and QT prolongation recorded shortly after an intense and prolonged exercise could contribute to the increased risk of arrhythmias occurring after the finish line.

P2734Aortic regurgitation in paediatric patients: new echo parameter strongly correlates with CMR

Background

Aortic regurgitation (AR) continues to be an important cause of morbidity and mortality, particularly in paediatric patients. In the paediatric population the prevalence of AR has increased, also due to expanded use of new surgical and hemodynamic procedures. While echocardiographic parameters are well established for the adults, there are no clear cut-off values to assess AR severity in children. Cardiac magnetic resonance (CMR) imaging is widely used to assess diagnostic and prognostic information and is considered a “gold standard” for a quantitative evaluation of the aortic regurgitation.

Purpose

The aim of the study is to assess which echo parameters can accurately define AR severity as assessed by CMR in paediatric patients.

Methods

A total of 36 paediatric patients (12±3,2 years of age, age range 6–18) with different degree of AR underwent echocardiographic assessment within an average of 25 days from CMR (no therapeutic changes were made in this period). Heart rate and arterial blood pressure were comparable during echo and CMR. CMR included phase-contrast velocity-encoded imaging for the measurement of regurgitant fraction (RF) at the sinotubular junction. Severe AR was defined as RF>33%. Echocardiographic evaluation included vena contracta (VC), pressure half time (PHT), the ratio between the AR jet and the LVOT diameter (jet/LVOT), presence of holodiastolic reversal flow in abdominal aorta (abdAo), the ratio between the velocity-time integral of the reversal flow over the forward flow in descending aorta (dAo-ratio).

Results

Among the echo parameters studied, the strongest predictor of severe aortic regurgitation, as assessed by CMR with RF, was dAo-ratio. ROC curve showed, for a cut-off >0.38: AUC 0.882, p<0.0001, sensitivity 71.4%, specificity 96.6%. Correlation coefficient between dAo-ratio and RF was R=0.9183 with a p<0.0001.

ROC curves were performed for all the echo parameters. PHT <410 ms: AUC 0,800, p=0,0001, sensitivity 100%, specificity 62,1%; VC >4 mm: AUC 0.783, p=0.0004, sensitivity 71.4%, specificity 72.4%; jet/LVOT >0.35: AUC 0.813, p=0,0002, sensitivity 71,4%, specificity 86,2%; abdAo =1: AUC 0,734, p 0,026, sensitivity 57,1%, specificity 89,7%.

dAo-ratio: measurement and statistics

Conclusions

Our findings suggest that dAo-ratio is a strong marker of severe aortic regurgitation in the paediatric population. This parameter should be routinely added in the standard echo evaluation of paediatric patients with aortic regurgitation.

Geochemistry of uranium and thorium in phosphate deposits at the Syrian coastal area (Al-Haffah and Al-Qaradaha) and their environmental impacts

The aim of this research was to study the geochemistry of uranium and thorium in phosphate deposits in the upper Cretaceous phosphate deposits in the Syrian coastal area. The study covered three sites, namely Ain Al-Tenah, Ain Laylon, and Al-Mhalbeh. Petrographical study showed that phosphate deposits are of nodular type with micrit to microspaite cement, containing siliceous bone residues, and green grains of glauconite, which are increasing in abundance and volume in the south toward Al-Mhalbeh, reflecting the formation of phosphate in a shallow marine environment. In addition, uranium concentration varied between 3 and 112 ppm in Ain Laylon, 4.2-17 ppm in Ain Al-Tenah and 5-61 ppm in Al-Mhalbeh. Thorium concentration varied between 0.2 and 7.5 ppm in Ain Laylon, 0.3-1.4 ppm in Ain Al-Tenah and 0.3-4.4 ppm in Al-Mhalbeh. The average Th/U ratio in the collected samples was within the range 0.04-0.08 except for five samples which exceeded the value 0.1. Moreover, the ²²⁶Ra/²³⁸U ratios are lower than unity in all samples, while the ²¹⁰Pb/²³⁸U ratios ranged between 0.4 and 1.2 and the ²¹⁰Pb/²²⁶Ra ratios were found to be higher than unity. On the other hand, the impact of leaching and mobility of uranium and thorium from deposits to the surrounding agriculture fields in the area has been studied using the Radium Equivalent Activity Index (Ra_eq). The equivalent radium activity was 102 Bq kg^-1 in Ain Al-Tenah, 403 Bq kg^-1 in Ain Laylon, 407 Bq kg^-1 in Al-Mhalbeh and 749 Bq kg^-1 in agricultural soil samples. However, the data reported in this study can be considered as a baseline data for the phosphate deposits at the coastal area.

P2739Can cardiac mechanics predict outcome in hypoplastic left heart syndrome patients? A speckle tracking echocardiography study

Introduction

Hypoplastic Left Heart Syndrome (HLHS) still carries a high morbidity and mortality. Right ventricle (RV) dysfunction is one of the most important responsible of a worse outcome. Unfortunately, RV assessment is a challenge. Speckle tracking echocardiography (STE) demonstrated an excellent ability in the estimation of RV function.

Purpose

The aim of our study is to evaluate the ability of STE and standard 2D echo parameters in predicting death and need for heart transplantation (HT) in HLHS patients.

Methods

31 patients with diagnosis of HLHS successfully completed Norwood (n=29) or comprehensive Norwood stage II at our Institution between 2016 and 2018. Survival at 6 months was 93.3%, survival at 18 months was 81.1%. We present our preliminary data on 23 HLHS patients (13 male).

All the studied patients underwent in-hospital interstage stay. Serial echocardiographic assessments were performed in all the included patients (baseline, one month after Norwood, three months after Norwood, one week before bidirectional cavopulmonary anastomosis [BCPA] and two months after BCPA).

From apical view we measured: tricuspid annulus peak systolic excursion (TAPSE), fractional area change (FAC), longitudinal strain (LS) and strain rate (LSR).

Results

After a median follow-up of 2.2 years (1.7–2.6 years), 6 out of 23 patients met the composite endpoint of death/HT.

At pre-Norwood assessment, there was no statistical difference between survivor and death/HT patients.

In death/HT group TAPSE declined at one-month after Norwood procedure. LS decreased significantly at three-months after Norwood. After BCPA, death/HT patients had much lower FAC, TAPSE, LS and LSR than survived patients.

At one-month evaluation, TAPSE ≤5 mm had a good specificity for death/HT (80%) and a moderate sensitivity (70.6%) with an area under the curve (AUC) of 0.80. Still at one-month evaluation, Δ LS ([{baseline LS – one-month post Norwood LS}/ baseline LS] *100) >7.7% showed a 100% sensibility and moderate specificity (76.5%) for death/HT (AUC 0.841).

LS in HLHS patient and LS ROC curve.

Conclusions

HLHS patients with TAPSE ≤5 mm and Δ LS of >7.7% one-month after Norwood had a high likelihood of death or HT. These preliminary data encourage the routine use of TAPSE and LS to monitor cardiac function in HLHS patients and to identify subgroup patients at high risk.

P4627Presentation, management, and outcomes of STEMI in Egypt: results from the European Society of Cardiology registry on ST elevation myocardial infarction

Background

Apart from few small single-center studies there are limited data about STEMI patients in Egypt.

Patients and methods

The European Society of Cardiology (ESC) Registry on ST Elevation Myocardial Infarction is a prospective, multicenter and observational registry. Nineteen Egyptian centers (with and without PCI facilities) participated in this registry with 1356 patients who were compared to 7420 patients from other ESC countries. Patient recruitment started from March 2016 to February 2018.

Aims of the study

The aims of this study was to describe the characteristics of patients with STEMI, to assess STEMI management patterns, to evaluate in-hospital patient outcome and to compare Egyptian patients with other ESC countries.

Results

Compared to other ESC countries, Egyptian patients were younger (mean age 55.4±11.3 vs. 62.9±12.4; P<0.001 and 4.3% vs. 19.4%% were ≥75 years old; P<0.001) with fewer females (18.4% vs. 25.6%; P<0.001). Fewer Egyptian patients had history of myocardial infarction (7.9% vs. 12.6%; P<0.001), chronic heart failure (2.0% vs. 11.5%; P<0.001), but Egyptians had higher prevalence of current smoking (59.0% vs. 42.8% p<0.001), Diabetes mellitus (40.7% vs. 21.9%, p<0.001). Egypt had longer median time between symptoms onset and first medical contact: 120.0 (60.0; 240.0) vs. 100.0 (50.0; 240.0) p<0.001. Self-presentation rather than EMS presentation was the mode of admission in 86.0% in Egypt vs. 25.8% in EU countries (p<0.001). On qualifying ECG, anterior STEMI was in 57.0% in Egypt vs. 45.9% in other countries (p<0.001). Initial reperfusion therapy was 49.1%, 43.0% and 7.2% for Primary PCI, thrombolytic therapy and no reperfusion in Egypt vs. 85.4%, 7.2% and 7.8% for EU countries, respectively. Thrombolysis when given was in the CCU/ICU rather than EMS or ER in 97.2% in Egypt vs. 43.7% in other countries. Compared to thrombolytic therapy, patients who were treated with primary PCI had less Cerebrovascular accident (0.75% vs. 1.3%; P<0.001), killip Class IV (3.0% vs. 5.9%; P<0.001) or AF (2.5% vs. 3.6%; P 0.008). In hospital mortality was 4.6% in Egypt vs. 3.5% in other countries P 0.040 and was 18.7% in No reperfusion vs. 2.1% in Primary PCI vs. 4.9% in Thrombolysis (P<0.001) among Egyptians. Patients were discharged on Aspirin in 98.6%, Clopidogrel in 91.0%, Ticagrelor in 7.1%, DAPT in 97.6%, Beta Blockers in 82.8%, ACE inhibitors in 84.7%, MRAs in 10.0%, and Statins in 99.7%.

Conclusion

Egyptian STEMI patients were younger, more frequently obese, smokers and diabetics had significantly longer delay between symptoms onset and first medical contact with more self-presentation rather than the recommended EMS presentation. Primary PCI was offered to only half of the patients. In hospital mortality was significantly higher and was highest among non-reperfused patients. National plans for primary and secondary prevention are urgently needed in Egypt.

Acknowledgement/Funding

This registry was funded by the ESC. The Egyptian Society of Cardiology was given a grant of €12000 to help with the implementation of this national E

Anti-proliferative effects of mesenchymal stem cells (MSCs) derived from multiple sources on ovarian cancer cell lines: an in-vitro experimental study

Mesenchymal stem cells (MSCs) have surfaced as ideal candidates for treatment of different therapeutically challenging diseases however their effect on cancer cells is not well determined. In this study, we investigated the effect of MSCs derived from human bone marrow (BM), adipose tissue (AT), and umbilical cord derived MSCs (UC-MSCs) on ovarian cancer.Measurements of ovarian tumor marker proteins were computed by ELISA. Proliferative, apoptosis and anti-inflammatory effects of the MSCs were measured by Flow cytometry (FCM). MMPs expression was measured by RT-PCR.The co-culture of cancer cell lines OVCAR3, CAOV3, IGROV3 and SKOV3 with the conditioned media of MSCs (CM-MSC) and MSCs showed an increase in cellular apoptosis, along with a reduction in the level of CA-125 and a decline of LDH and beta-hCG. A decrease in CD24 of the cancer cell lines in co-culture with the CM-MSCs showed a reduction of the cancer tumorigenicity. In addition, the invasion and aggressiveness of cancer cell lines was significantly decreased by CM-MSC; this was translated by a decrease in MMP-2, MMP-9, and CA-125 mRNA expression, and an increase in TIMP 1, 2, and 3 mRNA expression. An increase in IL-4 and IL-10 cytokines, and a decrease in GM-CSF, IL-6, and IL-9, were also noted.In conclusion, mesenchymal stem cells derived from different sources and their conditioned media appear to have a major role in inhibition of cancer aggressiveness and might be considered as a potential therapeutic tool in ovarian cancer.

Trauma intensive care in a terror-ravaged, resource-constrained setting: Are we prepared for the emerging challenge?

Introduction

Trauma in developing countries has been on the increase, a situation perpetuated by rising road traffic collisions, terrorism and firearms proliferation. Some of the victims of trauma are left with life threatening conditions requiring urgent surgical intervention and/or intensive care. The objectives of this study were to determine the pattern of major trauma needing intensive care in the region, and to determine the outcome of major trauma admitted to intensive care unit.

Methods

A six-year retrospective cohort study of trauma patients needing intensive care, set in the Intensive Care Unit of Ahmadu Bello University Teaching Hospital, Zaria, North-West Nigeria. Subjects were major trauma patients admitted into the intensive care unit of the institution, identified via an admission register kept in the unit. The main outcomes measured were length of stay and mortality.

Results

Trauma admissions represented 25.1% of the all intensive care admissions. Severe traumatic brain injury accounted for 32.1% of the trauma admissions, while burns accounted for 23.2%. Of the injuries, 15.5% were sustained in bomb blasts, and 8.3% were firearm injuries. The majority of the patients stayed for no more than seven days from admission. Burns patients had the worst outcomes, with 82.1% mortality.

Conclusion

Major trauma contributes significantly to local intensive care admissions, with terrorism- related trauma now an emerging challenging cause of major trauma in our region. The observed poor outcomes in this study are a reflection of the quality of available intensive care, and lends credence to the concept of appropriately resourced, specialised intensive care units for optimisation of care.

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

BACKGROUND

Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.

METHODS

This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy.

RESULTS

Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI.

CONCLUSIONS

After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.

Challenges in the diagnosis and treatment of mucormycosis

The diagnosis and treatment of mucormycosis are challenging. The incidence of the disease seems to be increasing. Hematological malignancies are the most common underlying disease in countries with high income and uncontrolled diabetes in developing countries. Clinical approach to diagnosis lacks sensitivity and specificity. Radiologically, multiple (≥10) nodules and pleural effusion are reportedly associated with pulmonary mucormycosis. Another finding on computerized tomography (CT) scan, which seems to indicate the presence of mucormycosis, is the reverse halo sign. Microscopy (direct and on histopathology) and culture are the cornerstones of diagnosis. Molecular assays can be used either for detection or identification of mucormycetes, and they can be recommended as valuable add-on tools that complement conventional diagnostic procedures. Successful management of mucormycosis is based on a multimodal approach, including reversal or discontinuation of underlying predisposing factors, early administration of active antifungal agents at optimal doses, complete removal of all infected tissues, and use of various adjunctive therapies. Our armamentarium of antifungals is slightly enriched by the addition of two newer azoles (posaconazole and isavuconazole) to liposomal amphotericin B, which remains the drug of choice for the initial antifungal treatment, according to the recently published guidelines by ECIL-6, as well as those published by ECMM/ESCMID. Despite the efforts for better understanding of the pathogenesis, early diagnosis and aggressive treatment of mucormycosis, the mortality rate of the disease remains high.

Knowledge, attitude, and practice of diabetic retinopathy among physicians in Northwestern Nigeria

Background

Diabetic retinopathy (DR) is the leading cause of preventable blindness in the productive population that poses a considerable global public health burden.

Objective

The objective of this study is to assess the knowledge, attitude, and practice of DR screening among physicians in Northwestern Nigeria. Materials and Methods: Survey responses were obtained from 105 physicians in 4 tertiary hospitals using a Likert scale questionnaire. The internal consistency of the questionnaire was calculated using Cronbach's alpha coefficient. Principal component analysis was used for data reduction and grouping with the varimax rotation method, and the factors were extracted based on an Eigenvalue> 1.

Results

Most of the respondents (78.8%) were aware of the most effective method of delaying the onset of DR and frequency of eye examination (94.1%). Lack of ophthalmoscopes (70.6%) and dilating eye drops (50.6%) form important barriers to performing a good eye examination.

Conclusion

DR screening among physicians practicing in Northwestern Nigeria was suboptimal, which prompts the need for improved training of physicians managing persons with diabetes on eye examination in a bid to strengthen DR screening and reduce the burden of visual impairment in our environment.

Polymeric clips are a quicker and cheaper alternative to endoscopic ligatures for securing the appendiceal stump during laparoscopic appendicectomy

Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015. Data collected included age, gender, body mass index, duration of surgery, length of hospital stay, antibiotic use, preoperative haematological and biochemical parameters, 30-day readmission rate and complications. Results A total of 125 patients were included within the study, with 78 within the endoloop group and 47 in the polymeric clip group. There were no differences in age, gender, body mass index, hospital stay, antibiotic use, 30-day readmission rates or postoperative complications. Operative time was significantly reduced in the polymeric clip group (59 vs. 68 minutes, P = 0.00751). The use of polymeric clips cost £21 compared with £49 for endoloops per operation, which rose to £70 if both clips and endoloops were used during the procedure. Discussion Polymeric clips are a safe, viable and economical method for securing the appendiceal stump during laparoscopic appendicectomy. The clinical significance of nine minutes of reduced operating time in the polymeric clip cohort warrants further study with an adequately powered randomised controlled trial.

5-fu for problematic scarring: a review of the literature

Keloids and hypertrophic scars represent a common complaint for plastic surgeons. These scars often leave patients with severe morbidity due to their resistance to therapy. A variety of therapeutic options exist, yet none seem to offer a permanent solution, and scars frequently reoccur. The antineoplastic drug 5-fluorouracil (5-FU) has been shown to inhibit fibroblast proliferation in vitro and has been used as a treatment modality for these pathologic and problematic scars. We present a review of literature on treatment protocols, and on the efficacy and safety profile of this drug in the treatment of problematic scarring in terms of size reduction and symptom resolution. Current evidence suggests that 5-FU is effective in treating keloids and hypertrophic scars, but further research must be done to correlate therapeutic response with the age of the scar. In addition, larger randomized control trials must be conducted with longer follow up periods to assess recurrence rates with better accuracy.

Dichlorvos Induced Oxidative and Neuronal Responses in Rats: Mitigative Efficacy of Nigella sativa (Black Cumin)

Poisoning from Organophosphates (OPs), especially Dichlorvos (DDVP) has become endemic due to theincreasing use in house hold and agricultural pests control, with most marked effects in the nervous system. However, it isevidenced that natural antioxidants are efficacious against OPs toxicity. Thus, this study investigated the possible antidotalefficacy of Nigella sativa oil (NSO) in Dichlovos (DDVP) induced oxidative and neuronal damages in Wistar rats. DDVPwas administered at sub-chronic daily dosage of 8.8 mg/kg.bw for 7 days and a post-administration of NSO at 1 ml/kg.bwfor the subsequent 7 days. The rats were euthanized on the 15thday, blood sample collected via cardiac puncture, centrifugedand the plasma used for biochemical analysis of total antioxidant capacity (TAC), reduced glutathione (GSH) and totalreactive oxygen species (ROS), while the frontal, occipital and cerebellar cortices and the medulla were removed for histomorphological examinations. The results showed significant (P≤0.05) decrease in plasma TAC and GSH, while a significant(P≤0.05) increase in ROS was recorded, and some vacuolation around the neurons especially in the frontal and cerebellarcortices following DDVP exposure. However, post treatment with NSO was observed to be efficacious in the recovery ofthe oxidative activities and the neuro-architectural integrities. Thus, it can be concluded that the antioxidant capacity of NSOcould be efficacious against OPs induced oxidative damages, especially in dichlorvos accidents.