In-hospital outcomes and delayed neurologic sequelae of seizure-related endosulfan poisoning

A narrative review of contemporary lethal pesticides: unveiling the ongoing threat of pesticide poisoning

Following the 2011 ban on paraquat sales, Korea has witnessed a significant reduction in the mortality rate associated with acute pesticide poisoning. Traditionally, paraquat and diquat, alongside several highly toxic organophosphates, carbamates, and organochlorine insecticides, have been recognized as culprits in causing fatalities among patients with acute pesticide poisoning. However, despite global efforts to curtail the use of these highly toxic pesticides, certain pesticides still exhibit a level of lethality surpassing their established clinical toxicity profiles. Understanding the clinical progression of these pesticides is paramount for physicians and toxicologists, as it holds the potential to enhance patient prognoses in cases of acute poisoning. This review aims to address the persistence of such highly lethal pesticides, which continue to pose a grave threat to victims of acute poisoning.

Endosulfan-Induced Prolonged Super-Refractory Status Epilepticus

Endosulfan is a highly toxic pesticide that causes hyperstimulation of the central nervous system by antagonizing gamma aminobutyric acid-mediated inhibition. Seizure is the most important manifestation of endosulfan poisoning, frequently progressing to status epilepticus and refractory status epilepticus. Here, we report a recent case of a 64-year-old man with endosulfan-induced super-refractory status epilepticus, which persisted for a remarkably longer period than has been described in previous reports. The patient arrived at the emergency room with continuous generalized tonic-clonic seizures. Electroencephalogram-recorded seizures that persisted even after intravenous administration of lorazepam and antiepileptic drugs. Intravenous anesthetic agents were administered for 9 days to confront the persistently recurring seizures. Immediately after this treatment period, the seizures subsided, and the patient showed marked neurological improvement. After 2 months however, he died of multiple systemic complications. This case report elucidates the importance of aggressive evaluation and management including continuous EEG monitoring in cases of endosulfan-related status epilepticus.

Genoprotective Effect of New Triazine Derivatives in Endosulfan Mediated Toxicity, an In vivo and In vitro Study

Background:

Recently, we reported synthesis and neuroprotective activity of some new 1,2,4-triazine derivatives against H2O2 and β-amyloid toxicity in two neurotic cell lines, SHSY5Y and PC12.

Methods:

The promising results obtained prompted us to further study on these potent neuroprotective agents. In the current study, in vivo anti-inflammatory effect and also genoprotective activity of these compounds in endosulfan-mediated toxicity were investigated. Compounds RT and SMO exhibited high anti-inflammatory effect at 3 and 4 hours after injection in 20 mg/kg, and were even more effective than Indomethacin (20 mg/kg).

Results:

Interestingly, compound SMO in 200 &#181;M was the best compound in reducing micronuclei significantly (P value <0.0001) in lymphocytes treated with endosulfan compared to control group.

Conclusion:

Herein, we report SMO as a genoprotective agent and a new drug candidate for endosulfan mediated toxicity.