scholarly journals The comparison of creatinine and cystatin C value in preeclampsia severity and neonatal outcome

2018 ◽  
Vol 24 (3) ◽  
pp. 84 ◽  
Author(s):  
John Wantania ◽  
Abraham Winarto
Keyword(s):  
Cystatin C ◽  
Statistical Tests ◽  
Severe Preeclampsia ◽  
Neonatal Outcomes ◽  
Intrauterine Fetal Death ◽  
Adverse Neonatal Outcomes ◽  
C Value ◽  
Mild Preeclampsia ◽  
The Mean ◽  
Better Than

Objectives: to compare the levels of creatinine and cystatin C with the severity of preeclampsia, and assess neonatal outcomes.Materials and Methods: Creatinine, cystatin C, and neonatal outcomes were assesed in 17 normotensive samples, 17 samples of mild preeclampsia and 17 samples of severe preeclampsia. Analysis of data with statistical tests of ANOVA and t test differences between 2 proportions.Results: The mean levels of creatinine in the normotensive group, mild preeclampsia, severe preeclampsia are 0.56 mg/dL, 0.67 mg/ dL, and 0.75 mg/dL, p=0.138; While on cystatin C are 0.82 mg/L, 1.03 mg/L and 1.32 mg/L, p=0.000. The adverse neonatal out-come wasn’t found in the normotensive group. In mild pre-eclampsia obtained 1 preterm birth and 1 intrauterine fetal death (IUFD), whereas in severe preeclampsia obtained 3 babies born preterm, 1 IUFD, and 1 intrauterine growth restriction (IUGR).Conclusion: levels of cystatin C was increased significantly in line with increased severity of preeclampsia, whereas creatinine was not increased significantly. Cystatin C is better than crea-tinine as a marker of renal dysfunction in preeclampsia patients. There was an increase in adverse neonatal outcomes in the group of preeclampsia.

scholarly journals The comparison of creatinine and cystatin C value in preeclampsia severity and neonatal outcome

2017 ◽  
Vol 24 (3) ◽  
pp. 84
Author(s):  
John Wantania ◽  
Abraham Winarto
Keyword(s):  
Cystatin C ◽  
Statistical Tests ◽  
Severe Preeclampsia ◽  
Neonatal Outcomes ◽  
Intrauterine Fetal Death ◽  
Adverse Neonatal Outcomes ◽  
C Value ◽  
Mild Preeclampsia ◽  
The Mean ◽  
Better Than

Objectives: to compare the levels of creatinine and cystatin C with the severity of preeclampsia, and assess neonatal outcomes.Materials and Methods: Creatinine, cystatin C, and neonatal outcomes were assesed in 17 normotensive samples, 17 samples of mild preeclampsia and 17 samples of severe preeclampsia. Analysis of data with statistical tests of ANOVA and t test differences between 2 proportions.Results: The mean levels of creatinine in the normotensive group, mild preeclampsia, severe preeclampsia are 0.56 mg/dL, 0.67 mg/ dL, and 0.75 mg/dL, p=0.138; While on cystatin C are 0.82 mg/L, 1.03 mg/L and 1.32 mg/L, p=0.000. The adverse neonatal out-come wasn’t found in the normotensive group. In mild pre-eclampsia obtained 1 preterm birth and 1 intrauterine fetal death (IUFD), whereas in severe preeclampsia obtained 3 babies born preterm, 1 IUFD, and 1 intrauterine growth restriction (IUGR).Conclusion: levels of cystatin C was increased significantly in line with increased severity of preeclampsia, whereas creatinine was not increased significantly. Cystatin C is better than crea-tinine as a marker of renal dysfunction in preeclampsia patients. There was an increase in adverse neonatal outcomes in the group of preeclampsia.

scholarly journals Cystatin C Serum Level and the Severity of Preeclampsia

2017 ◽  
pp. 133
Author(s):  
Abraham Winarto ◽  
Eddy Suparman ◽  
John Wantania
Keyword(s):  
Serum Level ◽  
Serum Concentration ◽  
Pregnant Women ◽  
Cystatin C ◽  
Statistical Test ◽  
Severe Preeclampsia ◽  
Cross Sectional ◽  
Mild Preeclampsia ◽  
The Mean ◽  
Cross Sectional Design

Objective: Determining the cystatin C serum level among normotensive, mild preeclamptic, severe preeclamptic pregnant women and their relationship with the severity of preeclampsia. Method: The study was held using cross sectional design in Prof. Dr. RD Kandou Hospital in Manado and its network hospitals. We did on 51 samples at term pregnant women, consisting of 17 samples for each group in normotensive, mild preeclampsia, and severe preeclampsia. The data were analyzed using SPSS version 22.0 software through ANOVA and Kruskal Wallis statistical test. Result: The mean cystatin C serum concentration in normotensive pregnant women, mild preeclampsia, and severe preeclampsia were 0.82 mg/l, 1.03 mg/l, and 1.32 mg/l; respectively. The ANOVA statistical test showed the significant association between cystatin C level and severity of preeclampsia (p

Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

2021 ◽  
pp. 45-50
Author(s):  
Suher Dafaus ◽  
Amel Morgham ◽  
Nasreen Osman
Keyword(s):  
Caesarean Section ◽  
Positive Family History ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Intrauterine Fetal Death ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Adequate Treatment ◽  
History Of ◽  
The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

scholarly journals Assessment and Development of Bone Preparation for Radiocarbon Dating at HEKAL

Radiocarbon ◽  
2019 ◽  
Vol 61 (5) ◽  
pp. 1551-1561 ◽  
Author(s):  
István Major ◽  
István Futó ◽  
János Dani ◽  
Orsolya Cserpák-Laczi ◽  
Mihály Gasparik ◽  
...  
Keyword(s):  
Uncertainty Range ◽  
Bone Measurement ◽  
Test Study ◽  
C Value ◽  
The Mean ◽  
Materials Used ◽  
Near Future ◽  
Preparation Techniques ◽  
Small Bone ◽  
Better Than

ABSTRACTBone is one of the most complex sample materials used for radiocarbon (14C) dating. The installation of the EnvironMICADAS AMS at HEKAL (department of ICER) in 2011 required the adoption of new sample preparation techniques for small bone samples. Since then, hundreds of procedural background and known-age bones have been processed using our modified Longin method (MLM) and dated along with unknown samples. Their results are used in this study to assess the reproducibility of our current bone preparation method and the real uncertainty of the final age result. In addition, using the background samples, which are included in each bone measurement batch, blank correction of the unknown samples could also be performed. The mean F14C value of our bone blanks is generally better than 0.005 (∼42,500 BP) alongside 0.0013 SD. Good reproducibility was confirmed by the results of the laboratory known-age bone as well, where the standard deviation of the mean is better than 0.0025. In addition, the results of the three bone samples used in an ultrafiltration (UF) test study did not show notable differences from the ones obtained by our current protocol in 1σ uncertainty range but more experiments will be performed in the near future.

scholarly journals Study on serum Lipoprotein (a) level in preeclamptic Bangladeshi women

2009 ◽  
Vol 4 (2) ◽  
pp. 32-35
Author(s):  
Noor E-Ferdous ◽  
Mahmuda Khatun ◽  
Md Abu Siddique ◽  
Asma Ul Hosna ◽  
Shirin Akter Begum ◽  
...  
Keyword(s):  
Case Control Study ◽  
Serum Lipoprotein ◽  
Severe Preeclampsia ◽  
College Hospital ◽  
Lipoprotein A ◽  
Medical College ◽  
Mild Preeclampsia ◽  
The Mean ◽  
Average Serum ◽  
Control Study

It is a case control study which was design to know the association of serum Lipoprotein (a) level in preeclamptic (PE) in women. This study was carried out in department of Obstetrics and Gynecology, Sir Salimullah Medical College Hospital, Mitford, Dhaka. Total number of subjects was 100. Out of which 50 were cases and 50 were controls. Cases were physically and clinically proved PE patients. Controls were age, parity and gestational age matched. Three ml of blood were collected from each subjects, serum fasting LP(a) level were measured The mean age of study group was 24.49 ± 6.48 years. Serum Lipoprotein(a) level was 51.51 ± 29.38mg/dl Vs 17.40 ± 7.89 mg/dl in cases and controls respectively. This difference was statistically significant (p < 0.001). Mean serum Lipoprotein(a) level was found to be raised in severe preeclampsia (74.87mg/dl) and lowest in control subject Severe preeclampsia was found to be associated with higher level of lipoprotein (a) than both control (p < 0.01) and mild preeclamptic (p < 0.01) subjects. Mild preeclampsia was also found to have higher average serum Lipoprotein (a) than the normal (P < 0.01) subjects. Key Words: Lipoprotein(a), Preeclampsia, Bangladeshi women. doi:10.3329/uhj.v4i2.2073 University Heart Journal Vol. 4 No. 2 July 2008 p32-35

Differences in the Coagulation Profile in Women with Mild and Severe Preeclampsia

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 15-16
Author(s):  
Elmina Lefkou ◽  
Patrick Van Dreden ◽  
Aurélie Rousseau ◽  
Grigorios T. Gerotziafas
Keyword(s):  
Pregnant Women ◽  
Prothrombin Time ◽  
Cell Activation ◽  
Severe Preeclampsia ◽  
Clotting Time ◽  
Endothelial Cell Activation ◽  
Mild Preeclampsia ◽  
The Mean ◽  
Group D ◽  
D Dimer

Introduction:Different coagulations abnormalities have been referred in women with early oncet preeclampsia (EOP), but there are only few studies comparing those changes regarding to the severity of the disease. Aim:In this study we aimed to investigate the differences between the coagulation profile in women with mild and severe preeclampsia. Methods:This is an observational retrospective case-control study. Plasma samples were collected from 84 women divided into three groups, the healthy pregnant (HP) group (n=35), the mild preeclampsia (MP) group (n=34) and the severe preeclampsia (SP) group (n=15). The study population general characteristics are shown in Table 1. We studied the following biomarkers of hypercoagulability and endothelial cell activation: Tissue factor activity (TFa), Procoagulant phospholipid activity (PPL), Protein S, D-Dimers, Antithrombin, thrombomodulin, TFPI levels. All women were assessed with classic coagulation tests (aPTT and PT) fibrinogen levels and hemogram. Statistical analysis was performed using the PASW Statistics 17.0.2 (SPSS Inc.) for Windows. Results:Women with preeclampsia - mild or severe- showed significant increase of TFPI, TFa and TMa levels as compared to healthy pregnant women. No significant difference of TFPI, TFa was observed between MP and SP groups. In contrast, TMa levels were significantly increased in SP as compared to MP group. The ratio TFa/TFPI was also lower in SP as compared to MP-group. Women in MP or SP group had similarly shorter PPL clotting time as compared to HP group. D-dimer levels were increased in women with preeclampsia as compared to the HP group. D-Dimer levels were significantly higher in SP as compared to MP group. The levels of free PS activity in HP as well as MP and SP groups were lower than normal range in non-pregnant women and the value in MP was significantly lower than that of the HP or SP. Fibrinogen levels were not significantly different in the three studied groups of pregnant women. Prothrombin time was found to be increased in cases as compared to that in the controls. The mean value of prothrombin time in mild preeclampsia was 13.24±0.80 seconds and in severe preeclampsia it was seconds 14.77±0.96 and in pregnant controls 12.23±0.59 seconds (p&lt;0.05 and p&lt;0.001 respectively). The mean prothrombin time was found to increase with increasing severity of disease (p&lt;0.001). The mean activated partial thromboplastin time were increased in mild preeclampsia and was 32.64±1.83 seconds and in severe preeclampsia it was 35.59±1.53 seconds and in pregnant controls 29.53±1.62 seconds (p&lt;0.001). The activated partial thromboplastin time was found to increase with increasing severity of disease (p&lt;0.001). The antithrombin III decreased in severe SP and MP or compared to pregnant controls (76.33±4.32 and 88.06±9.68 versus 95.40±0.36 respectively; p&lt;0.001). This decrease is more pronounced in SP compared to MP (p&lt;0.001). Conclusions:Preeclampsia is associated with endothelial cell activation as documented by the increase of TFa, soluble TM levels and TFPI levels in plasma. Release of soluble thrombomoduline and TFPI rather than TFa by endothelial cells appear to be related with degree of preeclampsia severity. Women with preeclampsia showed marked decrease of PPL clotting time indicating enhanced platelet activation that was independent of the severity of preeclampsia. In contrast, women with severe preeclampsia showed signs of enhanced hypercoagulability documented by the increase of D-dimer levels consumption of natural coagulation inhibitors and particularly of AT. This phenomenon tended to be reflected on the prolongation of PT and aPTT in women with severe preeclampsia. Disclosures No relevant conflicts of interest to declare.

scholarly journals POS0569 LONG-TERM OUTCOMES OF CHILDREN BORN TO WOMEN WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 519.1-519
Author(s):  
N. Calin ◽  
A. T. Florescu ◽  
F. Bobirca ◽  
C. Tataru ◽  
I. Ancuta ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Atopic Dermatitis ◽  
Juvenile Idiopathic Arthritis ◽  
Neonatal Outcomes ◽  
Childhood And Adolescence ◽  
Developmental Milestones ◽  
Patient Reported ◽  
Adverse Neonatal Outcomes ◽  
The Mean

Background:Children born to women with rheumatoid arthritis (RA) have increased incidences of adverse neonatal outcomes and a potential excess risk of specific diseases during childhood and adolescence [1]. Further studies aimed at confirming long-term consequences in the offspring are needed.Objectives:To evaluate whether maternal RA has an impact on the health and developmental outcomes of the offspring.Methods:A retrospective descriptive study was conducted on data regarding 43 children born to mothers diagnosed with either RA or juvenile idiopathic arthritis (JIA) prior to conception. Participants were recruited from several Clinics of Rheumatology located across Romania. Data on neonatal outcomes, lactation, developmental milestones, childhood illnesses, and hospitalizations was collected using a patient-reported questionnaire completed by maternal participants in 2020.Results:Favorable neonatal outcomes were found in 81% of the participants; however, children of mothers with RA had a higher occurrence of favorable outcomes than those with JIA (p = 0.009). Adverse neonatal outcomes reported include the following: small for gestational age (11.6%), intrauterine growth restriction (4.65%), and preterm births (2.75%). There were no incidences of congenital malformations. The mean birth weights of offspring born to mothers with RA are higher than those with JIA (p = 0.00829).While the majority of the children were breastfed (88.4%), those who were not breastfed were hospitalized more often than those who were breastfed for any period of time (p = 0.03). Mothers who experienced a postpartum flare up within the first 4 months breastfed their children significantly less than those who did not have a flare up (14.62 versus 48 weeks, p = 0.00011).The mean age of the children at inclusion was 7.6 ± 5.5 years.Developmental milestones were considered to be within the expected average limits, except for an increased incidence of delayed speech (12%).51.2% of the children were hospitalized at some point during their childhood, with viral enterocolitis, tonsilitis, bronchiolitis, and pneumonia being the most frequently encountered reasons for admission. Surprisingly, children with favorable neonatal outcomes were hospitalized more often than those with unfavorable outcomes (p = 0.0000436). Additionally, children born to mothers under the age of 35 were hospitalized more often than those over 35 (p = 0.02).77.3% of offspring experienced recurrent ear/nose/throat (ENT) infections, 55.8% had allergies, and 39.5% were diagnosed with atopic dermatitis. Childhood allergies were strongly associated with an increased incidence of atopic dermatitis (p = 0.0000585), as was a concurrent maternal thrombophilia diagnosis (p = 0.03).Of the remaining childhood afflictions that were assessed asthma/chronic respiratory diseases (4.65%), juvenile idiopathic arthritis (2.33%), ulcerative colitis (2.33%), diabetes, anxiety/personality disorders, thyroid diseases, febrile seizures, and epilepsy did not yield statistically significant results.Conclusion:Maternal RA was found to be associated with increased incidences of adverse neonatal outcomes, childhood hospitalizations, recurrent ENT infections, allergies, and atopic dermatitis. However, overall health outcomes of offspring did not show alarmingly significant excess morbidities.References:[1]Rom AL, Wu CS, Olsen J, et al. Parental rheumatoid arthritis and long-term child morbidity: a nationwide cohort study. Annals of the Rheumatic Diseases. 2016;75(10):1831–1837. doi:10.1136/annrheumdis-2015-208072Disclosure of Interests:None declared

scholarly journals Outcome of Hypertensive Disorders of Pregnancy

2014 ◽  
Vol 3 (1) ◽  
pp. 46-52
Author(s):  
Akhter Zahan ◽  
Md Nazrul Islam ◽  
Netay Kumer Sharma ◽  
Khadiza Begum ◽  
Kinkon Rani Bhowmik
Keyword(s):  
Birth Weight ◽  
Severe Preeclampsia ◽  
Neonatal Outcomes ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Mild Preeclampsia ◽  
Adverse Pregnancy ◽  
The Impact

Hypertension is the most common medical problem encountered in pregnancy and are leading causes of maternal, fetal and neonatal morbidity and mortality worldwide. Definitions, classifications, assessment and management of hypertensive disorders vary considerably in the literature and from country to country. In light of this, we aimed to evaluate different types of hypertensive disorders of pregnancy and to determine the impact of hypertensive disorders of pregnancy (HDP) on maternal, fetal and neonatal outcomes. This Cross Sectional descriptive study was conducted in the Department of Gynaecology and Obstetrics of Community Based Medical College, Mymensingh, Bangladesh from April 2012 to March 2013. All the patients who were diagnosed with HDP and gestational age of 20-40 weeks during the study period were included in the study. Patients with preexisting renal disease, diabetes mellitus, active urinary tract infection or who refused to cooperate with the study were excluded. The data regarding demographic variables, clinical features, pregnancy characteristics, maternal complications, fetal and neonatal outcomes were gathered from available data on medical record files. Edema was the most common clinical symptom. Primipara mothers were predominant in the both mild and severe preeclampsia group. Majority (88%) of mothers in mild preeclampsia group had a history of spontaneous vaginal birth, however 82.9% in severe preeclampsia group by Lower Segment Caesarean Section (LSCS). A higher proportion of mother in mild preeclampsia group delivered at term, whereas 65.7% in severe preeclampsia group delivered preterm. The proportion of maternal complications such as were significantly higher in severe preeclampsia group than those in mild preeclampsia group. Most babies (92%) were born with a birth weight 2500 grams in mild preeclampsia group, while 70% born with birth weight between 1500 - 2499 grams in severe preeclampsia group. All the babies were born with apgar score less than 7 between mild and severe preeclampsia groups. About three quarter (74.3%) of neonates born to women the severe preeclampsia group required resuscitation compared to 40% in mild preeclampsia group. The maternal death, still birth and neonatal death were found higher in severe preeclampsia group than those in mild preeclampsia group. Pregnancies affected by hypertensive disorders require careful monitoring due to the increased risks of adverse pregnancy outcomes. Frequency of severe hypertensive disorders is high in our set up. It is associated with high maternal, fetal and neonatal mortality CBMJ 2014 January: Vol. 03 No. 01 P: 46-52

scholarly journals A comparison of platelet count in severe preeclampsia, mild preeclampsia and normal pregnancy

2018 ◽  
Vol 6 (2) ◽  
pp. 671
Author(s):  
Amit Gupta ◽  
Bindu S. Gaur ◽  
K. B. Mishra ◽  
Ishan Dubey
Keyword(s):  
Platelet Count ◽  
Significant Role ◽  
Cost Effective ◽  
Normal Pregnancy ◽  
Severe Preeclampsia ◽  
Effective Management ◽  
Multisystem Disorder ◽  
Maternal Morbidity And Mortality ◽  
Mild Preeclampsia ◽  
The Mean

Background: Preeclampsia, the most common of hypertensive disorders of pregnancy is an idiopathic multisystem disorder affecting 2 – 10% of all pregnancies and together they form one member of the deadly triad, along with hemorrhage and infection that contribute greatly to the maternal morbidity and mortality rates. The identification of this clinical entity and effective management play a significant role in the outcome of pregnancy. Platelet count is emphasized to play a significant role in hemostasis mechanism of preeclampsia and the degree of thrombocytopenia increases with severity of preeclampsia. This study was conducted to find correlation of platelet count in severe preeclampsia, mild preeclampsia and normal subjects.Methods: Total 140 subjects, 70 control and 70 cases were enrolled in the study. Samples for platelet count were collected and estimation was carried out by the auto-analyzers. The statistical evaluation is done using SPSS version 22 along with Anova and student t-test.Results: The mean platelet count was significantly lower (p <0.05) in mild and severe preeclampsia than that in the normal pregnancy. Decreased platelet count in severe preeclampsia was significant compared to that in mild preeclampsia.Conclusions: The frequency of thrombocytopenia was found to be directly related with the severity of disease, so platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period.

Rice tablet (Aluminum Phosphide) poisoning

2016 ◽  
Vol 5 (11) ◽  
pp. 5041
Author(s):  
Farkhondeh Jamshidi ◽  
Ahmad Ghorbani ◽  
Sina Darvishi*
Keyword(s):  
Medical Records ◽  
Statistical Tests ◽  
Patient Records ◽  
Demographic Information ◽  
Aluminum Phosphide ◽  
Men And Women ◽  
Significant Difference ◽  
The Mean ◽  
Aluminum Phosphide Poisoning ◽  
Commit Suicide

The abuse of some pesticides especially to suicide is one of the current problems of pesticides. Aluminum phosphide induced poisoning usually happens to suicide and sometimes it is due to accidental occupational exposure and in a few cases it has some criminal intensions. This study is conducted to evaluate patients poisoned with aluminum phosphide. In the present study the medical records of cases of poisoning with rice tablets (aluminum phosphide) hospitalized in Ahvaz Razi hospital is studied. Accordingly, a checklist is prepared that included demographic information of patients (age, gender) and information on patient records (information on poisoning) are completed using the patients’ medical records. The analysis of data is done by SPSS V22. 18 patients poisoned with rice tablet (aluminum phosphide) are studied. Results of the study show that 11 patients are male and seven are female. The mean patient age is 27.06 ±8.04 years that is 28 ±9 and 25 ±6.02 in men and women respectively. Statistical tests show no statistically significant difference in mean age in both genders (P> 0.05). Among patients, 11 subjects took aluminum phosphide to attempt suicide and 3 cases took it unintentionally and of course the reason is not mentioned in four cases. Among the patients who tried to commit suicide by taking aluminum phosphide, 6 cases are male and 5 cases are female that no statistically significant difference is observed between the genders in this respect (P> 0.05). In addition to the study of the complications caused by this poisoning and its mortality, it is recommended to responsible authorities to provide the necessary educations and treatments to prevent this type of poisoning.

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