الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 120 |  |  |
| | | from | 120 | | |
Abstract
Co is a colorless, odorless, nonirritant and tasteless gas produced from incomplete burning of organic materials. Although, Co toxicity is preventable; it remains an important cause of morbidity and mortality worldwide.
The clinical symptoms of Co poisoning are non-specific and varied. The most common manifestations of Co toxicity include headache, nausea, vomiting, dizziness and alteration in the conscious level. It may include cognitive dysfunctions, depression, anxiety, personality changes, urine and fecal incontinence, gait disturbances, Parkinsonism and mutism.
Cognitive impairment is one of the most serious complications of Co poisoning because it may prevent full recovery of pre-morbid functions in Co intoxicated patients. It is a stressful condition that is characterized by varied degrees of cognitive deficits, movement problems, personality changes and focal neurologic deficits that can persist for one year or more.
However, some risk factors for developing these deficits have been identified such as CoHb level, age of the patient, prolonged time of exposure to Co and the intensity of toxicity, developing of such neurological consequence occurs widely in an unexpected pattern.
This study was conducted during the period from the first of December, 2018 to 30th of May 2020 at Minia Poisoning Control Center (PCC), Minia university Hospitals, Minia, Egypt to assess the effect of acute severe Co poisoning on the intellectual functions in children at the time of discharge, after 6 months and after one year of toxicity.
Sixty two children were included in this study 30 healthy (control), 32 (patients) aged 3-17 years. The children were selected from 139 patients admitted to Minia PCC during the period of the study. Diagnosis as acute severe Co poisoning was done after taking a full history from the parents or relatives, full examination with special concern to CVS and CNS systems, estimation of CoHb level (more than 25%) and ECG changes. Informed consents were obtained from the parents of children before performing any step and after explanation of the study. This study was approved by the Hospital Ethical Committee by Approval number 133-12/2018.
The subjects were classified into 2 groups, control group and children who were diagnosed as acute severe Co intoxication. The second group was furtherly subdivided into 3 subgroups according to time of examination; children were examined at the time of discharge, at 6 months after discharge and at 12 months after discharge.
Intellectual and cognitive functions were assessed in both groups using Wechsler’s Intelligence Scale for Children, 3rd ed., test and Conners Parent Rating Scale-48 at the beginning of the study. Acute severely intoxicated patients were reassessed after 6 and 12 months of toxicity.
As regarding evaluation of intellectual functions using Wechsler’s Intelligence Scale for Children, 3rd ed., the current study demonstrated that, there was a statistically significant decrease in all IQ scores in acutely intoxicated children at discharge and acutely intoxicated children after 6 months when compared with control group. While in group of acutely intoxicated children after 12 months, there was a statistically significant decrease in verbal and performance IQ only when compared to the control group, but full scale IQ showed an insignificant difference compared with the control group.
Also, there was a statistically significant decrease in IQ scores in acutely intoxicated children after 6 months when compared with acutely intoxicated children at discharge. On the other hand, there was a statistically significant improvement in the intellectual functions of the acute severely intoxicated children after 12 months when compared with the intoxicated ones on discharge and after 6 months.
As regarding to cognitive functions, the present study revealed that there was a significant increase in the Conner’s scores in acute severely intoxicated children at the time of discharge, after 6 months and after 12 months of toxicity when compared with control group. There was a significant increase in cognitive scores in acute severely intoxicated children after 6 and 12 months when compared with intoxicated ones at the time of discharge.
Affection of cognitive scores was more after 12 months of toxicity than at time of discharge and at 6 months. These findings indicate that acute severe Co intoxication has a delayed effect on cognitive functions of the evaluated intoxicated children that shows a continuous deterioration till 12 months.
Finally, the current study established a significant negative correlation between Verbal IQ and Full scale IQ and all Conner’s scores, but Performance IQ showed a negative significant correlation with all Conner’s scores except that for anxiety disorders AD at 6 months and for conduct disorders after 12 months.