European Journal of Molecular & Clinical Medicine

Background: Acute Organophosphorus poisoning (OP) is prevalent in the world and its numbers are constantly on the rise. It is more common in developing countries. Health Organisation (WHO) has estimated that nearly 2 lakh die from pesticide poisoning in the world. So, it has high inpatient mortality. All OP poisoning patients cannot be managed in ICU. So, it is important to know prognostic indicators at initial assessment. Few studies showed Serum Pseudo-cholinesterase levels and hyperglycemia were used in the initial assessment to know prognosis and severity in acute organophosphorus poisoning. The present study aims to evaluate the glycemic status at the time of admission and its correlation with pseudo-cholinesterase levels and severity in acute OP compound poisoning.
Objectives:

To assess the glycemic status by estimating random blood glucose level at the time of admission in cases of acute organophosphorus poisoning.
To assess the pseudo-cholinesterase level at the time of admission in cases of acute organophosphorus poisoning.
To correlate hyperglycemia with pseudo-cholinesterase levels and severity or clinical outcome of OP poisoning.

Methodology: The prospective study was conducted in tertiary care hospital. After obtaining informed written consent, 100 confirmed acute OP compound poisoning patients were enrolled for the study, underwent a detailed clinical examination as per the proforma. The Random Blood Glucose level and pseudo-cholinesterase levels at the time of admission were measured and patients were monitored closely and continuously for severity of clinical signs and symptoms. The data obtained were statistically analysed by using SPSS 21.0 Version. Results were presented as Mean (Median) ± SD, counts and percentages and diagrams. Association of Categorical variables was found using Chi square test. p<0.05 will be considered statistically significant.

Background:Organophosphate (OP) poisoning is an important cause of poisoning all over the world. Prompt recognition and aggressive management of acute intoxication are essential to minimize the morbidity and mortality from these potentially lethal compounds. Present study was aimed to study correlation of serum amylase with outcome in acute organophosphorous poisoning at a tertiary hospital.

Context:Organophosphorus (OP) poisoning is a common mode of suicidal poisoning. These compounds are widely available in developing country like India, resulting in high morbidity and mortality. The use of serum amylase in determining the severity of OP poisoning has showed promise.
Aims:This study was undertaken to estimate serum amylase levels in acute OP poisoning and to correlate it with the outcome.
Settings and Design:
Setting – tertiary care treating hospital
Design -cross-sectional observational study
Methods and Material:A hospital-based cross-sectional study was conducted on 80 patients who were clinically diagnosed with acute OP poisoning. Serum amylase was measured on days 1 and 2 of admission and correlated with clinical features and the end result.
Statistical analysis used was SPSS 23.0 version software, and the data was analyzed. To compare the variables across the groups, the H test and Chi-square test were used.
Results:The majority of the cases in the study (41%) were between the ages of 21 and 30. Males made up 65 % of the group, while females 28 %. Serum amylase levels were significantly elevated in patients with clinical features of OP poisoning. The median serum amylase level was 80 IU/l (IQR 50–224.5). Serum amylase levels were normal in 62.5 % (n-50), but elevated in 37.5 % (n-30). A bad outcome was linked to a persistently elevated serum amylase level on day 2.
Conclusions: Serum amylase levels is also considered as a prognostic marker of OP poisoning since it enables the first recognition of severity and to spot those in danger of developing the complications of OP poisoning.
 

In Organophosphorus poisoning raised serum amylase (hyperamylasemia) level is secondary to pancreatic injury because of parasympathetic overstimulation and hypersecretion. There have been studies showing that elevated serum amylase on admission day was related to the development of respiratory failure need for ventilatory support and increased mortality. Observation method of primary source of information in the department of general medicine. Secondary source of information from published articles, journals, books, case sheets, discharge summary, related websites are used in planning, developing, synopsis and during dissertation as supporting document. In our study, mean AMYLASE levels in mild poisoning is 114.23, in moderate it is 312.77 and in severe it is 774.66.

The treatment of a patient of suspected OPC Poisoning is initiated even before his/her admission to casualty in terms of decontamination by washing the contact body surface, removal of clothes and at arrival to casualty with suspicion of OP poisoning, history, examination, and specific treatment with investigations are carried out concurrently to reduce morbidity and mortality associated with OP poisoning. Ethical clearance was taken from the institutional ethical committee. Written informed consent was taken from all subjects and their attenders. In our study, total 7% patients went for intermediate syndrome, in that 5% patients were in mild group, 2% patients in moderate group. Compounds which led to IMS are Malathion-3%, Dimethoate2%, Parathion-2%, Dichlorovas-1%.