Abstract
Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Palestine and discussed the follow up treatments. Results showed sever fasciculation of tongue and all muscle, pinpoint pupils not reacting to light, losing consciousness and disoriented, irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE). Irritability and low level of ACHE activity were the unique syndromes of this case. Management of the poisoning with Atropine injection was not successful treatment to cure the case. Treatment with Toxogonin as intravenous injection resulted in relieved the irritability of the poisoned case and cure the patient at the end point. During the six weeks of follow up period, the case was severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to release the patient was made after ACHE activity level reached 4750 U/L, which very close to the normal range. The farmers left the hospital after three weeks of medical treatments and follow up. It is recommended to use Toxogonin in the management of poisoned cases with OPI immediately on arrival of cases with losing consciousness.
Highlights
Poisoned cases among population may be appeared due to using high volume techniques in windy days or due to misuse of insecticides
It is well known in the literature that organophosphorus insecticides (OPI) are strong inhibitors for acetyl choline esterase (ACHE) in human body
Application of OPI at high volume technique resulted on acute poisoning at windy days
Summary
Poisoned cases among population may be appeared due to using high volume techniques in windy days or due to misuse of insecticides. In this technique farmers used large fraction of water with motorized sprayers with a capacity of 400 L pesticide solution that discharge 1 L/min. Long term toxicity of pesticides in Gaza Strip has been documented [16] [17] [18]. Acute toxicity among population may be appeared due to occupational, accidental exposure to direct insecticide solution and/or suicidal attempt. Below we presented a case report of acute poisoning of Chlorpyrifos to a young farmer directly expose to pesticides solution
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