Clinical profile of organophosphate poisoning at a tertiary-care center

Abstract

Background: Nowadays, organophosphate (OP) compounds are widely used in agricultural field as an insecticide. Toxicity with these compounds is owing to inhibition of acetylcholinesterase enzyme. Patients are presented with muscarinic and nicotinic side effects. Red blood cells and plasma acetylcholinesterase enzyme (AChE) levels are helpful in diagnosis of the patients. It may cause life-threatening acute and chronic complications. All poisoned patients are required intensive care and treatment with injections atropine and PAM. Objective: To study the clinical aspect of OP poisoning in detail with hospital stay, clinical course, complication, and recovery and mortality in OP poisoning. Materials and Methods: This study was done at PDU Medical College, Rajkot, Gujarat, India, comprising 50 cases of OP poisoning. After taking written consent, personal history of the patients was taken. Then, a detailed history regarding poison and clinical symptoms was taken. Then, general and systematic examinations of patients were carried out, and blood samples were sent for investigations. We followed up the patients till discharge or expired. Result: In our study, maximum incidence of OP poisoning was in between 20 and 40 years age group (60%), and male to female ratio was 2:1. Clinical signs such as bradycardia and tachycardia were present in 20% cases. Miosis was present in 70% cases, and it is more dangerous. Low serum AchE level was found in 68% cases, with mortality in 44.62% among them. Type-I paralysis (52%) and acute respiratory failure (32%) were found as life-threatening complications. In our study, 64% patients survived. Conclusion: Detailed history and thorough clinical examination of patients are helpful in diagnosing the patients of OP poisoning. Life-threatening complications occurred in these patients. Early detection and immediate treatment in intensive care units with injections atropine and PAM can increase the chances of survival rate of patients.