Effect of Organophasphate poisoning among patients reporting at a tertiary healthcare facility of Sindh Pakistan.

Muhammad Saleh Khaskheli,Munazzah Meraj,Shamsuddin Shaikh,Hamid Raza

doi:10.12669/pjms.343.15000

Abstract

Objective:To determine the effect of organophosphate poisoning (OPP) among patients at tertiary healthcare, Pakistan.Methods:This cohort study was conducted over a six-year period (January 2011 to December 2016) of OPP patients admitted to the intensive care unit of Peoples University of Medical & Health Sciences for Women SBA, Hospital Pakistan and their outcome was determined.Results:Total mortality was 17.39% (84 deaths in 483 patients, excluding those referred to Karachi). Out of these 84 deaths, 65 patients (13.46%) expired due to cardiorespiratory failure, 17 deaths (3.52%) followed due to complication of mechanical ventilation & ICU acquired infection and two deaths (0.41%) occurred due to renal failure. The major cause of poisoning was deliberate self-harm /suicidal intention (93.02%), with gender distribution of female (57.07%) and male (35.95%), followed by unintentional/accidental exposure (6.98%) in males. The intensive supportive treatment, precise and appropriate respiratory care, and adequate amount of atropine and pralidoxime doses are keys to reducing the OPP patient’s mortality.Conclusion:Organophosphate poisoning (OPP) intoxication is common in female gender. The easy availability of these harmful compounds has resulted in increased mortality either by accidental exposure or most often by the deliberate suicidal attempt.

Highlights

Organophosphate compounds (OPCs) are widely used as an agricultural insecticide; this widespread use has resulted in increased mortality and morbidity due to the OP poisoning, in under developed countries.[1]
According to World Health Organization (WHO), the frequency of mortality due to OPCs poisoning has doubled in developing countries during past 10 years.[1,2]
According to a recent report, a difference is observed among OPCs insecticides in human self-poisoning, these findings suggest that all OPCs have different toxicity, though the books and publications consider all OPCs as a homogenous entity.[14,15]

Summary

Introduction

Organophosphate compounds (OPCs) are widely used as an agricultural insecticide; this widespread use has resulted in increased mortality and morbidity due to the OP poisoning, in under developed countries.[1]. Correspondence: December 20, 2017 January 1, 2018 May 12, 2018 May 13, 2018 May 15, 2018 have been reported annually, which results in almost 200,000 deaths. According to World Health Organization (WHO), the frequency of mortality due to OPCs poisoning has doubled in developing countries during past 10 years.[1,2] Organophosphate poisoning (OPP) can either be an accidental exposure of OPCs or deliberate suicidal attempt.[2,3,4] This compound can lead to the development of cardiac complications which may be serious or fatal, but preventable if diagnosed and brought earliest to hospital and treated well. As limited studies have been done related to the cardiac toxicity frequency, extent and pathogenesis are not well defined, so many physicians may not be fully aware of the complications.[5,6]

Methods

Results

Conclusion