Cholinesterase Levels Research Articles

Factors associated with health effects from occupational exposure to pesticide residues among greengrocers in fresh market, Bangkok, Thailand

ABSTRACTGreengrocers are occupationally exposed to pesticide residues (PRs) on vegetables via dermal contact, especially organophosphates (OPs). The study's aim was to explore health effects from exposure to PRs. Eighty five vegetable vendors at a large fresh market in Bangkok were tested blood cholinesterase activity by the Test-mate ChE Kit (Model 400). The average acetylcholinesterase (AChE) and plasma cholinesterase (PChE) levels were 3.33 ± 0.66 U/ml and 2.06 ± 0.46 U/ml, respectively. The subjective symptoms were skin rash/itching, fatigue/tiredness, eye irritation/blurred vision, headache, and excessive sweating. Multiple linear regression analysis showed a positively significant association between scores of practices regarding exposure to PRs and AChE levels, and a negatively significant relationship between OP residues on hands and PChE levels (p-value < 0.05). Binary logistic regression analysis revealed that either AChE or PChE was significantly associated with eye symptoms and neuromuscular symptoms (p-value < 0.05). A statistically significant association between low score of dermal practice and having skin symptoms was found. Exposure to PRs by hand contact and consumption with poor hygiene habits can pose health problems among greengrocers. The findings emphasized that good personal hygiene practices such as wearing gloves and washing hands can prevent and reduce the health effects from exposure to PRs.

Comparison of hepatoprotective effect from ischemia-reperfusion injury of remote ischemic preconditioning of the liver vs local ischemic preconditioning of the liver during human liver resections

AimTo compare and evaluate the hepatoprotective effect of remote ischemic preconditioning (RIPC) with local ischemic preconditioning (LIPC) of the liver during human liver resections. MethodsA prospective, single-centre, randomised control trial was conducted in the Clinical Hospital “***” from April 2017 to January 2018. A total of 60 patients, who underwent liver resection due to colorectal cancer liver metastasis, were randomised to one of three study arms: 1) a RIPC group, 2) an LIPC group and 3) a control group (CG) in which no ischemic preconditioning was done before liver resection. The hepatoprotective effect was evaluated by comparing serum transaminase levels, bilirubin levels, albumin, and protein levels, coagulograms and through pathohistological analysis. The trial was registered on ClinicalTrials.gov (NCT****). ResultsSignificant differences were found in serum levels of liver transaminases and bilirubin levels between thegroups, the highest level in the CG and the lowest level in the LIPC group. Levels of cholinesterase were also significantly higher in the LIPC group. Pathohistological findings graded by the Rodriguez score showed favourable changes in the LIPC and RIPC groups versus the CG. ConclusionStrong evidence supports the hepatoprotective effect of RIPC and LIPC preconditioning from an ischemia-reperfusion injury of the liver. Better synthetic liver function preservation in these two groups supports this conclusion.

Clinical and laboratory characteristics of juvenile myelomonocytic leukemia

To study the clinical and laboratory characteristics of juvenile myelomonocytic leukemia (JMML). The clinical characteristics and laboratory results were retrospectively analyzed in 10 children with newly diagnosed JMML. They were compared with those of 28 children with myelodysplastic syndrome (MDS) and 44 children with chronic myeloid leukemia (CML). Compared with the children with CML or MDS, the children with JMML had significantly higher rates of skin rashes, ecchymosis, and lymphadenectasis, a significantly lower serum cholinesterase (ChE) level, and a significantly higher fetal hemoglobin level (P&lt;0.05). The white blood cell count of children with JMML was significantly higher than that of children with MDS, but significantly lower than that of children with CML (P&lt;0.05). In addition, the myeloid/erythroid ratio and rate of dyshaematopoiesis were significantly lower in children with JMML than those in children with CML or MDS. The children with JMML had a significantly higher expression of mature monocyte marker CD14 than those with CML or MDS (P&lt;0.05). The levels of myeloid markers CD33, CD11b, CD13, and CD15 in children with JMML were significantly higher than those in children with MDS, but significantly lower than those in children with CML (P&lt;0.05). The levels of CD2 and CD7 in children with JMML were higher than those in children with CML, but lower than those in children with MDS (P&lt;0.05). Skin rashes, ecchymosis, lymphadenectasis, and ChE reduction are more common in children with JMML than in those with CML or MDS, while dyshaematopoiesis is less common. In addition, CD14 level increases significantly in children with JMML.

Effects of magnesium chloride on invitro cholinesterase and ATPase poisoning by organophosphate (chlorpyrifos).

The present study investigated possible benefits of magnesium ion (as MgCl2) in organophosphorus poisoning targeting its ability to interact with substrates and membrane enzymes. Blood samples collected from volunteered healthy adult by venepuncture into anticoagulant test tubes containing EDTA were separated into plasma and red blood cell and divided into three groups namely: normal, pesticide only (0.25‐2.0 mmol/L chlorpyrifos) and pesticide (0.25‐2.0 mmol/L chlorpyrifos) + 0.1 mol/L MgCl2. Acetylcholinesterase, Na+/K+ ATPase and Ca2+ ATPase activities were evaluated. Results showed that Chlorpyrifos significantly (P < .05) reduced the levels of cholinesterase both in plasma and on red blood cells. Red blood cells Na+/K+ ATPase and Ca2+ ATPase were also significantly (P < .05) reduced by chlorpyrifos while MgCl2 counteracted effects of chlorpyrifos with significant (P < .05) increase in the levels of cholinesterase, Na+/K+ ATPase and Ca2+ ATPase. We concluded that MgCl2 neutralized effects of chlorpyrifos by promoting normal ATPase activities and inhibiting release of acetylcholine from cell.

Nutrition status and Helicobacter pylori infection in patients receiving hemodialysis.

Chronic kidney disease (CKD) patients receiving hemodialysis (HD) often develop gastrointestinal abnormalities over their long treatment period. In general, prognosis in such patients is poor due to the development of protein-energy wasting (PEW). Therefore, it is important to clarify the etiology of PEW and to establish better strategies to deal with this condition. Chronic Helicobacter pylori (H. pylori) infection in the gastric mucosa has a close association with not only the development of peptic ulcer disease and gastric cancer, but is also associated with abnormal plasma and gastric mucosal ghrelin levels that are seen in malnutrition. It is unclear whether H. pylori infection of the gastric mucosa is directly associated with prognosis in HD patients by affecting ghrelin levels. Recent studies show that the prevalence of H. pylori infection in HD patients is significantly lower than in subjects with normal renal function. In the natural history of H. pylori infection in HD patients, the prevalence of infection decreases as the length of time on HD increases. The severity of gastric mucosal atrophy has been suggested as the major determinant of ghrelin levels in these patients, and eradication therapy of H. pylori improves nutritional status by increasing serum cholinesterase and cholesterol levels, especially in patients with mild-to-moderate gastric mucosal atrophy. Prompt H. pylori eradication to inhibit the progress of gastric atrophy may be required to prevent this decrease in ghrelin levels and subsequent PEW and improve the prognosis of HD patients by improving their nutritional status.

Leukocyte count: A reliable marker for the severity of organophosphate intoxication?

INTRODUCTION:Organophosphorus poisoning (OPP) is a major public health problem in developing countries like India. Leukocyte count is a simple and inexpensive test, and elevated count is associated with acute inflammation and increased oxidative stress-like OPP. This study was done to correlate the severity of acute OPP with leukocyte count and also to assess the prognosis.MATERIALS AND METHODS:A prospective, observational clinical study was done on 80 patients suspected of OPP of age >15 years admitted to emergency unit at a tertiary rural teaching health-care center of Central India. Serum cholinesterase level and leukocyte count were estimated at the time of admission in all patients and severity of OPP was assessed according to Peradeniya organophosphorus poisoning (POP) scale.RESULTS:The mean age of the patients was 33.52 years (standard deviation [SD] 11.62) in males and 27.30 years (SD 7.33) in females. Among them, 57 (71.25%) were males and 23 (28.75%) were females. The severity of poisoning was directly correlated with serum cholinesterase level (P = 0.0001). Leukocyte count had a sensitivity of 60%, specificity of 76%, and negative predictive value of 85% if counts were more than 12,000 and 30% sensitivity, 95% specificity, and 80% negative predictive value if counts were more than 15,000 in predicting mortality in patients with OPP.CONCLUSION:Leukocyte count levels on admission can be used a prognostic marker in patients with OP poisoning.

EFFECTS OF PRE AND POST EXPOSURE PREVENTIVE MEASURES ON SERUM CHOLINESTRASE LEVEL IN ORGANOPHOSPHORUS COMPOUNDS SPRAY WORKERS

In Pakistan organophosphorus compounds are basic necessity in current farming system. In addition to their benefits in yielding good crops, it causes health hazards to its users; particularly spray workers. Excessive use, inappropriate handling and unsatisfactory personal protective measures while spraying OPs put sprayers at increased risk for acute as well as chronic health hazards. This aspect of occupational exposure is less explored area in Pakistan. Almost all OPs share a general mechanism of action, by phosphorylation of cholinesterase enzyme and buildup acetylcholine neurotransmitter level at nerve terminals.&#x0D; Objective: The objective of present study was to measure levels of plasma cholinesterase in pesticide spray workers who take and who do not take pre and post exposure preventive measures. Material and Methods: Serum cholinesterase levels were measured in 123 rural male spray workers selected through purposive sampling method from Lahore district of Punjab. This was done using spectrophotometric analysis. Serum cholinesterase level was measured by means of kits. A planned questionnaire was arranged to get demographic and data about use of pre and post exposure preventive measures.&#x0D; Results: All spray workers were males with a mean age of 34±9 years, with a mean duration of work experience 10±7 years. The usage of pre and post spraying protective measures in sprayers was significantly correlated with somewhat high mean values of serum cholinesterase activity (6055 u/l) and with a minor risk of OPs related illness, as compared to those sprayers who did not use these devices (4217 u/l) .&#x0D; Conclusion: The above mentioned results propose that sprayers in regular contact with OPs must be screened by clinical symptoms along with serum cholinesterase enzyme levels. It can identify those spray workers who are at threat to develop chronic toxicity. Health education must be given about adopting pre and post exposure preventive measures.

PROGNOSTIC SIGNIFICANCE OF SERUM CHOLINESTERASE IN PATIENTS ADMITTED FOR ACUTE DECOMPENSATED HEART FAILURE

Recently, it has been reported that nutritional status is important prognostic factor in heart failure patients. Serum cholinesterase (CHE) is one of the nutritional marker, and is reported as prognostic factor in chronic heart failure patients. However, prognostic significance of serum CHE level in

Correlation Between Liver Stiffness Measured by Shear Wave Elastography and Child-Pugh Classification.

To explore the association between liver stiffness and the Child-Pugh classification of liver function by shear wave elastography (SWE). A total of 116 patients with liver cirrhosis were divided into 3 groups according to the Child-Pugh classification prospectively. Conventional ultrasound imaging and SWE were performed for all patients. The associations of liver stiffness measured by SWE with ultrasound measurements, serum biochemical indicators, and the Child-Pugh classification were analyzed. Receiver operating characteristic curves were analyzed and compared to determine the ability of liver stiffness to diagnose cirrhosis. Liver stiffness measured by SWE increased with an increasing Child-Pugh classification, internal diameter of the hepatic portal and splenic veins, spleen thickness, spleen length, total bilirubin level, and prothrombin time, which were positively correlated with the Child-Pugh classification (all P < .05). The albumin level and liver stiffness showed higher areas under the curve in comparison with other parameters for evaluating the Child-Pugh classification. Albumin and cholinesterase levels were negatively correlated with the Child-Pugh classification (P < .05). All of these indicators were significantly different between each pair of groups (all P < .05), except for the internal diameter of the hepatic portal vein, prothrombin time, and total bilirubin, and cholinesterase levels between groups B and C (P > 0.05) and the thickness and length of spleen and internal diameter of the splenic vein between groups A and B (P > 0.05). There were no differences among the groups for alanine aminotransferase, aspartate aminotransferase, and globulin levels. Liver stiffness measured by SWE was correlated with the Child-Pugh classification, and it may be able to help evaluate liver function in patients with cirrhosis.

Elevated systemic levels of the matrix metalloproteinase inhibitor TIMP-1 correlate with clinical markers of cachexia in patients with chronic pancreatitis and pancreatic cancer

BackgroundTissue inhibitor of metalloproteinases-1 (TIMP-1) is a candidate diagnostic and prognostic biomarker for pancreatic ductal adenocarcinoma (PDAC). Here, we determined the possible association of systemic TIMP-1 levels with cachexia and jaundice, two common PDAC-associated conditions.MethodsPlasma TIMP-1 was measured by ELISA in patients diagnosed with PDAC (n = 36) and chronic pancreatitis (CP) (n = 25). Patients without pancreatic pathologies and known malignancies of other origin served as controls (n = 13). TIMP-1 levels in these patients were tested for asscociation with jaundice and chachexia, and furthermore correlated with cachexia-related clinical parameters such as weight loss and ferritin, parameters of lung function, hemoglobin and liver synthesis parameters.ResultsTIMP-1 plasma levels were mostly higher in CP and PDAC patients with concomitant jaundice or cachexia. Elevated plasma TIMP-1 levels were also associated with clinical cachexia markers, including absolute and relative values of weight loss and lung function, as well as ferritin, hemoglobin, and cholinesterase levels. TIMP-1 levels significantly correlated with cachexia only in patients without jaundice. Jaundice also impaired the use of TIMP-1 as a prognostic marker in cancer patients. Relating to cachexia status alone, a slightly improved association of TIMP-1 levels with survival of PDAC patients was observed.ConclusionThis retrospective study reports for the first time that plasma levels of TIMP-1 are associated with pancreatic lesion-induced cachexia in patients without jaundice. TIMP-1 is counterindicated as a survival marker in patients with jaundice.

Cholinesterase Activity on Palm Oil Plantation Workers in Parenggean, Kotawaringin Timur

Use of pesticide is widely used in palm oil plantation industry. Pesticide exposure can affect pesticide-spraying workers' health. This study aimed to determine acetylcholinesterase enzyme (AChE) activity levels and identify of poisoning risk factors on pesticide-spraying workers in a palm oil plantation Comanditaire Venootschap (CV) unit in Parenggeran, Kotawaringin Timur, Central Kalimantan. The cross-sectional study design was conducted to examine cholinesterase enzyme activity levels on 15 pesticide-spraying workers. The cholinesterase levels were measured using an automated photometric technique. This study found that all workers have normal cholinesterase activity levels. The average cholinesterase activity levels were 7065,36 U/L and 6528 U/L, respectively for male and female workers. It was also found that two male workers cholinesterase activity levels of using glyphosate pesticide were almost close to the lower limit of the normal levels range, 4720 U/L, and 4958 U/L, respectively. Use of Personal Protective Equipment (PPE) during the pesticide spraying and maximum time allowed of pesticide spraying in a day have to be considered as an important rule to avoid excessive pesticide exposure.

Cholinesterase levels predict exercise capacity in cardiac recipients early after transplantation.

Although cardiac rehabilitation is recommended for patients early after heart transplantation (HTx), adequate exercise effect cannot always be obtained, partly because in patients with chronic heart failure, exercise capacity is reduced due to malnutrition while waiting for HTx. This study aimed to investigate the relationships between exercise capacity and clinical variables, including nutritional indicators, early after HTx. Forty-three HTx recipients were studied. The mean age at HTx was 38±14years, and 86% were male. We assessed the relationships between peak oxygen uptake (VO2 ) and clinical variables, including plasma B-type natriuretic peptide (BNP), isometric knee extensor muscle strength (KEMS), and nutritional indicators within 1week of their respective discharges. Peak VO2 correlated positively with isometric KEMS (r=.63, P<.0001) and negatively with BNP level (r=-.37, P=.015). Of the nutritional indicators, only cholinesterase levels had a significant relationship with peak VO2 (r=.34, P=.028), whereas the Geriatric Nutritional Risk Index and the Controlling Nutritional Status scores did not. In multiple linear regression analysis, cholinesterase levels and isometric KEMS were independent predictors of peak VO2 . Cholinesterase levels predicted exercise capacity early after HTx.

Clinical profile and outcome of intermediate syndrome in acute organophosphate poisoning

Background: Deaths by acute organ phosphorus poisoning is very common in rural India especially in people associated with agriculture sector. The present study was aimed to study the clinical characteristics of organ phosphorus compound (OPC) poisoning and to assess the associated factors related to the outcome (recovery/death) of intermediate syndrome (IMS).Methods: This is an observational study conducted on 40 patients showing features of intermediate syndrome at Poison center, Institute of internal medicine, Rajiv Gandhi Government General Hospital, Chennai. Detailed clinical examination was done on the day of admission and daily with close monitoring. All patients included under study will be treated with pralidoxime as per protocol, atropine as required and other supportive measures was provided. Mechanical ventilatory support was provided for patients in respiratory failure. Patients are followed up till the end point of outcome (recovered and discharged/death) that was correlated with type of compound, quantum of exposure, duration of IMS, serum cholinesterase and creatinine kinase levels and respiratory failure.Result: Patients of age group between 30-40 years are more affected. Males outnumbered the females and most of them are from agriculture sector (65%). Out of 40, on treatment and follow up 34 patients were recovered and 6 were died. Onset of intermediate syndrome ranges between days 2-4 following exposure and duration of symptoms was observed for 5–16 days. Methylparathion was the frequent compound associated with IMS in about 9 cases. Out of 40, 16 had respiratory failure and given ventilator support. Proximal muscle weakness was seen in about 38 patients as common symptom.Conclusion: The results of the present study concludes that factors such as mode of poisoning, onset of IMS, type of compound, PChE level are not correlated with the outcome of study. Duration of IMS, respiratory failure, ventilator associated pneumonia (VAP), ventilator support duration were associated with outcome of the study. Hence, early recognition of IMS and its associated respiratory paralysis is very important in patients affected with OPC toxicity to prevent morbidity and mortality rate.

Deficiencia de butirilcolinesterasa identificada después de la administración de succinilcolina. Reporte del caso

The main function of the enzyme butyrylcholinesterase is to hydrolyze exogenous esters such as those present in the neuromuscular blocking agent succinylcholine, which is frequently used in short surgical procedures. Inheritance of atypical butyrylcholinesterase or butyrylcholinesterase deficiency is considered an autosomal recessive characteristic and occurs worldwide in approximately one out of 3200 to 5000 people. Such deficiency may have serious consequences for patients anesthetized with that relaxant because sometimes it causes an extension of paralysis or postoperative apnea. We report the case of a 73-year-old woman submitted to subtotal thyroidectomy. After surgery, she did not spontaneously emerge from anesthesia, had signs of relaxation with poor inspiratory effort, and no recovery of neuromuscular response. After application of atropine, reversal was attempted with neostigmine, but it failed, and she was transferred to the ICU. Laboratory results revealed a reduced level of serum cholinesterase indicating a deficiency in butyrylcholinesterase consistent with her symptoms. Such situation has been described in medical literature.

Effects of Late Evening Snack on Cirrhotic Patients: A Systematic Review and Meta-Analysis.

Background Energetic effects of late evening snack (LES) on cirrhotic patients were reported recently, but there was no quantitative analysis. In this meta-analysis, we reviewed and quantified the effects of LES on energy metabolism and substrate oxidation in the patients with cirrhosis, which will be of benefit for liver cirrhosis nutritional therapy. Methods A systematic search was conducted in PubMed, Embase, Web of Science, Elsevier, China National Knowledge Infrastructure, and Wanfang Database for relevant trials published until July 2017. These studies statistically were combined and analyzed by RevMan 5.3. Results Fourteen trials comprising 478 cases were eligible for analysis. The results showed that the respiratory quotient value (MD = 11.09) and carbohydrate oxidation value (MD = 0.05) significantly elevated with one week or with up to three weeks of LES treatment in cirrhotic patients (P < 0.05). Meanwhile, the levels of serum albumin (MD = 2.98) and cholinesterase (SMD = 1.09) were increased with LES administration for three weeks or that lasting twelve weeks (P < 0.05). However, there was no significant improvement for the levels of alanine aminotransferase (ALT) (P = 0.53), aspartate aminotransferase (AST) (P = 0.96), and total bilirubin (TB) (P = 0.32). Conclusions LES could improve the energy malnutrition state of cirrhotic patients. However, it may have little effect on reducing liver parenchymal injury indexes such as serum aminotransferase.

Assessment of cases of poisoning with cholinesterase inhibitors insecticides in children: a retrospective 7-year study

In this study, 87 children poisoned with cholinesterase inhibitors (organophosphorus and carbamates) were admitted to the Regional Center of Toxicology of the “St. Mary” Children’s Emergency Clinical Hospital Iaşi between January 2011 and December 2017. The main etiology was diazinon (62/87 cases). The most commonly encountered muscarinic symptoms were miosis (93.1% of cases) and sweating (89.7%). Nicotinic syndrome manifested with tachypnea (32.1%) and fasciculations (25.2%). Neurological symptoms consisted of agitation (48.2%), coma (24.1%) and seizures (18.3%). In all cases, the serum level of cholinesterase was low, the initial value being 339.58 ± 283.20 u/l. All children received atropine as an antidote. Toxogonin was associated as cholinesterase reactivator, excluding the four cases of carbamate intoxication. For 46 of the patients, gastrointestinal decontamination by gastric lavage and activated charcoal was made. There were three deaths, the mortality rate being 3.1%.

Lamotrigine enhances the neuroprotective effects of memantine on aluminum chloride-induced behavioral changes in rats

Background and aimAlzheimer's disease (AD) is the most common reason for dementia in the aged population. AD increases the risk of seizures. Management of epilepsy in AD is difficult because of the possibility of drug interactions. Moreover, antiepileptic drug selection in the elderly needs special attention due to numerous pharmacokinetic factors. In the present study, the effect of lamotrigine (LTG) on the neuroprotective effect of memantine (MEM) was assessed. Materials and methodsA total of 32 adult male Wistar rats were divided into four groups: saline-treated group, aluminum chloride (AlCl3)-treated group, AlCl3+ MEM-treated group, and AlCl3+ MEM + LTG-treated group. AD was induced by intraperitoneal injection of AlCl3 (75 mg/kg/day) for 60 days, then the rats were evaluated using the Morris water maze, radial arm maze, novel object recognition, and passive avoidance tests. After accomplishing the behavioral tests, the rats were killed and their kidneys and brains were used for estimation of acetyl cholinesterase levels and histopathological studies. ResultsAlCl3 significantly impaired the performance in the Morris water maze, radial arm maze, novel object recognition test, and passive avoidance test and elevated acetyl cholinesterase levels in the cerebral cortex, hippocampus, serum, and kidneys. Moreover, the brain of AlCl3-treated rats showed an increased number of damaged neurons and glial cells. Concurrent administration of MEM and LTG significantly reversed behavioral and cognitive deficits induced by AlCl3. ConclusionLTG significantly potentiated the behavioral and cognitive improvement induced by MEM, a finding that suggests a neuroprotective profile of LTG and may hold promise in the management of dementia with epilepsy.

Technical efficiency of pesticide application on tomato, chinese cabbage and cauliflower in simpang empat sub-district Karo Regency

Prior research by authors on the use of pesticides and their impact on 75 vegetable farmers in Simpang Empat subdistrict, Karo district, North Sumatra showed that 60% of respondents applied pesticides in excess of the packaging instructions. Respondents were also found not to use a complete protective device. Almost 70% of respondents have mild toxicity complaints, and based on blood cholinesterase levels are also found most respondents have mild toxicity. Pesticide residue test results also found 0.728 residues of chlorpyrifos and 0.321 profenofos in vegetables produced in this area. This led to continued review by checking the technical efficiency in the use of pesticides. The method used is a quantitative method with the Data Envelope Analysis (DEA) approach to analyze technical efficiency of pesticide on each commodity. The population is the whole vegetable farmer who grew tomatoes, Chinese cabbage and cauliflower at the time of the study. The entire population is used to be a sample of 35 tomato and cauliflower farmers and 20 Chinese cabbage farmers. The results of the study indicate that the uses of pesticide as production inputs on tomato commodities, Chinese cabbage and cauliflower are not technically efficient. It is suggested to farmers to use pesticide input according to the rules, proper dosage, on target, on time, the right way so that pesticide used is technically efficient.

Morbidity and Mortality Indicators in Acute Organophosphate Poisoning in Zagazig University Hospital, Egypt: Retrospective Study

Introduction: Organ phosphorus (OP) toxicity has been studied extensively because of its world wide use. Toxicity of organophosphates is the result of inhibition of acetyl cholinesterase resulting in cholinergic signs. Aim of the Work: To evaluate initial indicators that can indicate prognosis of patients in OP poisoning. Materials and Methods: A retrospective study conducted in Zagazig university hospital over a year. OP poisoning was clinically diagnosed with history of OP compound exposure and confirmed by low pseudo cholinesterase levels. Results: In the present study, 76 patients were enrolled. Major cases were male. High mortality rates were in the youth and in prolonged ventilated patients. The mortality rate was proportionally related to lag time after exposure and plasma pseudo cholinesterase levels. Electrolyte disturbance did not affect clinical outcome. Conclusion: From this study, it could be concluded that mortality is directly proportionate to the lag time, amount of OP consumed, clinical severity, pseudo cholinesterase levels and duration of ventilator support. This study helps in rapid diagnosis, and rapid early and effective treatment, which may result in decreasing the morbidity and mortality rates. Recommendation: It is recommended to increase awareness regarding the rapid diagnosis, and rapid effective treatment of organ phosphorous.

Study of serum amylase levels in organophosphate poisoning

Background: Organophosphorus is poisoning producing clinical alterations in the serum amylase and lipase activity. Earlier plasma cholinesterase level was used to assess the severity of poisoning. Presently serum amylase is being recommended as a better indicator of severity. Aims and Objectives: The present study was undertaken to estimate serum amylase levels in acute organophosphate poisoning andto correlate serum amylase levels with outcome of patient . Methods : This cross sectional study was conducted in Shri Vasantrao Naik Government Medical College and Hospital, Yavatmal. A total of 120 patients with organophosphorus poisoning admitted to the hospital during the study period of 1st January 2017 to 30 th November 2017 were included in the study. Biochemical evaluation which includes serum amylase, blood glucose, urea, creatinine, and liver function tests were analyzed. Results: In OP poisoning patients , the amylase levels were significantly elevated at the time of admission (178.21 U/L) and have shown a gradual remission with proper treatment. The mean amylase level in severely poisoned patients was 294.8 U/L. The bad prognostic factors, very well correlated with serum amylase levels were Pinpoint pupil- 297 U/L, Fasciculations-309 U/L, Severe secretions-321 U/L, CNS depession-334 U/L, Respiratory failure-359 U/L and Convulsions-398 U/L. The overall mean value of serum amylase was significantly higher in non-survivors Vs survivors (482.46 U/L Vs 148.34 U/L, p<0.0001). Conclusion: Serum amylase levels may be considered as a marker of Organophosphorous intoxication, since it enables the early recognition of severity and to identify those at risk of developing the complications of Organophosphorous poisoning.