Organophosphorus Compound Poisoning Research Articles

Dual-Modal Nanoscavenger for Detoxification of Organophosphorus Compounds

Organophosphorus compounds (OPs) pose great military and civilian hazards. However, therapeutic and prophylactic antidotes against OP poisoning remain challenging. In this study, we first developed a novel nanoscavenger (rOPH/ZIF-8@E-Lipo) against methyl paraoxon (MP) poisoning using enzyme immobilization and erythrocyte-liposome hybrid membrane camouflage techniques. Then, we evaluated the physicochemical characterization, stability, and biocompatibility of the nanoscavengers. Afterward, we examined acetylcholinesterase (AChE) activity, cell viability, and intracellular reactive oxygen species (ROS) to indicate the protective effects of the nanoscavengers in vitro. Following the pharmacokinetic and biodistribution studies, we further evaluated the therapeutic and prophylactic detoxification efficacy of the nanoscavengers against MP in various poisoning settings. Finally, we explored the penetration capacity of the nanoscavengers across the blood-brain barrier (BBB). The present study validated the successful construction of a novel nanoscavenger with excellent stability and biocompatibility. In vitro, the resulting nanoscavenger exhibited a significant protection against MP-induced AChE inactivation, oxidative stress, and cytotoxicity. In vivo, apart from the positive therapeutic effects, the nanoscavengers also exerted significant prophylactic detoxification efficacy against single lethal MP exposure, repeated lethal MP challenges, and sublethal MP poisoning. These excellent detoxification effects of the nanoscavengers against OPs may originate from a dual-mode mechanism of inner recombinant organophosphorus hydrolase (rOPH) and outer erythrocyte membrane-anchored AChE. Finally, in vitro and in vivo studies jointly demonstrated that monosialoganglioside (GM1)-modified rOPH/ZIF-8@E-Lipo could penetrate the BBB with high efficiency. In conclusion, a stable and safe dual-modal nanoscavenger was developed with BBB penetration capability, providing a promising strategy for the treatment and prevention of OP poisoning.

Synthesis, Molecular Docking, BSA, and In Vitro Reactivation Study of Imidazopyridine Oximes Against Paraoxon Inhibited Acetylcholinesterase.

To synthesize and evaluate the fused heterocyclic imidazo[1,2-a]pyridine based oxime as a reactivator against paraoxon inhibited acetylcholinesterase. Organophosphorus compounds (OPs) include parathion, malathion, chlorpyrifos, monocrotophos, and diazinon, which are commonly used in agriculture for enhancing agricultural productivity via killing crop-damaging pests. However, people may get exposed to OPs pesticides unintentionally/intentionally via ingestion, inhalation, or dermal. The current treatment regimen includes reactivator such as mono or bis-pyridinium oximes along with anticholinergic and anticonvulsant drugs that are recommended for the treatment of OP poisoning. Unfortunately, the drawback of the existing reactivator is the permanent charge present on the pyridinium, making them inefficient to cross the blood-brain barrier (BBB) and reactivate OP-inhibited central nervous system (CNS) acetylcholinesterase. Therefore, there is a need of a reactivator that could cross the BBB and reactivate the OP inhibited acetylcholinesterase. The objectives of the study were synthesis, molecular docking, BSA binding, and in-vitro estimation of oximes of various substituted imidazo [1,2-a]pyridine against paraoxon inhibited acetylcholinesterase. The reactivators were synthesized in three steps and characterized using various spectroscopic techniques. The molecular docking study was performed on 2WHP and 3ZLV PDB using the Glide-XP software. The acid dissociation constant (pKa) of oximes was calculated experimentally, and the drug-likeness properties of the oximes were calculated in silico using Molinspiration and Swiss ADME software. The binding of oximes with bovine serum albumin (BSA) was also investigated using a Fluorescence spectrophotometer. The reactivation potential of the oximes was determined by in vitro enzymatic assay. The In-silico study inferred that the synthesized molecules fulfilled the parameters required for a successful CNS drug candidate. Furthermore, in-vitro enzymatic assay indicated reasonable reactivation potential of the oximes against paraoxon-inhibited AChE. The binding of oximes with bovine serum albumin (BSA) revealed that there was a static quenching of intrinsic fluorescence of BSA by the oxime. The binding constant value and number of binding sites were found to be 0.24 x 104 mol-1 and 1, respectively. The results of the study concluded that this scaffold could be used for further designing of more efficient uncharged reactivators.

Magnesium sulfate in organophosphorus compound poisoning: A prospective open-label clinician-initiated intervention trial with historical controls.

Background:The addition of magnesium sulfate (MgSO4) to standard treatment has improved mortality and morbidity associated with organophosphorus compound (OPC) poisoning. We aimed to assess the effectiveness of adjunctive intravenous MgSO4 (IV MgSO4) in poisoning from OPCs.Methods:Forty-seven cases and 72 controls were recruited to this prospective open-label clinician-initiated intervention trial after admitting OPC poisoning. All patients received standard treatment for anticholinesterase poisoning, and oximes were not used. Cases were divided into two groups. Group A (22 patients) received IV MgSO4 at 4 g/day in four divided doses (1 g every 6 h) on day 1. Group B (25 patients) received the same daily dose of IV MgSO4 throughout the hospital stay. Group C (72 patients) represents historical controls who did not receive IV MgSO4. The primary outcome was inhospital mortality. The secondary outcomes included the development of intermediate syndrome (IMS), the requirement of mechanical ventilation (MV), duration of MV, and length of hospital stay.Results:Baseline parameters in both groups were comparable. There is no statistically significant difference in mortality among three groups (Group A: 2/22, 9.1%; Group B: 5/25, 20% and Group C: 6/72, 8.3%). Results were similar for the development of IMS, the requirement of MV, length of MV, and duration of hospital stay.Conclusion:IV MgSO4 did not result in better outcomes compared with standard care alone in OPC poisoning.

“A CLINICAL STUDY ON PSEUDOCHOLINESTERASE LEVELS AS A PROGNOSTIC MARKER IN ORGANOPHOSPHORUS COMPOUND POISONING IN A TERTIARY CARE HOSPITAL."

Background: One of the most common poisonings in India is organophosphorus compound poisoning. The rise in agricultural pesticide use has paralleled the rise in the use of these products for intentional self-harm. In addition to a clinical diagnosis, this requires a set biochemical parameter. The research aims to provide a useful prognostic marker in treating organophosphorus compound poisoning. Aim: Ÿ To study the pseudocholinesterase levels as a prognostic marker in the outcome of organophosphorus compound poisoning Ÿ To predict the prognosis and mortality based on pseudocholinesterase activity Materials And Methods: A Hospital-based observational Prospective study was conducted in the Department of Medicine, Santhiram medical college, and the general hospital for six months. Atotal 50 number of patients with a history of consumption of organophosphorus compounds were admitted, investigated and followed up. Results: In the study, it was noted that 70% were suicidal, and 30% were of accidental poisoning. Organophosphate compound poisoning is more common in males. The male and female ratio was 2.57:1. The maximum number of cases in our study, about 86% of cases were below 40 years. 100% of cases in the present study showed low pseudocholinesterase activity on admission. Conclusion: Determining pseudocholinesterase activity is a reliable diagnostic test in the early stages of organophosphorus poisoning. The study also demonstrates that a higher rise in enzyme activity is directly proportional to a better prognosis.

Serum Amylase Level in Acute Organophosphorus Compound Poisoning in a Tertiary Level Hospital

Background: Organophosphorus compound (OPC) poisoning is an important clinical problem in the developing world and kills an estimated 3,00,000 people every year. In spite of high case fatality rate early and proper management is crucial to save the lives and alleviate the sufferings. Amylase level is an important biochemical marker, which is closely related to severity of acute OPC poisoning. Therefore, to assess Serum amylase level in acute organophosphorus compound poisoning in a tertiary level hospital was the objective of the study. Methods: This research was a hospital based descriptive cross-sectional study and was conducted at the inpatient department of Medicine in Dhaka Medical College. 50 Patient admitted in medicine department due to OPC poisoning and evidenced by history taking and physical examination were included in the study. Ethical issues were ensured properly. After written informed consent history and physical examination were done. Rest of the data were collected by interviewing each patient or from attendant of the patient by using a semi-structured questionnaire. Scoring of the severity were done by researcher himself by Peradeniya Organophosphorus Poisoning (POP) scale (Score range 0 to 11). Values of amylase level were collected from patient record file. All the Data was analysed by computer with the help of SPSS 16. Results: Out of a total of 50 patients, 24 (48%) were males and 26 (52%) were females. OPC poisoning was most frequent (52%) in age group 21-30 years. Mean age was 23.96 ± 6.071 SD. 96% (48) study population were Muslim and rest 4 % (2) were Hindus with diverse occupation. 86% population came from rural area whereas only 14% population reside in urban area. Among them suicidal attempts were seen significantly which was 96% and rest of them were accidental ingestion. Amylase level estimation were done in each case and 32 % (16) patient had elevated amylase level (>100U/L) and 68% (34) patient had amylase level within normal limit. Mean amylase concentration was 62.2U/L (SD±18.77) and among the 16 patients who had elevated serum amylase level mean concentration was 376.56U/L (SD±266.124). Mean amylase level differed significantly between these two groups (p value < 0.0001) estimated by one way ANOVA. Spearman Correlation and One way ANOVA both showed significant association between severity (assessed by POP scale) and elevated level of serum amylase (p value <0.0001). Outcome analysis showed that 47 patients recovered and 3 patients died. Their mean hospital stay was 3.87 (±1.76) days and relationship between serum amylase level and duration of hospital stay and was found to be significant in chi-square analysis (p value- <0.0001). Conclusion: Hyperamylasaemia in OPC poisoning can be used an important biomarker to assess the severity of the patient which may guide the clinicians for further management. J MEDICINE 2021; 22: 119-126

English

BACKGROUND Organophosphorus (OP) pesticides are one of the most common cause of morbidity and mortality due to poisoning worldwide especially in agrarian countries like India. Hence it is prudent to undertake a detailed study of clinico-pathological evaluation of OP poisoning and assess the role of serum potassium as an alternative, easy and convenient prognostic indicator in estimating the severity of OP poisoning. This study was undertaken to assess serum potassium levels in patients of acute organophosphorus poisoning and determine association between serum potassium level and outcome in cases of acute organophosphorus poisoning. METHODS This was a prospective observational study conducted in Department of General Medicine, Silchar Medical College & Hospital for one year from 1st June 2019 to 31st May 2020 with a sample size of 100 after satisfying the inclusion and exclusion criteria. Peradeniya organophosphorus poisoning (POP) scale was used for categorizing study population according to severity. RESULTS Among patients who were admitted with organophosphorus poisoning, 72 % of the patients discharged were having normal serum potassium levels on admission, whereas 22 % (n = 22) patients who died had hypokalaemia at the time of admission. The chi-square value for the association between serum potassium and outcome is statistically significant [P value is 0.001 (P < 0.05)]. CONCLUSIONS The serum potassium level on the day of admission was significantly correlated with the severity of the acute organophosphate poisoning as determined by Peradeniya OP poisoning scale. The cases that had lower serum potassium levels on admission had poor outcome. Reduced serum potassium levels also had significant association with the need for ventilator support. Therefore, serum potassium can be used as a predictive marker of severity in organophosphorus poisoning. This can help in early triage of patients and will be helpful in reducing mortality and morbidity. KEYWORDS Organophosphorus Compound Poisoning, Serum Potassium, POP Scale

Molecular Recognition of Nerve Agents and Their Organophosphorus Surrogates: Toward Supramolecular Scavengers and Catalysts.

Nerve agents are tetrahedral organophosphorus compounds (OPs) that were developed in the last century to irreversibly inhibit acetylcholinesterase (AChE) and therefore impede neurological signaling in living organisms. Exposure to OPs leads to a rapid development of symptoms from excessive salivation, nasal congestion and chest pain to convulsion and asphyxiation which if left untreated may lead to death. These potent toxins are prepared on a large scale from inexpensive staring materials, making it feasible for terrorist groups or states to use them against military and civilians. The existing antidotes provide limited protection and are difficult to apply to a large number of affected individuals. While new prophylactics are currently being developed, there is still need for therapeutics capable of both preventing and reversing the effects of OP poisoning. In this review, we describe how the science of molecular recognition can expand the pallet of tools for rapid and safe sequestration of nerve agents.

Random blood sugar at the time of presentation in acute organophosphorus compound poisoning and its correlation with prognosis

Random blood sugar at the time of presentation in acute organophosphorus compound poisoning and its correlation with prognosis

A prospective observational study on management and outcome of different poisoning cases in a tertiary care hospital

Background: Acute poisoning is a worldwide health problem hastened around million deaths yearly. It was estimated that two lakhs of these deaths are mainly due to Organophosphorus compounds (OPC) poisoning. The management of these emergencies poisoning cases is very difficult and requires intensive care as well as monitoring. Despite the large number, evidence on pattern prevalence, management and outcome in India is little. Aim and Objective: The purpose of our study was to assess the socio-demographic pattern of various poisonings, pharmacotherapy and factors associated with outcome in a tertiary care hospital. Materials and Methods: It is a prospective observational study was done from January 2014 to December 2014 at Casualty in government teaching medical college hospital. Results: 253 patients were identified to have suffered of poisoning, 47.0% (119) of these patients were poisoned by OPC followed by other poison such as pyrethroids, Organocabamates. From all assessed cases male over female dominance was observed. More poisoning cases were observed between the age group 21 and 30 years. Intentional poisoning was more common (87.74%). The time taken between the poison ingestion and treatment was found that 83.8% of patients introduced to hospital before 12 h of the incident, whereas 28.7% introduced before 3 h. The death rate was 1.97 % with male dominance. Conclusion: This study comes to a conclusion that there is load of poisoning for which some proper safety measures such as limitation of easy availability and securing the poisonous chemicals which reduce the incidence of different poisoning in susceptible patients.

Nicotinic acetylcholine receptors: Diversity and physiological importance for neurodegenerative disorders and development of organophosphate antidotes

The communication between the nervous and other systems in the organism is carried out by the transmission of nerve impulses. Diverse neurotransmitters are released into the synaptic cleft and bind to the specific receptors at the neighbouring cell to transmit the signal further. One of such receptors are nicotinic acetylcholine receptors (nAChR), integrated membrane proteins (ligand-gated ion channels) activated by the binding of a neurotransmitter acetylcholine. nAChR's main characteristic is their diversity, as they consist of five of the same or mutually different subunits, which contribute to the specific receptors properties and biological activity. During the assembly of a pentameric protein structure, various combinations of subunits are linked together. After the discovery of nAChR’s involvement in various diseases, they became an important therapeutic target, for example in the treatment of neurodegenerative diseases (Alzheimer's and Parkinson's) and in the treatment of organophosphorus compound poisoning. This paper presents an overview of current knowledge on nicotinic receptors and an accompanying discussion on diseases, poisonings, potential drugs and treatments is given.

A Study of Correlation of Peradeniya Organophosphorus Scale (POP) and Serum Amylase Level in Assessing the Clinical Severity and Outcome of Organophosphorus Compound Poisoning

A Study of Correlation of Peradeniya Organophosphorus Scale (POP) and Serum Amylase Level in Assessing the Clinical Severity and Outcome of Organophosphorus Compound Poisoning

C(RGDyK)-mediated Pluronic-PBCA nanoparticles through the blood-brain barrier to enhance the treatment of central organophosphorus intoxication

Human usually uses oximes as acetylcholinesterase (AChE)-activated antidotes to treat organophosphorus (OP) compound poisoning. In addition, drugs such as atropine can also be used for its detoxification treatment. However, the natural blood-brain barrier (BBB) severely limits the penetration of these drugs into the central nervous system. As a widely used reactivator, HI-6 is difficult to penetrate the BBB due to its hydrophilicity. Therefore, we hope that a large amount of HI-6 can penetrate the BBB through the drug delivery system. They can quickly release and activate the inhibited AChE in the center. Polybutylcyanoacrylate (PBCA) has good biodegradability and biocompatibility, which ensures the safety of the treatment. Pluronic P85 gets the advantages of inhibiting P-glycoprotein (P-gp) efflux and improving drug solubility. In this study, the HI-6-loaded nanoparticles that conjugated with c(RGDyK) cyclic peptide were successfully synthesized, with encapsulation efficiency 63.69%, drug loading 6.2%, average particle size 166.9 nm, and zeta potential − 22.0 mV. The shape was round and evenly distributed. The BBB model was established by astrocytes and brain capillary endothelial cells, and the transendothelial cell resistance values of the BBB model could reach 183 Ω. The penetration effect of the c(RGDyK)-modified nanoparticles was about 4 times the free HI-6 on the BBB model in vitro. The c(RGDyK)-modified nanoparticles were more effective at targeting the brain than the unmodified nanoparticles in vivo. In addition, reactivation evaluation showed that the modified nanoparticles had a higher reactivation rate for poisoned mice, indicating that the nanoparticles modified with c(RGDyK) cyclic peptide had more central targeting. The successful implementation of this study is expected to improve the treatment level of nerve agents. Graphical abstract

Role of Primary Aetiology of Intubation in Acquired Laryngotracheal Stenosis: An Institutional Audit and Review of Literature.

Aetiology of acquired laryngotracheal stenosis (ALTS) is complex and heterogenous. The aim of this study is to discuss the role of primary aetiology of intubation in the development and outcomes of Post intubation Laryngo tracheal stenosis (PILTS). A retrospective review of patients diagnosed and managed as PILTS from May 2008 to January 2017 was conducted. Demography, primary aetiology of intubation, grade of stenosis, length of the stenotic segment, treatment and outcomes of these patients were recorded and analysed. Based on aetiology of intubation, patients were divided into Poisoning (I), Neurogenic (II) and Rest of aetiologies (III) group respectively. Group I had 28/52 patients (53.8%) followed by group II, 15/52(28.8%) and group III, 9/52(17.3%) respectively. Organophosphorus compound poisoning (OPP) (44.2%) was the commonest cause overall followed by Brain injury (23.1%) and Acute Respiratory Distress Syndrome (ARDS) (11.5%). Trachea (46.15%) was the commonest subsite involved in this study. 24/28(85.7%) of patients had advanced (either grade 3 or 4) subglottic stenosis. The average length of stenotic segment in the study was 18.5 ± 9.2mm (7-34mm). 39/52(74.9%) of patients underwent open surgical approaches like cricotracheal resection and anastomosis, Laryngotracheal reconstruction or Shian-Yan Lee technique. 48/52(92.3%) patients were decannulated successfully. There was no significant association between primary etiology of intubation and outcomes. We conclude that OPP and neurological disease patients are more susceptible to airway injury. The authors emphasize that clinicians should be aware of these facts and manage these susceptible patients accordingly.

Profile of Fatal Cases of Organophosphosphorus Poisoning at a Tertiary Care Centre, Mandya

Organophosphorus Compound (OP) poisoning is the most common and the highest amongst fatal cases of poisoning consumption deal in MIMS hospital. It is the commonly abused poison amongst rural and urban population more so amongst our Farmers. Fatal cases of organophosphorus poisoning were analyzed during the study period from 01.01.2016 to 31.12.2018. The analysis was done on age, sex, occupation, socio economic status, motive of poison consumption and result. Mandya District being dominated by agriculturists and sugarcane being the cash crop, drought, insufficient rain fall, raising costs of living, high debts, Cauvery water non available for agricultural use due to water sharing between neighboring states like Tamilnadu, Pondichery etc., increasing number of bore wells and ground water depletion, leading to crop failures and thereby resulting in Farmers suicide. The major cause of death in these cases treated at MIMS were Respiratory failure.

Demographic study of 100 cases of deaths due to organophosphorous compound poisoning

Organophosphorus compounds are extensively used as pesticides for soft bodied insects in agriculture. They have been imported in India since 1951, but very few knew the nature of these compounds as a virulent poison till the food poisoning tragedy in 1958 which claimed above 100 lives. This was due to inadvertent stocking of food packages in the same hold as folidol containers. In countries such as India and Nicaragua, organophosphates are easily accessible and, therefore, a source of both intentional and unintentional poisonings. The incidence of international organophosphate-related human exposures appears to be underestimated.(1) Over time organophosphorus compounds have become the no.1 poison of choice for the purpose of suicide in India and remain so till date. Hence this study was conducted to shed some light on the scenario of deaths due to organophosphorus compound poisoning. Keywords: Organophosphorous compound poisoning.

Croton campestris A. St.-Hill Methanolic Fraction in a Chlorpyrifos-Induced Toxicity Model in Drosophila melanogaster: Protective Role of Gallic Acid.

Croton campestris A. St-Hill popularly known as “velame do campo” is a native species of the savannah from northeastern Brazil, being used in folk medicine due to its beneficial effects in the treatment of many diseases, inflammation, detoxification, gastritis, and syphilis; however, its potential use as an antidote against organophosphorus compound poisoning has not yet been shown. Here, the protective effect of the methanolic fraction of C. campestris A. St.-Hill (MFCC) in Drosophila melanogaster exposed to chlorpyrifos (CP) was investigated. Flies were exposed to CP and MFCC during 48 h through the diet. Following the treatments, parameters such as mortality, locomotor behavior, and oxidative stress markers were evaluated. Exposure of flies to CP induced significant impairments in survival and locomotor performance. In parallel, increased reactive oxygen species and lipoperoxidation occurred. In addition, the activity of acetylcholinesterase was inhibited by CP, and superoxide dismutase and glutathione S-transferase activity was induced. Treatment with MFCC resulted in a blockage of all CP-induced effects, with the exception of glutathione S-transferase. Among the major compounds found in MFCC, only gallic acid (GA) showed a protective role against CP while quercetin and caffeic acid alone were ineffective. When in combination, these compounds avoided the toxicity of CP at the same level as GA. As far as we know, this is the first study reporting the protective effect of MFCC against organophosphate toxicity in vivo and highlights the biotechnological potential of this fraction attributing a major role in mediating the observed effects to GA. Therefore, MFCC may be considered a promising source for the development of new therapeutic agents for the treatment of organophosphate intoxications.

Study of protective properties of butyrylcholinesterase in acute anticholinesterase poisoning on BChE-KO and BALB/c mice

Introduction: The article presents the results of studying the protective properties of recombinant human butyrylcho­linesterase (rhBChE) in a model of acute anticholinesterase poisoning in mice knocked out for the BChE gene. Balb/c inbred mice were also used to demonstrate the important role of BChE.
 Materials and methods: In the study, BChE-ko and Balb/c mice were used. An organophosphorus compound (OPC) paraoxon was used as a toxic agent causing acute anticholinesterase poisoning. rhBChE was used as an antidote for OPC poisoning. To obtain rhBChE, an expression system based on CHO cell lines was chosen. In order to suppress BChE in Balb/c mice, a carboxyl esterase blocker cresylbenzodioxaphosphorin oxide (CBDP) was used. Two parame­ters were used to study the recovery after toxicity modeling: the end time of the animal tremor and the distance covered in open-field for 3 minutes.
 Results and discussion: The acute poisoning model using the CBDP blocker showed that the sensitivity of Balb/c mice increased significantly. The use of rhBChE against the background of CBDP allowed achieving 100% survival of animals with the minimum lethal dose of paraoxon. Knockout mice are expected to be more sensitive to the toxin, and the use of a biological trap in the form of rhBChE made it possible for 70% of the animals to survive with the minimum lethal dose of paraoxon. Besides, the use of rhBChE facilitated reducing the recovery time after OPC poisoning.
 Conclusion: The results of the study showed that the use of rhBChE as a protective agent in acute OPC poisoning significantly increased the survival of the animals and reduced the clinical manifestations of poisoning.

Enzymatic decontamination of paraoxon-ethyl limits long-term effects in planarians

Organophosphorus compounds (OP) are highly toxic molecules used as insecticides that inhibit cholinesterase enzymes involved in neuronal transmission. The intensive use of OP for vector control and agriculture has led to environmental pollutions responsible for severe intoxications and putative long-term effects on humans and wild animals. Many in vivo models were studied over the years to assess OP acute toxicity, but the long-term effects are poorly documented. Planarian, a freshwater flatworm having a cholinergic system, has emerged as a new original model for addressing both toxicity and developmental perturbations. We used Schmidtea mediterranea planarians to evaluate long-term effects of paraoxon-ethyl at two sublethal concentrations over three generations. Toxicity, developmental perturbations and disruption of behavior were rapidly observed and higher sensitivity to paraoxon-ethyl of next generations was noticed suggesting that low insecticide doses can induce transgenerational effects. With the view of limiting OP poisoning, SsoPox, an hyperthermostable enzyme issued from the archaea Saccharolobus solfataricus, was used to degrade paraoxon-ethyl prior to planarian exposure. The degradation products, although not lethal to the worms, were found to decrease cholinesterase activities for the last generation of planarians and to induce abnormalities albeit in lower proportion than insecticides.

English

English

Pattern and Outcome of Self- Poisoning among Adult population Admitted in a Tertiary Care Hospital

Background: Attempted suicide or deliberate self-harm by self-poisoning among adult males and females are a major public health problem to be addressed like any other medical condition. In recent years, patterns of self-poisoning are changing. So it is important to know about the substances used in self poisoning and its outcome.
 Materials and Methods: It was a descriptive type of cross sectional study done in Department of Medicine, Dhaka medical college hospital, Dhaka on100 patients with a history of self-poisoning. Study period was six months. A semi structured questionnaire was used for collection of data.
 Results: In our study self-poisoning was more prevalent among young age group with female preponderance. Family disharmony (45%) was the commonest cause of self poisoning and most commonly used substance was pharmaceutical drugs. Anxiolytics were the commonest (42 %), organo phosphorus compound (OPC) 20%, mixed drugs 12%, harpic 11%, rat killer 8%, NSAIDs 3%, Dettol 3% and Wheel powder 1%. Out of 90 patients 91.11% patients recovered completely. Death was observed from OPC poisoning.
 Conclusion: Knowing the pattern and outcome of self poisoning may improve the community based support system through which we can combat against self- poisoning.
 J MEDICINE JAN 2020; 21 (1) : 20-25