Pesticide Poisoning Research Articles

Clinical Profile of Adult Organophosphorus Compound Poisoning in a Tertiary Care Hospital

Despite the apparent benefits of organophosphate compounds (OPCs) acute organophosphate (OP) pesticide poisoning is an increasing problem worldwide. In a country like Bangladesh, where agriculture is a major component of the economy, these compounds are readily available to the general public. There is paucity of evidence from Bangladesh showing the pattern of organophosphate poisoning (OPP) in healthcare facilities. The aim of this study is to see the clinical profile of organophosphorus compound poisoning in admitted patients of tertiary care hospital.
 Methods: This observational cross-sectional study was carried out over all admitted patient with OPC poisoning in the department of Medicine, Cumilla Medical college, Cumilla from July 2019 to January 2020. A total of 100 cases were enrolled in the study. Patients having history of poisoning with OPC compound were stabilized by ABC care system and then assessed according to detailed history, physical examination and paradeniya organophosphorus poisoning (POP) scale.
 Results: The mean age was found 25.0±8.0 years and male to female ratio was 1:1.2, were mostly married (78.0%) and most of them from poor family (86%). The commonest manner of poisoning was suicidal (90.0%) with oral ingestion. More than eighty (84.0%) percent patients came from rural area. Commonest symptoms were abdominal pain (88.0%), vomiting (63.0%), excessive sweating (58.0%), salivation (35.0%), breathlessness (34.0%) and lacrimation (27.0%). Total hospitalization period was more than one week and less than two weeks in majority of cases (73%) and mortality rate was 2.0%.
 Conclusion: Due to increasing numbers of organophosphorus poisoning cases in younger age groups strict legislature on the availability of organophosphate compounds, preventive measures and appropriate health education should be introduced to decrease the incidence.
 Central Medical College Journal Vol 5 No 2 Jul 2021 PP 76-83

“내 상처에 네 손을 넣어라”: 체리에 모라가의 Heroes and Saints가 말하는 몸 없는 물질성

With the playwright’s proses that energetically emphasize the recovery and redefining of Chicanx identities and motherland, Cherríe Moraga’s Heroes and Saints usually has been interpreted as a play that represents political and religious possibilities enabled by bodiless Chicana divinity. Cerezita Valle, the play’s heroine who does not have a body under her neck due to prenatal pesticide poisoning, transfigures herself as La Virgen de Guadalupe in order to purge the polluted Madre Tierra(mother-land) and exhort the people of San Joaquin Valley to form joint confrontation. Her absent body, a powerful symbol representing Madre Tierra, expands boundlessly and works as a useful vehicle for delivering urgent political messages, incorporating diverse and divergent Chicanx communities. This article concurs with the previous studies that read Cerezita’s bodiless body as a Chicanx hero-saint who represents the encompassing and caring mother-land required by mestizas living in a world polluted by pesticides and global capitalism. However, this article also argues that Cerezita’s body cannot be read only as an immaterial symbol. Cerezita is a complicated figure which reformulates various dichotomies: political hero and religious icon, Virgin Mary and La Malinche, and ethereality and corporeality. Moraga transfigures Cerezita into La Virgen de Guadalupe with a heavy price; the playwright highlights that Cerezita yearns for female sexuality and desire, thus making it clear that the heroine should be reduced to a religious/political icon only when she painfully abandons her disabled physical corporeality. Nevertheless, by doing so, the play makes the audiences recognize Cerezita’s bodily materiality on stage that cannot be seamlessly packed up into compelling metaphors. The bipolar, ambivalent vibration of the heroine illuminates the possibility of imagining the concrete and the indefinite simultaneously, suggesting the countermeasure against and the ethical representation of the prevalent ‘slow violence’ of the global environmental crisis.

Intrinsic dual emissive carbon dots for ratiometric sensing of acetylcholinesterase fluctuation induced by organophosphorus pesticide intoxication

Recently, the ratiometric analysis of AChE activity based on the intrinsic dual-emissive fluorescent (FL) nanomaterials is urgently required. The AChE activity can serve as a promising biomarker of neuro-toxicity induced by organophosphorus pesticides. In this work, oxidized carbon dots (ox-CDs) with intrinsic dual FL peaks at 650 and 680 nm are obtained. Moreover, the FL peak at 680 nm can be effectively quenched by Ag+ or Hg2+ while that at 650 nm can be served as self-reference signal. The introduction of AChE and acetylthiocholine (ATCh) contribute to the generation of TCh, which can capture the metal ions via competitive association to recover their FL signal to the initial status. Furthermore, the AChE activity can be determined by the ratio of FL intensity at 680 nm to that at 650 nm. As for the ox-CDs-Ag+ system, the linear range is determined to be 0.5–10 mU/mL and LOD is 0.127 mU/mL, while those for ox-CDs-Hg2+ system are 0.05–1.6 mU/mL and 0.019 mU/mL, respectively. Furthermore, the fluctuation of plasma and cerebrospinal fluid (CSF) AChE activity in dichlorvos-poisoned and pralidoxime therapeutic rats has been monitored by the ox-CDs-Ag+ system, which is essential for early diagnostics and prognostics of dichlorvos triggered neurotoxicity.

Assessment of genotoxic effects of organophosphate and carbamate pesticides by comet assay

Background and Aims: Pesticide poisoning is the most widespread occupational hazard for agricultural workers in the developing world, due to the extensive presence of pesticides in the environment. The aim of this study was to investigate the cytotoxicity and DNA damaging effects of organophosphosphate and carbamate pesticides. Methods: In the present study, the cytotoxicity of chlorpyrifos methyl, azinphos ethyl, [(O-Ethyl O-(p-nitrophenyl) pheriylphosphonothioate] (EPN), aldicarb sulfone, and ethiofencarb were assessed by the trypan blue dye exclusion method. An alkaline comet assay was performed to assess the genotoxic effects of applied pesticides in human peripheral blood lymphocytes. Results: We demonstrated the cytotoxic effect of EPN following 30 and 120 min exposure at 100 µg/mL concentration. Although chlorpyrifos-methyl and azinphos ethyl seem to be safer concerning cytotoxicity compared to other pesticides, significantly higher DNA damage levels were determined after exposure of these pesticides for 120 min at 100 µg/mL concentration by in vitro comet assay. The potential DNA-damaging effects of these pesticides were sorted from high to low, as chlorpyrifos-methyl, aldicarb sulfone, EPN, and azinphos ethyl after 30 min of exposure, and were sorted as chlorpyrifosmethyl, azinphos ethyl, aldicarb sulfone, and EPN after 120 min of exposure. Our results revealed that these pesticides tend to increase DNA damage in a dose- and time-dependent manner. Conclusion: The genotoxic effects of these widely used pesticides may cause prominent and serious health risks for human populations; hence, the DNA-damaging potential of pesticides can lead to genotoxic risk and adverse health effects like cancer.

Prevalence, clinical manifestations, laboratory findings, treatment, and outcome of intermediate syndrome in anticholinesterase pesticide intoxication of dogs: A retrospective study

Organophosphates and carbamates are important anticholinesterase intoxicants of humans and dogs. Intermediate syndrome (IMS) typically occurs 7–96 h following a toxicity-associated acute cholinergic crisis (ACC), and manifests clinically as weakness of the proximal limb, respiratory, and neck flexor muscles. The aim of this study was to describe the prevalence, clinical findings, and outcome of IMS in dogs. The medical records of a veterinary teaching hospital were searched for dogs diagnosed with ACC, IMS, or both, between 2017 and 2021. Case files were retrospectively reviewed. Six historical IMS cases were additionally reviewed. Thirty-two dogs were diagnosed with anticholinesterase intoxication during the search period, of which 23 (72 %) were only diagnosed with ACC, seven (22 %) progressed from ACC to IMS, and two (6 %) were only diagnosed with IMS. Duration of hospitalisation was longer in the IMS group compared to the ACC only group (P = 0.005). When all dogs with IMS (n = 15, including the six historical cases) were considered, survival was 100 %, including four (27 %) that required positive pressure mechanical ventilation following respiratory failure. Serum butyrylcholine esterase activity, a marker of cholinesterase activity, was below reference interval when first measured in 14 (93 %) of dogs; however, was not a useful as a recovery marker. IMS should be suspected in dogs demonstrating respiratory, neck, and proximal limb muscle paresis or paralysis, especially following clinical signs consistent with ACC. Absence of clinical signs consistent with ACC or butyrylcholine esterase activity within the reference interval does not exclude IMS as a differential.

Hexaconazole poisoning - An uncommon poisoning incidence in rural tertiary care and our experience

Acute pesticide poisoning is a very common in rural India. The pesticides used in the agriculture are major contributors in poisoning either intentiaonal or accidental. Poisoning itself is a major global concern. Hexaconazole is not as common poison in India and very few cases are reports. We report a rare case of hexaconazole poisoning and its successful management in rural tertiary care unit.

Partial hanging with multiple pesticide poisoning: A case report of a complex suicide

Compared to death by hanging, fatal cases due to pesticides intake with hanging is hardly seen. Here, we are reporting a rare case where the victim had used this combination to terminate his life as a complex suicide. The deceased was a 44-year-old man, who had ingested the pesticides and hung himself with nylon rope. A complete death investigation, including scene investigation and complete autopsy examination, was carried out. Autopsy report revealed the presence of greenish brown colour liquid with kerosene smell in stomach which was later confirmed by the chemical and instrument analysis with GC-MS as pestecides (Organophosphorus and Pyrethroid). The cause of death was although anti-mortem hanging but also due to the presence of massive amount of pesticides in visceral tissues, ingested by the victim. The method of death was more towards planned complex suicide. GC-MS Gas Chromatography-Mass Spectroscopy: Agilent 7890B GC with Mass Detector 5977A was used to analyze all the exhibits. The setting of the instrument is as described: Column- HP-5MS (30 M × 0.250 mm × 0.25 μ) Oven Temperature started from 100 °C for 1.5 min then rate of 7 °C/min till 300 °C for 10 min, Injection Temperature–280 °C, Injection volume–1 μL, Mode–Split, Carrier Gas–Helium, Flow Rate–70.9 ML/min., MSD parameters included EI tune type, temperature of MS source–300 °C, temperature of MS Quad- 150 °C, Start Mass-29.00 End Mass-400. Total run time for a cycle was 25 min. Mass spectral library:- National Institute of Standards and Technology (NIST). All exhibits and standard of Organophosphorus (Chlorpyrifos) and Pyrethroid (cypermethrin) were analysed by GC-MS after TLC. GC-MS analysis of exhibits showed by the peaks at Organophosphorus (Chlorpyrifos) RT 15.83.24 and Pyrethroid (cypermethrin) RT 27.75. No endogenous interference was observed during the determination of Organophosphorus and Pyrethroid. Hanging with poisoning are reported as the most complicated manner of suicide and the value of toxicological analysis should not be underestimated in these cases. This case further highlights the responsibility of various stake holders to ban highly hazardous pesticides. So, that it may not be used for of suicidal intent.

A CLINICAL STUDY OF ORGANOSPHOSPHORUS COMPOUNDS POISONING WITH SPECIAL REFERENCE TO ECG CHANGES AND TROPONIN I

Background: The modern world thrives well on revolution in the agricultural practices that has resulted in a massive thrust in agricultural productivity. One of the most important step in green revolution is pesticides. In the developing world, poisoning is a common method of suicide. Organophosphorus compounds inhibit acetyl cholinesterase and butyryl cholinesterase enzymes resulting in excess acetyl choline in the neuromuscular junction causing overstimulation at the cholinergic synapses. The cardiac manifestations occur in a majority of affected patients and may range from innocuous ECG manifestations, such as sinus tachycardia, to life-threatening complications including cardiogenic pulmonary edema. Repolarization abnormalities, including ST-segment elevation and T-wave inversion as well as prolongation of the QTc interval, are among the most frequent cardiac manifestations of acute OP poisoning. . study was carried out in the Department of Medicine, Assam MedicalMethods: College & Hospital,admitting in various ward of medicine,satisfying the inclusion and exclusion criteria. Patients were classied into three grades using 'Peradeniya organophosphorus poisoning scale'.76 Changes in ECG was monitored and Troponin I levels were measured at admission and repeated if required. . In our study, mean age of the cases was 44.32 years with 57.9% cases were below 40 years i.e. young adults. In theResults : study among the 190 patients 123 were males and 67 females. Among our study participants most of the cases were of suicidal OP poisoning (79.5%) while only 20.5% cases were accidental. Most common presenting symptoms in the study were blurring of vision (94.7%), lacrimation (92.1%), breathlessness (64.7%) and salivation (63.7%). In the present study out of 190 cases ECG changes were noted in 75 patients i.e 39.5% cases. Among them most common ECG nding was QTc prolongation (74.7%) followed by ST depression (24%) and T wave inversion (21.3%). A signicant association was observed between severity of poisoning and incidence of ECG changes (p<0.01). Saadeh AM et al.39 in a similar study observed arrhythmias in 11 (24%); prolonged Q-Tc interval in 31 (67%), ST-T changes in 19 (41%) and conduction defects, 4 (9%) cases. Karki P et al.40 observed electrocardiographical abnormalities including prolonged Q-Tc interval in 14 cases (37.8 percent), ST-T changes in 11 cases (29.7 percent), and conduction defects in two cases (5.4 percent). In our study out of 190 cases raised troponin I levels were seen in 30 (15.8%) cases. A signicant association was observed between severity of poisoning and increase in troponin I levels (p<0.01). Wan WG et al.45 discussed the diagnostic value of cardiac enzyme and troponin in acute organophosphorus pesticide poisoning (AOPP). We thus conclude thatConclusions: organophosphorus compounds poisoning is a major cause of morbidity and mortality and is suicidal in most of the cases. ECG abnormalities and myocardial injury is associated with OP poisoning and are more in POP severe grade of poisoning. Morbidity and mortality increases in patients with ECG changes (especially prolonged QTc) and raised Troponin I levels. Therefore, early hospitalization, treatment and follow up with ECG monitoring can be lifesaving in organophosphorus poisoning.

Direct Costs of Healthcare among Patients with Deliberate Self-harm: A Pilot Study from a Tertiary Care Hospital in South India.

Deliberate self-harm (DSH) in developing nations has a significant impact on health and economic conditions of patients and families. This retrospective study aims to study the cost of hospitalization and the factors affecting the cost of medical care. Adult patients with a diagnosis of DSH were included. A total of 107 patients were included with the most common type of poison consumed being pesticides (35.5%) followed by a tablet overdose (31.8%). There was a male preponderance with a mean (SD) age of 30.04 (9.03) years. The median cost of admission was ₹13,690 (USD 195.57); DSH with pesticide increased the cost of care by 67% as compared to non-pesticides. Other factors which increased the cost were need for intensive care, ventilation, use of vasopressors, and development of ventilator-associated pneumonia (VAP). Pesticide-based poisoning is the most frequent cause of DSH. Among different types of DSH, pesticide poisoning is associated with a higher direct cost of hospitalization. Barnabas R, Yadav B, Jayakaran J, Gunasekaran K, Johnson J, Pichamuthu K, et al. Direct Costs of Healthcare among Patients with Deliberate Self-harm: A Pilot Study from a Tertiary Care Hospital in South India. Indian J Crit Care Med 2022;26(7):836-838.

Application of Shewhart Control Chart in Controlling Adverse Events in Patients with Severe Acute Organophosphorus Pesticide Poisoning Undergoing Blood Purification.

Objective To explore the application effect of the Shewhart control chart in controlling adverse events in patients with severe acute organophosphorus pesticide poisoning (AOPP) undergoing blood purification. Methods A retrospective analysis was performed on the clinical data of 102 patients with severe AOPP admitted to the hospital between January 2020 and December 2021, including 47 cases in the control group and 55 cases in the observation group. The control group was given routine emergency nursing, while the observation group was given emergency nursing under the guidance of the Shewhart control chart on the basis of the control group. The specialized operations, basic operations, specialized theory, and basic theory of nursing staffs were scored to compare the comprehensive nursing quality. The total incidence of adverse nursing events in both groups was statistically analyzed. The dosage of atropine, disappearance time of muscarinic symptoms, recovery time of CHE activity to 60%, and hospitalization time in both groups were recorded. The total incidence of complications in both groups was statistically analyzed. The satisfaction of family members was statistically analyzed by a satisfaction questionnaire. Results The scores of specialized operations, basic operations, specialized theory, and basic theory of nursing staffs in the observation group were significantly higher than those in the control group (P < 0.05), total incidence of adverse nursing events was significantly lower than that in the control group (P < 0.05), dosage of atropine, disappearance time of muscarinic symptoms, recovery time of CHE activity to 60%, and hospitalization time were significantly lower than those in the control group (P < 0.05), total incidence of complications was significantly lower than that in the control group (P < 0.05), and scores of nursing attitude, communication process, psychological relief, and drug preparation were significantly higher than those in the control group (P < 0.05). Conclusion The Shewhart control chart can effectively improve the clinical effect, comprehensive nursing quality, and satisfaction of patients with severe AOPP and effectively reduce complications and adverse events.

Hematological Parameters Alteration in Thai Garlic Farmers Exposed to Mixed Pesticides

Fungicides, herbicides, and insecticides are commonly agrochemicals used to eliminate pests during garliccultivation. Occupational exposure to mixed pesticides can cause hematological abnormalities. The aim of thisstudy was toassess the adverse effects of chronic mixed pesticide exposure in the garlic farmers by using thehematological parameters. The blood sample was collected from 137 Thai farmers who chronically exposed tomixed pesticide and 59 control group who were not a history of exposure to mixed pesticide. Complete BloodCount (CBC) analysis was performed to investigate the hematological parameters alteration pattern of Thaifarmers. Statistical analysis also performed by using Mann-Whitney U test. Our investigations revealed thatthemean values of white blood cell (WBC) count, lymphocyte, basophil, platelet distribution width, mean plateletvolume and platelet large cell ratio significantly decreased in the chronic exposed group but did not affect whencompared with the normal reference ranges. The results clearly demonstrated that chronic exposure to the mixedpesticides during garlic cultivation alters the hematological parameters. The farmers should be aware and checktheir health to prevent the adverse effects from pesticide intoxication.

Quantification of multi-class pesticides in stomach contents and milk by gas chromatography–mass spectrometry with liquid extraction method

• Stomach content is the best specimen in acute pesticide poisoning. • Direct detection of pesticides in milk. • Salt-assisted liquid extraction method. • Quantification method of nine multi-class pesticides by GCMS. Pesticides belonging to carbamates, pyrethroids and organophosphate groups are being mostly used worldwide. These are toxic and their minute amount leads to severe illness or death when ingested through various means. In case of suicidal or homicidal incidents, trace levels of pesticides may lead to acute death. In this scenario, stomach content is the best specimen for the detection of pesticide poison. Conversely, trace levels of pesticides may reach the mammary glands of milking animals when they eat grassy feed exposed to pesticides spray. Trace levels of those pesticide residues present in milk remain stable even after pasteurization. Eventually, milk consumers are affected chronically by these pesticide residues. The current study includes the development and validation of nine multi-class pesticide residues analyses in stomach content and milk. Nine-multiclass pesticides were extracted from stomach content and milk by acetonitrile with the addition of extraction salt. Quantitative analysis of permethrin, lambda-cyhalothrin, pyriproxyfen, triazophos, profenophos, chlorpyriphos, carbofuran, phorate, and step, GC–MS was used as an analytical technique equipped with DB-5 ms capillary open tubular column (15 m × 0.25 mm × 0.25 µm) and 0.08 ml/L flow rate of helium mobile phase gas with constant pressure. LLOQ and ULOQ for all target analytes were 0.05 mg/L and 3 mg/L respectively.

A sensitive and selective fluorescent probe for acetylcholinesterase: Synthesis, performance, mechanism and application

The detection of acetylcholinesterase (AChE) activity is of great significance for studying the physiological functions of AChE and clinical diagnosis of pesticide poisoning. Herein, a small-molecule fluorescent probe BDFA was rationally designed and readily synthesized via a one-step reaction, which enables qualitative and quantitative detection of AChE. BDFA emits a slight fluorescence in an aqueous medium, while the fluorescence is significantly enhanced under the catalysis of AChE. Mechanism studies reveal that BDFA eliminates the N, N-dimethyl carbamate protective group in the presence of AChE and then spontaneously undergoes intramolecular cyclization conversion to generate an intense fluorescent product. Based on the above mechanism, BDFA exhibits a sensitive, selective, rapid and stable “turn-on” fluorescence response to AChE, without interference from pH, ions, thiols, amino acids and other enzymes. The fluorescence intensity of BDFA at 525 nm has a linear relationship with the AChE concentration in the range of 0.0045–1.0 U/mL, and the detection limit is 4.5 mU/mL. Moreover, BDFA is suitable for rapidly diagnosing AChE activity in blood samples, thus providing an efficient and convenient tool for diagnosing organophosphorus and carbamate pesticide poisoning. Compared with the reported AChE fluorescent probes, BDFA exhibits apparent advantages including simple synthesis, low detection limit and fast response speed.

Inflammatory cytokines in patients with pesticide poisoning: a pilot study

Purpose: Acute pesticide poisoning is lethal and can lead to death. A few studies about the effects of acute pesticide poisoning have focused on the immune system. In the current study, we preliminarily investigated the changes in blood inflammatory cytokine levels in acute pesticide poisoning patients. Methods: In this study, we prospectively investigated the inflammatory cytokines in patients with acute pesticide poisoning. This study included patients admitted from February 2021 to November 2021 with a diagnosis of intentional poisoning by pesticide ingestion. The inflammatory cytokines measured were IFN-γ, IL-1β, IL-6, and TNF-α. Results: Totally, 27 patients were enrolled in this study. The types of pesticide ingested were glufosinate (n=6), glyphosate (n=8), organophosphate (n=4), pyrethroid (n=2), and others (n=7). The levels of inflammatory cytokines obtained were as follows: IFN-γ 2.78±8.03 pg/ml, IL-1β 2.62±2.03 pg/ml, IL-6 44.58±80.16 pg/ml, and TNF-α 11.80±15.60 pg/ml. The overall mortality rate was 11.1% (3/27), and levels of IL-1β and TNF-α were significantly higher in the death group compared to the survival group. Conclusion: Increased levels of IL-6 and TNF-α were observed in patients with acute pesticide poisoning. IL-1β and TNF-α were significantly higher in the death group as compared to the survival group. Our results indicate the occurrence of an inflammatory response due to the activation of immune cells by pesticide poisoning. Future large-scale studies need to be conducted to investigate the application of inflammatory cytokines as predictors and therapeutic targets.

A case of severe organophosphate poisoning used a high-dose atropine

In this study, we report the case of a 59-year-old male patient with organophosphate pesticide poisoning. He visited the local emergency medical center after ingesting 250 ml of organophosphate pesticide. The patient's symptoms improved after the initial intravenous infusion of pralidoxime 5 g and atropine 0.5 mg. However, 18 hours after admission, there was a worsening of the symptoms. A high dose of atropine was administered to improve muscarinic symptoms. A total dose of 5091.4 mg of atropine was used for 30 days, and fever and paralytic ileus appeared as side effects of atropine. Anticholinergic symptoms disappeared only after reducing the atropine dose, and the patient was discharged on the 35th day without any neurologic complications.

SENSITIZATION AMONGST FARMERS TOWARDS HAZARDOUS EFFECTS OF AGROCHEMICALS

Pesticide poisoning is a huge global health issue that is particularly widespread in developing countries. It can cause a variety of human health problems depending on their toxicity, frequency and duration of exposure. Hazardous effects of agrochemicals will be reduced if the farmers become more sensitive of the proper use pattern of agrochemicals (pesticides) and follow prescribed self-protection mechanisms. The study assessed the sensitization amongst farmers towards hazardous effects of agrochemicals. A questionnaire-based simple random sampling survey was conducted on 120 farmers of Anand and Kheda districts of Gujarat state. The statistical measures, such as SPSS and Microsoft excel were used. Slightly more than three-fourth (76.67 per cent) of the farmers had an average level of sensitization. Training received (0.437) and Social participation (0.364) of farmers had a positive and highly significant correlation with their sensitization towards hazardous effects of agrochemicals. This study will assisted entomologist, pathologist and environmentalist for the implementing the training programmes related to safe handling and use of recommended doses of application of plant protection chemicals.

Predictors of mortality in emergency centre patients with acute pesticide poisoning in Uganda.

Although the global suicide deaths due to intentional pesticide poisoning disproportionately occur in low income countries (LIC) and lower to middle income Countries (LMIC), there is a scarcity of reports on emergency centre (EC) mortality and its predictors in these settings. Our goal was to determine the case fatality rate of Acute Pesticide Poisoning (APP) presenting to Mbarara Regional Referral Hospital (MRRH) EC and find out whether initial triage category predicted mortality in these patients. This was a prospective observational longitudinal study. Patients presenting with APP were enrolled using data collection forms. Data collected included initial triage category, vital signs, demographics, initial assessment, and management. They were followed up for 1 week. Out of 66 patients admitted with suspected pesticide poisoning, 61 had complete follow up during the study period. However, only 58 patients had the pesticide ingested confirmed. These were predominantly males 48 (73%) and farmers 28(42%) with a median age of 23 years (IQR 18-31). Majority of patients 58 (88%) were suicide attempts and had ingested mostly organophosphates 23 (35%), amitraz 11(17%), zinc phosphide 7(10%), and aluminium phosphide 4(6%). The median time from ingestion to presentation was 4hours (IQR 2.5-8). More than half 41(62%) of the patients were in the red triage category (ESI-1). The overall case fatality rate of APP was 18%. Majority of patients who died were in the red triage category but the initial triage category was not significantly associated with mortality (p=0.381). Male gender (p=0.018), time of admission (p= 0.037), and triage vitals including hypothermia (p=0.020), hypoxia (p= 0.004), hypotension (p= 0.031), and tachypnea (p= 0.031) were significantly associated with mortality. Although initial triage category was a poor predictor, triage vital signs, gender, and time of admission were significantly associated with mortality in patients with APP.

Conservation of Asian giant honeybee, Apis dorsata fabricius (Hymenoptera: Apidae)

The giant honeybee, Apis dorsata builds single largest open comb on a suitable substratum. It is a major honey producer and important pollinator of both wild and crop plants. However, recently colony population of these species is gradually declining due to many factors including traditional honey harvesting and pesticide poisoning. Conservation of these species is immediately required through development of sustainable methods of honey harvesting and reduced insecticide poisoning for better honey production and effective pollination.

Study on the Effectiveness and Complication Rate of Hemoperfusion and Hemodialysis in the Treatment of Emergency Patients with Severe Organophosphorus Pesticide Poisoning

Study on the Effectiveness and Complication Rate of Hemoperfusion and Hemodialysis in the Treatment of Emergency Patients with Severe Organophosphorus Pesticide Poisoning

A nursing socio-environmental approach for acute pesticide poisoning: A qualitative focus group study.

To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario. A qualitative descriptive study was conducted using focus groups. Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used. After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally competent practice and (iii) social factors in prevention strategies. Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice. Nurse managers, policymakers and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs to promote "glocal" competencies among nursing professionals.