scholarly journals Prediction of Acute Organophosphate Poisoning Using Glasgow Coma Sale, Serum Cholinesterase and S100B

2017 ◽  
Vol 28 (1) ◽  
pp. 100-107
Author(s):  
Merfat Oreby ◽  
Enas El-Madah
Keyword(s):  
Serum Cholinesterase ◽  
Organophosphate Poisoning

scholarly journals Association between ECG Alterations and Outcomes of Patients with Acute Organophosphate Poisoning

2020 ◽  
Vol 27 (1) ◽  
pp. 63-66
Author(s):  
Kavous Shahsavari Nia ◽  
Payman Moharamzadeh ◽  
Ali Taghizadieh ◽  
Samira Abedi ◽  
Afshin Gharekhani
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Admission ◽  
Qt Interval ◽  
Atrioventricular Node ◽  
P Wave ◽  
Deficiency Anemia ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning ◽  
St Segment ◽  
Acetylcholine Level

Background: Organophosphate (OP) poisoning leads to atrioventricular node blockade, alterations in ST segment, prolongation of QT interval, alterations in P wave, lethal arrhythmias, and cardiac arrest through the inhibition of acetylcholinesterase and consequent accumulation of free synaptic acetylcholine level. So the present study was aimed to investigate the role of electrocardiographic (ECG) monitoring combined with the introduction of anti-arrhythmic interventions on OPs poisoning outcomes. Methods: 41 patients with OPs poisoning were included. Patients with history of heart or liver diseases, cholinesterase deficiency, anemia, and poisoning with other toxins were excluded. Demographic characteristics, the time elapsed between OP ingestion and hospital admission, need for mechanical ventilation, and serum cholinesterase level were recorded. ECG of patients was analyzed for rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals. Study outcomes were measures of morbidity and mortality. Results: Of 41 patients, with mean age of 34.76±13 years, 19 were male. For 68.3% of the patients, the time elapsed between ingestion and hospital admission was 3-6 hours. Eight patients were treated with mechanical ventilation. There was a significant correlation between ST segment alterations and poisoning outcomes including uncomplicated discharge, complicated discharge, and death (P=0.02). Thirty one patients were discharged without any complication, 8 with morbidity and 2 expired. ST segment changes were seen in 4 patients. Two percent had PR interval greater than 0.21s and 3% had QT interval longer than 0.45s. The mean serum cholinesterase concentration was 3011.56 U/L. Conclusion: Due to lethal cardiac arrhythmia caused by OP poisoning, continuous monitoring, managing, and preventing irreparable effects of OP poisoning is highly emphasized.

scholarly journals Correlation of serum creatine phosphokinase and serum cholinesterase in organophosphate poisoning in children

2019 ◽  
Vol 6 (6) ◽  
pp. 2352
Author(s):  
Dhanalakshmi K. ◽  
Febina K. ◽  
Sarala Sabapathy ◽  
Chaithra R. ◽  
Thileepan N.
Keyword(s):  
Creatine Phosphokinase ◽  
Negative Relationship ◽  
High Serum ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning ◽  
Median Serum ◽  
Serum Creatine Phosphokinase ◽  
History Of ◽  
Study Population ◽  
Poisoning In Children

Background: Organophosphate (OP) poisoning is one of the most common pesticide poisoning in India in adolescents because of its easy availability. Serum pseudocholinesterase levels are commonly used to assess the severity and to know the prognosis in OP compound poisoning. Serum creatine phosphokinase (CPK) levels is another lab parameter which gets deranged in OP poisoning and has been tried in adults to assess the severity and to know the prognosis. Authors objective was to study the correlation of serum pseudocholinesterase and serum CPK in organophosphate poisoning at admission and to compare outcome with serum CPK levels.Methods: All the children in the age group of 1 month to 18 yrs, who were admitted with the history of suspected OP compound poisoning were enrolled for the study. Estimation of cholinesterase and CPK levels were done at admission and after 1 week. Patients were categorised in to latent, mild, moderate and severe cases based on the S. Cholinesterase levels. These values were analysed to see the correlation.Results: Among 34 OP poisoning cases,13(38%) were males and 21(62%) were females. Mean age of study population was12.6+4.25 yrs. The median CPK values in latent, mild, moderate and severe cases were 121.5 IU/L,276.5 IU/L, 308IU/L and 467IU/L respectively (p=0.015). Spearman’s rho Correlation coefficient was -0.522 between S. Cholinesterase and S CPK at admission which was significant. The median serum CPK level after 1week in non survivors was 2498.0IU/L and in survivors was 201.0IU/L (p0.014).Conclusions: There was a strong negative relationship between serum cholinesterase and serum CPK at admission in OP poisoning. Follow up values at 1 week showed that significantly high serum CPK and low cholinesterase, which was also significant and was associated with mortality.

scholarly journals Correlation of Serum Amylase, Lipase and Creatine Kinase with Severity of Organophosphate Poisoning- A Cohort Study

2021 ◽  
Author(s):  
Noas Tobias Minz ◽  
Sarat Chansra Singh ◽  
Priyabrata Jena ◽  
Pranay Kumar Patro
Keyword(s):  
Creatine Kinase ◽  
Cohort Study ◽  
Rural Areas ◽  
Serum Amylase ◽  
Hospital Admissions ◽  
Acetylcholine Esterase ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning ◽  
Mean Values ◽  
Organophosphorus Poisoning

Introduction: Organophosphate Compounds (OP) are widely used pesticides in agriculture. It is easily available and OP poisoning is most common cause of poisoning and hospital admissions. Severe poisoning is associated with high mortality. Severity of poisoning can be assessed by Peradeniya Organophosphorus Poisoning (POP) scale, Acute Physiology and chronic Health Evaluation (APACHE) II, Glasgow Coma Scale (GCS) or serum Cholinesterase Level (ChE). Serum amylase, lipase, and creatine kinase are important biomarkers raised in OP poisoning. Aim: To correlate serum amylase, lipase, and creatine kinase with severity of OP poisoning. Materials and Methods: This was a hospital based observational cohort study conducted on 130 patients of organophosphate poisoning admitted in General Medicine wards of SCB Medical College, Cuttack, Odisha from June 2019 to December 2020. Serum Acetylcholine Esterase (AChE), amylase, lipase and creatinine kinase were estimated at admission, day 2, and at discharge. Other routine investigations were done. Acetylcholine Esterase (AChE) was used to confirm the diagnosis. The severity of poisoning was assessed using POP scale and graded as mild, moderate and severe. The severity of poisoning and the level of enzymes were correlated. The parameters were tabulated and mean values and Standard Deviation (SD) were analysed using Statistical Package For The Social Sciences (SPSS) software version 22.0. Results: Out of 130 patients 91 were males and 39 were females, mostly from rural areas, both farming and non-farming community. Age ranged from 14 years to 79 years, with majority in 19 to 39 years. AChE decreased in all cases depending on severity confirming OP poisoning. Severity as assessed by POP score were mild (52 patients), moderate (46 patients) and severe (32 patients). At admission, the Amylase (U/L), Lipase (U/L), and Creatine kinase (U/L) level (mean±SD) in mild poisoning were 83.7±41.9 U, 70.9±18.6, 72.5±34.9, in moderate poisoning 153.6±109.7, 91.9±47.4, 92.6±81.5, and in severe poisoning 243.9±113.8, 195.3±147.7, 298.8±207.4, respectively. Measurements on second day also remained elevated. Among the severe cases 24 patients developed Intermediate Syndrome (IMS), and 26 patients died. There was positive correlation between increase of enzyme levels and the severity of OP poisoning as per POP score. Conclusion: Serum amylase, lipase, and creatine kinase level correlated well with the severity of organophosphorus poisoning and scan be used additionally as an indicator to assess the severity. Serum amylase is a better indicator of severity than lipase and Creatine Kinase (CPK).

Prognostic Value of Serum Cholinesterase in Organophosphate Poisoning

CHEST Journal ◽  
1994 ◽  
Vol 106 (6) ◽  
pp. 1811-1814 ◽  
Author(s):  
Semir Nouira ◽  
Fekri Abroug ◽  
Souheil Elatrous ◽  
Rafik Boujdaria ◽  
Slah Bouchoucha
Keyword(s):  
Prognostic Value ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning

scholarly journals Organophosphate poisoning from inappropriate topical use of malathion pesticide: A case report

2022 ◽  
pp. 201010582110685
Author(s):  
Joe Jia-Liang Chua ◽  
Kaibin K. Kuan
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Reference Range ◽  
General Ward ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning ◽  
Past Medical History ◽  
The Past ◽  
Neurologic Sequelae

A 43-year-old male with no past medical history presented to our emergency department with vomiting, diarrhea, and abdominal pain of 3 h’ duration. Upon further questioning, he revealed that he had been applying malathion pesticide over his body for the past 3 days for self-diagnosed scabies. He was otherwise afebrile and hemodynamically stable, and the physical examination was unremarkable. The patient was diagnosed with organophosphate poisoning and treated symptomatically due to the lack of worrying cardiorespiratory or neurologic sequelae. He was subsequently admitted to the general ward, where his symptoms abated within 4 h. Serum and red blood cell cholinesterase tests sent on admission returned on day three and were significantly decreased (serum cholinesterase 2131 U/L, reference range 4700–12000 U/L; red blood cell cholinesterase 3365 U/L, reference range 7700–14600 U/L). He was discharged home well and stable on day 5 of admission, with outpatient psychiatric follow-up for likely delusional parasitosis.

scholarly journals Clinical profile and outcome of intermediate syndrome in acute organophosphate poisoning

2018 ◽  
Vol 5 (1) ◽  
pp. 62
Author(s):  
Rajendran Velayudham ◽  
Senthilkumar S. ◽  
Viswanathan Pandurangan
Keyword(s):  
Respiratory Failure ◽  
Early Recognition ◽  
Ventilatory Support ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning ◽  
Poison Center ◽  
Close Monitoring ◽  
Duration Of Symptoms ◽  
Ventilator Support ◽  
Agriculture Sector

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. 

scholarly journals Cholinesterase Level in Erythrocyte or Serum: Which is More Predictive of the Clinical Outcome in Patients with Acute Organophosphate Poisoning?

2018 ◽  
Vol 12 (5) ◽  
pp. 23-26
Author(s):  
Mohammad Majidi ◽  
◽  
Mohammad Delirrad ◽  
Ali Banagozar Mohammadi ◽  
Mona Najaf Najafi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Outcome ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Activity Level ◽  
Serum Cholinesterase ◽  
Organophosphate Poisoning ◽  
Intratracheal Intubation ◽  
Laboratory Findings ◽  
Cross Sectional

Background: Acute organophosphate poisoning (AOPP) is related to several clinical complications that may be fatal. The aim of this study was to evaluate the effects of demographic, clinical and laboratory findings on AOPP outcome. Methods: In this retrospective cross-sectional study, medical records of all patients with AOPP admitted to Imam Reza Hospital, Mashhad, Iran, were reviewed from January 2016 to December 2017. Demographic data, clinical presentations, erythrocyte cholinesterase (RBC-ChE) and serum cholinesterase (S-ChE) activities were studied and evaluated in relation to clinical outcome of the patients. Results: A total of 64 patients (37 male, 27 female) were evaluated from whom 6 patients (9.4%) died. Statistically significant relationships were found between the outcome of the patients and RBC-ChE activity (p =0.008), intratracheal intubation (p=0.003), and abnormal blood pressure (p =0.009). Despite the lower mean S-ChE levels in the deceased patients and loss of consciousness in 42.2% (n=27) of patients, there was no statistically significant correlations between these factors and patients’ outcome (p =0.147, p =0.075, respectively). Conclusion: RBC-ChE activity, need for intratracheal intubation, and abnormal blood pressure on admission were important predictive factors in the clinical outcome of AOPP. Although S-ChE activity, level of consciousness, white blood cell count and blood glucose level on admission provide useful information, these data had no prognostic value in patients with AOPP.

Coronary Artery Bypass Grafting in a Patient with Organophosphate Poisoning

2015 ◽  
Vol 18 (4) ◽  
pp. 167 ◽  
Author(s):  
Rajeeva R. Pieris ◽  
Ravindra Fernando
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Previous History ◽  
Organophosphate Poisoning ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Excellent Health ◽  
History Of

A 43-year-old male, with no previous history of mental illness, was diagnosed with coronary heart disease, after which he became acutely depressed and attempted suicide by ingesting an organophosphate pesticide. He was admitted to an intensive care unit and treated with pralidoxime, atropine, and oxygen. His coronary occlusion pattern required early coronary artery bypass grafting (CABG) surgery. His family, apprehensive of a repeat suicidal attempt, requested surgery be performed as soon as possible. He recovered well from the OP poisoning and was mentally fit to express informed consent 2 weeks after admission. Seventeen days after poisoning, he underwent coronary artery bypass grafting and recovered uneventfully. Six years later, he remains in excellent health. We report this case because to the best of our knowledge there is no literature regarding CABG performed soon after organophosphate poisoning.

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