A Study on Correlation Between Serum Cholinesterase Level and Clinical Severity Based on Pop Scale in Organophosphorus Poisoning

2021 ◽  
Vol 18 (2) ◽  
pp. 55-58
Author(s):  
Anil Shrestha ◽  
Aasim Kidwai ◽  
Richa Shrestha ◽  
Suman KC
Keyword(s):  
Organophosphorus Pesticides ◽  
Case Fatality ◽  
Public Health Problem ◽  
Initial Presentation ◽  
Clinical Severity ◽  
Serum Cholinesterase ◽  
Major Public Health Problem ◽  
Age Group ◽  
Suicidal Intention ◽  
Organophosphorus Poisoning

Introduction: Organophosphorus (OP) compounds are the most commonly used pesticides worldwide and Organophosphorus poisoning has become the major public health problem especially in developing countries.The case fatality rate following ingestion of Organophosphorus pesticides in developing countries in Asia is 5-20%.Due to limited availability of facilities and resources in Nepal, it is important to prioritize treatment based on severity of poisoning as all patients can’t be managed in Intensive Care Unit. Aims: To study the correlation between serum cholinesterase level and clinical severity based on Peradenya organophosphorus poisoning scale in Organophosphorus poisoning. Methods: The study was conducted in the department of Medicine, Nepalgunj Medical College, Kohalpur, Banke from November 2019 to November 2020. It is based on the descriptive study of 66 patients with Organophosphorus poisoning attending to the emergency department. All patients with history of exposure to Organophosphorus poisoning were included in the study. Peradenya Organophosphorus Poisoning scale was used to assess the clinical severity as mild, moderate and severe. At the same time venous blood samples were collected for serum cholinesterase level. Results: Age group ranged from 16-60 years and majority of patients were in the age group of 20-29 years (34.85%). 53% were females. 74.2% of the patients were from lower socioeconomic status. 83.3% of the patients consumed poison with suicidal intention. Majority of the patients were from tharu ethinicity (40.9%) and were farmers (30.3%). It was observed that there is significant correlation between serum cholinesterase level and severity of poisoning based on Peradenya Organophosphorus Poisoning scale at initial presentation (p value <0.001). Conclusion: There is significant correlation between severity of poisoning and degree of derangement of serum cholinesterase level at the initial presentation. As the facility for the estimation of serum cholinesterase level is not available in all regions of Nepal.

scholarly journals A study on serum cholinesterase level in organophosphorus poisoning and its correlation with severity of organophosphorus poisoning

2018 ◽  
Vol 5 (4) ◽  
pp. 1021
Author(s):  
Vilas Honnakatti ◽  
Naren Nimbal ◽  
Prakash Doddapattar
Keyword(s):  
Developing Countries ◽  
Rural Areas ◽  
Initial Presentation ◽  
Serum Cholinesterase ◽  
Steady Increase ◽  
Age Group ◽  
Low Socioeconomic ◽  
Medical College ◽  
Organophosphorus Poisoning ◽  
Major Route

Background: There has been a steady increase in the use of organophosphates (OPs) as pesticides in most of the developing countries including India for more than 50 years. OPs tend to be the commonest cause of poisoning worldwide and are persistently and deliberately used in suicides in Agrarian areas. As stated by WHO, 3 million cases of pesticide poisoning occur every year, of these about 1 million are accidental and 2 million are suicidal poisonings, resulting in more than 0.25 million deaths per year. As there is limited availability of facilities and resources in developing countries, all OP poisoning patients are not managed in intensive care units. Hence it is important to understand the clinical features and other factors that indicate severity of poisoning which should be identified in the initial examination.Methods: It was a hospital based prospective study of 100 OP poisoning patients that were attending to casualty of BIMS Hospital and Medical College Belagavi, India. Over a period, patients fulfilling inclusion criteria were included and patients were categorized according to Peradeniya Organophosphorus Poisoning (POP) scale. Serum cholinesterase level measured at the time of admission.Results: The patients were in the age group of 18 to 70 years. Majority of the patients were in the age group of 21-30 years (51%). Sixty nine percent of the patients were from rural areas and 38% of them were farmers. Sixty nine percent of patients were from low socioeconomic stratum. Major route of intake of poison was ingestion. Eighty four percent of patients consumed poison with a suicidal intent. In this study, authors observed that there is a significant correlation between the severity of poisoning categorized by the POP scale and the serum cholinesterase at the time of initial presentation of the patients (P<0.001).Conclusions: Present study concluded that significant correlation between the degree of derangement in serum cholinesterase level and severity of poisoning at the initial presentation. Higher the score on the POP scale, the greater was the degree of derangement in the serum cholinesterase level.

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

2018 ◽  
Vol 10 (02) ◽  
pp. 185-188 ◽  
Author(s):  
Sunil Kumar ◽  
Sachin Agrawal ◽  
Nitin Raisinghani ◽  
Shameem Khan
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Leukocyte Count ◽  
Care Center ◽  
Public Health Problem ◽  
Central India ◽  
Serum Cholinesterase ◽  
Major Public Health Problem ◽  
Health Care Center ◽  
Organophosphorus Poisoning

ABSTRACT 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.

scholarly journals Haematological profile of children with malaria in Sorong, West Papua, Indonesia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Syilvia Jiero ◽  
Ayodhia Pitaloka Pasaribu
Keyword(s):  
Malaria Infection ◽  
Clinical Symptoms ◽  
Public Health Problem ◽  
Malaria Diagnosis ◽  
White Blood Count ◽  
P Value ◽  
Major Public Health Problem ◽  
Age Group ◽  
Haematological Profile ◽  
West Papua

Abstract Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.

scholarly journals Prevalence of STHs (Soil transmitted helminthes) of school children in Sadar upazila, Mymensingh, Bangladesh

2018 ◽  
Vol 7 (1) ◽  
pp. 4-9
Author(s):  
Md Mahamudur Rahman ◽  
Md Akram Hossain ◽  
Shyamal Kumar Paul ◽  
Salma Ahmed ◽  
Md Murshed Alam ◽  
...  
Keyword(s):  
School Children ◽  
Total Population ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Close Monitoring ◽  
Age Group ◽  
Total Study Population ◽  
Economic Class ◽  
Study Population ◽  
Mcmaster Method

Soil transmitted helminthes (STHs) infections are common throughout the tropics and subtropics and represents a major public health problem in developing countries. The rate of STHs infection found in the present study was very high in comparison to other countries of this Subcontinent, though they are taking antihelmintics every 6 months interval under Government National Health Program. The present study was carried out to see the Prevalence of STHs infection among the school children in Mymensingh, Bangladesh. A total of 500 stool samples from healthy individuals were collected during April, 2012 to February, 2013 from 20 schools comprising 10 rural and 10 urbans under Sadar upazila, Mymensingh, Bangladesh. The samples were examined in the department of Microbiology, Mymensingh Medical College using saline and iodine preparation microscopy and McMaster technique for the detection of ova of STHs.  The STHs prevalence irrespective of the age and sex of the individuals were 37.0% (185) out of 500 specimens where 68.0% (340/500) individuals were male represents the prevalence 38.0% (129/340) and 32.0% (160/500) individuals were female represents the prevalence 35.0% (56/160). Majority of the cases belonged to the age group >5-10 years 50.2% (251/500) of the total, constituted the prevalence 20.2% (101/500) of the total population and 40.2% (101/251) of the individual age group. The distribution of different STHs with their prevalence in the study population where Ascaris lumbricoides (AL) was 63.8% (118), Trichuris trichiura (TT) 37.3% (69), Enterobius vermicularis (EV) 8.1% (15), Ancylostoma duodenale (AD) 7.5% (14), and mixed infection was 15.1% (28). The upper socio-economic class constituted 5.0% (25/500) of the total study population with the prevalence of 20.0% (5/25). The middle socio-economic class constituted 50.0% (250/500) of the total study population with the prevalence of 37.2% (93/250) and the lower socio-economic class constituted 45.0% (225/500) of the total study population with the prevalence of 38.6% (87/225). The urban population constituted 34.0% (170/500) of the total population representing the prevalence 31.2 % (53/170) and rural population constituted 66.0% (330/500) of the total population representing the prevalence 40.0% (132/330).  In this study, STHs detection by McMaster method was satisfactory. Thereby, McMaster method could be adapted for rapid detection and quantification of STHs. Moreover, one more frequent administration of antihelmintics with close monitoring of drug administration may reduce the prevalence of STHs infection in Bangladesh. CBMJ 2018 January: Vol. 07 No. 01 P: 04-09

scholarly journals Usefulness of Various Peripheral Blood Leukocyte Count ratios in Malaria Evaluation

2017 ◽  
pp. 52-60
Author(s):  
Akshay Louis Dias ◽  
Sumanth D.
Keyword(s):  
Blood Cell ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Severity ◽  
Major Public Health Problem ◽  
Monocyte Count ◽  
Count Ratio ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
The Absolute

Malaria is a major public health problem in India. Changes in blood cell counts are a wellknown feature of malaria. Hence an attempt has been made to assess the role of leucocyte ratios in malaria as predictors of malaria infection and its clinical severity. Methods: A retrospective observational cohort study was carried out in a tertiary care teaching hospital over a period of 2 months. A total of 171 samples and 48 controls were included in the study. All the absolute and differential white blood cell counts were done. The neutrophillymphocyte count ratio (NLCR), monocyte-lymphocyte count ratio (MLCR) and monocyteneutrophil count ratio (MNCR) were calculated by using the absolute neutrophil, lymphocyte and monocyte count respectively. The results were analyzed statistically using SPSS software for windows. Results: Among 171 cases 145(84.8%), 19(11.1%), 7(4.1%) were Pl. vivax, Pl. falciparum and mixed malaria respectively. 52 cases were severe and 119 were non-severe. 52, 45, 47, 27 were parasitemia grade 1, 2, 3, 4 respectively. NLCR, MLCR and MNCR showed a sensitivity of 60.8%, 71.7%, 70.8% and specificity of 43.8%, 60.4%, and 56.3% respectively in malaria diagnosis. There was no association of NLCR, MLCR, MNCR with the type and severity of malaria. NLCR, MNCR correlated with varying grade of parasitemia. Conclusion: The results show the ratios NLCR, MLCR and MNCR have a better sensitivity but less specificity. The sensitivity and specificity for MLCR are the highest and can be used as a supportive to a screening test. The ratios can be used to show the presence of malaria parasite but there is no association with the type and severity of malaria. MLCR is a good predictor of malarial presence. NLCR and MNCR are associated with parasitemia.

scholarly journals The burden of presumed tuberculosis in hospitalized children in a resource-limited setting in Papua New Guinea: a prospective observational study

2017 ◽  
Vol 9 (6) ◽  
pp. 374-378 ◽  
Author(s):  
Villa Watch ◽  
Jimmy Aipit ◽  
Tina Kote-Yarong ◽  
Allanie Rero ◽  
John W Bolnga ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Public Health Problem ◽  
New Guinea ◽  
Final Diagnosis ◽  
Severe Malnutrition ◽  
Major Public Health Problem ◽  
Northern Coast ◽  
Fatality Rate

Abstract Background In Papua New Guinea, TB is considered to be a major public health problem, but little is known about the prevalence and prognosis of presumed TB in children. Methods As part of a prospective hospital-based surveillance on the northern coast of mainland Papua New Guinea, the authors investigated the admission prevalence and case fatality rate associated with presumed TB over a 6-year period (2011–2016). All children admitted who were diagnosed with TB were followed-up until discharge or death. Results Of 8992 paediatric admissions, 734 patients (8.2%) were diagnosed with presumed TB and there were 825 deaths, with TB accounting for 102 (12.4%). Extrapulmonary TB was the final diagnosis in 384 admissions {prevalence 4.3% [384/8992 (95% CI 3.9–4.7)]} with a case fatality rate of 21.4% [82/384 (95% CI 17.4–25.9)]. TB meningitis, disseminated TB and pericardial TB had high case fatality rates of 29.0% (53/183), 28.9% (11/38) and 25% (4/16), respectively. Severe malnutrition was more common in patients with pulmonary compared with extrapulmonary TB (25.4% vs 15.6%; p&lt;0.01). Conclusions Improved community-based case detection strategies, routine BCG vaccinations and other effective forms of TB control need revitalization and sustainability to reduce the high case fatality rates associated with childhood TB in Papua New Guinea.

scholarly journals Serious non-fatal unintentional injuries among in-school adolescents in Sri Lanka: results from the 2016 Sri Lankan Global School-Based Health Survey

2020 ◽  
Author(s):  
Sashimali Wickramasinghe ◽  
Nalika Gunawardena ◽  
Dhanusha Punyadasa ◽  
Shanthi Gunawardena ◽  
Champika Wickramasinghe ◽  
...  
Keyword(s):  
Public Health ◽  
Sri Lanka ◽  
Health Survey ◽  
Health Problem ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Age Group ◽  
Unintentional Injuries ◽  
School Based ◽  
The World

Abstract Background Unintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka. Methods A cross-sectional survey was conducted using a self-administered questionnaire, among 3,262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8-12 . Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates. Results During the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight. Conclusion This study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.

scholarly journals Screening of osteoporosis using calcaneal quantitative ultrasound in a rural population of Jammu, Jammu and Kashmir, India

2017 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Rishabh Gupta ◽  
Shavi Mahajan ◽  
Deepika Dewan ◽  
Rajat Gupta
Keyword(s):  
Rural Area ◽  
Age Groups ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Age Group ◽  
Jammu And Kashmir ◽  
Time Period ◽  
Calcaneal Quantitative Ultrasound ◽  
Prevalence Of Osteoporosis ◽  
Substantial Morbidity

Background: Osteoporosis is a major public health problem, associated with substantial morbidity and socio-economic burden. The objective of the present study was to screen the general population for osteoporosis in a rural area of Jammu region. Methods: 3 screening camps were conducted at 6 monthly intervals between the time period 2015-2016, at the Accidental Hospital, Chowki Choura, which is a rural area of district Jammu, J&K. A total of 270 subjects in the age group 20 to 80 years were subjected to screening through BMD measurements using calcaneal QUS and they were analyzed on the basis of T-scores. Results: Out of 270 subjects, 120 were males and 150 were females. Among 120 males, 68 were in the age group of 20 - 49 years, and 52 were above 50 years. In the age group 20-49 years, 26 males (38.2%) had osteopenia, and 4 (5.9%) had osteoporosis. In males above 50 years of age, 35 (67.3%) had osteopenia and 6 (11.5%) had osteoporosis. Out of 150 females, 94 were in the age groups 20-49 years, and 56 were above 50 years of age. In the age group 20-49 years, 51 females (54.3%) had osteopenia and 12 (12.8%) had osteoporosis. In females above 50 years of age, 32 (57.1%) had osteopenia and 15 (26.8%) had osteoporosis. Conclusions: The overall prevalence of osteoporosis among screened population was 13.7%. It increased with age in both males and females; however the prevalence of osteoporosis was more among females as compared to males (18% vs. 8.3% respectively). 

scholarly journals Study of role of prognostic markers in the management of organophosphorus poisoning patients

2018 ◽  
Vol 6 (6) ◽  
pp. 1996
Author(s):  
Sameer Chaudhary ◽  
Rohan Kalmegh
Keyword(s):  
Scale Score ◽  
Prognostic Markers ◽  
Initial Presentation ◽  
Serum Cholinesterase ◽  
Ventilator Support ◽  
Organophosphorus Poisoning ◽  
Severe Group

Background: POP scale and serum cholinesterase levels may be effective indicators for mortality in organophosphorus poisoning. The objective of this study was to assess the POP scale score and serum cholinesterase levels at initial presentation in OP poisoning and its correlation with need for ventilator support and mortality.Methods: One hundred and fifty eligible participants were recruited, and POP scale and serum cholinesterase levels were assessed.Results: Total 32.7% patients died; of which 30 out of 75 belonged to moderate and 19 out of 22 patients belonged to severe group; as per POP scale score. 49 out of 75 in moderate poisoning and all patients in severe poisoning required ventilator support. With respect to serum cholinesterase level; 20 out of 23 and 29 out of 77 patients died in the severe and moderate poisoning categories respectively. Forty eight out of 77 in moderate poisoning and all patients in severe poisoning required ventilator support.Conclusions: Assessment by POP scale and serum cholinesterase levels is useful in assessing the need for ventilator support and are indicators of mortality in OP poisoning cases.

scholarly journals Long-Term Trends in Unintentional Fall Mortality in China: A Population-Based Age-Period-Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Zhenkun Wang ◽  
Youzhen Hu ◽  
Fang Peng
Keyword(s):  
Public Health Problem ◽  
Mortality Rates ◽  
Population Based ◽  
Mortality Data ◽  
Major Public Health Problem ◽  
Age Group ◽  
Men And Women ◽  
Long Term Trends ◽  
Unintentional Falls

Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them.Methods: This population-based multiyear cross-sectional study of Chinese people aged 0–84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework.Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, −0.04 to 0.3%) per year for men and −0.71% (95% CI, −0.96 to −0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China.Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.

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