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).

scholarly journals CASE STUDY: ORGANOPHOSPHATE POISONING – ATROPINE-INDUCED PSYCHOSIS IN INTENSIVE CARE UNIT PATIENT

2021 ◽  
pp. 3-4
Author(s):  
VATHSALYA PORANKI
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Patient ◽  
Rural Areas ◽  
Postsynaptic Membrane ◽  
The Body ◽  
Organophosphate Poisoning ◽  
Competitive Antagonist ◽  
Organophosphorus Poisoning

Organophosphate compounds are used as commercial insecticides and applied as aerosols or dust. Consuming these compounds intentionally or unintentionally lead to dangerous conditions even to fatality. The most common obstacle in treating organophosphorus poisoning is the availability of sufficient medical care, equipment to provide proper emergency care observed in rural areas where there is a lot of gap between intensive care and acute care. Atropine use is as an antidote in organophosphorus poisoning. The dose of atropine mainly depends on the organophosphorus toxic doses. Atropine is a competitive antagonist of acetylcholine at the muscarinic postsynaptic membrane. Atropine blocks all the muscarinic effects in the body. This study presents a case of organophosphorus poisoning treated with atropine leading to atropine psychosis. Patient’s conditions, outcomes, and improvements are studied.

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 Study of Serum Amylase for Predicting the Severity of Organophosphorus Poisoning and Correlation with Respiratory Failure - A Cross Sectional Study at KIMS, Hubballi, Karnataka

2021 ◽  
Vol 8 (20) ◽  
pp. 1473-1478
Author(s):  
Raghu Gangadharappa ◽  
Manojkumar B. Kalegowda ◽  
Bharath Golla
Keyword(s):  
Respiratory Failure ◽  
Serum Amylase ◽  
Financial Burden ◽  
Limited Resource ◽  
Biochemical Parameter ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
Organophosphorus Poisoning ◽  
Acute Organophosphorus Poisoning

BACKGROUND Organophosphorus (OP) compounds are insecticides which are widely used in agriculture. Acute organophosphorus poisoning is one of the important causes of morbidity and mortality in developing countries like India. Considering financial burden / availability of tests, we need cheap and easily measurable biomarkers for predicting prognosis / complications in a limited resource country, like India. We intend to correlate the levels of serum amylase in patients admitted with acute organophosphorus poisoning for predicting the severity of acute OP poisoning and also to correlate serum amylase association with respiratory failure. METHODS This was a prospective observational study. Total of 94 patients of OP poisoning admitted to KIMS Hospital, Hubballi between January 1st 2017 and December 31th 2017 were studied. Detailed history, clinical examination, and lab investigations like pseudocholinesterase, serum amylase and other relevant investigations were carried out. Peradeniya OP poisoning scale was applied to all the study subjects and the severity of OP poisoning was graded as mild, moderate, severe. Data obtained was analysed by different statistical methods. RESULTS OP poisoning was more common in adults of age group between 20 – 30 years, Incidence was more in male patients and mortality rate was 12.8 %. Mean values of serum amylase negatively correlate with pseudocholinesterase levels and it was statistically significant. Correlation between the severity of OP poisoning (based on Peradeniya score) and biochemical parameters like pseudocholinesterase, serum amylase was statistically significant. CONCLUSIONS The correlation between the severity of OP poisoning and biochemical parameter– serum amylase, was statistically significant and it was useful in predicting the development of respiratory failure. Pseudocholinesterase and serum amylase were also useful to predict the outcome of the patient. KEYWORDS Amylase, Organophosphorus Poisoning, Pseudocholinesterase, Peradeniya Score

Full compliance with Respiratory syncytial virus prophylaxis was associated with fewer respiratory‐related hospital admissions in preterm children: A cohort study

2020 ◽  
Author(s):  
Heloise Torchin ◽  
Marie‐Laure Charkaluk ◽  
Jessica Rousseau ◽  
Laetitia Marchand‐Martin ◽  
Ludovic Treluyer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Hospital Admissions ◽  
Preterm Children ◽  
Full Compliance ◽  
Syncytial Virus

scholarly journals Patterns of Alcohol Consumption in the PURE Poland Cohort Study and Their Relationship with Health Problems

2021 ◽  
Vol 18 (8) ◽  
pp. 4185
Author(s):  
Katarzyna Zatońska ◽  
Piotr Psikus ◽  
Alicja Basiak-Rasała ◽  
Zuzanna Stępnicka ◽  
Maria Wołyniec ◽  
...  
Keyword(s):  
Cohort Study ◽  
Alcohol Consumption ◽  
Rural Areas ◽  
Urban Areas ◽  
Level Of Education ◽  
Adult Participants ◽  
Frequent Consumption ◽  
Urban And Rural Areas ◽  
Socio Demographic Factors ◽  
High Level

(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007–2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64–10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03–2.17; OR 1.66, CI 1.27–2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05–2.85; OR 1.76, CI 1.22–2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education.

scholarly journals How does general practitioner discontinuity affect healthcare utilisation? An observational cohort study of 2.4 million Norwegians 2007–2017

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042391
Author(s):  
Lena Janita Skarshaug ◽  
Silje Lill Kaspersen ◽  
Johan Håkon Bjørngaard ◽  
Kristine Pape
Keyword(s):  
Cohort Study ◽  
General Practitioner ◽  
Service Use ◽  
Hospital Admissions ◽  
Age Groups ◽  
Healthcare Utilisation ◽  
Acute Hospital ◽  
Secondary Outcome ◽  
Out Of Hours ◽  
Adult Age

ObjectivesPatients may benefit from continuity of care by a personal physician general practitioner (GP), but there are few studies on consequences of a break in continuity of GP. Investigate how a sudden discontinuity of GP care affects their list patients’ regular GP consultations, out-of-hours consultations and acute hospital admissions, including admissions for ambulatory care sensitive conditions (ACSC).DesignCohort study linking person-level national register data on use of health services and GP affiliation with data on GP activity and GP characteristics.SettingPrimary care.Participants2 409 409 Norwegians assigned to the patient lists of 2560 regular GPs who, after 12 months of stable practice, had a sudden discontinuity of practice lasting two or more months between 2007 and 2017.Primary and secondary outcome measuresMonthly GP consultations, out-of-hours consultations, acute hospital admissions and ACSC admissions in periods during and 12 months after the discontinuity, compared with the 12-month period before the discontinuity using logistic regression models.ResultsAll patient age groups had a 3%–5% decreased odds of monthly regular GP consultations during the discontinuity. Odds of monthly out-of-hours consultations increased 2%–6% during the discontinuity for all adult age groups. A 7%–9% increase in odds of ACSC admissions during the period 1–6 months after discontinuity was indicated in patients over the age of 65, but in general little or no change in acute hospital admissions was observed during or after the period of discontinuity.ConclusionsModest changes in health service use were observed during and after a sudden discontinuity in practice among patients with a previously stable regular GP. Older patients seem sensitive to increased acute hospital admissions in the absence of their personal GP.

scholarly journals Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044196
Author(s):  
Madalene Earp ◽  
Pin Cai ◽  
Andrew Fong ◽  
Kelly Blacklaws ◽  
Truong-Minh Pham ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Heart Disease ◽  
Chronic Disease ◽  
Acute Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Specialist Palliative Care ◽  
Icu Admission

ObjectiveFor eight chronic diseases, evaluate the association of specialist palliative care (PC) exposure and timing with hospital-based acute care in the last 30 days of life.DesignRetrospective cohort study using administrative data.SettingAlberta, Canada between 2007 and 2016.Participants47 169 adults deceased from: (1) cancer, (2) heart disease, (3) dementia, (4) stroke, (5) chronic lower respiratory disease (chronic obstructive pulmonary disease (COPD)), (6) liver disease, (7) neurodegenerative disease and (8) renovascular disease.Main outcome measuresThe proportion of decedents who experienced high hospital-based acute care in the last 30 days of life, indicated by ≥two emergency department (ED) visit, ≥two hospital admissions,≥14 days of hospitalisation, any intensive care unit (ICU) admission, or death in hospital. Relative risk (RR) and risk difference (RD) of hospital-based acute care given early specialist PC exposure (≥90 days before death), adjusted for patient characteristics.ResultsIn an analysis of all decedents, early specialist PC exposure was associated with a 32% reduction in risk of any hospital-based acute care as compared with those with no PC exposure (RR 0.69, 95% CI 0.66 to 0.71; RD 0.16, 95% CI 0.15 to 0.17). The association was strongest in cancer-specific analyses (RR 0.53, 95% CI 0.50 to 0.55; RD 0.31, 95% CI 0.29 to 0.33) and renal disease-specific analyses (RR 0.60, 95% CI 0.43 to 0.84; RD 0.22, 95% CI 0.11 to 0.34), but a~25% risk reduction was observed for each of heart disease, COPD, neurodegenerative diseases and stroke. Early specialist PC exposure was associated with reducing risk of four out of five individual indicators of high hospital-based acute care in the last 30 days of life, including ≥two ED visit,≥two hospital admission, any ICU admission and death in hospital.ConclusionsEarly specialist PC exposure reduced the risk of hospital-based acute care in the last 30 days of life for all chronic disease groups except dementia.

scholarly journals Association between home insulation and hospital admission rates: retrospective cohort study using linked data from a national intervention programme

BMJ ◽  
2020 ◽  
pp. m4571 ◽  
Author(s):  
Caroline Fyfe ◽  
Lucy Telfar ◽  
Barnard ◽  
Philippa Howden-Chapman ◽  
Jeroen Douwes
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
Confidence Interval ◽  
Hospital Admission ◽  
Retrospective Cohort ◽  
Rate Ratio ◽  
Hospital Admissions ◽  
Relative Rate ◽  
Intervention Programme ◽  
Admission Rates

Abstract Objectives To investigate whether retrofitting insulation into homes can reduce cold associated hospital admission rates among residents and to identify whether the effect varies between different groups within the population and by type of insulation. Design A quasi-experimental retrospective cohort study using linked datasets to evaluate a national intervention programme. Participants 994 317 residents of 204 405 houses who received an insulation subsidy through the Energy Efficiency and Conservation Authority Warm-up New Zealand: Heat Smart retrofit programme between July 2009 and June 2014. Main outcome measure A difference-in-difference approach was used to compare the change in hospital admissions of the study population post-insulation with the change in hospital admissions of the control population that did not receive the intervention over the same two timeframes. Relative rate ratios were used to compare the two groups. Results 234 873 hospital admissions occurred during the study period. Hospital admission rates after the intervention increased in the intervention and control groups for all population categories and conditions with the exception of acute hospital admissions among Pacific Peoples (rate ratio 0.94, 95% confidence interval 0.90 to 0.98), asthma (0.92, 0.86 to 0.99), cardiovascular disease (0.90, 0.88 to 0.93), and ischaemic heart disease for adults older than 65 years (0.79, 0.74 to 0.84). Post-intervention increases were, however, significantly lower (11%) in the intervention group compared with the control group (relative rate ratio 0.89, 95% confidence interval 0.88 to 0.90), representing 9.26 (95% confidence interval 9.05 to 9.47) fewer hospital admissions per 1000 in the intervention population. Effects were more pronounced for respiratory disease (0.85, 0.81 to 0.90), asthma in all age groups (0.80, 0.70 to 0.90), and ischaemic heart disease in those older than 65 years (0.75, 0.66 to 0.83). Conclusion This study showed that a national home insulation intervention was associated with reduced hospital admissions, supporting previous research, which found an improvement in self-reported health.

Estimating life expectancy among older multimorbid adults to personalize preventive care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Gastens ◽  
C Del Giovane ◽  
D Anker ◽  
L Syrogiannouli ◽  
N Schwab ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Screening ◽  
Life Expectancy ◽  
Preventive Care ◽  
Hospital Admissions ◽  
Prognostic Index ◽  
Preventive Treatment ◽  
Prognostic Indices ◽  
Multimorbid Patients

Abstract Background Providing high value care and avoiding care overuse is a challenge among older multimorbid adults. There is evidence on benefits and harms of cancer screening and cardiovascular diseases (CVD) preventive treatment up to the age of 75. However, this evidence is not directly applicable to older multimorbid patients. Because each cancer and CVD preventive care has a specific lagtime to benefit, many guidelines recommend tailoring preventive care according to the estimated life expectancy (LE). However, there is no tool to estimate LE among multimorbid patients. Our objectives are therefore to develop new mortality risk prognostic indices and to derive a new LE estimator, what will help clinicians tailoring preventive care in older multimorbid adults. Methods and Results We conduct a prospective cohort study by extending the follow-up of 822 patients in Bern, Switzerland, included in the OPtimising thERapy to prevent Avoidable hospital admissions in Mulitmorbid older people (OPERAM) study over 3 years. Detailed information about cancer screening and CVD preventive treatment will be collected. We will identify variables independently associated with mortality and weight the variables to create 1 year and 3 year mortality prognostic indices. We will transform the 3 year prognostic index into a LE estimator. Preliminary results will be presented at the congress. Conclusions We will develop the first life expectancy estimator specifically for older multimorbid adults. This tool will help clinicians to tailor cardiovascular and cancer preventive care in older multimorbid adults. Key messages Because of the lagtime to benefit, personalizing preventive care by estimated life expectancy is recommended. We will provide the first life expectancy estimator for older multimorbid adults.

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