Hydrolysis of Methylphosphonic Anhydride Solid to Methylphosphonic Acid Probed by Raman and Infrared Reflectance Spectroscopies

Much is still unknown about the mechanisms and rates of environmental degradation of organophosphorous pesticides and agents. In this study we focus on the degradation of one organophosphorous compound, namely...

Study of the pattern, intent behind and outcome of acute poisoning in a tertiary care centre

Background: Acute poisoning is one of the major medical emergencies with significant morbidity and mortality. Appropriate planning, prevention and management techniques can be designed by knowing the nature, severity and outcome of acute poisoning cases. Most of the poisoning is due to the intention of deliberate self-harm. This study aimed to study the pattern and outcome of acute poisoning and the intent behind poisoning. Methods: This is a cross sectional study which included 100 acute poisoning cases in a tertiary care hospital. The study includes data regarding age, sex, time elapsed after intake of poison; name of the poisonous substance, duration of hospitalization, severity and outcome were collected in the prestructured proforma. Intent behind poisoning was calculated using Beck’s suicide intent score. Results: Incidence was more common among males (69%) but there was no significant correlation between gender and mortality. Mean age of presentation was 35.66 years but age of presentation and mortality correlation was not statistically significant (t=0.92, p=0.3). Organophosphorous compound poisoning (36%) was the most common type of poisoning. Total mortality was found to be 12%. Beck’s suicide intent scores were higher in patients who died and statistically significant (t=8.96, p=0.0001). Maximum patients expired when there was a delay in admission to hospital by more than 8 hours after exposure. Conclusions: Poisoning is more common in young males. The overall mortality depends on type of poison, time elapsed since exposure to hospital arrival, suicidal intent and many other factors. Early care in a tertiary care center may help to reduce mortality in India.

Transplacentally transmitted organophosphorous compound poisoning in a newborn : Acase report and narrative review of literature

Organophosphorous compound (OPC) poisoning in the newborn is a medical emergency but completely treatable condition. Early recognition and treatment is of paramount importance in preventing fatality. A newbornmale of severe perinatal asphyxia was admitted in our neonatal intensive care unit (NICU) with a history of maternal OPC poisoning 31 hours before delivery. We treated the case on urgent basis, had stormy neonatal course and finally baby went home safely. OPC poisoning in newborn is a rare occurrence in the tropics. We report a rare case of transplacentally transmission of OPC poisoning innewborn and it is going to be 3rd and latest such reported case across the world upon literature search. Bangladesh Crit Care J September 2020; 8(2): 120-123

Organophosphate Induced Delayed Neuropathy (OPIDN)

A 13 years old boy who consumed organophosphorous compound later on developed delayed neuropathy is described.TAJ 2014; 27(1): 62-63

Predicting the need for ventilatory support in organophosphorous compound poisoning

Background: Organophosphorus compound poisoning is one of the most common poisonings often requiring ICU care and ventilatory support. Hence this study was undertaken to identify the factors, which predict the need for ventilation in these patients.Methods: All the patients who were diagnosed to have consumed organophosphorus compound poison admitted in RLJ Hospital and SNR District Hospital Kolar, Karnataka, India who presented within 24hours of consumption were included in the study. Patients with concomitant respiratory illness, double poisoning and those treated outside were excluded from the study.Results: A total number of 50 patients were studied. 30(60%) were males and 20 (40%) were females. 18 patients required ventilation. 100% of patients with respiratory rate>25 breaths/minute and 55% of patients with a fasciculation score of >4 required ventilation. Ventilation was required by 84.6% of patients who has a GCS Score of <10. 21.7% of patients with mild and 33.3% with moderate poisoning required ventilation. In contrast 66.6% of patients with severe poisoning required ventilation. Of the patients admitted to the hospital >4hours after consumption of poison, 36% required ventilation. Of the 19 patients who had oxygen saturation levels <89%, 18 patients (94.7%) required ventilation. Patients who were ventilated required a higher dose of atropine within 48hours of admission as compared to those who were not ventilated.Conclusions: Patients who presented with higher respiratory rate, accessory muscles of respiration in action, higher fasciculation score, GCS score of 10, greater lag time between consumption of poison and admission to hospital (4hours), severe grade of poisoning and O2 saturation <89% were more likely to require ventilation. There is no relationship between the age group, sex, pulse rate, pupil size and type of organophosphorous compound consumed with the need for ventilation.

Clinico-Epidemiological Study of Self-Poisoning by Different Pharmaceutical Agents

Background: In Bangladesh self-poisoning cases are mostly of organophosphorous compound (OPC). It is documented that 14% of all deaths amongst 10 to 50 year old women in Bangladesh were due to poisoning, the majority following suicidal ingestion of pesticides. In tertiary level hospital, a large number of self-poisoning cases are of different pharmaceutical agents, mostly from urban areas and mostly of teenager group. So the trend of self-poisoning is different in urban area than that of rural area. These pharmaceutical agent self-poisoning cases admitted into the hospitals have different modalities of clinical features with variable outcomes and socioeconomic background. But there is no actual data of these self-poisoning by the different pharmaceutical agents. Therefore, this study was aimed to describe the pattern of self-poisoning by different pharmaceutical agents.Methods: A descriptive longitudinal study was conducted in five adult medicine units of a tertiary level hospital from January 2008 to June 2008. All self-poisoned patients with different pharmaceutical agents were included with their prior informed written consent. A pre-tested questionnaire was used for data collection.Results: A total of 281 patients were interviewed. Most of the patients were female (70.8%) with highest age range from 13 to 30 years (91.81%). Most of the patients were students (53%) and 40.9% were secondary school certificate pass. 60.1% patients were unmarried. Most of the patients were from urban area (84%). The commonest background for self-poisoning was family disharmony (74.46%). Most common offending pharmaceutical agents were benzodiazepines (44.10%), collected mostly from local dispensary without prescription (89.33%). Most of the patients consulted within 1 to 2 hours of poisoning (44.5%). Commonest consultation before admission was in a Government hospital (48.40%). Only 3 patients (1.10%) were known to have psychiatric illness. Five patients (1.80%) had previous history of self-poisoning. Most of the patients (89.3%) stayed in the hospital for 1 day with no mortality.Conclusion: Self poisoning by pharmaceutical agents is common especially in urban areas. Common offending pharmaceutical agents were benzodiazepines. The commonest background for self-poisoning was family disharmony.J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 17-22