Study on Plasma Pseudocholine Esterase Levels in Organophosphate Poisoning and it’s Outcome
Abstract
Background and Objective: DSH is a major problem in the developing world. Poisoning is one of most common methods employed for the act of DSH. The delay in attaining medical care and the lack of facilities in the rural areas have resulted in increased number of deaths due to OP poisoning. In this study, we aim to find out the most common OP compound used for DSH and the variation in the level of PCE with respect to various compounds. Also the prognosis and outcome of each patient are assessed in relation to the PCE values.
Methods: 100 patients admitted to this hospital were enrolled into this study. After getting informed consent, investigations were carried out especially PCE levels. Serial monitoring of PCE levels was done in each case. The incidence of complications and other measures of outcome were compared with respect to the PCE levels.
Results: 66 males and 34 females were studied. 74% of the patients survived following poisoning while 26% expired. Chlorpyriphos was the compound consumed by most of the patients, followed by Quinalphos. 50% death is due to Chlorpyriphos poisoning. The most common symptom was vomiting followed by frothing. 12% of patients had history of psychiatric illness. Crackles were the most common clinical sign which was seen in 66% of the study population.
Interpretation and Conclusions: From this study it was revealed that lower the PCE, higher the mortality. Majority of the ventilated patients had PCE levels below 200. The incidence of intermediate syndrome seemed to be a very important factor in the survival of the patient. In this study, all patients who developed IMS expired. PCE levels, ventilator assistance and IMS were all high in the Chlorpyriphos group.
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