Abstract

A Study of Clinical Profile of Patients of Organophosphate Poisoning in a Teaching Hospital in Rural Maharashtra

Author(s):Onkar Pensalwar, Arun Tyagi, A. B. Khare, Awani Kumar Srivastava and M. S. Waran

 Background: Organophosphates (OP) or phosphate esters are the most used compounds as pesticides in agriculture. Toxic exposure to these substances, accidental or intentional, is also not uncommon, especially in rural areas. Acute toxicity manifests as a cholinergic crisis, and the death is usually due to cardiovascular and respiratory failure. Objectives: This study was conducted to analyze the clinical profile of OP poisoning patients in a teaching hospital, where the majority of the clientele is from rural background. Methods: 80 patients, above 16 years of age, admitted with OP poisoning were included in the study. The diagnosis was based on a history of exposure and characteristic clinical features and was supported by serum pseudocholinesterase (PChE) levels. The clinical features, management, complications, and outcome were analyzed. Results: Deliberate self-harm was the leading cause of exposure. The mean age of patients was 32.3 years. The male-to-female ratio was 1.4:1. Four patients developed the intermediate syndrome. The average dose of atropine required was 26.84 mg and pralidoxime 24 gm. The serum cholinesterase level was 50% in 52 cases. The mean ICU stay was 4 days. The mortality rate in our study was 3.75%. Conclusions: The mortality was directly proportional to the amount of OP consumed, clinical severity, PChE levels, and delay in seeking medical attention. This study highlights the importance of rapid diagnosis and initiation of early treatment

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