Journal of Krishna Institute of Medical Sciences University (Jan 2012)
ORIGINAL ARTICLE: Acute Poisoning with Organophosphorus Pesticide: Patients Admitted to A Hospital in Bijapur, Karnataka.
Abstract
Background: Organophosphorus compounds are the pesticides most often involved in human poisoning. Toxicity of these compounds is due to the inhibition of acetyl cholinesterase at cholinergic junctions of the nervous system. Aims & Objectives: Toxicities of OP pesticidescause adverse effects on many organs and systems hence the present study was planned to study the plasma Cholinesterase, serumcholesterol and thyroid function tests in acute organophosphorus pesticide poisoning. Materials and Methods: Plasma ChE, serumcholesterol and serum triiodothyronine, thyroxine, and thyroid stimulating hormone levels were estimated using standard methods.Result: In our study we found the maximum (95%) cases were suicidal poisoning. We found that the incidence of poisoning was more common among age group between 15-35 years and males (57%) were more likely to attempt suicide as compared to females (38%). Among the organophosphorus compounds the most commonly used were dimethoate,monocrotophos, chlorpyriphos. 79% organophosphorus poisoned patients recovered, while 21% died. Plasma Cholinesterase levels were significantly (p<0.001) decreased in all grades of organophosphate poisoning as compared to controls. Inhibition of Plasma Cholinesterase occurs at the time of admission due to toxic effect of organophosphorus compounds; but the levels significantly (p<0.001) normalized after treatment i.e. on the last day of hospitalization. Serum total cholesterol levels significantly decreased (p<0.001) in all grades of organophosphate poisoning cases as compared to controls without any change after treatment as compared with the patients before treatment. There was a slight and nonsignificant decrease in serum triiodothyronine and serum thyroxine levels in organophosphorus poisoning cases without anysignificant change in serum thyroid stimulating hormone levels as compared to control. The organophosphorus poisoned patients after treatment do not show more changes in their values. Conclusions: Thepresent finding indicate that plasma ChE can be used as a parameter to assess the severity of poisoning and also to monitor the prognosis of OP poisoning. We also support that serum cholesterol estimation can be used as a biological marker in intentional OP poisoning. Acute OP poisoning may not disrupt thyroidhormone metabolism.
