Background:Organophosphorus (OP) compounds are commonly used pesticides. In OP poisoning, intermediate syndrome (IMS) manifests between the end of the acute cholinergic crisis and delayed neuropathy. Respiratory paralysis in IMS, if identified early can reduce the need for ventilator support, morbidity, and mortality. Serum creatine phosphokinase (CPK) is elevated in IMS. The objectives of our study were to measure serum CPK level, correlate CPK levels with severity of poisoning and estimate atropine dose used.Materials and Methods:A prospective, observational study was conducted for 1-year. Patients diagnosed with OP poisoning were included. Demographic characteristics, type of poison, time since poisoning, Peradeniya Organophosphorus Poisoning (POP) score, serum pseudocholinesterase, CPK levels, atropine dose, and outcome of treatment were documented.Results:Seventy-five patients were recruited of which 57% and 43% were males and females, respectively, with a mean age of 31.48 ± 11.76 years. The most common OP compound was chlorpyriphos followed by triazophos and methylparathion. The time required to reach hospital was 181.26 ± 89.53 min. About 73.3% and 26.7% of patients had mild and moderate poisoning, respectively, as per POP scale. Pseudocholinesterase level was 364 (205–2168) IU. The amount of atropine used was 190.66 ± 78.83 mg. Serial serum CPK values were 279.72 ± 350.21 IU, 389.78 ± 376.33 IU and 163.13 ± 155.15 IU at admission, 48 h, and 96 h after admission, respectively. A weak positive correlation between serum CPK levels and severity of poisoning (r = 0.352) was observed. All patients recovered completely within 10.69 ± 5.57 days. Three patients developed IMS, and their serial CPK levels were 1837.33 ± 243.19 IU/L, 1935 ± 97.41 IU/L, and 714.66 ± 394.82 IU/L; and recovered in 17 ± 5.6 days.Conclusion:Increased serum CPK levels at 48 h after poisoning was observed in all the patients, but three patients had more than 1500 IU/L, who manifested with IMS. Early diagnosis of IMS by serial estimation of CPK may help in timely intervention and reduce further life-threatening complications.

||ABSTRACT Background: The introduction of highly active antiretroviral therapy (HAART) has led to decline in HIV-related opportunistic infections (OIs). Knowledge of the most common OI of that geographical area will help in implementing the preventive measures against that pathogen. We determined the prevalence and risk factors for OIs among patients who developed adverse drug reaction (ADR) to antiretroviral therapy (ART) in a tertiary-care teaching hospital. Aims and Objective: To collect demographic details of HIV-positive patients who were on ART and developed ADR to ART with OI and without OI; to determine the prevalence of OIs in HIV-positive patients who developed ADR to ART; and to investigate the sociodemographic and clinical risk factors associated with their occurrence. Materials and Methods: A cross-sectional study carried out between January and June 2012. The study population comprised HIV-infected patients, who were receiving ART at who developed ADRs to ART with or without OI. Results: The prevalence of OI was 50.63%. The sociodemographic variables that had significant positive association with the presence of OIs on univariate analysis includes employment [odds ratio (OR) = 4.96, 95% confidence interval (CI) = 2.52-9.75; p = 0.00). The risk of OIs did not significantly differ according to gender (OR = 0.77, 95% CI = 0.41-1.45; p = 0.21), age (OR = 1.658, 95% CI = 0.82-3.32; p = 0.079), residence (OR = 0.812, 95% CI = 0.43-1.52; p = 0.26), literacy (OR = 0.90, 95% CI = 0.48-1.70; p = 0.38), marital status (OR = 1.8, 95% CI = 0.70-4.61; p = 0.11), or weight (OR = 1.69, 95% CI = 0.84-3.42; p = 0.07). The univariate analysis of clinical risk factors for OIs had a significant positive association with WHO staging (OR = 24.04, 95% CI = 5.5-105.01; p = 0.00) and CD4 count (OR = 2.61, 95% CI = 1.32-5.16; p = 0.00). The risk of OIs did not significantly differ with adherence (OR = 0.37, 95% CI = 0.07-1.99; p = 0.13). Conclusion: OIs remain a challenge in patients receiving ART in resource-limited settings. There is a need to intensify the management of OIs despite ART use.