A study profile and incidence of organophosphate poisoning at Gandhi hospital, Hyderabad, and Telangana- A three year study

Abstract

Introduction: Nowadays, organophosphate (OP) compounds are widely used in agricultural field as an insecticide. Toxicity with these compounds is owing to inhibition of acetylcholinesterase enzyme. Patients are presented with muscarinic and nicotinic side effects. Objective: To study the clinical aspect of OP poisoning in detail with hospital stay, clinical course, complication, and recovery and mortality in OP poisoning. Materials and Methods: This study was done at Gandhi Medical College and in association with ayan Institute of Medical Sciences, Hyderabad India, comprising 271 cases of OP poisoning. After taking written consent, personal history of the patients was taken. Then, a detailed history regarding poison and clinical symptoms was taken. Then, general and systematic examinations of patients were carried out, and blood samples were sent for investigations. We followed up the patients till discharge or death. Result: In our study, maximum incidence of OP poisoning was in between 21-30 years age group (40%), and male to female ratio was 4:1. Clinical symptoms such as unconsciousness, stupor (90.47%), vomiting (9.42%), convulsions (66.00%) are froth at mouth and nostrils (62.00%) and the common symptoms whereas constricted pupils (85.71%), pulmonary oedema (88.00%), Tachycardia (76.17%), hypotension (28.57%)are the common signs noted in this series of cases who were treated in the hospital and where the hospital records were available. Post-mortem appearances no specific anatomic changes are found in acute poisoning the changes are suggestive os asphyxia. The appearances are external or internal. The histopathological findings are not significant. Histopathological examination of tissue revealed usually congestion of brain, oedema and congestion of lungs and fatty degeneration in liver and in some cases cloudy swelling and tubular necrosis in kidneys. Conclusion: Detailed history and thorough clinical examination of patients are helpful in diagnosing the patients of OP poisoning. Lifethreatening complications occurred in these patients. Early detection and immediate treatment in intensive care units with injections atropine and PAM can increase the chances of survival rate of patients.