Correlation of PeradeniyaOrganophosphorus Poisoning Scale (POP) and outcome of Organophosphorus poisoning

Regmi, Gunjan; Arjyal, Batsalya; Khanal, Kanak; Pyakurel, Kumud; Shahi, Rejina

doi:10.3126/bjhs.v5i1.29702

Cited by 2 publications

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“…Most of the patients in our study population (65%) were male; the male-to-female ratio was 1.85:1. A similar male preponderance was observed by Kamath and Gautam and other researchers in their studies [2,3,[5][6][7].…”

Section: Discussionsupporting

confidence: 84%

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Assessment of the Peradeniya Organophosphorus Poisoning Scale as a Severity and Prognostic Marker in Patients With Acute Organophosphorus Poisoning Presenting to an Emergency Medicine Department

Malaviya,

Parikh,

Pancholi

et al. 2023

Cureus

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Background Organophosphorus (OP) compound poisoning is the most common toxicological medical emergency in India, where the majority of the population lives on agriculture. The Peradeniya Organophosphorus Poisoning (POP) scale can be a simple and effective system to determine the need for ventilatory support early in the course of admission. The objective of this study was to evaluate the prognostic value of the clinical parameters of the POP scale in predicting the severity of organophosphorus compound poisoning, by comparing early predicted patient prognosis evaluated by the POP scale on admission with the patient outcome. Methods This was a prospective observational study of acute organophosphorus compound poisoning presenting to the emergency department of Sir Sayajirao General (SSG) Hospital and Medical College, Baroda. We included patients over 12 years of age with a history of, or symptoms suggestive of, acute OP poisoning. The patients received initial resuscitation according to airway, breathing, circulation, disability, and exposure simultaneously with decontamination and gastric lavage by Ryle’s tube. They also received the standard antidotes of atropine and pralidoxime immediately. We applied the POP scale to each patient upon admission and graded the poisoning severity as mild (a POP scale score of 0-3), moderate (4-7), or severe (8-11). This scale assessed the patients’ need for mechanical ventilation and ICU management and their final clinical outcome. Results We enrolled 60 patients in the study. Most of them were under 20 years of age, and 65% of them were male. Social laborers were the major population, and most of them had suicidal intention. Monocrotophos was the most commonly consumed OP compound. Most of the patients were brought to the hospital within two to six hours of consumption. Vomiting and profuse secretions were the primary presenting symptoms. A majority of the patients (47) fell into the mild POP scale range. None of the patients had severe poisoning. Out of 60 patients, 49 patients improved and 11 patients died. Seven patients (15%) with mild POP scale scores and four patients (31%) with moderate scores died. Overall, 61.7% of patients with mild POP scale scores and 100% of patients with moderate scores needed mechanical ventilation. Conclusion The POP scale is an effective tool to measure severity and make a prognosis in patients with acute OP compound exposure. It may be a simple, inexpensive tool that may help predict the need for ventilatory support at admission. Early identification of danger signs may help in the reduction of mortality and morbidity when resources are limited. However, we found incorporating other clinical parameters and biochemical markers provides better prognostication than using the POP scale alone.

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Section: Discussionsupporting

confidence: 84%

“…The mean duration of ICU stays was 5.82 days for mild poisoning and 9.67 days for moderate poisoning. Regmi et al had similar findings [6].…”

Section: Discussionmentioning

confidence: 61%

Assessment of the Peradeniya Organophosphorus Poisoning Scale as a Severity and Prognostic Marker in Patients With Acute Organophosphorus Poisoning Presenting to an Emergency Medicine Department

Malaviya,

Parikh,

Pancholi

et al. 2023

Cureus

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L-carnitine: A novel approach in management of acute cholinesterase inhibitor insecticide poisoning

Ragab,

El-Banna,

Elshaer

et al. 2024

Toxicology Research

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Cholinesterase inhibitors (ChEIs) insecticide poisoning is a serious global health concern that results in hundreds of thousands of fatalities each year. Although inhibition of the cholinesterase enzyme is the main mechanism of ChEI poisoning, oxidative stress is considered the mechanism underlying the related complications. The study aimed to assess the oxidative status of the patients with ChEI insecticide poisoning and the role of L-carnitine as adjuvant therapy in their management. Human studies on the efficacy and safety of L-carnitine in treating insecticide poisoning are limited despite its growing research interest as a safe antioxidant. This prospective study was conducted on eighty patients with acute ChEIs insecticide poisoning admitted to Alexandria Poison Center, Alexandria Main University Hospital, Egypt. Patients were allocated into two equal groups randomly. The L-carnitine (LC) group received the conventional treatment (atropine & toxogonin) and LC and the standard treatment (ST) group received the standard treatment only. Outcome measures were fatality rate, the total administered dose of atropine & toxogonin, length of hospital stay, and the requirement for ICU admission or mechanical ventilation. The study results revealed that malondialdehyde (MDA) significantly decreased in the LC group. Cholinesterase enzyme levels increased significantly after treatment in the LC group than in the ST group. The LC group needed lower dosages of atropine and toxogonin than the ST group. Also, the LC group showed no need for ICU admission or mechanical ventilation. The study concluded that LC can be considered a promising adjuvant antioxidant treatment in acute ChEIs pesticide poisoning.

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Correlation of PeradeniyaOrganophosphorus Poisoning Scale (POP) and outcome of Organophosphorus poisoning

Cited by 2 publications

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Assessment of the Peradeniya Organophosphorus Poisoning Scale as a Severity and Prognostic Marker in Patients With Acute Organophosphorus Poisoning Presenting to an Emergency Medicine Department

Assessment of the Peradeniya Organophosphorus Poisoning Scale as a Severity and Prognostic Marker in Patients With Acute Organophosphorus Poisoning Presenting to an Emergency Medicine Department

L-carnitine: A novel approach in management of acute cholinesterase inhibitor insecticide poisoning

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