Organophosphate Poisoning: Demographics, Severity Scores and Outcomes From National Poisoning Control Centre, Karachi

Amir, Anum; Raza, Asif; Qureshi, Talha; Mahesar, Ghulam Basit; Jafferi, Salman; Haleem, Farhan; Khan, Muhammad Ali

doi:10.7759/cureus.8371

Cited by 25 publications

(24 citation statements)

References 7 publications

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“…A previous study from Karachi also showed a similar relation between POP score and severity. 32 In this study, 26.86 per cent of all poisoning cases developed complications, very similar to one of the studies from Central Nepal. 10 This shows that the majority of the patients recovered completely without any complications and sequelae which might be because of various reasons like adequate and proper management, ingestion of low doses, and induction of vomiting at home as seen in this study as well.…”

Section: Discussionsupporting

confidence: 89%

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience

Basnet

Shrestha²,

Chaulagain

et al. 2021

F1000Res

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Background Poisoning has become a major public health problem, with the intent in most cases being self-harm and commit suicide. This study highlights the psychological and clinical-epidemiological profile of patients visiting Scheer Memorial Adventist Hospital after poisoning. Methods This retrospective record-based study was done among poisoning patients of a hospital in Nepal from 1st January 2018 to 31st December 2020. Data were analyzed using STATA version-15. Results Out of 134 total poisoning cases, 71 had consumed organophosphate compounds. The majority of the cases were female (59.2% in organophosphate groups, 69.8% in non-organophosphate groups). The circumstances of poisoning were mostly suicidal (95.8% in organophosphate groups, 90.5% in non-organophosphate groups) and the reasons for this being mostly family disputes. Organophosphate groups had 8.41 times higher odds of having complications when compared to non-organophosphorus compounds. Conclusions The majority of the poisoning cases were suicidal in nature and family disputes being the major reason for the intake of a poisonous substance. This demands that more attention be given to psychological and family counseling to resolve any disputes, as well as psychological management of poisoning cases after medical management. Also, a strong regulatory mechanism should be imposed to control the easy access to poisonous substances.

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Section: Discussionsupporting

confidence: 89%

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience

Basnet

Shrestha²,

Chaulagain

et al. 2021

F1000Res

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“…As opposed to inhalational or skin contact in unintentional poisoning, ingestion was the most common method for suicide by pesticide. [106][107][108][109] The chemical structure and management of organophosphates and aluminium phosphide poisoning are discussed later in the paper.…”

Section: Discussionmentioning

confidence: 99%

Suicide by poisoning in Pakistan: review of regional trends, toxicity and management of commonly used agents in the past three decades

et al. 2021

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Background Suicide is one of the leading mental health crises and takes one life every 40 seconds. Four out of every five suicides occur in low- and middle-income countries. Despite religion being a protective factor against suicide, the estimated number of suicides is rapidly increasing in Pakistan. Aims Our review focuses on the trends of suicide and means of self-poisoning in the past three decades, and the management of commonly used poisons. Method We searched two electronic databases (PubMed and PakMediNet) for published English-language studies describing agents used for suicide in different regions of Pakistan. A total of 46 out of 85 papers (N = 54 747 cases) met our inclusion criteria. Results Suicidal behaviour was more common among individuals younger than 30 years. Females comprised 60% of those who attempted suicide in our study sample, although the ratio of completed suicides favoured males. There were regional trends in the choice of agent for overdose. Organophosphate poisoning was reported across the nation, with a predominance of cases from the agricultural belt of South Punjab and interior Sindh. Aluminium phosphide (‘wheat pills’) was a preferred agent in North Punjab, whereas paraphenylenediamine (‘kala pathar’) was implicated in deaths by suicide from South Punjab. Urban areas had other means for suicide, including household chemicals, benzodiazepines, kerosene oil and rat poison. Conclusions Urgent steps are needed, including psychoeducational campaigns on mental health and suicide, staff training, medical resources for prompt treatment of self-poisoning and updated governmental policy to regulate pesticide sales.

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“…Patients with higher severity on the POP scale were associated with a higher rate of morbidity and mortality 12. A recent study conducted in Pakistan among 3300 participants, including teenagers, demonstrated that patients classified as mild poisoning under the POP scale did not require atropine and were associated with the lowest risk for mortality 13. They also observed that the presence of an altered level of consciousness, fasciculations and seizures were associated with a higher score and worse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Role of intravenous lipid emulsion therapy and packed red blood cell transfusion as adjuvant treatment in the management of a child with severe organophosphate poisoning (chlorpyrifos)

2022

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A previously well 3-year-old child presented with rapidly deteriorating clinical status minutes after ingestion of an orange-coloured liquid housed in a soda bottle (HomeTrek—chlorpyrifos). She had miotic pupils, copious oral secretions, crackles on lung auscultation, hyperactive bowel sounds, impending signs of respiratory failure and declining sensorium. A diagnosis of severe organophosphate (OP) toxicity was made. Despite resuscitation and atropine administration, she deteriorated and exhibited atropine toxicity. She was given 20% intravenous lipid emulsion therapy and red blood cell (RBC) transfusion as adjunctive therapy with favourable outcome. She was discharged after 11 days and her RBC cholinesterase levels were 45% and 17% below normal, taken on day 10 and day 35 postingestion, respectively. She showed no signs of intermediate syndrome and delayed polyneuropathy. This case highlights the need for timely recognition of severe OP poisoning, and the role of lipid emulsion therapy and packed RBC transfusion as adjunctive treatment.

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Organophosphate Poisoning: Demographics, Severity Scores and Outcomes From National Poisoning Control Centre, Karachi

Abstract: Open Access Original Article

Cited by 25 publications

References 7 publications

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience

Suicide by poisoning in Pakistan: review of regional trends, toxicity and management of commonly used agents in the past three decades

Role of intravenous lipid emulsion therapy and packed red blood cell transfusion as adjuvant treatment in the management of a child with severe organophosphate poisoning (chlorpyrifos)

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