A STUDY ON BIOCHEMICAL PARAMETERS IN ASSESSING THE SEVERITY OF ACUTE ORGANOPHOSPHORUS POISONING

SARITA BEHERA; Satyabrata Sahoo; Kaumudee Pattnaik

doi:10.22159/ajpcr.2023.v16i7.48559

Authors

SARITA BEHERA Department of Medicine, Bhima Bhoi Medical College and Hospital, Bolangir, Odisha, India.
Satyabrata Sahoo Department of Medicine, SCB Medical College and Hospital, Cuttack, Odisha, India.
Kaumudee Pattnaik Department of Pathology, Bhima Bhoi Medical College and Hospital, Balangir, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i7.48559

Keywords:

Organophosphorus poisoning, Creatinine phosphokinase, Troponin T, Amylase, Lipase, Bilirubin, Aspartate aminotransferase, Alanine aminotransferase, Serum cholinesterase, Serum creatinine phosphokinase

Abstract

Objectives: Organophosphorus (OP) poisoning is an important global health issue with increasing mortality rate for every year particularly in developing countries since its overuse in agricultural activity. The present study was performed to analyze the clinical profile and biochemical parameters such as serum cholinesterase, serum creatinine phosphokinase (CPK), liver enzymes, serum amylase, lipase, serum k+, troponin, serum urea, and creatinine on day 1 for correlation with clinical severity of poisoning.

Methods: A observational study was performed on 100 cases with OP poisoning at a tertiary care center. Peradeniya OP Poisoning Scale was applied to all cases at the time of admission and the severity was designated as mild, moderate, and severe taking into account 5 vital parameters such as miosis, fasciculations, respiration rate, bradycardia, and level of consciousness and data were statistically analyzed by SPSS.

Results: Rise in clinical severity of poisoning and substantial reduction in the level of serum cholinesterase was observed. The mean serum CPK, troponin T (Trop T), amylase, lipase, bilirubin, aspartate aminotransferase, and alanine aminotransferase showed marked elevation according to the severity of OP poisoning. In addition, serum potassium levels showed decreased level as per the severity level.

Conclusion: Initial serum cholinesterase and serum Trop T are strong predictors of the clinical severity of OP poisoning.

Downloads

Download data is not yet available.

Author Biographies

Satyabrata Sahoo, Department of Medicine, SCB Medical College and Hospital, Cuttack, Odisha, India.

Assistant Professor, Department of Medicine, SCB Medical College & Hospital, Cuttack, Odisha, Email: dr.satya143@gmail.com

Kaumudee Pattnaik, Department of Pathology, Bhima Bhoi Medical College and Hospital, Balangir, India.

Associate Professor, Department of Pathology, Bhima Bhoi Medical College & Hospital, Balangir, Email: drkaumudee@gmail.com

References

Karalliedde L. Organophosphorus poisoning and anaesthesia. Anaesthesia 1999;54:1073-88. doi: 10.1046/j.1365-2044.1999.01061.x,PMID 10540097

Jesslin J, Adepu R, Churi S. Assessment of prevalence and mortality incidences due to poisoning in a south Indian tertiary care teaching hospital. Indian J Pharm Sci 2010;72:587-91. doi: 10.4103/0250- 474X.78525, PMID 21694990

Bardin PG, van Eeden SF, Moolman JA, Foden AP, Joubert JR. Organophosphate and carbamate poisoning. Arch Intern Med 1994;154:1433-41. doi: 10.1001/archinte.1994.00420130020005, PMID 8017998

Wadia RS. Organophosphorus Poisoning; API Textbook of Medicine. 74th ed. Mumbai: JP Medical Ltd.; 2000.

Bardin PG, Van Eeden SF. Organophosphate poisoning; Grading the severity and comparing the between atropine and glycopyrrholate. Crit Care Med 1990;18:956-60. doi: 10.1097/00003246-199009000-00010, PMID 2394119

Eddleston M, Buckley NA, Eyer P, Dawson AH. Management of acute organophosphorus pesticide poisoning. Lancet 2008;371:597-607. doi: 10.1016/S0140-6736(07)61202-1, PMID 17706760

Senanayake N, de Silva HJ, Karalliedde L. A scale to assess severity in organophosphorus intoxication: POP scale. Hum Exp Toxicol 1993;12:297-9. doi: 10.1177/096032719301200407, PMID 8104007

Raddi D, Anikethana G. Liver enzymes for assessment of severity of organophosphorus poisoning. Int J Health Sci 2015;4:60-3.

Rangaswamy BM. A study of cardiac involvement in organophosphorus poisoning. Int J Sci Stud 2017;5:38-42.

Banerjee I, Tripathi S, Roy AS. Clinico-epidemiological characteristics of patients presenting with organophosphorus poisoning. N Am J Med Sci 2012;4:147-50. doi: 10.4103/1947-2714.93884, PMID 22454830

Gagarin DP, Rajagopal DR. Clinical profile and outcome of organophosphorus poisoning in a tertiary care centre, a prospective observational study. Int J Med Res Rev 2020;8:148-53. doi: 10.17511/ ijmrr.2020.i02.02

Bhattacharyya K, Phaujdar S, Sarkar R, Mullick OS. Serum creatine phosphokinase: A probable marker of severity in organophosphorus poisoning. Toxicol Int 2011;18:117-23. doi: 10.4103/0971-6580.84263, PMID 21976816

Sujata T, Vijay P. Serum cholinesterase: A diagnostic and prognostic marker in cases of acute poisoning. Int J Res Med 2017;6:1-4.

Patil SL, Vasepalli P. Prognostic value of clinical and lab parameters in assessing the severity of organophosphorus compound poisoning. Ind J Basic Appl Res 2014;4:77-91.