JIST

Abstract

Background: Organophosphorous poisoning (OPP), a global health crisis, bears high morbidity and mortality. The global burden of OPP has increased the importance of quantifying the activity of plasma cholinesterase (PCh), as a marker. We aimed to study PCh level in predicting the prognosis of OPP and correlation with morbidity and mortality features.

Objective: To correlate PCh level with morbidity and mortality in acute OPP.

Materials & Method: After the ethical clearance, one year cross-sectional study was conducted among 76 patients, by observing the clinical features and estimation of PCh with inclusion criteria being confirmation of presence OP compound at Poison Detection Center and exclusion criteria being liver dysfunction, malnutrition, chronic infections, hypersensitivity reaction and on drugs like succinyl choline, codeine, morphine, pregnancy and age more than 60 years. Results analysed in relation to clinical features, severity of intoxication, requirement of ventilator support and duration of hospital stay.

Results: The reduction in PCh was more in those who have more time lapse in initiation of treatment and in presence of grievous features like cyanosis, respiratory distress, fasciculation, muscle weakness and convulsion.

Conclusion: Significant fall in PCh was seen in acute OPP and in delayed intervention. In severe suppression grievous symptoms like cyanosis, respiratory distress, fasciculation, muscle weakness, convulsion and mortality were observed. Without any fixed trend, a significant relationship between the pre- and post-intervention PCh level was observed. Good correlation between improvements in patients’ motor power with improved PCh levels fixed the time to wean the case from ventilator.