Faran Maqbool, Arshad Iqbal Satti, Roshan Ara Jeelani, Haider Zaigham Baqai.
Organophosphate Poisoning - Clinical Profile.
J Rawal Med Coll Jan ;19(1):15-9.

Background: To study the clinico-demographic profile and mortality in patients with organophosphate poisoning. Methods: In this descriptive study patients of age >13 years of either gender, who themselves or attendants gave history of intake of organophosphate (OP) containing substance, or presenting with such substance (Rat killing pills/powder, anti lice lotion, or insecticide), were included. Patients suffering from other systemic illness like diabetes mellitus, hypertension, ischemic heart disease, which could affect mortality were excluded from the study. Glasgow Coma Scale (GCS) was recorded on presentation . Mortality was determined according to GCS < 13. Outcome was measured according to GCS score in terms of mortality during hospital stay. All patients were given standard treatment for OP poisoning, i.e. securing Airway, Breathing and Circulation, administering atropine at a dose of 2 mg every 10 minutes till reversal of cholinergic symptoms and administering a stat dose of pralidoxime 1 gram. Results: A total of 62 patients with the diagnosis of acute organophosphate poisoning were registered The gender distribution was almost equal in this study with 33 (53.2%) male patients and 29 (46.8%) females. The mean age of patients was 23.3 + 6.1 years ranging from 14 to 40 years. The mean time since poison taken was 1.3 + 0.7 hours ranging from 0.25 to 4.0 hours. Among these patients, majority (88.7%) took rat killing pills/powder as poison,3.2% took insecticide spray while 8.1% of the patients took anti lice lotion. Sixteen (25.8%) patients presented with GCS < 13 while 46 (74.2%) presented having GCS of > 13. Overall 9 (14.5%) of study patients required intubation and/or ventilation, while 1 (1.6%) patient died in our study due to poisoning. Nine (56.3%) out of 16 patients with GCS < 13 needed intubation compared to none out of 44 patients in the group having GCS > 13. Conclusion: GCS level is an important factor in assessing Organophosphate poisoning. Severe morbidity and mortality occurs in patients having GCS levels of < 13.

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