Abstract

Dr. Zunaira Khalid, Dr. Afifa Shafiq Khan and Dr. Muhammad Hamza Khawaja*

ABSTRACT

Objective: The purpose of this study was to determine the demographics, clinical profile and outcome of patients admitted with organophosphate poisoning at a tertiary care center. Methods: It is a descriptive study. We enrolled 100 patients of age >14 years of either gender, with the history organophosphate (OP) intake or who showed either signs of muscarinic or nicotinic involvement. We excluded those patients in which organophosphorous poisoning was doubtful and Patients suffering from other systemic illness like diabetes mellitus, hypertension, ischemic heart disease, which could affect morbidity and mortality rate. All patients were given standard treatment for Organophosphate poisoning, i.e. Maintaining Airway, Breathing and Circulation, gastric lavage, administration of atropine at a dose of 2 mg every 10 minutes till reversal of muscarinic symptoms and administering a stat dose of pralidoxime. Results: We enrolled 100 patients those met our inclusion criteria. The mean average age was 31±5.7 years. Out of 100 cases, male to female ratio was 1:1.5 i.e. 40% male and 60% female. We found that 67% patients were in 14-35 years of age group. There were only 5 cases above age of 50 years. The youngest patient was 14 years old while the oldest was 59 years old. Incidence of poisoning decreases with higher educational level. Majority of the cases belonged to lower socioeconomic status i.e. 59 patients followed by middle socioeconomic status i.e. 36 patients. Incidence of pesticide poisoning was more common in married population i.e. 70. Suicidal cases were highest in number 75% followed by accidental cases and homicidal cases. In 72% of cases ingestion was mode of exposure. Nausea/Vomiting were the most common symptom observed in 100 patients (100%). Other common symptoms were excessive salivation (60%), abdominal pain (20%), respiratory difficulty (36%), altered sensorium 42% and 2% patients had convulsion. Most common physical finding was meiosis in 90 of total patients i.e. in 90%. Other common physical signs were fasciculation (63%), bradycardia (60%), neck muscle weakness (16%) and oro-nasal frothing (15%). In present study, few patients developed complications. Respiratory failure was the most common complication found in 20 patients i.e. in 20% of the total patients, 9 patient had aspiration pneumonia, 16 patients had circulatory collapse and 1 patient had septic shock. Out of total 100 patients 55 patients (55%) died, 31 patients got cured and 14 got LAMA. Conclusion: The mortality rate due to organophosphate poisoning was very high at our tertiary care center due delayed presentation, late treatment and of medical facilities. Pesticides are the major chemical agents, which pose a health threat particularly to young people, depressed individuals and farm workers. So this serious condition needs rapid diagnosis, early and effective treatment. The importance of first aid cannot be overlooked because patients who received first aid at the primary center survived better than those without first aid and have less complication and severity of poisoning.