Organophosphates are commonly used in rural, agricultural communities worldwide. Poisoning in Nepal is commonly a result of suicide attempt via ingestion with a mortality rate of 41 times higher than in the United States even after appropriate treatment. The patient discussed in this case is a 46-year-old Nepalese female with a complicated psychosocial history that presented with a suicide attempt via organophosphate ingestion. She required higher doses and greater lengths of treatment of atropine and pralidoxime to resolve symptoms of toxicity that resulted in atropine-induced psychosis, a side effect rarely cited in the literature. This patient was one of many who attempt suicide in Nepal, where suicide is the leading cause of death for young to middle aged women in the country.
Organophosphate compounds are chemicals containing central phosphate molecules with alkyl or aromatic substituent’s. They occur in diverse forms and are used as pesticides, herbicides, nerve agents, etc. Organophosphate compounds are frequently used as pesticides in agrarian communities all across the world. South Asian countries such as Nepal use vast quantities of Organophosphate compounds for pest control in agriculture. Therefore, accidental and suicidal ingestion of Organophosphate compound poisoning has been common especially among the agricultural rural communities. Apart from muscarinic, nicotinic and central nervous system effects in rare instances, Organophosphate compounds are known to cause pancreatitis.
Organophosphate compounds are chemicals containing central phosphate molecules with alkyl or aromatic substituent’s. They occur in diverse forms and are used as pesticides, herbicides, nerve agents, etc. Organophosphate compounds are frequently used as pesticides in agrarian communities all across the world. South Asian countries such as Nepal use vast quantities of Organophosphate compounds for pest control in agriculture. Therefore, accidental and suicidal ingestion of Organophosphate compound poisoning has been common especially among the agricultural rural communities. Apart from muscarinic, nicotinic and central nervous system effects in rare instances, Organophosphate compounds are known to cause pancreatitis. Although pancreatitis is a rare complication of Organophosphate poisoning, it is necessary to evaluate patients with Organophosphate poisoning with serum lipase level, Ultrasound abdomen, and Contrast- Enhanced Computed Tomography(CECT) abdomen in patients with pain abdomen for early detection and management of acute pancreatitis.
Hypertriglyceridemia led acute pancreatitis secreted exudative fluid tacked to the right iliac fossa may cause irritation of retroperitoneum leading to acute periappendicular inflammation and acute appendicitis.
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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