Correlation of Clinical Score and Serum Acetylcholinesterase Level as a Predictor of Outcome among Patients with Acute Organophosphate Poisoning Admitted in Emergency Ward of a Tertiary Hospital

Chaudhary, R. N.; Bhandari, Rabin; Malla, GB; Poudel, Mohan; Lamsal, M

doi:10.3126/jbpkihs.v2i2.27853

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Mean serum CK level in males was as elevated as seen in the intermediate phase but the patients were not followed up. 12 Our study has shown that females outnumbered males in organophosphate poisoning as with other studies carried out in Nepal, 2,8 in contrast to the studies done in India which have shown male preponderance. 11,12 Another tissue injury marker, LDH has also been reported to be elevated in organophosphate poisoning in many studies.…”

Section: Discussionsupporting

confidence: 65%

“…7 Predominant cholinergic effects are seen when serum cholinesterase is less than 50% normal range. 8 Few studies have reported a significant positive correlation between CK with the severity of organophosphate poisoning. 5 , 7 , 9 This might be the reason that we found raised serum creatine kinase levels in a higher proportion of cases (94%) in contrast to the studies done in India (24%), 10 and (8%).…”

Section: Discussionmentioning

confidence: 99%

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Mean Serum Creatine Kinase among Organophosphate Poisoning Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study

et al. 2022

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Introduction: Major cases of poisoning are associated with organophosphates. Cholinergic effects and an intermediate phase seen with organophosphate poisoning may implicate myopathy. Creatine kinase is a marker of muscle tissue damage. This study aimed to find out the mean serum creatine kinase among organophosphate poisoning cases in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out among organophosphate poisoning cases in a tertiary care hospital from 13 October 2017 to 30 March 2018. Ethical approval was taken from the Institutional Review Committee [Reference number: 117(6-11-E) 2/074/075]. Blood samples were assayed for serum acetylcholinesterase in the pharmacology laboratory and for serum creatine kinase and lactate dehydrogenase in the biochemistry laboratory. Low serum acetylcholinesterase was taken as the basis for the establishment of organophosphate poisoning. A convenience sampling technique was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 103 organophosphate poisoning cases, the mean serum creatine kinase was 931.35±446.60 IU/l (845.10-1017.60, 95% Confidence Interval). Conclusions: The mean serum creatine kinase level among organophosphate poisoning cases was higher than in other studies done in similar settings.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Mean Serum Creatine Kinase among Organophosphate Poisoning Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study

et al. 2022

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“…Kumar et al (2020) stated that out of 80 patients, 29 were classified as mild poisoning, 31 as moderate poisoning, and 20 as severe as per POP scale. Chaudhary et al (2019) reported that out of 100 OPC patients, 57 (57%) were classified as mild, 38 (38%) moderate and five (5%) as severe poisoning. On the other hand, Eisa et al (2021) stated that 61.1% of studied patients had moderate toxicity, 25% had mild toxicity, while 13.9% had severe toxicity according to POP score.…”

Section: Discussionmentioning

confidence: 99%

“…The high survival rate can be explained by early referrals, adequate first aid, early administration of antidotes and oxygen when indicated (Amir et al 2020). Chaudhary et al (2019) had demonstrated that the POP scale is a reliable predictor of the severity of OPC poisoning and that it can access the intensity, morbidity, and mortality of individuals who have been exposed to OPC. Also, Samy et al (2018) revealed the mortality rate was considerably greater in patients with severe poisoning compared to those with moderate poisoning.…”

Section: Discussionmentioning

confidence: 99%

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

Alí

El-Shafey

Eldin

et al. 2022

Zagazig Journal of Forensic Medicine

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Background: Human serum paraoxonase-1 (PON-1) hydrolyzes organophosphate compounds (OPC) and so significantly alters an individual's susceptibility to the toxicity of these chemicals. Aim: The study was designed to assess the serum PON-1 activity in patients with OPC poisoning and to correlate its level with the severity and outcome of acutely organophosphate poisoned patients. Patients and methods: This was a prospective clinical study that was performed at Benha Poison Treatment and Toxicological Research Unit (BPTTRU), Benha University Hospitals, Egypt, for one year, from 1 August 2020 till 31 July 2021. Patients were divided into case and control groups. Socio-demographic information of patients, clinical findings, treatments given, length of hospital stay and outcome were collected into datasheets. Patients were classified according to degree of toxicity according to Peradeniya Organophosphorus Poisoning (POP) scale. Blood samples were collected from patients to assess pseudocholiesterase and PON-1 activities. Results: Reduction of serum pseudocholinesterase and paraoxonase-1 (PON-1) activities in poisoned patients and patients can be graded according to (POP) scale into: mild, moderate and severe cases. In conclusion: This study concluded that serum paraoxonase-1 (PON-1) activity was significantly lower in patients with severe organophosphorus compounds (OPC) poisoning as compared to patients with moderate poisoning. Lower PON-1 activity was significantly associated with lower serum cholinesterase and poorer outcomes. PON-1 activity may be considered as an indicator of prognosis in OPC poisoning.

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“…Chaudhary R et al [20] concluded that the higher degree of POP score correlated to higher degree of serum acetylcholinesterase derangement, need for atropine, PAM and length of hospital stay. Thus, it enhances in the prediction of outcome among patients with acute organophosphate poisoning.…”

Section: Need Of Atropine and Pralidoximementioning

confidence: 99%

Study to evaluate the correlation of serum cholinesterase levels, peradeniya clinical score at presentation and severity of organophosphorus poisoning

Thakare,

Dhurve,

Yelke

2023

Int. J. Adv. Res. Med.

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Background: The incidence of OP poisoning in India is among the highest in the world. The Peradeniya Organophosphorus Poisoning scale assesses the severity of poisoning based on the symptoms at presentation and is simple to use. We planned this study to evaluate the correlation of serum cholinesterase levels, Peradeniya clinical score at presentation and severity of organophosphorus poisoning. Methodology: A prospective observational study was conducted on 140 adult patients with history of acute OP poisoning. The diagnosis was made based on history or evidence of exposure to OP compound within 24 hours, assessment was also done based on the POP scaling system. A score of 0 to 3 is considered as mild poisoning, 4 to 7 as moderate poisoning and 8 to 11 as severe poisoning. Pseudocholinesterase were measure to assess the severity of poisoning as per Proud foot classification. Correlation between serum cholinesterase level and POP was assessed. Results: Majority of the patients (32.14%) belongs to age group between 31-40. Mean age of patients were 40.41±9.55 years. Male (69.28%) and rural (91.42%) patients were more common. Most of the patients had suicidal poisoning (87.85%). More than 50% of the poisoning cases were caused by Monocrotofos, Chlorpyrifos and Profenophos. Nausea, vomiting and sweating were more common symptoms and present in more than 60% of the patients. The most frequent sign was miosis (55.71%) patients, tachypnea (42.14% patients) and fasciculation (34.28% patients). 32.85% patients had moderate and 7.85% patients had severe poisoning according to their POP score. All the patients with severe POP score needed the ventilator support, positive correlation between the POP score and the need for ventilator support. Overall mortality was (8.57%). Patients with low Pseudocholinesterase level had higher incidence of need for ventilator support. The relation between POP score and the Sr. Pseudocholinesterase levels was statistically significant. As the severity of poisoning increases the average dose of Atropine needed to treat the patients also increases. As the severity of the poisoning increases, the dose of Pralidoxime needed to treat patients also increases. Conclusion:Patients with low POP score and high level of Sr, Pseudocholinesterase level needed less ventilator support as compared to patients with high POP score and low Sr, Pseudocholinesterase level. Mortality is more in patients with high POP score and low Sr, Pseudocholinesterase. There is significant correlation between POP score, Sr, Pseudocholinesterase level and need of mechanical ventilation and final prognosis in patients with acute organo-phosphorous poisoning and can be can be used as a prognostic marker indicating severity of the poisoning.

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Correlation of Clinical Score and Serum Acetylcholinesterase Level as a Predictor of Outcome among Patients with Acute Organophosphate Poisoning Admitted in Emergency Ward of a Tertiary Hospital

Cited by 6 publications

References 16 publications

Mean Serum Creatine Kinase among Organophosphate Poisoning Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Mean Serum Creatine Kinase among Organophosphate Poisoning Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

Study to evaluate the correlation of serum cholinesterase levels, peradeniya clinical score at presentation and severity of organophosphorus poisoning

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