Prevalence of Hyper Amylasemia and Acute Pancreatitis in Organophosphate Poisonings

Chaturvedi, Abhay Nath; Dutta, Soumyakanti; Sarkar, Sanjay; Saha, Tushar Kanti; Adhikary, Subhajyoti

doi:10.9790/0853-13115962

Cited by 5 publications

(5 citation statements)

References 6 publications

(1 reference statement)

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“…53% of patients were females and 47% were males with a female to male ratio 1.1: 1. This was in agreement with Chaturvedi et al (2014) and Gündüz et al (2015) study in which also females were affected more than males. Banerjee et al (2012) postulated in their study that male to female ratio was 1:1.38.…”

Section: Discussionsupporting

confidence: 93%

“…Among one hundred patients in the present study, hyperamylasemia was found in twenty four patients (24%) while hyperlipasemia was seen in 5 patients (5%). This was in agreement with Chaturvedi et al (2014) where hyperamylasemia was more frequently seen in organophosphate poisoning. Sahin et al (2002) concluded that acute pancreatitis was not a rare complication of organophosphorus poisoning.…”

Section: Discussionsupporting

confidence: 91%

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The Role of APACHE II, SOFA, Serum amylase and Lipase in Assessment of Severity and Outcome of Acute Organophosphorus Poisoning

Moussa

Mohamed

Hilal

et al. 2018

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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All right received. AbstractPoisoning with Organophosphate (OP) compounds is responsible for great morbidities and mortalities all over the world especially in developing countries including Egypt. Scoring systems have been continuously developed to predict outcomes in patients with severe illness, to improve resource allocation and to assist in clinical decision-making particularly for ICU patients. The quest for biomarkers in relation to OP compound poisoning started quite a long time back but cheap and easily measurable biomarkers having prognostic value is the need of the hour. The objective of this study is to evaluate the role of acute physiology and chronic health evaluation II (APACHE II) score, the Sequential Organ Failure Assessment (SOFA) score, serum amylase and lipase in assessing severity and outcome of acute organophosphorus poisoning. A retrospective and prospective study was carried out on 200 patients of acute OP poisoning admitted to the Poison Control Center (PCC), Ain Shams University Hospitals. Information after obtaining the permission of the director of PCC and the regional ethics committee was collected from the sheets and computerized data base of the patients, an informed written consent has been obtained from each patient or from his/her caregiver for inclusion in the prospective part of the study. APACHE II and SOFA scores were calculated to each patient admitted and biochemical analysis of serum amylase and lipase were estimated in the prospective part of the study. The results were revised, coded and organized for statistical analysis. The study results revealed 180 (90%) patients discharged and 20 (10%) patients died. The study showed that there were 76% of patients had APACHE II score ≤ 9, while 12.5% of patients had APACHE II score from 10 to 14, there were 8.5% of patients had APACHE II score from 15 to 24 and APACHE II score was > 24 in 3% of patients. SOFA score in 88.5%of patients was ≤ 6, while in 4.5% of patients SOFA score was from 7 to 9 and in 7%of patients SOFA score was > 9. Hyperamylasemia observed in 83.3% of died and 33.3% of died patients had increased lipase. There was significant difference between discharged and died patients as regards APACHE II score, SOFA Score, serum amylase and lipase. It could be concluded that SOFA score, APACHEII score, serum amylase and lipase had a role in assessment of severity of acute organophosphorus poisoning but only SOFA score, APACHEII score and serum amylase could be used as predictors of outcome. SOFA score is more useful in predicting mortality, and easier and simpler than the APACHEII and serum amylase. From the previous results, our study recommends that predictors of outcome (APACHE II score, SOFA score and serum amylase) should be assessed routinely and as early as possible to evaluate the severity, improve the course of management and deciding the pathway of care.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

The Role of APACHE II, SOFA, Serum amylase and Lipase in Assessment of Severity and Outcome of Acute Organophosphorus Poisoning

Moussa

Mohamed

Hilal

et al. 2018

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…Importantly cost burden is very high in the pralidoxime added group. The incidence of female patients were more in both the groups with 33 female patients out of 54 patients in group A and 30 female patients out of 49 patients in group B respectively which was consistent with the study done by Chaturvedi et al 13 The majority of the patients were presented within 6 hours of duration in both the groups. The mean duration was 8.6±7.6 hours in group A and 8.3±7.3 hours in group B respectively.…”

Section: Resultssupporting

confidence: 90%

A comparative study of atropine and atropine plus pralidoxime in the management of organo-phosphorous poisoning

Baruah,

Das,

Hossain

et al. 2023

Int J Adv Med

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Background: Poisoning with organophosphorus compounds (OP) is a common problem throughout the world particularly in developing countries. Standard treatment involves resuscitation, administration of the anti-muscarinic agent atropine, an acetylcholinesterase reactivator (pralidoxime) and assisted ventilation if necessary. In this study we compared the efficacy of add-on pralidoxime therapy over therapy with atropine alone in OP poisoning. Methods: The study included 103 patients, out of 103 OP poisoning cases, 54 patients received both atropine and PAM (group A) and 49 received only atropine (group B). Main outcome parameters of the study were total hospital stay and mortality. The data was compared using ‘t’ test while mortality was compared using Fisher’s exact test. Data was tabulated, analysed, reviewed and evaluated. Results: There was no difference in duration of hospital stay between the two group. The mean hospital stay in group A was 3.71±1.92 days and in group B was 3.14±2.01 days (p value >0.05). No difference in mortality was seen between the two group. Out of 54 in group A, 8 died and in group B out of 49, 7 died (p value >0.05). Importantly cost burden is very high in the pralidoxime added group. Conclusions: There is no significant difference in use of atropine alone or atropine-pralidoxime combination in terms of morbidity and mortality in OP poisoning rather the later incurs more economic burden which may not be practicable in poor countries like India. However, a larger multicentric prospective study needs to be conducted, to be able to draw a definitive conclusion.

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“…A retrospective and prospective study was performed by Moussa et al, (2018) on acute OPs poisoning cases admitted to the Poison Control Center, Ain Shams University Hospitals in which 24 % of cases had high amylase level, while 5% of cases had high lipase level. This was in agreement with previous study carried by Chaturvedi et al (2014) where high amylase level was repeatedly observed in OPs poisoning.…”

Section: Discussionsupporting

confidence: 94%

Evaluating Chloropyrifos Induced Diabtes Mellitus, Pancreatic Toxic Effects in Adult Albino Rats and Whether This Insult Is Permanent or Temporary

Ahmed

2019

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Chlorpyrifos is one of the most commonly used organophosphorus insecticide. Many studies showed a relationship between pesticide exposure and occurrence of diabetes. The aim was to assess toxic effect of chloropyrifos on pancrease, its ability to induce diabetes mellitus in adult male rats and evaluate whether this toxic insult is permanent or temporary. Material and methods: 24 adult male albino rats were classified into four groups. Group I: negative control. Group II: positive control gavaged orally with 0.5 ml of corn oil once a day for 8 weeks. Group III: gavaged orally with chlorpyrifos dissolved in corn oil (6.75 mg/Kg b.w /day) for 8 weeks. Group IV: orally gavaged with chlorpyrifos by the same dose as group III for 8 weeks, then left without treatment for another 4 weeks. At the end of the study, body weight of all rats were measured then blood samples were taken from all rats to estimate serum levels of amylase, lipase, glucose, insulin, reduced glutathione (GSH) and malondialdehyde (MDA) levels. Then the pancreatic tissues were dissected and submitted to histopathological and ultra-structural examination. Results: chloropyrifos administration caused significant increases in serum amylase, lipase, glucose and MDA with also significant decreament in serum insulin and GSH. These biochemical changes were associated with hisopathological changes. Stoppage of exposure for 4 weeks caused partial to complete improvement. Conclusion: chloropyrifos had toxic effects on pancrease and was considered as a risk factor for diabetes mellitus and improvement could occur after stoppage of its exposure for a period.

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Prevalence of Hyper Amylasemia and Acute Pancreatitis in Organophosphate Poisonings

Cited by 5 publications

References 6 publications

The Role of APACHE II, SOFA, Serum amylase and Lipase in Assessment of Severity and Outcome of Acute Organophosphorus Poisoning

The Role of APACHE II, SOFA, Serum amylase and Lipase in Assessment of Severity and Outcome of Acute Organophosphorus Poisoning

A comparative study of atropine and atropine plus pralidoxime in the management of organo-phosphorous poisoning

Evaluating Chloropyrifos Induced Diabtes Mellitus, Pancreatic Toxic Effects in Adult Albino Rats and Whether This Insult Is Permanent or Temporary

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