US EPA

598602 

Journal Article 

Impairment in Clinical Indices in Acute Organophosphate Insecticide Poisoning Patients in India 

Agarwal, SB; Bhatnagar, VK; Agarwal, A; Agarwal, U; Venkaiah, K; Nigam, SK; Kashyap, SK 

2008 

Yes 

Internet Journal of Toxicology
EISSN: 1559-3916 

4 

1 

3-3 

This report defines with the impairment in clinical indices and laboratory investigations in acute organophosphate poisoning patients admitted to Outdoor Patient Department of B.J. Medical College and Civil Hospital, Ahmedabad - 380016, India. Out of 121 OP poisoning patients (65.3% males and 35.7% females), about 70% cases were educated (matriculate and higher secondary passed) and remaining illiterate. It was noticed that suicidal and intentional poisoning being a major cause as recorded in 80.2% cases followed by occupational (9.1%), accidental (6.6%), homicidal (1.6%) and unknown (2.5%). The major signs and symptoms reported by the poisoning cases were muscarinic and nicotinic manifestations. ECG abnormalities were recorded in 46 cases (38%); the sinus tachycardia (24%), depression of ST segment and inversion of T wave (7.4%) and sinus bradycardia (6.6%). Plasma and RBCs ChE activities in OP poisoning cases were significantly decreased (p ≤ 0.01). The activities of serum LDH and CK activities were significantly elevated (p ≤ 0.01) in poisoning cases indicating muscular functional impairment due to OP toxicity. In a sub-set of samples, the serum levels of IgA, IgG and circulating immune complexes (C[sub 3] and C[sub 4]) were also found significantly increased (p ≤ 0.01). The findings indicated that administration of atropine with 2-PAM increases the probability of survival although the results showed no significant variation. Logistic regression analysis showed that the survival rate of the cases was about 6 times more when number of days (indirectly the quantum of atropine and 2-PAM received by the cases) increased from <+3 compared to >3 days. When duration of atropine administration was divided into 4 quartiles, it was observed that there is significant trend of survival of the cases (63% survival in the 1st quartile, 80% survival for 2nd quartile and 100% for 3rd and 4th quartile). The findings of this study reflect the usefulness of few... [ABSTRACT FROM AUTHOR] Copyright of Internet Journal of Toxicology is the property of Internet Scientific Publications LLC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts) 

ORGANOPHOSPHORUS compounds; INSECTICIDES -- Toxicology; POISONING; TACHYCARDIA; BRADYCARDIA; INDIA; Acute OP poisoning; Cholinesterase; Creatine kinase; Immunological profile; Lactate dehydrogenase