DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20173950

Sociodemographic characSociodemographic characteristics and assessment of severity in organophosphorus poisoning in a tertiary care hospitalteristics and assessment of severity in Organophosphorous poisoning in a Tertiary care hospital

Sidhart Timsinha, Rajesh K. Shah, Suvarna M. Kar

Abstract


Background: In Nepal pesticide poisoning is a common problem and organophosphorus poisoning (OP) is the most common form of acute poisoning responsible for majority of deaths. However, sufficient data is still lacking from Western region of Nepal. The present study analysed the sociodemographic factors of OP poisoning cases, the association of severity based on admission clinical score (POP scale) and lag time with mortality.

Methods: This is a cross-sectional study conducted in patients of organophosphorus poisoning, admitted to our casualty ward during a period of one-year June 2015 to 2016.

Results: In this study incidence of OP poisoning was more in females 51 (65.38%) compared to males 27 (34.46%). The commonest age group involved in poisoning was 21-30 years 30 (38.4%). Housewives 32 (41.02%) were the commonest victims of poisoning. Incidence was high during rainy season 34 (43.58%) and mainly during late hours 27 (34.61%) of the day. Majority 24 (30.76%) cases reached hospital within 2 hours of poison intake. Methyl parathion (Metacid) 24 (30.76%) was the commonest OP compound consumed by the victims. Suicide 62 (79.48%) was the main motive of poison intake and financial problem (37.17%) was the main reason behind poison ingestion. In majority of the cases the sign and symptoms were mild (80.76%) in severity. In this study majority of the victims survived (9.30%) with prompt and appropriate treatment.

Conclusions: The numbers of OP poisoning cases are increasing every year and poisoning is seen commonly in younger age groups. Therefore, strict legislature on the availability of OP compounds, preventive measures and appropriate health education should be introduced to decrease the incidence.


Keywords


Organophosphorus, Pesticide, Poisoning, Severity

Full Text:

PDF

References


Jayaratnam J. Acute Pesticide Poisoning: a major global health problem. World Health Stat Q. 1990;43(3):139-44.

Joshi SK. Pesticides poisoning in Nepal. Kathmandu Uni Med J. 2003;1(3):157.

Eddleston M. Patterns and problems of deliberate self-poisoning in the developing world. Q J Med. 2000;93(11):715-31.

HMG of Nepal. Central Bureau of Statistics, National Planning Commission. Statistical Year Book of Nepal; 2001.

Gupta SK, Joshi MP. Pesticide Poisoning Cases Attending Five Major Hospitals of Nepal. J Nep Med Assoc. 2002;41:447-56.

Jones AL, Karallidde L. Poisoning. In: Nicholas A. Boon, Colledge NR, Walker BR, John A, Eds, Davidson’s Principles and Practice of Medicine, 20th ed. Churchill Livingstone Elsevier; 2006:204-220.

Linden CH, Burns MJ, Mycyk B. Poisoning and drug over dosage. In: Kasper DL, Fauci AS, Longo DL, Jameson JL, Loscalzo J, Hauser SL, editors. Harrison’s Principles of Internal Medicine. 17th ed. Mc Graw-Hill Companies, Inc., New York 2008:e35:e281.

Eddleston M, Sheriff MHR, Hawton K. Deliberate self-harm in Sri Lanka: an overlooked tragedy in the developing world. Br Med J. 1998;317:133-5.

Bhattarai N, Rauniyar A, Chaudhary D, Jaiswal S, Banthia P, Rana BB. Patterns of organophosphorus poisoning attending a teaching hospital. J Nep Med Assoc. 2006;45(162):228-32.

Kar S, Timsinha S, Agrawal P. An epidemiological study of organophosphorus poisoning at Manipal teaching hospital, Pokhara, Nepal. J Indian Acad Forensic Med. 2010;32(2):108-9.

Laudari S, Patowary BS. Analysis of organophosphorus compound poisoning patients attending CMS-TH, Bharatpur, Nepal. J Col of Med Sci. 2011;7:(4):9-19.

Prasad DR, Jirli PS, Mahesh M, Mamatha S. Relevance of plasma cholinesterase to clinical findings in acute organophosphorus poisoning. Asia Pac J Med Toxicol. 2013;2(1):23-7.

Joshi SC, Prakash C, Joshi A, Joshi G. Profile of organophosphorus poisoning at tertiary care hospital in Uttarakhand. J Indian Acad Forensic Med. 2013;35(4):346-8.

Karki RK, Risal A. Study of poisoning cases in a tertiary care hospital. Kathmandu Uni Med J. 2012;10(4):70-3.

Chintale KN, Patne SV, Chavan SS. Clinical profile of organophosphorus poisoning patients at rural tertiary health care centre. Int J Adv Med. 2016;3(2):268-74.

Gunduz E, Dursun R, Içer M, Zengin Y, Gullu MN, Durgun HM. Factors affecting mortality in patients with organophosphate poisoning. J Pakistan Med Assoc. 2015;65:967-72.

Karki P, Ansari JA, Bhandary S, Koirala S. Cardiac and electrocardiographically manifestations of acute organophosphate poisoning. Singapore Med J. 2004;45:385-9.

Chataut J, Adhikari RK, Sinha NP, Marahatta SB. Pattern of organophosphorus poisoning: a retrospective community based study. Kathmandu Uni Med J. 2011;9(2):31-4.

Kora SA, Doddamani GB, Halagali GR, Vijayamahantesh SN, Boke UM. Sociodemographic profile of the organophosphorus poisoning cases in Southern India. J Clin and Diag Research. 2011;5(5):953-6.

Thunga G, Sam KG, Khera K, Pandey S, Sager SV. Evaluation of incidence, clinical characteristics and management in organophosphorus poisoning patients in a tertiary care hospital. J Toxicol Environ Health Sci. 2010;2(5):73-6.

Bertolote JM, Fleischmann A, Eddleston M, Gunnell D. Deaths from pesticide poisoning: a global response. Br J Psychiatr. 2006;189:201-3.

Khadka SB, Ale SB. A study of poisoning cases in emergency Kathmandu medical college teaching hospital. Kathmandu Uni Med J. 2005;3(4):388-91.

Kishore PV, Palaian S, Paudel R, Mishra D, Ojha P, Alam K, et al. Pattern of poisoning cases in a teaching hospital in Western Nepal. J Inst Med. 2008;30(1):26-34.

Marahatta SB, Singh J, Shrestha R, Koju R. Poisoning cases attending Emergency department in Dhulikhel hospital-Kathmandu university teaching hospital. Kathmandu Uni Med J. 2009;7(2):152-6.

Laudari S, Patowary BS, Sharma SK, Dhungel S, Subedi K, Bhattacharya R. Cardiovascular effects of acute organophosphate poisoning. Asia Pac J Med Toxicol. 2014;3(2):64-7.

Rehiman S, Lohani SP, Bhattarai MD. Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorus poisoning. J Nepal Med Assoc. 2008;47(170):47-52.

Makwava PV, Odedara RV, Shah HD. Acute organophosphorus poisoning and clinical admission Score association among patients admitted in emergency ward of a tertiary teaching hospital of medical college. JPBMS. 2012;17(8):1-5.