Twayana RS1*, Pandey R2, Shrestha S2, Vaidya N2, Shrestha H3 and Subedi N4
1Department of General and Respiratory Medicine, Shadwell and West Birmingham General Hospitals NHS Trust, UK
2Department of Internal Medicine, Kathmandu University Hospital, Nepal
3Department of Endocrinology, Kathmandu University Hospital, Nepal 4 Kathmandu University Hospital, Nepal
Introduction: Poisoning is the most common mode of unnatural death in South East Asia causing hundreds of thousand deaths per year. Among them Organophosphorus (OP) compound, a pesticide poisoning is the major clinical problem in Nepal.
Methods: A prospective observational study was conducted from July 2013 to September 2014 in Kathmandu University Hospital, Dhulikhel Hospital. A total of 110 patients of organophosphorus compound poisoning were evaluated using the clinical score of Peradeniya Organophosphorus Poisoning (POP) scale and level of Serum Pseudocholinesterase (SChE) to determine the correlation between POP scale and the serum SChE activity and their prognostic value in terms of severity and clinical outcomes.
Results: Of the total 110 cases of organophosphorus compound poisoning, the mean age was 32.69 ± 10.96. Majority of them were female (60%) and the most provoking factor was household conflict (85.40%). The most common compound consume was dimethyl (70.9%) over diethyl compound (29.1%). The mean amount of poison was 26.4 ± 31.61 ml and the mean atropinization dose was 14.77 ± 15.21 mg. Similarly, the mean cholinesterase level was 1792.90 ± 2305.9 IU/L and the duration of hospital stay was 3.99 ± 2.63 days. The level of serum SChE and POP score scale differed significantly in male and female (P=0.000 and P=0.010 respectively). There was a significant correlation between low serum cholinesterase and duration of hospital stay P=0.023. However, there was no statistical significance between POP scale score and gender, lag time, atropine dose, ventilator support and clinical outcomes.
Conclusion: The organophosphorus compound is the most common self-poisoning in Nepal. The simple POP score scale is the useful clinical severity assessment tool. Serum cholinesterase level and its activity can be a guide to the physician for predictive and prognostic value.
Cholinesterase; Organ phosphorus, Poisoning; Severity
Twayana RS, Pandey R, Shrestha S, Vaidya N, Shrestha H, Subedi N. Clinical Correlation of the Severity and Outcomes of the Organophosphorus Compound Poisoning Cases Admitted to Kathmandu University Hospital based on POP Score and Serum Pseudocholinesterase Level - A Prospective Observational Study in Nepal. Int J Intern Emerg Med. 2019;2(1):1016.