Correlation of Serum Pseudocholinesterase Level And Peradeniya Organophosphorus Poisoning Scale In Acute Organophosphorus Poisoning Admitted In Medical College, Trivandrum

Abstract

INTRODUCTION: 

Organophosphorus (OP) compounds are commonly used for suicide in rural India. The rate of OP poisoning as a suicidal agents ranges from 10.3% to 43.8% in various studies in India. So present study was done to find the correlation of serum Pseudocholinesterase level and Peradeniya Organophosphorus Poisoning scale with the severity and inhospital outcome of acute organophosphorus poisoning.

OBJECTIVES:

1. To find the correlation of serum pseudocholoinesterase level and Peradeniya Organophosphorous Poisoning scale (POP) in cases of acute oraganophosphorous poisoning admitted in Government Medical College,


2. To assess the clinical outcomes and severity in acute op

MATERIALS AND METHODS:

This was a Hospital based descriptive, observational study carried out in department of internal medicine,medical college Thiruvananthapuram.The study was carried out for 1 year from June 2020 to June 2021 After obtaining institutional ethics committee clearance, 70 patients was enrolled to my study – all those who satisfy the inclusion criteria and consent to take part in the study. For all statistical interpretations, P<0.05 was considered the threshold for statistical significance.Data analysis was done using SPSS 20.0 software.After getting consent from the bystanders patient will be assessed based on the profoma containing all the variables. Profoma was filled in written format after assessing the clinical status of patient and eliciting a detailed history from the bystanders.4 ml of venous blood sample will be collected from the patient to assess the serum pseudocholinesterase level. Both blood sample and profoma filling was done at the time of admission.POP score was also calculated at the time of admission. Suitable statistical methods applied to assess correlation and variables.

RESULTS:

In present study, the majority of patients were in the age group of 21-30 years (54.3%) with a mean age of 30yrs with standard deviation of 10.9 yrs. Our present study showed the following clinical manifestations, bradycardia (71.5%) miosis (34.3%), tachypnea with cyanosis(8.6%), altered sensorium (57.2%), fasciculations-both generalized and continuous (10%) and seizure (11.4%). Pseudocholinesterase was measured at the time of admission and on analysis it was found that lower pseudocholinesterase was found in patients with severe clinical manifestation. The POP scale was calculated for all patients at initial presentation. There was the significant correlation between the severity of poisoning categorized by the POP scale and the serum cholinesterase at the time of initial presentation of the patients (P<0.001).

CONCLUSION

Present study concluded that there is a significant correlation between the severity of poisoning and degree of derangement of serum cholinesterase level at the initial presentation. The higher the POP scale, the higher was the degree of derangement in the serum cholinesterase level. Both serum cholinesterase and POP scale are an important tool for the diagnosis of the severity of OP poisoning. The facility of estimation of serum cholinesterase is not available in all centres of India. In that case, POP scale can be used to describe the severity of OP poisoning. Timely administration of an antidote sufficient dose and duration are much more important in the patients with evidence of a moderate and severe degree of OP poisoning. Such patients need to be monitored and observed closely with good supportive care. Larger population- based studies are needed as the study group is just adequate.