Analysis of Organophosphates Intoxication in a Tertiary Care Hospital

ABSTRACT As the mortality rate is found to be high in organophosphorous poisoning, the study was aimed at studying the socio demographic pattern and mode of presentation of organophosphorous (OP) intoxication in Madurai, Southern Tamil Nadu. A prospective study of fifty organophosphorous compound poisoning cases, admitted through the emergency department of Government Rajaji Hospital, Madurai, were evaluated in the study. Treatment outcome was studied and reduction in cholinesterase activity was estimated to confirm the exposure and assess the severity of OP poisoning. Among the 50 cases evaluated,39 (78%) patients were males, 11(22%) were females and the mean age was 35.82 ±1.779 years. Thirty two (64%) percent of cases were illiterate and twenty six (52%) of the patients were in the lower middle socioeconomic status.Mean arrival time to the hospital after poisoning was 2.609 hours. Exposure routes were gastrointestinal in all the patients. The mortality rate was 34% and related to either the ingestion of higher doses or delay in approaching the hospital for emergency management. There was a significant reduction in serum cholinesterase level (2.5120X10 7 ± 1.592 mol/min/mg protein) (P<0.05) after OP poisoning.The extent of depression reflected the severity and was found to be reverted back towards normal upon treatment. Fatal issue is often related to causes of poisoning (suicide vs. non-suicide), delayed hospitalization and delay in diagnosis or an improper management. These findings call for a shift in emphasis in educating the masses towards first-aid care for intoxication and further necessitate the need for strict regulation of their use and adequate medical management monitoring for serum cholinesterase level will help to bring down the mortality rate