ABSTRACT
Background: Organophosphorus Compounds (OPC) are main cause of accidental and suicidal poisoning in agrarian countries like India. Aim was to study the clinical profile of OPC-Poisoning and correlate it with the electrocardiographic (ECG) changes and electrolyte abnormalities.Methods: Hundred consecutive cases admitted to Medicine Department underwent clinical examination, ECG, electrolytes, Acetyl Choline Esterase (AChE) estimation from time to time and Paradeniya Organophosphorus Poisoning (POP) score at the time of admission. All these parameter with duration of hospital stay and outcome were statistically analysed using X2 test, Fisher exact test, and inference was drawn.Results: In hundred OPC-Poisoning patients [Male (n=48), Female (n=52), M: F ratio 0.92:1] with mean age of 37.78�.95 years, commonest poison was cholropyrifos+cypermethrin and was mostly suicidal (96%). Common symptoms were sweating (48%), salivation, blurring of vision, breathlessness and signs were smell of poison (90%), tachypnea, altered sensorium, miosis and fasciculation. POP scoring found 41% of patients in mild, 26% in moderate and 33% in sever grade of poisoning. Hospital stay ranged from 4-18 days. Complications were pulmonary Edema (PE) in 28%, Respiratory Failure (RF) 18%, Aspiration Pneumonia (AP) 15% and Intermediate Syndrome (IS) 4%. 10 died out of 42 patients who had complications and the cause of death was RF in 4, Ventricular Fibrillation (VF) 2 and IS in 2. ECG finding showed sinus tachycardia (31%), prolonged corrected QT (QTc) interval (28%), sinus bradycardia (25%), ST-T changes (17%) and Premature Ventricular Contraction (PVC) in 4% which degenerated to VF in 2%. 24 patients were Hypokalemic from which 16 developed complications.Conclusions: Similar to earlier studies we observed poisoning which was suicidal. QTc prolongation and Hypokalemia are associated with high morbidity and mortality in OPC-Poisoning.
ABSTRACT
Background: Studies regarding correlation of various conventional risks factors for Coronary Artery Disease (CAD) are many. Keeping in mind the scarcity of studies regarding Vit-D Deficiency (VDD), a new risk factor in CAD, present study was conducted to correlate Vit-D level with conventional risk factors and Coronary Angiography (CAG).Methods: Hundred adult patients admitted to Medicine and Cardiology undergoing CAG with suspected or established CAD were kept in study. Patients having renal, hepatic, parathyroid disease, osteomalacia and patients taking drugs interfering with Vitamin D (Vit-D) metabolism were excluded. After detailed history and thorough clinical examination, routine investigations and 25-(OH) D level was estimated. Subsequently patients underwent CAG. Statistical analysis by Mann Whitey test and Chi-square Test was done and inference was drawn.Results: 100 patients in different age groups had hypertension (HTN) in 53, diabetics mellitus (DM) 39, dyslipidemia 62, smokers 38 and family history of CAD 19. CAG showed normal coronaries in 4, Single Vessel Disease (SVD) in 30, double vessel diseases (DVD) 43 and triple vessel disease (TVD) 22. Vit-D level <20ng/ml i.e. Vit-D deficiency (VDD) in 68, 20-30ng/ml i.e. Vit-D insufficiency (VDI) in 22 and >30ng/ml (normal) in 10. VDD was profound in 51-60 and 61-70 years age groups. Statistical correlation of VDD was not significant with conventional risk factors, but statistically significant correlation of VDD was observed with dyslipidemia and CAG findings in our study.Conclusions: Like earlier studies we observed significant correlation of Vit-D levels with CAD. Though dyslipidemia was significantly correlated with VDD, correlation of other conventional risk factors like age, sex, HTN, DM, smoking and family history was not found. We conclude from this study presence of significant association of VDD with severe CAD. DVD and TVD by CAG were common with low Vit-D levels.