Clinical profile of organophosphorous poisoning in children admitted to tertiary care hospital

Background: Organosphophorous compounds are the commonly available insecticides in households. Therefore, children are vulnerable to accidental poisoning. It is associated with significant morbidity and mortality. The aim of this study was to study the clinical profile of organophosphorous poisoning in children.Methods: This was prospective study conducted over a period of two years from January 2018 to January 2020 in department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India. All the patients in the age group of 1-18 years with history and examination suggestive of organophosphorous poisoning were included in this study.Results: In this study there were total of 54 patients. In majority of cases poisoning was accidental. Oral consumption was most common route of poisoning. The most common symptoms were excessive salivation (100%), vomiting (72%), abdominal pain (26%), diarrohea (13%), agitation (11%) and convulsions (3.7%). The most common signs were miosis (78%), bradycardia (59%), fasciculation (57%) and altered sensorium (13%). Respiratory failure and circulatory collapse were two main complications which contributed to mortality in this study.Conclusions: Organophosphorous poisoning is one of the most common poisoning in children. Early diagnosis and treatment is of pivotal importance to prevent mortality.

A study on glasgow coma scale score and QTC interval in predicting prognosis and outcome of organophosphate and carbamate poisoning

Background: Poisoning with organophosphorous substances is the commonest cause of inpatient mortality among all poisonings in developing countries like India. This study is undertaken with an aim of assessing simple parameters like GCS and QTc (marker of ventricular arrythmias) in predicting the outcome and complications of organophosphate compound poisoning considering the mortality and sufferings of Organophosphorous poisoning patients. Aim: To assess the utility of GCS score and QTc interval in predicting prognosis in patients who had consumed organophosphate and carbamate poisoning and to assess whether the above parameters helps to identify the high risk groups requiring mechanical ventilation. Materials and methods: This study was conducted among 200 organophosphate and carbamate poisoning patients who were admitted at Government Rajaji Hospital, Madurai from February 2014 to September 2014. After taking detailed history and physical examination and investigations the Glasgow coma scale score and QTc interval at the time of admission was calculated. Patients with GCS score < 13 and QTc interval > 0.44s in males and 0.46s in females as poor outcome. Results: There was a linear relation with QTc interval and severity of Organophosphorous poisoning i.e. as the QTc interval increases the severity of poisoning increases. There was an inverse relationship Prabhakaran R, Marannan N, Ponnusamy Kumar, Vijayakumari Vrinda. A study on glasgow coma scale score and QTC interval in predicting prognosis and outcome of organophosphate and carbamate poisoning. IAIM, 2017; 4(6): 1-7. Page 2 between the GCS score and severity of Poisoning, .i.e. as the GCS decreases the severity of poisoning increases. Conclusion: Our study showed that respiratory failure in patients with OP compound poisoning can be predicted at admission by simple parameters like lower GCS and prolonged QTc interval in ECG.

Outcome among Patients of Organo-Phosphorous Compound Poisoning in Comparison with Scoring System Applied.

Background: Organo-phosphorous compound poisoning is an important medical emergency in which if early treatment is not received the mortality is high. The leading cause of death is due to respiratory failure, which results from combination of respiratory muscle weakness, central respiratory depression, increased bronchial secretions, bronchospasm and pulmonary edema. Methods: For a period of 2 years, a total of 1200 poisoning cases were admitted in the Government Medical College Hospital, Nanded. Out of them, 240 were the cases of Organo-phosphorous compound poisoning. After applying inclusion and exclusion criteria, and after having the completed questionnaires, finally it was possible to include 200 patients. Results: Maximum number of patients who died was in the severe grade at the time of admission. In moderately severe grade only one patient died. While there was no mortality in the mild and moderate grades of poisoning. It is observed that as the scoring increased the mortality also increased. In patients with score more than 30, it was almost 100%. So patients with higher scores were more at risk of death and this association was found to be statistically significant. (p < 0.05). Conclusion: It can be concluded that all patients with Organophosphorous compound poisoning at admission should be assessed for scoring. Those having high scores should be given special attention.

Rapid Determination of 9 Organophosphorous Flame Retardants in Textiles by Ultra High Performance Liquid Chromatography Tandem Mass Spectrometry / 分析化学

A rapid method was developed for the determination of 9 organophosphorous flame retardants ( OPFRs) in textiles by ultra high performance liquid chromatography tandem electrospray ionization mass spectrometry ( UHPLC-MS/MS ) . Analytes in textile samples were extracted in a closed bottle at 50℃ with methanol by ultrasonic extraction for 30 min. And then, the extracted solution was injected after filtration and determined by UHPLC-MS/MS. Target analytes were separated by C18 column and methanol/water containing 5. 0 mmol/L NH4 COOH. The positive electrospray ionization and multiple reaction monitoring mode ( MRM) was utilized. The matrix effect (ME) could be compensated by adjusting the concentration of NH4COOH and the composition of the mobile phase after careful investigation with blank samples. An external standard calibration method was chosen to the quantitative analysis. Under the optimized conditions, method precision represent with relative standard deviations (RSDs) was 5. 2% (TOCP) -12. 5% (TRIS) for cotton, 6. 4%(TBEP)-13. 8% (TRIS) for polyester, and 6. 9% (TDCP) -14. 5% (TEPA) for wool samples. The recoveries for standard addition were in the range of 52 . 5% ( TEPA ) -116 . 4% ( TPP ) . The limits of quantification (LOQ, S/N=10) were between 1. 0 (TBP) and 10. 0 (TRIS) μg/kg.

Analysis of methyl parathion in biological samples using thin layer chromatography.

Pesticides are major contaminating chemicals in agriculture environment and a hazard to exposed population. The pesticides form a strong class of environment pollutants, as they are sometimes nonbiodegradable, damaged not only the environment and agriculture but also have entered into the food chain thereby affecting health and development. Methyl parathion is a broad-spectrum organophosphorus insecticide generally used to control a variety of insects. The present study was planned to develop a new method for analysis of Methyl parathion in human blood samples using thin layer chromatography technique, which is simple and quick. Methyl Parathion was extracted from blood using solvent extraction methods and then identified on the TLC plates. For chromatographic separation, various binary and tertiary solvent systems were used and for detection on developed plates, palladium chloride reagent was used which successfully increased the sensitivity without dispensing with the simplicity of the method. Statistical analysis was performed on four solvent systems namely benzene: chloroform (80:20), hexane: carbontetrachloride (50:50), hexane: carbontetrachloride (20:80), hexane: propanol (20:80) which included the calculation of mean Rf value, value of standard deviation and coefficient of variance. It is evident from the statistical data that hexane: carbontetrachloride (50:50), hexane: carbon tetrachloride (20:80) is preferably good solvent systems for parathion identification by thin layer chromatography.

Arrhythmia induced by acute organophosphorous pesticide poisoning: a literature review / 中华全科医师杂志

Literatures on arrhythmia induced by acute organophosphorous pesticide poisoning published in domestic journals from 1979 to 2010 were searched. Total 3468 cases of acute organophosphorous poisoning were collected and analyzed. The average abnormal ECC rate was (53 ±15)%(35. 4% -68. 4% ) in acute organophosphorous poisoning, the most common ECG abnormalities were ST-T segment changes (26. 5% ) and sinus tachycardia (16. 6% ). The rate and severity of ECG abnormalities were increased with the severity of organophosphorous poisoning(x2 = 33. 253,P < 0. 01). The most common causes of death in acute organophosphorous poisoning were ventricular tachycardia and ventricular fibrillation (26.2%).

The status of pesticide pollution in surface water (Lakes) of Bijapur.

The paper evaluates and summarizes the results of the pollution of surface waters (lakes) of Bijapur by pesticides. Pesticide classes mostly detected involve herbicides used extensively in cotton, vegetables and grape production, organophosphorus insecticides as well as organochlorines due to their persistence in aquatic environment. The compounds most frequently detected were Endosulphan, 4- bromro-2-chlorphenol, Captan, Chloripyrifosethyl, Fipronil, Oxyfluorfenand monochrotophos respectively. . Nationwide, in many cases the reported concentrations ranged in low levels. However, elevated concentrations were recorded in areas of high pesticide use and intense agricultural practices. Generally, similar trends and levels of pesticides were found in Bijapur lakes. Monitoring of the Bijapur water resources for pesticide residues must continue, especially in agricultural regions, because the nationwide patterns of pesticide use are constantly changing. All these were present above the permissible limits specified by the European Economic Community (EEC), which is the norm used all over the Europe. Moreover emphasis should be placed on degradation products not sufficiently studied so far. Information on pesticide pollution of surface waters in Bijapur is reported.

Resistencia focal a insecticidas organosintéticos en Aedes aegypti (Linneaus, 1762) (Díptera: Culicidae) de diferentes municipios del estado Aragua-Venezuela / Focal resistance to organosynthetic insecticides in Aedes aegypti (Linneaus, 1762) (Diptera: Culicidae) from different municipalities in Aragua state, Venezuela

En el presente estudio fueron determinados los niveles de resistencia a insecticidas enlarvas de Aedes aegypti de tres municipios del estado Aragua – Venezuela (Girardot, Mario BriceñoIragorri y Urdaneta), en comparación con una cepa susceptible (Rockefeller), a través del métodode inmersión de la OMS. Se evaluaron los insecticidas organofosforados (malatión, pirimifos metil ytemefos) y el carbamato (propoxur). Se encontró resistencia al malatión en las tres cepas, con valoresde FR50 de 69,50x; 150,6x y 113,52x; para las cepas Girardot, Mario Briceño Iragorri y Urdaneta,respectivamente; sugiriendo esta diferencia en los niveles de resistencia a este insecticida, que lanaturaleza del fenómeno es focal. Todas las cepas resultaron susceptibles a los organofosforadospirimifos metil y temefos, y al carbamato propoxur. Estudios con sinergistas PB y DEF demostraronque las enzimas del grupo multifunción oxidasas están implicadas en el desarrollo de la resistenciaal malatión. Los resultados aportan información referencial, sobre el comportamiento de las cepasfrente a insecticidas durante el periodo de estudio y deben ser tomados en consideración para laimplementación de estrategias para el manejo y vigilancia de la resistencia a insecticidas a nivellocal

In the present study the levels of resistance to insecticides in larvae of Aedes aegypti were determinedin three municipalities of Aragua state, Venezuela(Girardot, Mario Briceño Iragorri and Urdaneta), incomparison with a susceptible strain (Rockefeller),through the WHO method of immersion. Theorganophosphorous insecticides (methyl malathion,pirimiphos methyl and temephos) and the carbamate(propoxur) were evaluated. Malathion resistance wasfound in the three strains, with values of FR50 69.50x,113.52x and 150.6x to the strains from Girardot, MarioBriceno Iragorri and Urdaneta respectively, suggestingthat differences in the levels of resistance to thisinsecticide, is a phenomenon of focal nature. All strainswere susceptible to the organophosphate pirimiphosmethyl, temephos and the carbamate propoxur. Studieswith synergists PB and DEF showed that the enzymesin the group multifunction oxidases are involved in thedevelopment of resistance to malathion. The resultsprovide reference information on the behavior of thestrains compared with insecticides during the period ofstudy and should be considered for the implementationof strategies for managing and monitoring of insecticide resistance locally

Neurological manifestations in organophosphorous toxicity.

Organophosphorous compounds are one of the efficient methods available for pest control. Because of its easy availability, the various preparations of organophosphorpus compounds cause significant morbidity and mortality to the human lives. In addition to producing pesticide related illness and death, Organophosphorous compounds produces different neurological manifestations as a sequelae to its toxicity. Four such neurological syndromes are discussed with their salient clinical features.

Effect of immediate abundant sucraffate suspension perfusion to prevent upper gastrointestinal hemorrhage after washing stomach / 中华急诊医学杂志

Objective To study effect of immediate abundant sucralfate suspension perfusion to prevent upper gastrointestinal hemorrhage on the organophosphorous insecticides toxicosis suffer after washing stomach.Methods Total 83 patients suffering organophosphorous insecticides toxicosis were divided randomly into 2 groups randomly.In the control group,40 samples were given cimetidine 0.4 g by vein injection after stomach washing completely twice one day. Meanwhile,they were taken sucralfate 1.0 g/(4 times day) orally or by nastal feeding,continuing 5 days.In the treatment group,the samples were perfused sucralfate suspension 3.0 g (grind to powder,mixed with warm water 80 ml) by stomach tube after each stomach washing,and given routine treatment to assist (method as the control group).Results In the aspects of recessive hemorrhage,conspicuous hemorrhage and hospitalizing period the treatment group was significant decreased compared with the control group (P＜0.05).However,Analysis of the results showed no significant difference in death rate (P＞0.05).Conclusion Immediate abundant sucralfate suspension perfusion after washing stomach has significant curative effect on preventing upper gastrointestinal hemorrhage and decreasing hospitalizing period.

Intermediate syndrome in organophosphorous poisoning.

One hundred and fifty three cases of Organophosphorous poisoning cases presented to Kasturba Hospital, Manipal, India during a 2 year period ( 2001- 2002), out of which 45 cases (29.4%) had features of Intermediate Syndrome. Largest number of victims were in the age group of 21-30 years (37.7%). Males predominated (71.1%). Methyl Parathion was the commonest compound (57.7%). Respiratory muscle weakness was the most common manifestation seen (84.4%). Mortality was 22.3%.

The Effects of Ethanol on Cholinesterase Inactivation by Organophosphorous / 영남의대학술지

BACKGROUND: In korea the agricultural community widely uses organophosphorous, and organophosphorous poisonings are increasing every year. We compared change in activity of acetylcholinesterase and pseudocholinesterase by organophosphorous and by the interaction of ethanol and organophosphorous. We also compared the effect of reversible anticholinesterase drugs, physostigmine and neostigmine. The object of this study is to investigate the effects of several anticholinesterase drugs and on how ethanol influences the activity of cholinesterase. MATERIALS AND METHODS: Fifteen male university students were randomly selected, and blood samples were taken from the antecubital vein. The acetylcholinesterase in the RBC and the pseudocholinesterase in the serum were extracted and separated. The enzyme activity change was measured by the electrometric method. After adding acetylcholine, the pH change was measured with a pH meter. RESULTS AND CONCLUSION: Our results indicated that reversible anticholinesterase drugs decreased the cholinesterase activity more efficiently than organophosphorous. The acetyl cholinesterase and pseudocholinosterase activity were decreased by ethanol. When ethanol was added, oxime a cholinesterase activator, increased acetylcholinesterase activity but dose not increased pseudocholinesterase activity.

Effect of repeated oral administration of quinalphos to male goat (Capra hircus).

Quinalphos given in daily oral doses of 0.5 mg/kg for 110 days induced severe signs of organophosphorus poisoning in male goats. The inhibition of acetylcholinesterase activity in erythrocyte was highly significant. The activity of liver glutamic; oxaloacetic transaminase, glutamic; pyruvic.transaminase, alkaline phosphatase and protein indicated marked alteration. The haematological changes were however, relatively less significant with the exception of a very low count of red blood cells and white blood cells in the treated animals. Among the vital organs, only liver suggested mild cellular changes due to quinalphos intoxication. There was no significant pathological change in other organs of the treated animals. In animals observed after 15 and 30 days rest, the activity of acetylcholinesterase in red blood cells and haematological picture showed a fairly good recovery. This study suggests that although quinalphos in low concentrations did not produce discernible cellular changes, it induced highly significant enzymatic and haematological changes in the goat.