Study on some prognostic criteria in cases of organosphosphate insecticides poisoning

ABSTRACT

The most common insecticides used worldwide are the organophosphate. They are used in the industrial, commercial and household fields. They act as irreversible cholinesterase inhibitors [organophosphate cholinesterase bond is not spontaneously reversible without pharmacology intervention]. The aim of the present work was to study some prognostic criteria in cases of organophosphate insecticides admitted to the Poisoning Unit of Alexandria Main University Hospital in order to assess the validity of each criterion. This work was carried out on 50 cases of OP insecticide poisoning that were admitted during the period from February to August 2002, All patients were clinically assessed by a full clinical sheet including. Socio demographic data, time lapsed since intake of poisoning, clinical examination including vital signs investigations, ECU, blood gases, pseudo cholinesterase level that have been estimated on admission and before discharge. Antidotal therapy has also been reported. The present study showed that organophosphate poisoning is a serious health and social problem because of it's using as a suicidal tool especially by females, also the wide using in the agriculture aggravate this problem. History of short-term exposure plays a role in prognosis The characteristics of clinical signs and symptoms are important on the outcome. Improvement of signs and symptoms after treatment with atropine is a good prognostic sign. Results of the present work revealed also that decrease in serum cholinesterase activity per se is not reliable in prognosis but could be used to monitor the proper management of the cases. Other alarming signs, which could give an idea about the severity and prognosis of the case, are the decreased conscious level, blood gases changes, as well as the prolongation of QTc interval in the ECG