Severity and clinical outcome of OPC poisoning and its association with glycemic status

 

 

Abstract              Background: Organophosphorus compound (OPC) poisoning is one of the common medical emergencies among rural population in India due to suicide attempts. Its toxicological threat may affect human and animal health because of their various toxicities such as neurotoxicity (cholinergic toxicity, Organophosphorus ester-induced delayed neurotoxicity (OPIDN) and Organophosphorus ester-induced chronic neurotoxicity (OPICN)), endocrine toxicity (pancreatic insufficiency), immunotoxicity, reproductive toxicity, genotoxicity and ability to induce organ damage, OPC induced oxidative stress and disrupted glucose homeostasis. Among the various factors contributing to the mortality of the OPC poisoning, extremes and fluctuation in the glycemic status is a well documented parameter affecting the outcomes of these patients. The purpose of this study was to investigate the relationship between the glycemic status of the patients with the severity and clinical outcome of the OPC poisoning. Aims and Objectives : 1.To assess the glycemic status by estimating random blood glucose (RBS) level at the time of admission in cases of acute OPC Poisoning 2.To assess severity of the poisoning with Peradeniya organophosphorus poisoning scale (POP scale) 3.To determine the relation between glycemic status at admission with the severity and clinical outcome in organophosphorus poisoning. Method: A prospective analytical study of 100 patients with diagnosed acute OPC poisoning, above the age of 18 years and fulfilling the inclusion and exclusion criterias was done and the patients were grouped according to their glycemic status into hypoglycemic [<100mg/dL], euglycemics [ RBS of 100-200] and hyperglycemics [ RBS of more than 200 mg/dL ] and the same was correlated with the severity and clinical outcome using descriptive statistics, association and test of significance Conclusion: We conclude that the glycemic status at the time of presentation in acute organophosphate poisoning patients is a simple, cheap, reliable marker in guiding the clinical severity and outcome when considered with clinical severity scores in a resource limited country like India.

Key Word: OPC poisoning.