Ashy Stephanie, A (2023) Serum Phosphorus as a Prognostic Indicator in Acute Liver Failure in Rat Killer Paste Poisoning: An Observational Study. Masters thesis, Madurai Medical College, Madurai.
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Abstract
BACKGROUND: Yellow phosphorus, commonly used as rodenticide has a lethal dose of 1 milligram per kilogram, the most common mode of poisoning being ingestion. It causes periportal necrosis of liver leading to acute liver failure with the elevation of enzymes usually after 72 hours. After 72 hours the person develops coagulopathy, acute liver failure, which can also progress to MODS. Serum phosphorus level is considered as an important predictor of mortality in acetaminophen poisoning with acute liver failure. Hypophosphatemia occurs as a result of increased intracellular uptake of phosphorus to replenish high energy intermediates when there is brisk hepatocyte regeneration. Hence high serum phosphate level is associated with poor prognosis in patients with acute liver failure. OBJECTIVES: To study the association between serum phosphorus and acute liver failure and to prognosticate the patients with acute liver failure with regard to serum phosphate level. METHODOLOGY: Fifty patients admitted with consumption of toxic dose of Rat killer paste (yellow phosphorus) are segregated, they are then grouped on the basis of age and gender. Routine blood investigations are done. Serum phosphorus level at D1, D3 and D7 of poisoning are done along with serial monitoring of liver enzymes and PT- INR. The collected data is analysed by using Statistical Package for Social Sciences (SPSS) . The class intervals are fixed by using the formula, I ≥ (L− S) / n.5 ≤ n ≤ 15. Using Sturges' rule as a guide: n = 1 + 3.322 log10 (N), where N = Total number of observations. RESULTS: In the study, it is found that there exists a correlation between the values of serum phosphorous and the patients’ outcome irrespective of the treatment options. CONCLUSION: In cases of acute liver failure presenting with coagulopathy and acute encephalopathy in yellow phosphorous poisoning, patients with transaminitis more than 2000 are associated with poor regenerative capacity of liver. In the study, survivors almost always had a dip in Serum phosphorus level on day 7 correlated as increased in regeneration of the liver which could compensate for the massive hepatic necrosis which occurred as a result of yellow phosphorous poisoning. The sensitivity of serum phosphorus in terms of prognostication is good in acute liver failure in yellow phosphorus poisoning.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.200120101503 |
| Uncontrolled Keywords: | Serum Phosphorus, Prognostic Indicator, Acute Liver Failure, Rat Killer Paste Poisoning, Observational Study. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Jan 2024 14:05 |
| Last Modified: | 20 Mar 2024 16:15 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21321 |
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