Jayalakshmi, R (2013) Serum creatine phosphokinase a prognostic indicator in Organophosphorus compound poisoning. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
INTRODUCTON Organophosphorus compounds are becoming one of the most common causes of poisoning. OPC were first synthesized by Schrader during the Second world war. OPC were first used as an agricultural insecticide and later as potential chemical warfare agents. Organophosphorus compounds are used as pesticides, herbicides, and chemical warfare agents in the form of nerve gases. WHO has estimated approximately 3 million pesticide poisoning occur every year and cause more than 220000 deaths. India is a predominantly an agrarian country with about 60 – 80 % of rural population. So, pesticide is an easy access for the suicidal purpose. Organophosphorus compounds act by irreversibly inhibiting the enzyme cholinesterase, resulting in accumulation of acetylcholine at synapse and myoneural junction leading to cholinergic over activity. Respiratory failure is the most common complication leading to death.Early recognition and prompt ventilatory support may improve survival. 2 Peradeniya OP poisoning scale has not been studied much in Indian scenario. It is a simple effective scale to determine the need for ventilatory support early on the course. Serum cpk is found elevated in op poisoning .it can be used as a biomarker in predicting the prognosis. Hence this study was undertaken to assess the severity OP poisoning using both Peradeniya scoring and by estimating serum CPK levels. BACKGROUND AND OBJECTIVES : Organophosphorus compound poisoning is the commonest medico toxic emergency in India, because of its easy availability. Respiratory failure is the most common complication of OPC poisoning leading to death. Early recognition and prompt ventilatory support may improve survival. Hence this study was undertaken to assess the severity of organophosphorus compound poisoning both clinically by using Peradeniya scoring and by estimating serum creatine phosphokinase level. METHODS : A prospective study was conducted on 50 patients admitted at emergency ward of GMKMCH, Salem within 6hrs of OPC intoxication. Detailed history and clinical examination were done. Patients were evaluated for Peradeniya OPC poisoning scale and serum CPK was taken at the time of admission. RESULTS : Age group ranged from 17-67 years. Majority of the patients were in the age group of 21-30 years. 66% of patients were males and 34% were females. Most common poison encountered is monocrotophos. Common signs were miosis 88%, difficulty in breathing 76%.According to POP scale 52% were in mild grade, 40% were in moderate grade and 8% were in severe grade. Study revealed significant elevation of serum CPK in moderate to severe grade of POP scale. INTERPRETATION : Serum CPK more than 500 IU/L predicts high degree of suspicion of subsequent respiratory failure. Peradeniya scoring more than 5 provide high degree of suspicion of subsequent respiratory failure.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Serum creatine phosphokinase ; prognostic indicator ; Organophosphorus ; compound poisoning. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Feb 2018 18:24 |
| Last Modified: | 16 Feb 2018 18:25 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5775 |
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