Ezhilan, N (2007) Comprehensive Analysis of Organophosphorous Poisoning in Poison Centre, Government General Hospital, Chennai. Masters thesis, Madras Medical College, Chennai.
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Abstract
Organophosphorous poisoning is a menace to the human race both as a weapon of mass destruction and a misused pesticide of self harm. The case fatality rate exceed 60% in developing countries where there are many pit falls in treatment protocol and research activities. So a comprehensive analysis of 87 patients of organophosphorous poisoning was done in Poison Centre Government General hospital Chennai. All the cases included in the studied underwent detailed clinical evaluation and extensive laboratory work up.Each patient was monitored periodically till the outcome. 47 intensive care unit. There were 76 males and 22 female patients. The predominant age group was 21- 30years.75 patients were suicide attempts and 12 had accidental exposure. 75 (86.2%) of the patients were poisoned through the gastrointestinal route. 10 (11.5%) patients had inhalational poisoning and two (2.3%) patients had topical exposure There were 12 different types of OP insecticide agents involved. The estimated average time for the admission to POISON CENTRE after the exposure was 9.9hours. According to Dreisbach clinical criteria at admission, 49.4% of patients belong to the severe grade of poisoning. 47 out of 87 cases had involvement of proximal muscles such as neck flexors, bulbar muscles and muscles of the shoulder and pelvic griddle. The blood gas analysis and serum cholinesterase levels had significant correlation with clinical severity,mechanical ventilation and outcome. Serum amylase, LDH, creatine kinase and ck-mb elevation were significant. The average total dose of atropine was 268.51mg.All patients received pralidoxime. The grade of clinical severity, the need of ventilatory support and the mortality were more among the high dose group when compared to the low dose group of patients who received pralidoxime. Mechanical ventilatory support was needed for 42(48.27%) patients The duration of mechanical ventilation was 7.11 ± 4.5days. The mortality rate for the patients who were mechanically ventilated was 45.23%(19 patients), although the mortality rate was 25.29% (22 patients) for all patients. The mortality rate for the mechanically ventilated patients was statistically significant when compared with those patients not mechanically ventilated. The grade 3 clinical severity, proximal muscle affection, elevation of creatine kinase, low values of day 1 serum cholinesterase and the high dose of pralidoxime predicted the need of ventilatory support. The predictors of adverse outcome were prolonged duration of hospital stay, grade 3 clinical severity, proximal muscle involvement, suppressed day 1 and day 5 levels serum cholinesterase ,elevated creatine kinase, high dose of pralidoxime and mechanical ventilation.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Comprehensive Analysis ; Organophosphorous Poisoning ; Poison Centre ; Government General Hospital ; Chennai. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Mar 2018 03:37 |
| Last Modified: | 30 Mar 2018 15:42 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6642 |
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