RETROSPECTIVE ANALYSIS OF OUTBREAK OF ORGANOPHOSPHORUS POISONING IN CHILDREN, OUR EXPERIENCE IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2015, Vol 4, Issue 16
Abstract
[b]BACKGROUND:[/b] Organophosphate pesticides are the most important cause of severe toxicity and death worldwide. Outbreaks of organophosphorus poisoning has increased specially in Bihar and south india after introduction of Mid-day meals schemes. [b]AIM[/b]: To study the clinical profile of patients with organophosphorus poisoning outbreak, and efficacy of poison severity score as a triage to predict complications. [b]MATERIALS AND METHODS[/b]: Thirty four students referred from primary health care to our tertiary care hospital. Medical History, physical examination and in some cases pseudocholinesterase was done. Medical records were retrospectively analysed and patients were divided into three groups (A, B, C) based on poison severity score. Inclusion and exclusion criteria were developed. The Incidence of complications were studied in each group. Patients were also divide into those achieving early atropinisation versus late atropisation and compared. Statistical probability of each group was calculated with CHI SQUARE test. [b]RESULTS[/b]: All patients were male children between 12 to 16 years (mean age being13.6 years). Group A, Group B, Group C had 11, 20, 3 patients respectively. Overall vomiting (88%), abdominal pain (79%) and depressed mental status (55%) were the commonest symptoms. The rate of complication in Group A, Group B ,Group C were 18%,35% and 100%respectively, however a p value calculated(6.84 Vs 9.49) with CHI SQUARE test was not significant. The commonest complications were cardiovascular, followed by respiratory and renal failure. Two patients developed multiple organ dysfunction and has to be referred. Retrospectively among 18 patients were atropinised early, 3 had complications and among 16 atropinised late, 9 developed complications. By using CHI SQUARE test the p value calculated was significant (3.94 >3.84).[b] CONCLUSION[/b]: Poison severity score reliably predicts the incidence of complication and help in triage of patients in outbreaks of organophosphorus poisoning. Early atropinisation should be the goal to reduce complications.
Authors and Affiliations
Saif Kibriya, Sadaf Rakhshan, Mushaf Baig
Keywords
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- EP ID EP164083
- DOI 10.14260/jemds/2015/400
- Views 87
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