International Journal of Forensic Medicine

Author(s): Dr. Siddesh RC and Dr. Vijayakumar B Jatti

Abstract: Background & Objectives: Organophosphorus (OP) poisoning is the most common toxicological emergency in India. Medico legal deaths including OP poisoning claim a substantial number of lives in Karnataka. Respiratory failure is the most common complication of OP compound leading to death. The aim of the study is to know the incidence of acute OP poisoning, to correlate between the clinical score described by Peradenya Organophosphorus Poisoning (POP) scale and plasma pseudo cholinesterase levels at the time of admission, ventilator requirement and hospital mortality.Materials and Methods: The study was conducted on patients of OP poisoning admitted to SS hospital, SSIMS & RC, Davangere for a period of three years from January 2021 to December 2023. Total number of cases studied were 150. At the time of admission blood was drawn for estimation of plasma pseudo cholinesterase estimation. The patients were clinically divided into 3 grades according to Peradenya Organophosphorus Poisoning (POP) scale. Analysis was performed by cobas integra 400 cholinesterase Calorimetric assay system. All patients were followed-up for 3 days to know the outcome and results were analyzed.Results: Majority of the cases (40%) belong to 21 to 30 years age group and predominantly belonged to male sex (73%). All the cases were farmers by occupation. Average time taken to reach hospital was 5 hours (+/- 2.54 hours). Commonest poison consumed in the study was Malathion (18.67%) followed by dimethoate (17.33%) and dichlorvos (DDVP) (14%). According to POP scale 78 cases (52%) had severe poisoning, 40 cases (26.67%) had moderate poisoning and 32 cases (21.33%) had mild poisoning. 60 cases (40%) had fatal outcome. Suicidal consumption was seen in 128 cases (85.33%). Plasma pseudo cholinesterase levels associated with all fatalities which were seen in the group with severe poisoning and was found to range from 912 U/L to 2,490 U/L which accounts to suppression of plasma pseudo cholinesterase levels by 84.04% to 93.19%.Conclusion: Plasma pseudo cholinesterase levels equal to less than 1,390.35 U/L (+/- 200.68 U/L) were proved to be fatal. This amounts to suppression of plasma pseudo cholinesterase by 90.414% (+/-1.384%). The POP scale and cholinesterase level at presentation appeared useful to assess the severity of poisoning, particularly in terms of need for ventilator and prolonged duration of hospital stay.

DOI: 10.33545/27074447.2024.v6.i1b.83

Pages: 92-98 | Views: 355 | Downloads: 142

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