Volume : III, Issue : XII, December - 2014

Treatment Of Cases of Organophosphorous Compound Poisoning According to Symptom Score System

Dr. Mukesh N. Rathod, Dr. Dhrupal C. Suthar, Dr. Rizwan N. Ansari, Dr. Nisheeth M. Patel, Dr. Vaibhav S. Chaudhari

Abstract :

AIMS AND OBJECTIVES The present study of patients presented with organophosphorous poisoning was carried out with the following objectives, 1) To study the clinical course of patients of organophosphorous poisoning having various grades of severity as managed by symptom score method. 2) To correlate the level of cholinesterase activity in blood with severity grading by symptom score method. 3) To study severity of toxic effects of various organophosphorous compounds consumed by our patients of organophosphorous poisoning. MATERIAL AND METHODS All the adult patients admitted in our hospital with an alleged history and signs / symptoms suggestive of OP poisoning were considered s study material. Clinical diagnosis of OP poisoning was established by detailed clinical and circumstantial history as well as smell of organophosphorous compounds from body parts, clothes, eath and gastric aspirate obtained from stomach wash. After an emergency stomach lavage with a wide bore stomach tube, a detailed clinical examination was done in each patient. Before specific therapy with atropine was given, blood for plasma cholinesterase level estimation was sent to the laboratory. The normal reference value for plasma cholinesterase is 2900-5800 units/l. A particular score was given to certain symptoms/signs of OP poisoning when present and total score was calculated as follows, SYMPTOM SCORE Nausea/vomiting/sweating/diarrhea 1 for each Excessive salivation/lacrimation/miosis/fasciculations 2 for each Coma/convulsion 3 for each Admission pseaudocholinesterase below 10% of normal 4 Each patient was categorized in mild,moderate or severe grade as per the total score as follow, score grade <4 Mild 4-8 Moderate >8 severe CONCLUSION The clinical severity guidelines which we used in the study was very simple, easy, informative but had only limited diagnostic correlation with the plasma cholinesterase level when reduced to <10% of normal value only. While no consideration was given to mild or moderate reduction in scoring for severity and/or treatment. Though plasma cholinesterase level do correlate with severity of poisoning, it doesn’t have any added significance in either diagnosis or management and when clinical features do suggest diagnosis and severity of poison, this investigation may not be insisted unless for academic interest. The therapeutic guidelines given in the symptom score method was found to be effective and safe in mild to moderate grade of poisoning , however further study with more sample size in severe grades is required to opine in severe cases.

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

Dr. Mukesh N. Rathod,Dr. Dhrupal C. Suthar,Dr. Rizwan N. Ansari,Dr. Nisheeth M. Patel,Dr. Vaibhav S. Chaudhari Treatment Of Cases of Organophosphorous Compound Poisoning According to Symptom Score System International Journal of Scientific Research, Vol : 3, Issue : 12 December 2014

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