A clinic-epidemiological study of organophosphorus poisoning in children in a tertiary care medical college hospital

Authors

  • Mohammed Anees-ur-Rahman Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India
  • Karthik Suresh Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India
  • Kumar Gowripura Visweswaraiah Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India
  • Ananda Kumar Tumkur Subbaraya Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20205510

Keywords:

Organophosphorus compound, Pesticides, Children, Atropine

Abstract

Background: Acute organophosphorus (OP) pesticide poisoning is widespread and is the most common poisoning in many developing countries and varies in different geographic regions. Organophosphorus compounds are anti acetyl cholinesterase which exert their toxicity by interfering with the normal function of acetylcholine, an essential neurotransmitter throughout the autonomic and central nervous system.

Methods: The present study was conducted in department of pediatrics Sri Siddhartha medical college, Tumkur. All children with OP poisoning admitted in the pediatric ward were included in the study. Unknown compound/tablet poisoning, which was contradictory to the diagnosis of OP compound were excluded.

Results: Out of 5,274 cases which were admitted in pediatric ward, 15 children were diagnosed as OP poisoning.  In the present study the incidence of OP poisoning was 2.84%. Out of 15 cases 3 cases were below 1 year of age, 2 cases were in the age group of 1-5 years, 5 cases were in the age group of 6-10 years and 5 cases were seen in above 11 years of age. Among 15 cases 13 (86.7%) cases were accidental poisoning and 2 (13.3%) cases were attempt to suicide. Out of 15 cases 4 (26.7%) cases were seen in monsoon, 4 (26.7%) cases were seen in winter and 7 (46.6%) in summer season. Out of 15 cases 14 (93.3%) cases improved with treatment and 1 (6.7%) case discharged against medical advice.

Conclusions: Most cases of accidental poisoning are preventable by close watch on the toddlers and younger children who have a habit of tasting unknown things. Educate school children in all aspects of childhood poisoning.

Author Biographies

Mohammed Anees-ur-Rahman, Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India

Assistant professor of pediatrics

Karthik Suresh, Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India

Professor of pediatrics

Kumar Gowripura Visweswaraiah, Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India

Postgraduate of pediatrics.

Ananda Kumar Tumkur Subbaraya, Department of Pediatrics, Sri Siddhartha Medical College, Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India

Professor of pediatrics

References

Unnikrishnan B, Singh B, Rajeev A. Trends of acute poisoning in south Karnataka. Kathmandu Univ Med J. 2005;3(2):149-54.

Murat S, Guiven M. Intensive care management of organophosphate insecticide poisoning. Crit Care. 2001;5(4):211-5.

Eddlestron M, Szinicz L, Eyer P. Oximes in acute organophosphorous poisoning: a systematic review of clinical trials. QJ Med J. 2002;275-83.

Cherian MA, Roshini C, Visalakshi J. Biochemical and Clinical Profile After Organophosphorus Poisonning-A Placebo-Controlled Trial using Pralidoxime. JAP1. 2005;53:427-30.

Behere PB, Behere AP. Farmers' suicide in Vidarbha region of Maharashtra state: A myth or reality? Indian J Psychiatry. 2008;50(2):124-7.

Grob D, Harvey AM. The effects of and treatment of nerve gas poisoning. Am J Med. 1953;14:32.

Guyton AC, Hall JE. Textbook of medical physiology. 10th ed. W.B. Saunders Company; 2001;80-4:690-708.

Ganong FW. Review of medical physiology. 21st ed. McGraw Hill Medical Publication Division. 2003.

Laurence DR. Clinical pharmacology. 8th ed. Churchill Livingstone Publishing Division. 1997.

Zawar S. Correlation between plasma cholinesterase levels and clinical severity of acute organophosphate and carbamate poisoning. JAPI. 2001;149:91.

Aygun D, Doganay Z, Altintop L, Guven H, Onar M, Deniz T et al. Serum acetylcholinesterase and prognosis of acute organophosphate poisoning. J Toxicol: Clin Toxicol. 2002;40(7):903-10.

Peter JV, Cherian AM. Organic insecticides. Anaesth Intensive Care. 2000;28:11-21.

Wadia RS, Sadagopan C, Amin RB, Sardesai HV. Neurological manifestations of organophosphorous insecticide poisoning. J Neurol Neurosurg Psychiatry. 1974;37:841-7.

Singh G, Khurana D. Neurology of acute organophosphate poisoning. Neurol India 2009;57:119‑25.

Singh S, Sharma N. Neurological syndromes following organophosphate poisoning. Neurol India. 2000;48:308-13.

Eddleston M, Mohamed F, Davies JO, Eyer P, Worek F, Sheriff MH et al. Respiratory failure in acute organophosphorus pesticide self‑poisoning. QJM. 2006;99:513‑22.

Noshad H, Ansarin K, Ardalan MR, Ghaffari AR, Safa J, Nezami N. Respiratory failure in organophosphate insecticide poisoning. Saudi Med J. 2007;28:405-7.

Anand S, Singh S, Nahar Saikia U, Bhalla A, Paul Sharma Y, Singh D. Cardiac abnormalities in acute organophosphate poisoning. Clin Toxicol (Phila). 2009;47:230-5.

Karki P, Ansari JA, Bhandary S, Koirala S. Cardiac and electrocardiographical manifestations of acute organophosphate poisoning. Singapore Med J. 2004;45:385‑9.

Saadeh AM, Farsakh NA, Al‑Ali MK. Cardiac manifestations of acute carbamate and organophosphate poisoning. Heart. 1997;77:461-4.

Eddleston M, Dawson A, Karalliedde L, Dissanayake W, Hittarage A, Azher S et al. Early management after self-poisoning with an organophosphorus or carbamate pesticide-A treatment protocol for junior doctors. Crit Care 2004;8:R391-7.

Eddleston M, Szinicz L, Eyer P, Buckley N. Oximes in acute organophosphorus pesticide poisoning: A systematic review of clinical trials. QJM. 2002;95:275-83.

Buckley NA, Eddleston M, Szinicz L. Oximes for acute organophosphate pesticide poisoning. Cochrane Database Syst Rev. 2005;CD005085.

Peden M, Oyegbite K, Joan Ozanne-Smith J, Hyder AA, Branche C, Fazlur Rahman AKM et al. editors, World report on child injury prevention. World Health Organization. 2008.

Singhal PK, Kumar H, Rastogi V, Saili A, Patwari AK, Mullick DN. Accidental poisoning. Indian Pediatr. 1988;25:350-3.

Niayaz AB, Ahmed K, Sethi AS. Poisoning in children. Indian Pediatr.1991;28:521-4.

Dutta AK, Seth A, Goyal PK, Agarwal V, Mittal SK, Sharma R et al. Poisoning in children, Indian scenario. Indian J Pediatr. 1998;65:365-70.

Kohli U, Kuttiat VS, Lodha R, Kabra SK. Profile of childhood poisoning at a tertiary care centre in North India. Indian J Pediatr. 2008;75:791-4.

Sharma J, Kaushal RK, Profile of poisoning in children. Pediatric Oncall. 2014. Available from: http://www.pediatriconcall.com/pediatricjournal/View/fulltextarticles/ 828/J/0/0/439/0. Accessed on 1 April 2020.

Mandal A, Pradip Kumar D, Ashok D. clinic-epidemiological profile of poisoning in children under 8 years of age, at rural medical college in west Bengal. New Indian J pediatr. 2016;5(2):71-5.

Manjunath V, Balaji Prasad Y, Jagadish Kumar K. Profile of acute childhood poisoning in South India. Sri Lanka J Child Health. 2018;47(4):321-5.

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Published

2020-12-23

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Original Research Articles