Clinical Profile of Acute Organophosphorus Poisoning with Special Reference to Its Metabolic Complications

Author(s): Abdul Barik Ahmed1 , Hussain Ahmed2 , Sangitanjan Dutta3

BACKGROUND Organophosphorus poisoning accounts for significant morbidity and mortality worldwide, especially in developing countries. METHODS This prospective observational study was done on 50 cases of acute organophosphorus poisoning admitted in Gauhati Medical College and Hospital, Guwahati, for a period of one year, from August 2015 to July 2016. A detailed history was obtained, and thorough clinical examination and laboratory tests were done in each case. RESULTS In our study, most OP compound poisoning cases were observed in 2nd and 3rd decades of life (96%) with a male preponderance (male to female ratio is 3:2). 46 (92%) cases had ingested poison in an attempt to commit suicide. Common clinical manifestations were pupillary constriction (82%), nausea & vomiting (82%), abdominal pain (48%), bradycardia (44%), salivation (44%), breathlessness (32%), headache (30%), and fasciculation (22%). 15 cases had blood sugar more than 140 mg% (6 cases had blood sugar ≥200 mg%) while 4 had less than 60 mg% at admission. 7 cases showed a rise of ALT, 15 cases showed hypokalaemia, 5 cases showed a rise of lipase and 12 cases showed a rise of urea. CONCLUSIONS In our study, majority of cases belonged to the younger age group. The common symptoms seen were nausea, vomiting, miosis, abdominal pain, bradycardia, salivation, breathlessness, headache, tachypnoea and fasciculation. Common metabolic complications are hyperglycaemia, hypokalaemia, elevated serum urea and aminotransferases.