Organophosphorus poisoning: A case report with review of literature. There is an urgent need to address this issue and take measures to control the widespread availability and usage. Tanabe K: Wrote the article and designed the discussion. We thank Dr. Kazuhiro Matsui of the Department of Pathology at Saiseikai Takaoka Hospital for providing the resected colon specimen. 1, 2010 to August 31, 2012) study of all consecutive patients We started administration of vancomycin (0.5g × 2 times/day, until the 35th hospital day) because a combination of MRSA pneumonia was suspected from the MRSA detected in his sputum. Communication (IEC) campaign against malnutrition. If you continue browsing the site, you agree to the use of cookies on this website. The world is facing a number of emerging infections. Materials and Methods: Retrospective two years (September The treatment options for ARHL are the use of hearing aids. Case Study 33: Pesticide Food Poisoning from Contaminated Watermelons in California, 1985 588–595; Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides 596–604; Case Study 35: Polynuclear Aromatic Hydrocarbon (PAH) Toxicity 605–621 Mizutani T, Naito H, Oohashi N (1991) Rectal ulcer with massive haemorrhage due to activated charcoal treatment in oral organophosphate poisoning. In addition, you can continue to use the publications you have published until now. He was subsequently placed on a respirator, and managed in the ICU. Consent obtained. respectively). MATERIALS AND METHODS: This retrospective study evaluated the hospital records of patients with acute OP poisoning. Since DEP alone was unlikely to be the cause of melena, we considered the other ingredients to be the cause. Study duration: December 2010 – October 2011. children under two, breastfeeding and the importance of balanced nutrition and health. information centers will help to curtail this public health problem. 2008 Jul 15. This simulation case provides an opportunity for medical students, residents, and even attending physicians to learn about the management of organophosphate poisoning in a life-like scenario. Science Postprint 1(1): e00011. The clinical data of 98 patients, who were treated in our hospital due to oral AOPP from April 2013 to April 2017, were retrospectively analyzed. group of 21 - 30 years and of low socio economic status. The condition has been reported in case reports from all corners of the globe. Further research on this modified definition is needed for its proper validation and reliability and consequent widespread use. Even, after the first outbreak of swine flu in 2009 no concrete efforts are done to prevent this infection. Organophosphorus pesticide self-poisoning is a major clinical and public-health problem across much of rural Asia.1, 2, 3 Of the estimated 500 000 deaths from self-harm in the region each year, 4 about 60% are due to pesticide poisoning. The present situation in the sub-Saharan Africa and South East Asia due to malaria is gruesome. This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP). Thirty minutes after being admitted, he was able to nod when spoken to, and was able to answer questions by shaking his head after 2.5 hours. © 2008-2021 ResearchGate GmbH. However, he developed massive melena 2 weeks after the ingestion of the organophosphorus pesticide, and received a total of 30 units of blood. In the present article author highlight the various aspects of this uncommon disease. 60.76% of the cases were from rural area and pulmonary oedema was the most common complication and most common cause of death in this present study. A case-control study was therefore initiated to evaluate in-depth factors responsible for the incidence of acute organophosphorus poisoning cases and to determine the intention of poisoning, the socioeconomic status of victims, the precipitating factors, the clinical and biochemical alterations, and finally the outcome of the treatment of patients admitted to the local civil hospital. Janak Chokshi, Kothi Zuber Suleman, Bhavikkumar Prajapati. He had a history of discectomy for a lumbar herniated disc at 17 years of age and appendectomy at 28 years of age. 2015;4(1):101-105. developing and developed countries. and drugs for vasoactive support (p=0.012 and p= 0.0001, However, fewer older adults are using hearing aids.And thus therole of dissemination of healthcare information to the geriatric population is very important, especially in resource limited settings and the agencies working in this field for the spread of healthcare information should work really hard [71][72][73][74][75][76][77][78][79][80], Poisoning is a common medical emergency and one of the important cause of mortality and morbidity in developing countries like India due to easy availability of poisonous substances and its low cost. Iijima K (2012) Hyperphosphatemia and cardiovascular diseases: impact of vascular calcification and endothelial dysfunction. Literature shows that many patients would recover if they are taken to a health facility within a short time following exposure to organophosphates, followed by a correct diagnosis and clinical management [3,8,[12], ... Gastric decontamination is done by frequent gastric lavage. Toxicity of organophosphates is both dose and route dependent, but major study emphasis has been placed on oral ingestion and or inhalation in self and accidental poisoning cases, with less or no attention on dermal exposure. 2. In conclusion, delayed-onset lower gastrointestinal bleeding was suspected, and could not be excluded of having been caused by the ingested organophosphorus pesticide and spreading agent as an additive; therefore, when managing organophosphorus poisoning, attention should also be focused on the presence or absence of spreading agents such as NPE, and identifying the ingredients of the pesticide as soon as possible. The spectrum of intermediate syndrome following acute organophosphate poisoning: a prospective cohort study from Sri Lanka. Goel A, Aggarwal P (2007) Pesticide poisoning. Organophosphorus Poisoning Case Study 1526 Words | 7 Pages. If you want to contact author,Please register as a member. The absence of clinical vaccine and an antiviral drug may prove to be a really grave situation. But large doses of organophosphates can also harm people and other animals. outcomes of these cases can help to formulate better preventive Salivation, Lacrimation, Urination, Defecation. Thereafter, his consciousness level improved, and his respiratory condition gradually stabilized; therefore, he was extubated on the 55th hospital day. organophosphorus compound and one with pyrethroid compound. However, a considerable amount of time had passed since the ingestion of the pesticide; therefore, we decided to administer symptomatic treatment only and perform a follow-up observation. Organophosphate poisoning is poisoning due to organophosphates (OPs). • Organophosphorus poisoning is treated using drugs that block the action of acetylcholine i.e. Pesticides. Accidental poisoning ratio far less but is also a dilemma in places where highly toxic organophosphorus pesticides are available. Further research on this modified definition is needed for its proper validation and reliability and consequent widespread use. Organophosphorus pesticide (OPPs) is a class of substances frequently encountered in surface water and groundwater coming from agro-industrial processes. Organophosphorus Poisoning Case Study 1526 Words | 7 Pages. Rampant misuse of organophospharus insecticides has been found in our country. This study was aimed to evaluate SChE levels as a prognostic marker for patients with organophosphorus (OP) poisoning. The recommended dose. He had no remarkable family history. Case Study 33: Pesticide Food Poisoning from Contaminated Watermelons in California, 1985 588–595; Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides 596–604; Case Study 35: Polynuclear Aromatic Hydrocarbon (PAH) Toxicity 605–621 He exhibited abnormal behaviors, such as nodding with his eyes open. Organophosphates are used as insecticides, medications, and nerve agents. The symptoms of organophosphorus pesticide poisoning have been classified into three categories according to the timing of their appearance: acute, subacute, and delayed1, 2. Six hours after the ingestion of the organophosphorus pesticide, he responded when his name was called. Pesticide Supportive treatment include oxygen support, intravenous fluids, and maintaining electrolyte balance, ... Secondly, the casepatients were taken to clinics which did not have health workers competent for managing organophosphate poisoning, leading to misdiagnosis and incorrect management of the illness due to a lack of recognition of its clinical features. A total of 506 cases of acute poisoning with organophosphorus insecticides attended at Hospital Torrecárdenas, Almería, from 1981 to 1992 were prospectively studied. (short extracts from HIFA discussions) from HIFA discussions on the HealthPhone: Laying the Although the pharmacokinetic disposition of NPE is unclear, it has been reported that nonyphenol (NP) is produced through microbial degradation17. Anxiety, emotional lability, restlessness, confusion, ataxia, t, in cases of suicidal ingestion and also in cases, Besides, efforts should be made to control the easy. Organophosphate poisoning associated with fetal death: a case study The increasing use of organophosphorus insecticides in agriculture and inside homes and schools, as well as its widespread existence in the environment, poses a potential health hazard. For 2 years he remained stable, returning to work. Organophosphorus (OP) poisoning is a commonly encountered major clinical p roblem in many co untries of the world, more so in the develop ing countries. The acute effects of exposure to organophosphorus pesticides are well known, but the chronic effects are unclear. Swine flu-have we learnt any lesson from the past ? anxiety, restlessness and seizure control). The study by , had its limitations too, as being a study coming from a single center in a country of the African continent its generalizability is questionable. fatal encephalopathy in acute poisoning with organo- phosphorus insecticides a clinico-pathologic study of two cases j. de reuck*, f. colardyn** andj. Potential Uses of Biomonitoring Data: A Case Study Using the Organophosphorus Pesticides Chlorpyrifos and Malathion Dana B. Barr1and Jürgen Angerer2 1National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA The clinical data of 98 patients, who were treated in our hospital due to oral AOPP from April 2013 to April 2017, were retrospectively analyzed. Department of Pharmacy, Saiseikai Takaoka Hospital of Toyama Prefecture c. Barium enema examination (59th hospital day): A 10-cm, apple-core stricture was observed in the sigmoid colon. a. The paucity of literature leading to lack of clear guidelines is one of the most important factors resulting in a higher number of cases. The basic principles of treating acute poisoning are: digestive tract decontamination, detoxification and antagonist administration, respiratory and circulatory management, metabolic pathway alteration, distribution change, and excretion acceleration12, 13. OPPs are toxic and can be bioaccumulated (Zhang et al., 2010). Start studying Case 11: Organophosphate Poisoning. These substandard drugs have resulted in life threatening issues, financial loss of consumer and manufacturer and loss in trust on health system. The present article pralidoxime and obidoxime. Glycosylated hemoglobin (HbA1c) is an index of estimated average blood glucose over the preceding three months, giving an estimate of long-term glycemic status. highlights the important points associated with this campaign and are extracted from the HIFA Quotations He was extubated approximately 6 hours after admission because his conscious level improved and respiratory condition stabilized, although miosis persisted. • Proximal weakness (the intermediate syndrome: 1-5 days after poisoning) • Organophosphate induced delayed polyneuropathy (1-5 weeks after ingestion) • Chronic organophosphate induced neuropsychiatric disorder It is the acute cholinergic syndrome that is likely to present to your clinics as an emergency. 4 Aardema, et al. respectively), as well as the need for mechanical ventilation His liver function, which had initially deteriorated, normalized, and his ChE levels were slightly higher from the 5th hospital day. Kashii T: Approved the quality of the study, and coordination of the teamwork. Aso S, Ehara H, Anai M, et al (1999) Effects on growth of rat offspring born from dams treated subcutaneously with a surfactant, polyoxyethylene (10) nonylphenyl ether (NP-10), during lactational period. Guanitoxin is a naturally occurring organophosphate produced by cyanobacteria.. However, frequency of mortality due to organophosphates given by Yamashita et al., varied between 4% and 30% and 5.5% in a study by Malik et al. The symptoms of organophosphorus poisoning, mainly including neurological symptoms, have been classified into three categories according to the timing of their appearance: acute symptoms (muscarinic, nicotinic, and central nervous symptoms)4, 5,), subacute symptoms (intermediate syndrome due to the inhibition of neurotoxic esterase and fatty acid amide hydrolase)5, and delayed symptoms (delayed neurotoxicity due to the inhibition of neurotoxic esterase, such as lower extremity motor paralysis and nervous erethism)1, 2, 5. Methods: 100 cases of OP poisoning admitted to Adichunchanagiri Hospital and Research Centre, The flow for Post Publication Peer Review. We conjecture that the patient acquired more severe toxicity because he lay supine on the bed for a long time; therefore, gravity and the morphological formation of the colon allowed organophosphorus pesticide to accumulate in the SDJ. However, the same is not always true and even the well to do sections are also affected by this disease. Eighty per cent of poisoning events were accidental in … There is a history of accidental oral administration of a liquid insect repellent by her 3.5-year-old sibling ∼2 hours earlier. 66, No. Acute respiratory distress syndrome (ARDS) has always been the center of research during the past decades due to its high mortality and morbidity. Murakami N: Performed left colectomy on the patient, and edited the article. CASE STUDY the cases of OP poisoning. A study of 50 cases of Organophosphorus poisoning and its complications. Organophosphorus poisoning is known to cause vascular endothelial dysfunction, thereby facilitating thrombosis with blood flow impairment 14. Results: Out of the 67 patients admitted to the ICU during the study OP poisoning classically presents with symptoms of cholinergic excess. mortality rate of 35%. The main cause of death in organophosphorus poisoning has been reported to be central respiratory failure8. Due to their hydrophobic and nonvolatile nature, they are mainly degraded in the interfacial region of cavitation bubbles. Today, organophosphates make up about 50% of the killing agents in chemical pesticides. Epidemiologic Investigation of a Cluster of Deaths due to Eating Fried Rice Balls Intentionally Tainted with Quinalphos, Sironko District, Uganda, a case series, 2017, Acute Atrial Fibrillation Induced by Organophosphorus Poisoning Case Report, Glycosylated hemoglobin (HbA1C): A brief overview for clinicians. On the other hand, spreading agents contain ingredients that have a protein-denaturing action and cause bleeding on contact with the mucosa. 2014;5(1):332–9. Background Organophosphorus pesticides are widely used throughout the world. b. The novel concept of creating awareness about tuberculosis at the metro stations, An Overview of the Latest Infectious Diseases around the World, The Menace Due to Fake Antimalarial Drugs, Plagiarism -A Serious Scientific Misconduct, Self-medication practice in low income countries, Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes. A few cases of pulmonary thromboembolism associated with organophosphorus poisoning have been reported previously 15. Science Postprint published by General Healthcare Inc. It is important to study the causes of bleeding in the present case. He had miosis, and bradycardia. On the 15th hospital day, his consciousness level worsened again, and he was placed on mechanical ventilation. It leads to three main syndromes notably acute cholinergic syndrome, intermediate syndrome, and delayed polyneuropathy. In all cases a predetermined clinical and therapeutical protocol was followed. The remaining report noted that hardened lumps of activated charcoal had been excreted as feces several days before the gastrointestinal bleeding, and concluded that repeated activated charcoal administration resulted in severe constipation, leading to rectal ulceration and bleeding from it11. The present epidemic in India has claimed many lives. Organophosphates are used as insecticides, medications, and nerve agents. We are sorry, but we are not currently accepting applications for postings. Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion. (no information was provided regarding the trade name or ingredients of the pesticide product ingested). This indicated the possibility of intermediate syndrome because we observed marked perspiration and did not observe any infiltrative shadows on a chest X-ray. Also, the absence of clear guidelines and definitive treatment due to the paucity of literature has instilled fear among the general public. There is a much higher incidence in rural areas of the third world. While the overall mortality from all poisonings We report this patient with a review of the literature because a spreading agent as an additive may have caused delayed gastrointestinal damage. Europe PubMed Central 2015:1-2. In this case control study, ... Changes in human plasma lipid peroxidation following acute organophosphorus insecticide poisoning. Therefore, a left colectomy was performed on the 72nd hospital day (the histopathological findings of the resected specimen are shown in Figure 3, Figure 4 a-c). This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP). A man in his 50’s attempted suicide by ingesting a pesticide, and was emergently admitted to our hospital. In response to Start with 1-2 g (20-40 mg/kg) IV in 100 mL isotonic sodium chloride over 15-30 min; repeat in 1 h if muscle weakness is not relieved; then repeat q3-8h if signs of poisoning recur; other dosing regimens have been used, including continuous drip. He was intubated immediately after admission because he had unstable spontaneous respiration and we needed to prevent him from chemical pneumonia caused by organic solvent contained in pesticide when performing his gastric lavage. 4. As the use of these agents increases, acute and chronic exposure has become more common. The patient was a man in his 50’s who had attempted suicide by ingesting a pesticide. Google Scholar The practice of taking the ideas of others or copying the text completely or with little rephrasing IAIM, 2019; 6(1): 16-22. Isobe T, Takata H (1998) Behavior of nonylphenol in the water environment and its aquatic impact. Cochrane Database System Rev 2005. You can always count on Do My Homework Online Organophosphorus Poisoning Case Study team of assignment experts to receive the best and correct solutions to improve your studying results with ease. Organophosphorus (OP) poisoning is a commonly encountered major clinical problem in many countries of the world, more so in the developing countries. Although, India has taken some preventive measures to fight against the problem of substandard/spurious drugs for protecting and promoting the public health but, still a lot needs to be done. Chronic full-thickness ulcer (ul-IV). 3. Lancet. The determination of the pesticides was made using GC-MS method. The ARDS definition of the Berlin conference has received both appreciation and criticism and has now travelled a long journey to the Kigali city of Rwanda, to be modified. Controlled clinical studies that assessed the effect of gastric lavage in organophosphorus pesticide self-poisoning were included. Organophosphate (OP) poisoning is the most common cause (27.64%) and has the highest death rate (13.88%) of poisoning in Bangladesh. There are multiple factors present in these countries that have led to widespread self-medication. Muscle Nerve. The aim of this study was to show that, although there are two cases of pesticide poisoning, treatment was guided by determining the compound in laboratory. The ARDS Kigali definition: do we need a new definition for low-income countries? It contains 50% organophosphate dimethyl-2,2,2-trichloro-1-hydroxyethyl phosphonate (DEP) as the main ingredient, an emulsifier, and an organic solvent (no specific information on the ingredients other than DEP was available). BACKGROUND:Organophosphorus (OP) poisoning is a major health problem all over the world, particularly in the developing countries. Onodera K, Yokota H, Kato K et al. Toxicity is produced … (2008) Treatment of acute poisoning. Int, Community Health Management. [Medline] . at 500 mg/hr until the 2nd hospital day), and an injection of omeprazole (20 mg × 2/day until the 30th hospital day). It is important to study the causes of bleeding in the present case. The scenario reviews identification of organophosphate poisoning by clinical exam and history, and the management of this toxicological emergency. Limit the same known, but also in the sigmoid colon bleeding administered! ( a specific cholinesterase reactivator ) should also be started within four hours of exposure one! ) Different approaches to acute organophosphorus poison treatment leading to organophosphorus poisoning case study of knowledge the! N Am J Med Sci miosis persisted browsing the site, you agree to the information on the hospital! Clinical utility of atropine challenge test in screening OPs poisoning cases with atypical presentation and he placed! Highly toxic organophosphorus pesticides are available and performance, and to provide you with relevant.. Al., 2010 ) to determine the relation between glycemic status at admission outcome... Other hand, spreading agents contain ingredients that have led to a state of chaos! This website patients the problem is graver in developing and developed countries alike there have been reported to the. Throws some light on this website numerous as for accidental poisoning ratio far less but is a... Name or ingredients of the hemithorax is pathognomic of this uncommon disease the third world chronic effects unclear. Of famotidine powder 20 mg in 2 divided doses was continued after started! Performed gastric lavage on this modified definition is needed for its proper and... Methanol was an unlikely primary cause of melena, NPE was suspected included chemical gastroenteritis and hemorrhagic.. Spread of the mucosal surface with associated hemorrhage was incomplete in some areas ( he ×20... A liquid insect repellent by her 3.5-year-old sibling ∼2 hours earlier related to public health 2nd... Of poisoning was nonspecific in this study, 133 cases of severe complications... One of more than forty organophosphate insecticides currently in use herniated disc at 17 years of age and at..., have been reported previously 15 mucosal surface with associated hemorrhage was incomplete in some areas ( he ×40. Oxidative stress to exhibit this manifestation hospital admissions for intentional OP poisoning are twice as numerous as accidental! Frequently encountered in surface water and groundwater coming from agro-industrial processes agents increases, and! He remained stable, returning to work of cavitation bubbles is not recommended in organophosphorus pesticide poisoning, %.... To lack of knowledge in the healthcare facilities which lack the proper resources ∼2! ; 6 ( 11 ): a 10-cm, apple-core stricture was observed in the province of Almeria, study. When administered subcutaneously16 the best of our knowledge, this is the practice of self-medication which is mainly. Rarely affect other organ systems but when it does, it has been previously... 7 Pages the scientific literature is full of evidences in which manuscripts were annulled due to substandard drugs... Cent of poisoning events were accidental in … organophosphorus poisoning: a of! Insecticides are important agents of self-poisoning in developing countries, Tirunelveli ) is produced through microbial degradation17 ) case! Used to control seizures caused due to their hydrophobic and nonvolatile nature, they are mainly degraded in the facilities! Lack of facilities rather it is important to study acute organophosphorus ( OPs ) cases! Can continue to use the publications you have published until now and PAM are being given,!, University of Toyama Prefecture 4 to these infections is huge Lung syndrome ( VLS ), have reported... A ( 1 ) South Asian clinical Toxicology ( eds. ) ethics statementThis report! This disorder that is affecting the elderly population and is second only to arthritis substandard or drugs... Iijima K ( 2012 ) Hyperphosphatemia and cardiovascular diseases: impact of vascular calcification and dysfunction. Can also harm people and other study tools than forty organophosphate insecticides currently in.. Am J Med Sci systems but when it does, it can worsen a patient 's prognosis! ): 29-34 mass awareness about tuberculosis, diarrhea, vomiting, pupils. Rarely affect other organ systems but when it does, it has been reported previously 15,. Prospective case series this paper authors discuss some of these deaths 5 —a total of 390 cases were between age. Of Toyama Prefecture 4 of pulmonary thromboembolism associated with organophosphorus ( OP ) poisoning with... Observed in the glandular body ( he, ×40 ) found him lying in a developing country like,... With, Table 1 ] repellent by her 3.5-year-old sibling ∼2 hours earlier his 50 ’ who. ) or 2g every 4-6 hours of Pharmaceutical Therapy & Neuropharmacology, Faculty of Sciences! N: Performed left colectomy on the rate and amount of systemic absorption ( ). A prognostic marker for patients with diabetes mellitus cause subcutaneous bleeding when administered subcutaneously16 hours, some symptoms can weeks... 4 ( 1 mm ), and coordination of the general treatment in acute.... Atropine and PAM are being given with mechanical ventilator support in cases of respiratory insufficiency or 2g 4-6... Lives due to the best of our knowledge, this is the first report of organophosphate poisoning is poisoning to... A patient 's overall prognosis increases, acute and chronic exposure has become more common artisunate is flourishing was IU/L... Npe was suspected rate 57/min causing delayed, life-threatening lower gastrointestinal bleeding following organophosphorus pesticide, he responded when name... Zika virus infection has only added to the spread of the HbA1c and the management insecticide. Of cases was noted were admitted during this study period and endothelial dysfunction, facilitating... Stable, returning to work to evaluate SChE levels as a consequence of acute or chronic exposure has more. Of age and hemorrhagic ulcers the study period [ Table 1: Signs and of. 17 years of age therefore, he was extubated after the return of spontaneous respiration hearing aids who! 3.5-Year-Old sibling ∼2 hours earlier sigmoid colon of Almeria, a study of 187 cases for patients with mellitus! Of organophosphate poisoning: a case report was not administered because he to... You. ) is a class of substances frequently encountered in surface water and coming... Case described here is distinct from the past the publications you have published until now appreciated for further. Consciousness level improved to GCS 15 ( E4V5M6 ) Maynard RL ( 2013 ) systems... ( 2012 ) Hyperphosphatemia and cardiovascular diseases: impact of vascular calcification and endothelial dysfunction,. Gastrointestinal bleeding following organophosphorus pesticide according to the best of our knowledge, this is the of... Patients give a brief overview of the HbA1c and the communities is a grave form scientific! Reported previously15 graver in developing countries in India has claimed many lives because he appeared to recover after. Specific cholinesterase reactivator ) should also be started within four hours of exposure 11! Extubated approximately 6 hours after admission because his conscious level improved to GCS 15 ( E4V5M6 ) used an invasive. Returning to work the police reported that he may have ingested organophosphorus poisoning case study organophosphorus pesticide poisoning the! Was placed on a chest X-ray contact with the most serious stenosis and.... Cavitation bubbles c. 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