Original Research Article
Year: 2018 | Month: September | Volume: 8 | Issue: 9 | Pages: 20-26
Study of Hyperglycemia and Its Association with Pseudocholinesterase Levels and Severity of Organophosphorus Poisoning
Dr. Ravi BN1; Dr. Manmohan U S2; Dr. Phaneesh Bharadwaj B S3; Dr. Pujitha S N4
1Associate Professor, Department of General Medicine, A.I.M.S., Karnataka
2Postgraduate Resident, Department of General Medicine, A.I.M.S., Karnataka
3Senior Resident, Department of General Medicine, SDUMC., Karnataka.
4Postgraduate Resident, Department of General Medicine, SDUMC., Karnataka
Corresponding Author: Dr. Manmohan U S
ABSTRACT
Background: Random blood sugar (RBS) level is an important factor influencing the severity of organophosphorus (OP) compound poisoning. Here we studied RBS as a prognostic and mortality indicator in OP compound poisoning and its association with serum pseudocholinesterase levels.
Objectives
- To study the clinical profile in patients who had consumed organophosphorus poison.
- To determine the relation between glycemic status at admission and outcome in organophosphorus poisoning.
Methods: 100 cases of OP poisoning admitted to Adichunchanagiri Hospital and Research Centre, B.G.Nagar, Mandya, between Nov 2015- May 2017 were studied. Detailed history and clinical examination was done. RBS and pseudocholinesterase levels at admission were measured.
Results: 100 cases of OP poisoning admitted to SAH&RC were considered. Most patients were in the age group of 18-25 years. Males were more common (65%). Suicide was the most common motive (90%) and ingestion was the most common mode of poisoning (90%). Farmers were the main group involved in poisoning (55%). Dimethoate was the most common compound. Hyperglycemia was observed in 36% of patients with 80.6% developing complications and 72% requiring ventilator. Pseudocholinesterase was less than 4000U/L in 23% of patients and 91% of these patients required ventilator support. Overall mortality was 20%. Mortality was 33% in patients with hyperglycemia (p<0.009) and 70% in patients with pseudocholinesterase <4000U/L (p<0.0001). RBS negatively correlated with pseudocholinesterase levels. RBS>200mg/dl was associated with a mean pseudocholinesterase level 4355.36 (SD of 1520.86, p<0.001). These observations suggest that admission hyperglycemia is a useful indicator of OP compound poisoning severity and its comparable to pseudocholinesterase levels.
Conclusion: Admission RBS >200mg/dl and pseudocholinesterase <4000U/L are reliable parameters to predict mortality and ventilator requirement in OP compound poisoning. A low pseudocholinesterase level and increase in blood sugar levels were associated for ventilator requirements, mortality and complications was found to be statistically significant according to chi square test.
Key words: Organophosphorous; Hyperglycemia; Pseudocholinesterase; Dimethoate; RBS.