Title: Serum Amylase Levels in Acute Organophosphorus Poisoning and It’s Correlation with Clinical Severity

Authors: Dr Kamleshwar Mahto, Dr Rajesh Manocha, Dr Charanjeet Kaur

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.118

Abstract

Introduction

Organophosphorus (OP) compounds have been widely used for a few decades in agriculture for crop protection and pest control. India is a predominantly agrarian country with about 60-80% rural population. Pesticides are routinely used for advanced farming. Therefore, a pesticide is an easy access source for suicidal purpose particularly after trivial family squabbles. Poisoning is seldom included as a priority for health research in India, though every year, hundreds of people are losing their lives prematurely from pesticide poisoning. Vomiting soon after consumption of pesticide and with its smell easily detected even by a lay person poses no diagnostic difficulty. Thereby, quite often, the victim is brought to a health center within an hour of consumption of the pesticide – usually Organo-Phosphorus Compounds (OHPs). This is the “Golden Hour” for clinical intervention, before irreversible “ageing” of toxic compounds in blood occurs. Primary Health Centers in India are known for lack of drugs, doctors and application of evidence-based treatment.

References

  1. Worek F, Mast U, Kiderlen D, Diepold C, Eyer P. Improved determination of acetylcholinesterase activity in human whole blood. Clinca Chimca Acta1999;288:73-90.
  2. Reiner E, Buntic A, Trdak M, Simeon V. Effect of temperature on the activity of human blood cholinesterases. Arch Toxicol 1974;32:347-350.
  3. Sumiya MN, Tanaka M, Iwai M, Konda T, Takahashi S, Sato S et al. Elevated serum amylase is related todevelopment of respiratory failure in organophosphate poisoning. Hum Exp Toxicol 1996;15:250-253.
  4. Bhardwaj SSU, Verma SK, Bhalla A, Gill K. Hyperamylasemia and acute pancreatitis following anticholinesterase poisoning. Hum Exp Toxicol 2007;26:467-471.
  5. Lee WC, Yang CC,Deng JF, Wu ML,Ger J, Lin HC. The Clinical Significance of Hyperamylasemia in Organophosphate Poisoning. J Toxicol Clin Toxicol 1998;36:673-681.
  6. Brent J., Wallace K., Burkhart K,Phillips SD,Donovan J. Organophosphorus and carbamate insecticides, Methanol poisoning. Critical care Toxicology. Diagnosis and management of the critically poisoned patient. Philadelphia: Elsevier Mosby;2005:937-947.
  7. Ahmed A , Begum I, Aquil N, Atif S, Hussain T, Vohra EA . Hyperamylasemia and acute pancreatitis following organophosphate poisoning. Pak J Med Sci 2009;25:957-961.
  8. Lin CL, Yang CT, Pan KY, Huang CC. Most common intoxication in nephrology ward organophosphate poisoning. Ren Fail 2004;26:349‑354.
  9. Rohit NS, Amar SW. Study of serum amylase levels in organophosphate poisoning. IJBAR 2017;8:450-454.

Corresponding Author

Dr Kamleshwar Mahto
Post Graduate Student

Guru Gobind Singh Indastha University, New Delhi