Patterns oF organoPHosPHorous Poisoning attenDing a teacHing HosPital

Abstract

The objective of this was to study the pattern of patients of organophosphorous (OP) poisoning
attending Kathmandu Medical College Teaching Hospital (KMCTH). This is a retrospective study
of OP poisoning from hospital records were analyzed meticulously and data extracted. Data col-lected were: patient’s demographics, motive for poisoning, type of OP poison, arrival time, time
since ingestion, patient’s vitals, predisposing factors, serum cholinesterase levels, treatment given,
duration of hospital stay and mortality. A total of 47 patients of OP poisoning attended KMCTH
from Aug 2003 to July 2005. 22(46.8%) cases were male and 25(53.2%) were female. The maximum
number of patients were between the age of 20-40 (33-70.2%). Married patients outnumbered the
unmarried (35/74.5% vs 12/25.5%). The most common motive for poisoning was suicidal, 41 cases
(87.2%). Metacid (methyl-parathion) was the most commonly used OP compounds in 32 (68%)
patients. Interpersonal marital relationship seemed to be the commonest predisposing factor, 23
cases (48.9%).The commonest time of presentation was between 6 pm-12 midnight. 7(57.4%) cases
presented within 2 hours of ingestion of the poison. Serum cholinesterase level measured after full
atropinisation was >50% of normal level in 17 cases (36.2%). 10 cases (21.3%) required respiratory
support. Intermediate syndrome (IMS) was observed in 3 cases. Overall mortality occurred in 3
cases (6.4%). This study highlights the problem of OP poisoning in our region. Establishment of
strict policies against the sale and availability of insecticides and pesticides which are freely avail-able in the market is an effective way to control OP poisoning.

Key Words: Organophosphate poisoning (OPP), OP compounds, insecticides, pesticides.