International Journal of Health Research and Medico Legal Practice

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Evaluation of Management of Organophosphorus Toxicity in Tripoli City Hospitals (Libya) and that in Minia University Hospital (Egypt)


Affiliations
1 Forensic Medicine and Toxicology, India
2 Forensic Medicine and Toxicology, University of Tripoli, Libya
3 Forensic Medicine and Clinical Toxicol Department, Minia University, Egypt
4 Biochemistry Department, University of Tripoli, Libya
5 General Courses Department, University of Tripoli, Libya
 

Anticholinesterase insecticides are used worldwide causing serious poisoning. This study was done to evaluate the management of organophosphorus poisoning in Tripoli, and in Minia. 49 cases were studied in Tripoli city hospitals. The study of Minia research was chosen to evaluate the effect and outcome of used fresh frozen plasma (FFP) and magnesium sulphate (MgSO4) in addition to the routine managements of poisoning by organophosphorus compounds (OP) which manifested in the form of gastric lavage, atropine and oximes and the routine methods of treatments of OP toxicity in Tripoli and 64 in Minia university hospital, divided into 4 groups 16 patients/group of both sexes. Group1: (control group); and other groups treated with atropine and oximes plus MgSO4 (Group II), FFP (Group III), FFP and MgSO4 (GroupIV). Groups III and IV recieved two plasma bags (300-400 ml/bag)/day. FFP doses were repeated according to BuChE levels (e" 2100 IU/L). There was significant decrease in total plasma bags dose needed in-group IV. There was significant decrease in hospital stay in groups II, III and IV. 2 patients developed intermediate syndrome in-group I, and one in-group II. Use of MgSO4 and FFP gave best result by reducing dose of atropine and oximes, mortality rate and days of hospitalization. 40.8% of Tripoli cases were treated by atropine in addition to the supportive treatment. This study concluded that use of atropine sulphate as antidote for treatment of OP in Tripoli hospitals is not enough, the use of oximes and FFP should be introduced if possible to decrease the fatality rate and the toxicity complications.

Keywords

Organophosphorus Insecticides, Anticholinestrase, Plasma, Magnesium Sulphate, Oximes, Atropine.
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  • Evaluation of Management of Organophosphorus Toxicity in Tripoli City Hospitals (Libya) and that in Minia University Hospital (Egypt)

Abstract Views: 148  |  PDF Views: 73

Authors

Khaled M. Gdarah
Forensic Medicine and Toxicology, India
Basheer A. Belkhair
Forensic Medicine and Toxicology, University of Tripoli, Libya
Osama A. Hassan
Forensic Medicine and Clinical Toxicol Department, Minia University, Egypt
Mahmoud S. Annajar
Biochemistry Department, University of Tripoli, Libya
Nouri M. Elmiladi
General Courses Department, University of Tripoli, Libya

Abstract


Anticholinesterase insecticides are used worldwide causing serious poisoning. This study was done to evaluate the management of organophosphorus poisoning in Tripoli, and in Minia. 49 cases were studied in Tripoli city hospitals. The study of Minia research was chosen to evaluate the effect and outcome of used fresh frozen plasma (FFP) and magnesium sulphate (MgSO4) in addition to the routine managements of poisoning by organophosphorus compounds (OP) which manifested in the form of gastric lavage, atropine and oximes and the routine methods of treatments of OP toxicity in Tripoli and 64 in Minia university hospital, divided into 4 groups 16 patients/group of both sexes. Group1: (control group); and other groups treated with atropine and oximes plus MgSO4 (Group II), FFP (Group III), FFP and MgSO4 (GroupIV). Groups III and IV recieved two plasma bags (300-400 ml/bag)/day. FFP doses were repeated according to BuChE levels (e" 2100 IU/L). There was significant decrease in total plasma bags dose needed in-group IV. There was significant decrease in hospital stay in groups II, III and IV. 2 patients developed intermediate syndrome in-group I, and one in-group II. Use of MgSO4 and FFP gave best result by reducing dose of atropine and oximes, mortality rate and days of hospitalization. 40.8% of Tripoli cases were treated by atropine in addition to the supportive treatment. This study concluded that use of atropine sulphate as antidote for treatment of OP in Tripoli hospitals is not enough, the use of oximes and FFP should be introduced if possible to decrease the fatality rate and the toxicity complications.

Keywords


Organophosphorus Insecticides, Anticholinestrase, Plasma, Magnesium Sulphate, Oximes, Atropine.