Paper Title
Study of Correlation Between Plasma Cholinesterase Levels and The Clinical Outcome in Patients of Organophosphorous Poisoning

Abstract
Background - Organophosphorus compound poisoning is one of the most commonly encountered poisonings in India. Various factors like type of compound used, general health of the patient, delay in discovery and transport, amount ingested, delay in intubation and failure in weaning off ventilatory support, insufficient respiratory management decide the rate of mortality. This study was done with an aim to assess the clinical profile of organophosphorus poisoning with a special reference to plasma cholinesterase levels. Methods - In our study a total of 50 consecutive cases with alleged history of Organophosphorus poisoning above the age of 18 were included after fulfilling the eligibility criteria and after giving informed consent. Results - Mean age of the study cases was 33.85 years with 78% cases were 40 years or below i.e. young adults. Male predominance was seen in the cases of OP poisoning with 56% males to 44% females. Most common presenting symptom was vomiting (80%), muscle weakness (28%) and convulsions (24%). Respiratory distress was seen in 22% cases. Most common compound identified was Chlorpyrifos (38%) followed by tribufos (28%), diazinon and malathion (16%) each. On examination, most common finding was miosis (38%). Fever, tachyapnea and tachycardia was observed in 36%, 24% and 26% cases respectively. Anemia was seen in 40% study subjects while raised creatinine was observed in 18% cases. As per Proudfoot classification for severity of OP poisoning, 62% cases were mild, 12% were moderate and 26% cases were of severe poisoning. Associated complications among OP poisoning cases were Acute kidney injury (8%), sepsis, cardiomyopathy and heart failure (4% each). Mortality rate in present study was 8%. Mean plasma cholinesterase levels were significantly lower among cases with severe poisoning as compared to cases with mild and moderate poisoning (p<0.01). Conclusion - The present study revealed significant correlation between severity of poisoning and plasma cholinesterase levels with morbidity and mortality among organophosphorus poisoning cases. Plasma cholinesterase levels on admission can provide useful information but it must be interpreted carefully along with severity predicting scales like Proudfoot and POP scales Keywords - Organophosphorus Poisoning, Plasma Cholinesterase Levels, Mortality