A Study of Clinical Features, Management and Outcome of Organophosphate and Carbamate Poisoning in Children

Authors

  • Deepak Prasad Koirala Manipal College of Medical Sciences, Pokhara
  • Kalipatnam Seshagiri Rao Manipal College of Medical Sciences, Pokhara
  • Kalpana K Malla Manipal College of Medical Sciences, Pokhara
  • Tejesh Malla Manipal College of Medical Sciences, Pokhara

DOI:

https://doi.org/10.3126/jnps.v33i2.7799

Keywords:

Acetylcholinesterase, Atropine, Carbamates, Organophosphates, Poisoning, Pralidoxime

Abstract

Introduction: Organophosphates (OP) are commonly used pesticides in rural agricultural regions of Nepal and carbamates are popular household insecticides. Because of poor legislation these poisons are easily accessible and are the most popular suicidal poisons.

Materials and Methods: This was a retrospective study done in poisoning cases admitted in PICU of Manipal Teaching Hospital (MTH) over a seven year period.

Results: Out of 187 cases of poisoning, 30 (16.04%) were OPs and 4 (2.13%) were Carbamates. The male to female ratio was 56:44 and these poisonings were more common in rural areas (56%). Accidental poisoning (82.4%) was more common but suicidal attempts (17.6%) were also observed. Atropine and pralidoxime were used in 82.4% of the cases. The total atropinizing dose was 0.77±0.6 mg/kg and patients required 56.6±23.7 hours of atropinization. In our study 94.1% of the patients survived and none of them developed any sequel. Children developed muscarinic, nicotinic and CNS symptoms similar to adults. Complications were seen in 41.1% of the children and most common being seizure (85.7%). The most common OP observed in childhood poisoning was Metacid (methyl parathion) seen in 26.4% of the cases.

Conclusion: OP and Carbamate poisonings are common in children. Possibility of self-harm poisoning in adolescent females cannot be ignored. Atropine is the mainstay of therapy after initial resuscitation and complications are common in children. With prompt treatment the outcome is good even with complications. The case fatality rate is much less as compared to adults.

DOI: http://dx.doi.org/10.3126/jnps.v33i2.7799

J Nepal Paediatr Soc. 2013; 33(2):85-90

Downloads

Download data is not yet available.
Abstract
2003
PDF
1177

Author Biographies

Deepak Prasad Koirala, Manipal College of Medical Sciences, Pokhara

Lecturer, Department of Paediatrics,

Kalipatnam Seshagiri Rao, Manipal College of Medical Sciences, Pokhara

Professor and Head of Department, Pediatrics

Kalpana K Malla, Manipal College of Medical Sciences, Pokhara

Associate Professor, Pediatrics

Tejesh Malla, Manipal College of Medical Sciences, Pokhara

Associate Professor, Pediatrics

Downloads

Additional Files

Published

2013-10-07

How to Cite

Koirala, D. P., Rao, K. S., Malla, K. K., & Malla, T. (2013). A Study of Clinical Features, Management and Outcome of Organophosphate and Carbamate Poisoning in Children. Journal of Nepal Paediatric Society, 33(2), 85–90. https://doi.org/10.3126/jnps.v33i2.7799

Issue

Vol. 33 No. 2 (2013)

Section

Original Articles

License

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).