Polok Das, Prithwiraj Bhattacharjee, Bhaskar Kanti Nath, Manish Jain, Dwijen Das
BACKGROUND Organophosphorus (OP) pesticides are arguably one of the most common cause of morbidity and mortality due to poisoning worldwide especially in developing countries like India, where agriculture is the backbone of the economy. Organophosphorus pesticides poisoning can result from intentional, occupational or accidental exposure. The primary toxicity from these compounds is derived from excessive stimulation of muscarinic and nicotinic cholinergic receptors by accumulated acetylcholine in central and autonomic nervous systems as well as in skeletal neuromuscular junction. Patients with acute Organophosphorus poisoning are usually monitored by using serum acetylcholinesterase level which are expected to fall. It is not specific and does not correlate with the severity of poisoning and cannot be used as a prognostic indicator. Estimation of Creatine Phosphokinase is economical, and levels are increased both in acute as well as in intermediate syndrome and can be used as a low budget, easily available prognostic marker for acute organophosphorus poisoning. The aim and objective of the study is to assess serum Creatine Phosphokinase (CPK) level in acute organophosphorus poisoning and to find out the correlation of serum Creatine Phosphokinase (CPK) level with the severity of organophosphorus poisoning. MATERIALS AND METHODS A hospital based prospective observational study was conducted on 100 patients admitted at department of medicine, Silchar Medical College & Hospital, Assam over a period of 1 year, after applying inclusion and exclusion criteria. Detailed history and clinical examination was done on each patient. Serum CPK level was measured at admission and correlation was studied with various outcome. RESULTS The study has shown statistically significant positive correlation between initial CPK level and severity of OP poisoning (as per POP scale) on the day of admission and atropine requirement on day 1. The cases who had higher initial CPK levels had poor outcome. CONCLUSION It can be inferred from this study that serum CPK level can be used as an alternative biomarker in stratifying severity of acute OP poisoning, as it is cheap, easily available.
