6. /

Brief resume of the intended

6.1Need for the study
Organophosphate(OP) compounds are a diverse group of chemicals used in both domestic
and industrial settings.So organophosphate compounds are very commonly used for
intentional poisoning and also inhalational poisoning is common in agricultural and
industrial settings. Organophosphate pasticides irreversibly inhibit enzyme
acetylecholinesterase and it has very high mortality if not diagnosed and treated early. The
objective of this study to know the association of serum levels of liver enzymes, LDH and
CK with OP poisoning.

6.2Review of literature

1. S.B.Agarwal, V.K.Bhatnagar, Amol Agarwal, Usha Agarwal, K.Venkaiah, S.K.Nigam,
S.K.Kashyap et al1 stated stated serum LDH activity was significantly elevated (p≤0.01) in
poisoning cases indicating muscular functional impairment due to OP toxicity and the
CK activity was significantly increased in poisoning cases (p≤0.01) and comparatively
marked elevation was observed among the expired patients.
2. Murat Sungur, Muhammed Guven et al2 stated thatabnormal laboratory values were
elevated liver enzymes, elevated lactate dehyrogenase seen in organophosohate poisoning.
3. Vanneste Y, Lison D et al3 stated that rhabdomyonecrosis lesion occurred in the diaphragm
after 24 hours and were accompanied by a concurrent increase in urinary creatine excretion
rate (300% of the control) and serum total creatine kinase activity (280% of the control).
4. Kamal AA, Elgarhy MT, Maklady F, Mostafa MA, Massoud A et al4 stated that O.P. sprayers
showed significantly higher SGPT and serum Alkaline Phosphatase and lower Cholinesterase
and serum proteins than the controls. Among sprayers, duration of exposure to O.P. was
significantly correlated with their levels of Cholinesterase, SGPT, and serum Alkaline
Phosphatase.
5. John M, Oommen A, Zachariah et al5 stated that temporal profiles of blood muscle
isoenzymes showed significantaly greater muscle injury in those patients with greater
sevearity of poisoning at admission, those who developed intermediate syndrome and in
patients with longer duration intermediate syndrome.
6. Yusuf Yurumez, Polat Durukan, Yucel Yavuz, Ibrahim Ikizceli, Levent Avsarogullari, Seda
Ozkan, Okhan Akdur, Cagllar Ozdemir et al6 stated that increase in serum liver enzymes,
lactate dehydrogenase in organophosphorus compound poisoning.

6.3Objectives of the study

To knowchanges in serum levels of liver enzymes, LDH and CK in organophosphate
poisoning and its prognosis.
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MATERIAL AND METHODS

7.1Source of Data:

Patients admitted with history of organophosphate poisoning in Basaveshwar
Teaching and GeneralHospital, attached to Mahadevappa Rampure Medical college,
Gulbarga.

7.2Methods of collection of data (including sampling procedure, if any)

By using simple random method, 50 cases of organophosphate poisoning admitted over a
period of 2 – years in BasaveshwarTeaching & GeneralHospital, Gulbarga.
Inclusion criteria:
All adult patients with history of consumption of organophosphorus compounds of either
sex, admitted to hospital within 12 hours of ingestion and not having been treated outside.
Exclusion criteria
All patients with poisoning due to compounds other than organophosphorus compounds are
excluded. Those patients with history of prior consumption of organophosphorus
compounds and received treatment are also excluded.

7.3Does the study require any investigation or intervention to be conducted on patients or other humans or animals? If so please describe briefly.

Yes, the study requires investigations like serum levels of liver enzymes, LDH, CK and cholinesterase.

7.4Has ethical clearance been obtained from your institution in case of 7.3?

YES. Ethical clearance has been obtained from “Ethical Clearance Committee” of the institution for the study.
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LIST OF REFERENCES

1. S.B.Agarwal, V.K.Bhatnagar, Amol Agarwal, Usha Agarwal, K.Venkaiah, S.K.Nigam,
S.K.Kashyap et al1. Impairment in clinical indices in acute organophosphate insecticide
poisoning patients in India. The Internet Journal of Toxicology.2007.Volume 4
Number1.
  1. Murat Sungur, Muhammed Guven et al2. Intensive care management of organophosphate
insecticide poisoning. Crit Care 2001 ;5(4) 211-215.
  1. Vanneste Y, Lison D et al3. Biochemical changes associated with muscle fiber necrosis
after experimental organophosphate poisoning. Hum Exp Toxicol. 1993 Sep; 12(5): 365-
70
4. Kamal AA, Elgarhy MT, Maklady F, Mostafa MA, Massoud A et al4. Serum
cholinesterase and liver function among a group of organophosphorus pesticides sprayers
in Egypt. J Toxicol Clin Exp.1990 Nov-Dec;10(7-8):427-35.
5. John M, Oommen A, Zachariah et al5. Muscle injury in organophosphorus poisoning and
its role in the development of intermediate syndrome. Neurotoxicology. 2003
Jan;24(1):43-53.
  1. Yusuf Yurumez, Polat Durukan, Yucel Yavuz, Ibrahim Ikizceli, Levent Avsarogullari,
Seda Ozkan, Okhan Akdur, Cagllar Ozdemir et al6.Acute Organophosphate Poisoning in
UniversityHospital Emergency Room Patients. DOI: 10.2169/internalmedicine. Oct 11,
2006. 46.6304.
7. Bagchi D, Bagchi M, Hassoun EA, Stohs SJ. et al7. In vitro and in vivo generation of
reactive oxygen species, DNA damage and lactate dehydrogenase leakage by selected
pesticides. Toxicology. 1995 Dec 15;104(1-3):129-40.

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