SIGNIFICANCE OF SERUM AMYLASE AND SERUM LIPASE LEVELS IN ACUTE ORGANOPHOSPEROUS POISONING.

Background: Organophosphorous compounds are principally used as pesticides, and their exposure is highly prevalent in developing countries. Toxic effects of OPs are associated with significant morbidity and mortality and are a major global clinical problem. Case reports on acute pancreatitis following acute OP compound ingestion has been reported worldwide now and then, but regular studies with reference to Pancreatitis is not very much available in a serial manner. Hence an attempt was made to study pancreatic involvement through biochemical means. Aims and objectives: To estimate serum Amylase and Lipase levels in acute organophosphorous compound poisoning, And To find out the relationship between prognosis and Hyperamylasemia and Hyperlipasemia Methods: A total of 41 patients treated in Mahatma Gandhi Medical college hospital with organophosphorous poisoning were taken up for the study, their serum Amylase and serum Lipase levels were checked during the time of admission and during discharge with correspondence to presence of pancreatitis in patients were analysed and were treated accordingly. Results: All the patients on our study consumed poison in a suicidal intension, the incidence were higher with the age group between 41-50 years,Female predominance was found (61%). The most common reason for consumption in our study was found to be the familial stress (68.3%) followed by financial stress (24.4%). Mostly the substance in our study was mixed with water (46.3%), followed by alcohol (29.3%). Monocrotophos accounted for about (34.4%) followed by chlorpyriphos (26.8%) and methylparathion (19.5%). Mean blood sugar - 223+128.43, mean urea - 44.98+33.58, Mean serum creatinine-1.40+33.582, Mean AST - 66.98+56.723, Mean ALT - 65.02+62.705, Mean serum sodium 138.61+15.899, Mean serum potassium 3.72+0.864.The outcome was 12.2% death and 87.8% survival.85.3% had normal serum amylase level; 14.6% had elevated serum amylase level which is very significant,9.8% had significant elevation in lipase levels and was proved to have pancreatitis. 9.8% developed pancreatitis, out of which 50% survived and 50% died. In 22% of the total patient studied there were respiratory failure during time of presentation. Conclusion: Serum amylase and serum lipase levels may be considered as a marker of Organophosphorous poisoning, it enables the early recognition of severity and to identify those at risk of developing the complications. Our study shows correlation between elevated Amylase, Lipase level with respiratory failure and pancreatitis, convulsions, CNS depression, fasciculations, respiratory failure.