الفهرس 
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Abstract
Organophosphate insecticide poisoning represents an important cause of poisoning in developing countries. Early diagnosis and management is considered lifesaving and helps to reduce associated morbidity and mortality.
A prospective study of 50 acutely intoxicated adult patients of both sexes with a history of organophosphate compounds ingestion were admitted to the Minia Poison Control Center (MPCC) throughout the period from November, 1st, 2019 to October, 31th, 2020. Criteria for enrolling patients in our study included adults with age group (18-50) years, both sexes, and diagnosed as acute OPh poisoning.
All selected cases have undergone the following:
• Detailed history: Patients or their corresponding relatives were questioned about age, sex, residence, and type of organophosphate compound.
• Clinical examination: full clinical examination of the patients was done to confirm toxicity. The Glasgow coma scale (GCS) was used to assess the mental consciousness of the patients.
• Laboratory investigations: On admission, a blood sample was withdrawn from all patients before performing any intervention or giving any medications for the following biochemical investigations:
- Serum pseudocholinesterase level (PChE).
- Serum amylase level.
• Electrocardiography (ECG): On admission, an electrocardiography for all patients and results were then assessed and any significant data in Q-T interval duration were estimated and recorded.
• Outcome of the patients: Need for mechanical ventilation, any complications occurred, and duration of hospital stay were recorded.
Demographic variables:
The age ranged from 18-50 years. 64% of patients were males and 36% were females with male to female ratio of 1.7:1. The data in this study revealed that 60% of patients came from rural areas while 30% from urban areas.
Clinical picture:
The predominance of muscarinic symptoms and signs was reported in patients as following; nausea (100%), vomiting (100%), pinpoint pupils (PPP) (100%), abdominal pain (88%), and respiratory symptoms (70%).
Laboratory investigations:
On admission, there was a reduction in serum pseudocholinesterase (PChE) level less than normal values and significant increase in serum amylase level above the normal level on admission.
Electrocardiography:
Q-T was prolonged in 70% of patients and was normal in 30% of patients.
Outcome of the patients:
The total percentage of recovered patients was 64% while of the dead patients was 36%. The current study showed that patient’s age was a predictor of bad prognosis in poisoned patients as each one year increase in age was associated with an increase in the incidence of the bad outcome by13%.
The current study showed that the incidence of occurrence of muscarinic, nicotinic, and central manifestations increase in patients with a bad prognosis group of patients.
Analysis of data concerning serum PChE and amylase levels revealed a significant correlation between changes in their levels and the bad prognosis of OPh poisoning patients.
Comparing elevated serum amylase level to DROP in serum PChE and age as predictors of outcome in acute OPh poisoning yielded a significant statistical difference in favor of serum amylase level changes.
The current study showed that each unit increase in serum amylase increased the need for mechanical ventilation and each unit decrease in PChE level increased the need for mechanical ventilation. However, elevated serum amylase level was found to be significantly better than PChE level in predicting the need for mechanical ventilation. Prolonged Q-T interval had no role in the prediction of the need for mechanical ventilation in patients with acute OPh insecticide poisoning.