STUDY OF LEVELS OF SERUM CREATINE PHOSPHOKINASE AND LIVER ENZYMES AS A PROGNOSTIC INDICATORS IN ACUTE ORGANOPHOSPHORUS POISONING

Background: Organophosphorus (OP) poisoning is one of the most common poisoning in rural and in developing country. Due to their easy availability and cost effective it is used frequently for homicidal and suicidal attempts. Routinely used biochemical markers like Erythrocyte cholinesterase (EChE) and Plasma cholinesterase (PChE) are used for the diagnosis of acute organophosphorus (OP) poisoning but estimation of these are very costly and not easily available. The mortality increases with increase in initial creatine phosphokinase level and can be used as alternative biomarker. Hence study was done to estimate levels of serum Creatine Phosphokinase (CPK) and liver enzymes in acute OP poisoning patients and its prognostic significance. Methodology: Patients (80) admitted in our hospital were included in this study. A brief history and detailed clinical examination was performed and patients were categorized on the basis Modified Dreisbach\u27s clinical criteria classification. Serum levels of Creatine kinase (CK) and Liver enzymes were analysed at the time of admission. The outcome of the patients were observed. Results: Out of 80 patients recruited for the study, 41 cases (51.3%) were females, and 39 cases (48.8%) were males. Majority of them were in the age group of 21-30 years. More cases of OP poisoning were among agriculturalists 28 (35%) and housewife 21 (28.8%) and among students 15 (18.8%). Malathion was the most common compound used followed by Monocrotphos. 60% had mild, 31.3% had moderate and 8.8% had severe poisoning. There is increase in Creatine Phosphokinase (CPK) levels in 6 patients who survived with ventilator support and also in 2 patients who died with ventilator support which was statistically highly significant (p<0.05). Serum liver enzymes were within normal limits. Conclusion: Elevated Creatine kinase is commonly seen in OPC poisoning. High initial serum Creatine Phosphokinase (CPK) levels are associated with severe degree of poisoning and are associated with complications and mortality. Serum liver enzymes (SGOT AND SGPT) are not elevated in OP poisoning

STUDY OF LEVELS OF SERUM CREATINE PHOSPHOKINASE AND LIVER ENZYMES AS A PROGNOSTIC INDICATORS IN ACUTE ORGANOPHOSPHORUS POISONING

Background: Organophosphorus (OP) poisoning is one of the most common poisoning in rural and in developing country. Due to their easy availability and cost effective it is used frequently for homicidal and suicidal attempts. Routinely used biochemical markers like Erythrocyte cholinesterase (EChE) and Plasma cholinesterase (PChE) are used for the diagnosis of acute organophosphorus (OP) poisoning but estimation of these are very costly and not easily available. The mortality increases with increase in initial creatine phosphokinase level and can be used as alternative biomarker. Hence study was done to estimate levels of serum Creatine Phosphokinase (CPK) and liver enzymes in acute OP poisoning patients and its prognostic significance. Methodology: Patients (80) admitted in our hospital were included in this study. A brief history and detailed clinical examination was performed and patients were categorized on the basis Modified Dreisbach's clinical criteria classification. Serum levels of Creatine kinase (CK) and Liver enzymes were analysed at the time of admission. The outcome of the patients were observed. Results: Out of 80 patients recruited for the study, 41 cases (51.3%) were females, and 39 cases (48.8%) were males. Majority of them were in the age group of 21-30 years. More cases of OP poisoning were among agriculturalists 28 (35%) and housewife 21 (28.8%) and among students 15 (18.8%). Malathion was the most common compound used followed by Monocrotphos. 60% had mild, 31.3% had moderate and 8.8% had severe poisoning. There is increase in Creatine Phosphokinase (CPK) levels in 6 patients who survived with ventilator support and also in 2 patients who died with ventilator support which was statistically highly significant (p<0.05). Serum liver enzymes were within normal limits. Conclusion: Elevated Creatine kinase is commonly seen in OPC poisoning. High initial serum Creatine Phosphokinase (CPK) levels are associated with severe degree of poisoning and are associated with complications and mortality. Serum liver enzymes (SGOT AND SGPT) are not elevated in OP poisoning

A VERY INFREQUENT ASSOCIATION OF WILLIAM-BEURAN SYNDROME AND TETRALOGY OF FALLOT

WB-S Autosomal Dominant Disorder is the most common genetic disorder. We report a case of 20 year old with infrequent association of WBS and TOF. Clinical examination and ECHO confirmed TOF, WB-S was suspected based on the clinical signs used in the scoring system of WB-S which were described by AAP(2001), FISH study was performed in this patient because of having more than 3 clinical signs of WB-S and FISH study showed 7q11.23 deletion and remains the gold standard laboratory investigation for WB-S. KEYWORDS: Tetralogy of Fallot; William Beuren Syndrome; Clinical Diagnosis; Fluroscence In Situ Hybridisation

A VERY INFREQUENT ASSOCIATION OF WILLIAM-BEURAN SYNDROME AND TETRALOGY OF FALLOT

WB-S Autosomal Dominant Disorder is the most common genetic disorder. We report a case of 20 year old with infrequent association of WBS and TOF. Clinical examination and ECHO confirmed TOF, WB-S was suspected based on the clinical signs used in the scoring system of WB-S which were described by AAP(2001), FISH study was performed in this patient because of having more than 3 clinical signs of WB-S and FISH study showed 7q11.23 deletion and remains the gold standard laboratory investigation for WB-S. KEYWORDS: Tetralogy of Fallot; William Beuren Syndrome; Clinical Diagnosis; Fluroscence In Situ Hybridisation