Study of Various Liver Enzymes in Patients with Organophosphorous Poisoning

Introduction: Organophosphate (OP) pesticides are used widely for agriculture, vector control, and domestic purposes. Organophosphate poisoning (OPP) is most commonly results from exposure to these pesticides either accidentally or consumed for suicidal purpose. OPP is one of the most common causes of poisoning worldwide including India especially among the farmers. The patients with the OPP are classified according to the Peradeniya Organophosphorous Poisoning (POP) Scale. POP scale is a scoring system based on clinical features. In OPP there is decrease in serum cholinesterase level. So serum cholinesterase level is mostly used as a supportive laboratory investigation for the confirmation of diagnosis of OPP and is severity. But this laboratory investigation is not available in all laboratories especially in rural areas where OPP is very common.So we have investigated serum liver enzymes along with serum cholinesterase level in OPP and tried to find out the relation between liver enzymes with OPP and serum cholinesterase. Aims and Objectives: 1)Estimation of the level of following parameters before any treatment -Serum liver enzymes like alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphates (ALP) , 2)Comparison of the above parameters in the controls with the OPP cases. 3)Comparison of liver enzymes with serum acetyl cholinesterase level in OPP. Material and methods: This study will be carried in the department of the Biochemistry in the Dr. Shankarrao Chavan Government Medical College, Nanded (MS.nclusion criteria: 1)Patients with definite history of ingestion of organ phosphate compound poisoning within twenty-four hours of admission. 2)Patients with presence of characteristic clinical signs and symptoms of organophosphate compound poisoning. A valid written consent was taken from 60 patients admitted in the Hospital. These patients were divided into two groups as- Group-I is control with 30 patients and Group-II has 30 patients with OPP. After obtaining history, clinical examination, 5ml of blood sample is taken in plain bulb by single prick for laboratory investigations before any treatment. Serum acetyl cholinesterase and liver enzymes were estimated in the above patients.Data will be represented as Mean ± S.D. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 11.5. Conclusions: Serum liver enzymes like alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP) increases in all cases of OPP. These enzymes had shown inverse relationship with the levels of serum acetyl cholinesterase. Further level of these enzymes significantly increases in cases where serum cholinesterase activity falls below 50% of normal value which is suggestive of severe OPP. Hence these liver enzymes can be used in OPP instead of acetylcholinesterase where laboratory facilities are limited and they not only help in the diagnosis of OPP but also suggest severity of OPP.