Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Pale...Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Palestine and discussed the follow up treatments. Results showed sever fasciculation of tongue and all muscle, pinpoint pupils not reacting to light, losing consciousness and disoriented, irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE). Irritability and low level of ACHE activity were the unique syndromes of this case. Management of the poisoning with Atropine injection was not successful treatment to cure the case. Treatment with Toxogonin as intravenous injection resulted in relieved the irritability of the poisoned case and cure the patient at the end point. During the six weeks of follow up period, the case was severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to release the patient was made after ACHE activity level reached 4750 U/L, which very close to the normal range. The farmers left the hospital after three weeks of medical treatments and follow up. It is recommended to use Toxogonin in the management of poisoned cases with OPI immediately on arrival of cases with losing consciousness.展开更多
Background:Penehyclidine hydrochloride(PHC)has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning(AOPP).The purpose of this meta-analysis was to explore...Background:Penehyclidine hydrochloride(PHC)has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning(AOPP).The purpose of this meta-analysis was to explore whether PHC has advantages over atropine in the use of anticholinergic drugs in AOPP.Methods:We searched Scopus,Embase,Cochrane,PubMed,ProQuest,Ovid,Web of Science,China Science and Technology Journal Database(VIP),Duxiu,Chinese Biomedical literature(CBM),WanFang,and Chinese National Knowledge Infrastructure(CNKI),from inception to March 2022.After all qualified randomized controlled trials(RCTs)were included,we conducted quality evaluation,data extraction,and statistical analysis.Statistics using risk ratios(RR),weighted mean difference(WMD),and standard mean difference(SMD).Results:Our meta-analysis included 20,797 subjects from 240 studies across 242 different hospitals in China.Compared with the atropine group,the PHC group showed decreased mortality rate(RR=0.20,95%confidence intervals[CI]:0.16–0.25,P<0.001),hospitalization time(WMD=-3.89,95%CI:-4.37 to-3.41,P<0.001),overall incidence rate of complications(RR=0.35,95%CI:0.28–0.43,P<0.001),overall incidence of adverse reactions(RR=0.19,95%CI:0.17–0.22,P<0.001),total symptom disappearance time(SMD=-2.13,95%CI:-2.35 to-1.90,P<0.001),time for cholinesterase activity to return to normal value 50–60%(SMD=-1.87,95%CI:-2.03 to-1.70,P<0.001),coma time(WMD=-5.57,95%CI:-7.20 to-3.95,P<0.001),and mechanical ventilation time(WMD=-2.16,95%CI:-2.79 to-1.53,P<0.001).Conclusion:PHC has several advantages over atropine as an anticholinergic drug in AOPP.展开更多
文摘Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Palestine and discussed the follow up treatments. Results showed sever fasciculation of tongue and all muscle, pinpoint pupils not reacting to light, losing consciousness and disoriented, irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE). Irritability and low level of ACHE activity were the unique syndromes of this case. Management of the poisoning with Atropine injection was not successful treatment to cure the case. Treatment with Toxogonin as intravenous injection resulted in relieved the irritability of the poisoned case and cure the patient at the end point. During the six weeks of follow up period, the case was severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to release the patient was made after ACHE activity level reached 4750 U/L, which very close to the normal range. The farmers left the hospital after three weeks of medical treatments and follow up. It is recommended to use Toxogonin in the management of poisoned cases with OPI immediately on arrival of cases with losing consciousness.
文摘Background:Penehyclidine hydrochloride(PHC)has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning(AOPP).The purpose of this meta-analysis was to explore whether PHC has advantages over atropine in the use of anticholinergic drugs in AOPP.Methods:We searched Scopus,Embase,Cochrane,PubMed,ProQuest,Ovid,Web of Science,China Science and Technology Journal Database(VIP),Duxiu,Chinese Biomedical literature(CBM),WanFang,and Chinese National Knowledge Infrastructure(CNKI),from inception to March 2022.After all qualified randomized controlled trials(RCTs)were included,we conducted quality evaluation,data extraction,and statistical analysis.Statistics using risk ratios(RR),weighted mean difference(WMD),and standard mean difference(SMD).Results:Our meta-analysis included 20,797 subjects from 240 studies across 242 different hospitals in China.Compared with the atropine group,the PHC group showed decreased mortality rate(RR=0.20,95%confidence intervals[CI]:0.16–0.25,P<0.001),hospitalization time(WMD=-3.89,95%CI:-4.37 to-3.41,P<0.001),overall incidence rate of complications(RR=0.35,95%CI:0.28–0.43,P<0.001),overall incidence of adverse reactions(RR=0.19,95%CI:0.17–0.22,P<0.001),total symptom disappearance time(SMD=-2.13,95%CI:-2.35 to-1.90,P<0.001),time for cholinesterase activity to return to normal value 50–60%(SMD=-1.87,95%CI:-2.03 to-1.70,P<0.001),coma time(WMD=-5.57,95%CI:-7.20 to-3.95,P<0.001),and mechanical ventilation time(WMD=-2.16,95%CI:-2.79 to-1.53,P<0.001).Conclusion:PHC has several advantages over atropine as an anticholinergic drug in AOPP.
