Prognostic Utility Of POP Scale, PMS, And Pseudocholinesterase In Acute Organophosphate Poisoning: A Prospective Observational Study

Abstract

Organophosphate (OP) toxicity continues to pose a major public health challenge worldwide, especially in low- and middle-income countries where pesticide application in agriculture is extensive. According to the World Health Organization (WHO), pesticide-related toxicities contribute to over 300,000 deaths each year, with OP compounds accounting for a significant proportion (1). The fundamental pathophysiological mechanism of organophosphate poisoning is the irreversible inhibition of acetylcholinesterase, a critical enzyme that degrades acetylcholine at synaptic clefts and neuromuscular junctions. This enzymatic blockade results in the excessive accumulation of acetylcholine, leading to persistent stimulation of cholinergic receptors and the onset of a cholinergic crisis, which manifests as a constellation of muscarinic, nicotinic, and central nervous system symptoms (2). Clinically, OP poisoning manifests across a broad spectrum, ranging from non-specific symptoms like nausea, vomiting, and dizziness to life-threatening complications such as convulsions, respiratory paralysis, and ultimately death (3).