Pesticide use pattern among farmers in a rural district of West Bengal, India.

BACKGROUND: A vast majority of Indian population are engaged in agriculture. While pesticides help in increasing crop production, inappropriate pesticide storage practice and inadequate protective measures frequently causes accidental poisoning among farmers. OBJECTIVE: The present study was conducted to explore the pattern of pesticide use among farmers in a district of India with an attempt to identify the lacunae in their knowledge and awareness level on risks and hazards of pesticides use. MATERIALS AND METHODS: A cross-sectional questionnaire based study was conducted in the district of Burdwan, West Bengal, to address the study objective. Data analysis was performed by using descriptive statistical methods: Frequency, percentage, mean, standard deviation. RESULTS: In the present study alpha-cypermethrin (46%) was the most commonly used pesticide followed by methyl parathion (25.6%), imidacloprid (16.4%), dichlorvos (7.8%) and phorate (4.2%). The farmers used to store pesticides mostly in cowshed (48.4%) followed by storeroom (29.6%). During spraying of pesticides, farmers experienced headache (29.8%) followed by nausea (26%), burning sensation in eyes (9.8%), cough (9.2%), muscle cramps (2%). Regarding the personal protective measures taken by the farmers for spraying, covering nose, mouth with cloth combined with bath after spraying was the most common practice (27%). When asked about suggested actions to be taken if anybody becomes sick following exposure to pesticides, 86% of farmers prefer consulting a doctor. CONCLUSION: The study suggested that farmers of Burdwan were exposed to highly hazardous, restricted and banned pesticides, with insufficient protection. In this situation, educational and training interventions on pesticide handling and safety precautions are urgently needed.

Clinico-epidemiological profile of poisoned patients in emergency department: A two and half year's single hospital experience.

CONTEXT: Poisoning is a common cause for attending emergency department of hospitals. AIMS: To explore the epidemiological characteristics and clinical profile of patients presenting with poisoning in emergency department. SETTINGS AND DESIGN: Prospective, cross-sectional, hospital-based study. MATERIALS AND METHODS: Relevant epidemiological and clinical data from patients, presenting with history/clinical features of poisoning in emergency department of a tertiary care district hospital in India, were collected and analyzed. STATISTICAL ANALYSIS: DATA ANALYSIS WAS DONE BY USING DESCRIPTIVE AND INFERENTIAL STATISTICAL METHODS: Frequency, percentage, mean, and standard deviation (SD). A two-tailed P < 0.05 was considered to be statistically significant. RESULTS: A total of 4,432 patients with history and/clinical features of poisoning were included in the study. The females clearly outnumbered male patients. Poisoning with suicidal intent was more frequent (81.08%) than accidental (18.92%) (P < 0.0001). Majority of the patients were housewives followed by farmers, businessmen, laborers, and students. The mean time interval between poison consumption and admission to hospital was 6.4 hours (Mean ± SD: 6.4 ± 2.29). Snakebite (31.90%) was the most common cause of poisoning followed by organophosphorus compounds (21.84%), rodenticide (16.49%), alcohol (13.80%), chemicals (9.04%), and drugs (2.3%). The mean GCS (Glasgow Coma Scale) score of the poisoned patients at presentation was 6.85 ± 1.62. Of all the patients included in the study, 3,712 patients (83.76%) survived and 720 patients (16.24%) expired. CONCLUSIONS: The current piece of work suggests that most of the poisoning cases involved young age group particularly females. Snakebite and organophosphorus compounds contributed most of the poisoning cases which calls for urgent government initiatives for improvement in proper lighting of the district to prevent snakebite and controlled use of pesticides.

Efficacy of pralidoxime in organophosphorus poisoning: revisiting the controversy in Indian setting.

CONTEXT: Poisoning with organophosphorus (OP) compounds constitutes a global public health problem. Standard treatment of OP poisoning involves use of atropine and pralidoxime. While efficacy of atropine is well-established, clinical experience with pralidoxime in management of OP poisoning is controversial. AIMS: To explore the efficacy of add-on pralidoxime with atropine over atropine alone in the management of OP poisoning. SETTINGS AND DESIGN: An open-label, parallel-group, randomized clinical trial was conducted in a tertiary care district hospital in West Bengal. MATERIALS AND METHODS: Patients presenting with features of OP poisoning were randomly allocated to receive atropine or atropine-plus-pralidoxime. Efficacy was assessed by analyzing mortality, requirement for ventilator support and the duration of stay in hospital. STATISTICAL ANALYSIS: Chi-square test was done to compare the efficacy parameters between the two groups. A two-tailed P-value <0.05 was considered as statistically significant. RESULTS: During the study period, 150 patients were screened following which 120 patients were randomized to either of the treatment arms. Add-on pralidoxime therapy did not offer any appreciable benefit over atropine alone in terms of reducing mortality (18.33% (11/60) versus 13.33% (8/60)) and ventilator requirement (5% (3/60) versus 8.33% (5/60)). However, patients randomized in the add-on pralidoxime arm experienced longer duration of hospital stay (7.02 ± 1.12 days) than those receiving atropine-alone therapy (5.68 ± 1.87 days) (P < 0.001). CONCLUSION: The present study suggested that add-on pralidoxime with atropine therapy did not offer any appreciable benefit over atropine alone in management of OP poisoning. However, further trials are needed to explore different dosing regimens of pralidoxime in order to determine its efficacy in OP poisoning.

Clinico-epidemiological characteristics of patients presenting with organophosphorus poisoning.

BACKGROUND: Organophosphorus (OP) poisoning is a major health problem all over the world, particularly in the developing countries. AIM: The present study aims to explore the clinical and epidemiological features found in patients presenting with OP poisoning. MATERIALS AND METHODS: A 1-year cross-sectional study was conducted on patients presenting with clinical features of OP poisoning in a tertiary care medical college. RESULTS: A total of 968 patients presented during the study period. Poisoning with suicidal intent (82.02%) was more common than the accidental one (17.98%). Majority of the patients were housewives (42%) followed by farmers, shopkeepers, laborers, students. Methyl parathion was the most common poison consumed by the patients (35.74%) followed by diazinon, chlorpyriphos, dimicron. Nausea and vomiting (85.02%) was the most common symptom while miosis was the most common sign observed in 91.94% patients. A total of 56 patients of OP poisoning died (5.78%) with respiratory failure being the primary cause of death followed by CNS depression, cardiac arrest, and septicaemia. CONCLUSION: The present study showed that majority of the patients were of young age with females outnumbering males. Poisoning with suicidal intent was more common than accidental. Nausea and vomiting was the most common symptom reported by the patients while miosis was the most common sign observed by the treating physicians of the research team.