Abstract

Context: Pesticides are chemical compounds used for crop protection and poisoning with them is a very common occurrence in farmers. In an emergency setting, the identification of quick and powerful prognostic markers can be of high significance in the management of these patients. Aims: To assess the severity of Pesticide Poisoning by assessing the leukocyte count, neutrophil count, neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) and its comparison with levels of Plasma Cholinesterase (PChE) as an aid to clinical diagnosis, for early treatment of the patients. Settings and Design: Hospital based Cross-sectional study. Study period 1st November 2018 - 30th May 2020 Methods and Material: Study was done on 148 confirmed cases of pesticide poisoning over a period of 1.5 years. Blood samples were collected in EDTA and plain vacutainers within 24 hours of admission and the values of total leukocyte Count (TLC), neutrophil count, NLR, PLR and PChE were measured and compared. The severity of poisoning was assessed according to Peradeniya Organophosphorus (POP) scale. Statistical Analysis used: Mean ± SD, Chi square test for association, Comparison of mean using ANOVA test for comparison between and among groups, Sensitivity and specificity analysis. Results: 89.86% and 10.14% of cases were due to poisoning by Organophosphorus compounds and carbamate respectively. The severely poisoned patients according to POP scale had more leukocyte count, neutrophil count, NLR and PLR; and less plasma cholinesterase level as compared to the patients with mild and moderate poisoning. Conclusions: Total Leukocyte count, neutrophil count, NLR and PLR are simple and easy to use parameters for estimating the severity of pesticide poisoning and assessing its prognosis. In resource limited setups, along with the clinical history, these basic CBC parameters can be useful and patient’s immediate treatment can be started as early as possible.

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