POSSIBLE CORRELATION BETWEEN ACUTE ORGANPHOSPHOROUS EXPOSURE AND OCCURRENCE OF SOME CARDIAC ARRHYTHMIA AND BIOCHEMICAL ABNORMALITIES

Background: Pesticides are often used indiscriminately in large amounts and widespread use of pesticides in agriculture causes environmental pollution and severe health risks such as acute and chronic human poisoning due to acetylcholinesterase enzyme inhibition. A cardiovascular effect of acute organophosphorus (OP) poisoning is very common and requires more estimation. The aim of the work: The present work studied the possible correlation between acute exposure of some (OP) as phosphor dithionate (PDT=Malathion) and diethyl para-nitrophenyl phosphate parathion (DPT=Falidol or Police El-Nagda) and the occurrence of cardiac and biochemical abnormalities. Patients and methods: The study was conducted from the 1^st of December 2016 to 1^st of October 2017.  It involved 100 cases who recruited from the emergency department of Al-Azhar University hospital (New Damietta) and emergency hospital at Mansoura University. In addition to 50 healthy subjects as a control group. After free informed consent to participate in this study and within one hour after admission to general internal medicine, 10 mL of blood was separated and the serum was divided into three portions, One of which for residues extraction of (PDT) and (DDT)) by using high performance liquid chromatography (HPLC) and the remaining two portions were stored at ^_8C  for subsequent assays to all subjects; complete blood count (CBC), fasting blood sugar, serum urea, serum creatinine, serum uric acid, arterial blood gases (ABG), serum electrolytes, cholinesterase level and cardiac enzymes such as (troponin, creatine kinase (CK-MB), lactate dehydrogenase (LDH), aspartate transaminase (AST) and myoglobin (Mb). Cases and controls were subjected to a standardized questionnaire; major variables included in the interview were social and demographic factors, personal habits, and history of bilharziasis, diabetes, alcoholism and occupational exposure to pesticides. Chest X-ray and Electrocardiography (ECG) and clinical examination to all groups were done with a special attention to manifestation of cardiac abnormalities. Results: Significant positive correlation in the study group of pesticide exposures were observed with serum creatinine, arterial blood gases, serum potassium, moderate and severe reduction in cholinesterase level, cardiac enzyme, QTc prolongation, ST elevation and ventricular extrasystole especially among farmers with moderate and severe exposures and living in rural area. Recommendation: It is recommended that; early diagnosis and perfect treatments can save the life of the patients. Careful observation of EEG changes in patients exposed to (OP) compounds is obligatory parallel to the suitable medical treatment as a QTc prolongation and ventricular extrasystole can cause lethal arrhythmia. People who are in touch with pesticides, especially those who spray farmlands and gardens must awareness sufficient protective instruments and consider safety guidelines. Social media awareness and more researches are needed for pesticide compounds and their hazards on the heart and other vital organs.