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Predictors of Detected Organophosphorus Pesticides Among Orang Asli Children Living in Malaysia

Mat Sutris J, Md Isa Z, Sumeri SA, Ghazi HF

Ann Glob Health, 2017 3 12;82(5):770-778.
PMID: 28283128 DOI: 10.1016/j.aogh.2016.10.008

BACKGROUND: Increasing use of pesticides in agriculture to control pest may result in permanent damage to the environment and consequently cause harmful health problems especially among infant and children. Due to pesticide's natural toxicity and its widespread use, it causes a serious threat to public health especially to this vulnerable group.
OBJECTIVE: The purpose of this study was to determine the organophosphorus pesticide urinary metabolite levels and its predictors among Orang Asli children of the Mah Meri tribe living in an agricultural island in Kuala Langat, Selangor.
METHODS: Data collection was carried out at an island in Kuala Langat, Selangor, where a total of 180 Orang Asli children of the Mah Meri tribe voluntarily participated in the study. Data were collected via a validated, modified questionnaire. Urinary organophosphate metabolites, namely dimethylphosphate, diethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylthiophosphate, and diethyldithiophosphate were measured to assess organophosphate pesticide exposure in children.
FINDINGS: Eighty-four (46.7%) of the respondents were positive for urine dialkyl phosphate metabolites. In multivariable analysis, children who frequently consumed apples had 4 times higher risk of pesticide detection than those who consumed apple less frequently. In addition, those who frequently ate cucumbers had 4 times higher risk for pesticide detection than those who ate cucumbers less frequently. Children with a father whose occupation involved high exposure to pesticides (agriculture) had 3 times higher risk of pesticide detection than those with a father in a low-risk occupation (nonagriculture).
CONCLUSIONS: Almost half of the children (46.7%) in the study area tested positive for urinary dialkyl phosphate metabolite levels. Most of the metabolite levels were equal to or higher than that reported in other previous studies. Major factors associated with pesticide detection in children in this study were frequent intake of apple and cucumber and fathers who are working in an agricultural area.

Matched MeSH terms: Organophosphate Poisoning/epidemiology*; Organophosphate Poisoning/urine
Protective antioxidant effect of Centella asiatica bioflavonoids on lead acetate induced neurotoxicity

Ponnusamy K, Mohan M, Nagaraja HS

Med J Malaysia, 2008 Jul;63 Suppl A:102.
PMID: 19025005

Lead (Pb) is a neurotoxic heavy metal and children in the developmental stage are particularly susceptible to toxic effects of lead exposure. The brain is the key organ involved in interpreting and responding to potential stressors. Epidemiological investigations have established the relationship between chronic lead exposure and cognitive impairments in young children. Excessive production of radical species plays an important role in neuronal pathology resulting from excitotoxic insults, therefore one plausible neuroprotective mechanism of bioflavonoids is partly relevant to their metal chelating and antioxidant properties. Centella asiatica (CA) is a tropical medicinal plant enriched with bioflavonoids and triterpenes and selenium, reported to rejuvenate the cells and promote physical and mental health. Bioflavonoids are claimed to be exert antimutagenic, neurotrophic and xenobiotics ameliorating and membrane molecular stabilizing effects. The objective of the present work is to study the protective antioxidant effect of pretreatment of CA extract (CAE) on lead acetate induced changes in oxidative biomarkers in the central nervous system (CNS) of mice.

Matched MeSH terms: Lead Poisoning, Nervous System/drug therapy*; Lead Poisoning, Nervous System/etiology; Lead Poisoning, Nervous System/prevention & control
Comparative toxicity of eight metals on freshwater fish

Shuhaimi-Othman M, Yakub N, Ramle NA, Abas A

Toxicol Ind Health, 2015 Sep;31(9):773-82.
PMID: 23302712 DOI: 10.1177/0748233712472519

Two freshwater fish, Rasbora sumatrana (Cyprinidae) and Poecilia reticulata (guppy; Poeciliidae), were exposed to a range of eight heavy metals (copper (Cu), cadmium (Cd), zinc (Zn), lead (Pb), nickel (Ni), iron (Fe), aluminium (Al), and manganese (Mn)) at varied concentrations for 96 h in the laboratory. Mortality was assessed and median lethal concentrations (LC50) were calculated. It was observed that the LC50 values increased with a decrease in mean exposure times, for all metals and for both fish types. The 96-h LC50 values for Cu, Cd, Zn, Pb, Ni, Fe, Al, and Mn were 0.006, 0.10, 0.46, 0.63, 0.83, 1.71, 1.53, and 5.71 mg/L for R. sumatrana and 0.038, 0.17, 1.06, 1.99, 15.62, 1.46, 6.76, and 23.91 mg/L for P. reticulata, respectively. The metal toxicity trend for R. sumatrana and P. reticulata from most to least toxic was Cu > Cd > Zn > Pb > Ni > Al > Fe > Mn and Cu > Cd > Zn > Fe > Pb > Al > Ni > Mn, respectively. Results indicated that Cu was the most toxic metal on both fish, and R. sumatrana was more sensitive than P. reticulata to all the eight metals.

Matched MeSH terms: Poisoning/diagnosis; Metals, Heavy/poisoning
Neurological disorders in sheep during signal grass (Brachiaria decumbens) toxicity

Abdullah AS, Noordin MM, Rajion MA

Vet Hum Toxicol, 1989 Apr;31(2):128-9.
PMID: 2929118

Severe neurological dysfunction was observed in sheep 4 weeks after grazing on Signal grass (Brachiaria decumbens). These neurological disorders included the stamping of forelegs, star-gazing, incoordination, head-pressing against the fence and circling movements. Histologically, numerous vacuolations of various sizes were observed in the white matter of the brain giving rise to a spongy appearance.

Matched MeSH terms: Plant Poisoning/etiology; Plant Poisoning/pathology; Plant Poisoning/veterinary*
Notes on two interesting cases

Sivasambandan R

Malayan Medical Journal, 1928;3:64.

Matched MeSH terms: Poisoning
Poisoning by cantharides

Haridas G

Journal of the Malaya Branch of the British Medical Association, 1940;3:406-9.

Matched MeSH terms: Poisoning
Fulltext Effects of substratum and depth on benthic harmful dinoflagellate assemblages

Lee LK, Lim ZF, Gu H, Chan LL, Litaker RW, Tester PA, et al.

Sci Rep, 2020 07 09;10(1):11251.
PMID: 32647125 DOI: 10.1038/s41598-020-68136-6

Microhabitats influence the distribution and abundance of benthic harmful dinoflagellate (BHAB) species. Currently, much of the information on the relationships between BHABs and microhabitat preferences is based on non-quantitative anecdotal observations, many of which are contradictory. The goal of this study was to better quantify BHAB and microhabitat relationships using a statistically rigorous approach. Between April 2016 to May 2017, a total of 243 artificial substrate samplers were deployed at five locations in the Perhentian Islands, Malaysia while simultaneous photo-quadrat surveys were performed to characterize the benthic substrates present at each sampling site. The screen samplers were retrieved 24 h later and the abundances of five BHAB genera, Gambierdiscus, Ostreopsis, Coolia, Amphidinium, and Prorocentrum were determined. Substrate data were then analyzed using a Bray-Curtis dissimilarity matrix to statistically identify distinct microhabitat types. Although BHABs were associated with a variety of biotic and abiotic substrates, the results of this study demonstrated differing degrees of microhabitat preference. Analysis of the survey results using canonical correspondence analysis explained 70.5% (horizontal first axis) and 21.6% (vertical second axis) of the constrained variation in the distribution of various genera among microhabitat types. Prorocentrum and Coolia appear to have the greatest range being broadly distributed among a wide variety of microhabitats. Amphidinium was always found in low abundances and was widely distributed among microhabitats dominated by hard coral, turf algae, sand and silt, and fleshy algae and reached the highest abundances there. Gambierdiscus and Ostreopsis had more restricted distributions. Gambierdiscus were found preferentially associated with turf algae, hard coral and, to a lesser extent, fleshy macroalgae microhabitats. Ostreopsis, almost always more abundant than Gambierdiscus, preferred the same microhabitats as Gambierdiscus and were found in microbial mats as well. With similar habitat preferences Ostreopsis may serve as an indicator organism for the presence of Gambierdiscus. This study provides insight into how BHAB-specific microhabitat preferences can affect toxicity risks.

Matched MeSH terms: Ciguatera Poisoning
Fulltext Glyphosate Herbicide Induces Changes in the Growth Pattern and Somatic Indices of Crossbred Red Tilapia (O. niloticus × O. mossambicus)

Muhammad UA, Yasid NA, Daud HM, Shukor MY

Animals (Basel), 2021 Apr 22;11(5).
PMID: 33922293 DOI: 10.3390/ani11051209

The development of glyphosate-resistant genetically modified organisms (GMO) has increased the use of herbicide glyphosate by several magnitudes in recent years. It is now the most commonly used pesticide globally that affects aquatic habitats, especially fish. This study aims to add new knowledge on the effect of technical grade glyphosate on several toxicity parameters and to identify the most effective parameter in predicting technical grade glyphosate chronic toxicity (seven weeks) to fish, especially Malaysia's heavily farmed red tilapia. The results show that a relatively high concentration of technical grade glyphosate is needed to induce significant changes in all tested parameters. However, the results also indicate that the bodyweight index is the most sensitive toxicity parameter in that a reduction in body weight was observed at 25 mg/L of glyphosate. Negative correlations between the glyphosate concentration and toxicity parameters such as specific growth rate (SGR), hepato-somatic index (HIS), and gonado-somatic index (GSI) were observed. The fish condition factor and feed conversion ratio were found not to be affected at the highest glyphosate concentration tested (150 mg/L). To conclude, crossbred red tilapia (O. niloticus × O. mossambicus) is one potential species for evaluating the toxic effects of technical grade glyphosate on fish.

Matched MeSH terms: Organophosphate Poisoning
Fulltext Mercury release from a Sn-Cu-Zn free amalgam

Lui JL, Tong SL, Teh SK

Ann Dent, 1994;1(1):1-4.
MyJurnal

The mercury controversy related to dental amalgam is still continuing. In Malaysia, part of, this controversy has been attributed to a recently - introduced dental amalgam claimed to be non-mercury releasing and causing no mercury toxicity. The purpose of this study was to investigate whether this amalgam, Composil, was indeed non-mercury releasing. Six specimens each of Composil and a control (GS-80) were incubated at 3TC in deionised-distilled water. The daily mercury release was determined over a four-week study period using the stationary cold-vapour atomic absorption spectrometric method. The mean mercury release of Composil was 30.9 Ilg/cm2/ 24hr whilst that of GS-80 was 0.9 Ilg/cm2124hr and the difference was found to be highly significant (P < 0.00l). Results of this study therefore did not substantiate the manufacturer's claim. The release of mercury from amalgam restorations and their implications in clinical practice were also discussed.

Matched MeSH terms: Mercury Poisoning
Neurobehavioral performances among lead exposed workers in Malaysia: an early detection of lead toxicity

Mazrura Sahani, Noor Hassim Ismail

Journal of Occupational Safety and Health, 2005;2(1):1-9.
MyJurnal

The objectives of this study is to evaluate subjective symptoms and neurobehavioral performances among workers exposed to lead and its relation with blood lead levels. The methodology of this study was restricted to 141 Malaysian battery manufacturing factories male workers with mean (SD) age of 35.2 (9.6) years, years of employment 9.1 (7.1), current blood lead concentration 40.5 (16.8) μg/dl were given WHO neurobehavioral core test battery. Results showed that highly exposed group blood lead level (high ≥ 40 μg/dl) performed less well in 4 of 13 responses reported higher subjective symptoms of weakness of lower limbs and anorexia. Significant correlation was found between blood lead and Digit Symbol, Digit Forward, Digit Backward, Aiming Pursuit Test and Trail B. Regression analysis showed reduction in cognitive, memory and concentration functions at ≤ 30 μg/dl blood lead levels with maximum lead effect at Digit symbol’s score at 40 μg/dl. In conclusion, this study is consistent with the larger body of neurobehavioral tests in lead exposure and has proven the ability of these tests in detecting low level of lead toxicity.

Matched MeSH terms: Lead Poisoning
Harmful algal blooms in Malaysian waters

Lim PT, Usup Gires, Leaw CP

Sains Malaysiana, 2012;41:1509-1515.

Harmful algal blooms (HABs) events have been increasingly reported in the country, not only of the frequency and severity of the events, but also involved more species than previously known. In this paper, a decadal review of HABs events in Malaysia is summarized. Bloom events caused by harmful dinoflagellate species including the shellfish poisoning events were highlighted. Paralytic shellfish poisoning (PSP) is no longer restricted to Sabah coasts and Pyrodnium bahamense. Bloom of Alexandrium minutum was reported for the first time in the Peninsula with six persons hospitalized including one casualty after consuming the contaminated benthic clams. Algal blooms that are associated with incidence of massive fish kills have been reported from both east and west coasts of the Peninsula in conjunction to finfish mariculture loses. The culprits of these bloom events have been identified as the dinoflagellates, Cochlodinium polykrikoides, Neoceratium furca, Prorocentrum minimum, Noctiluca scintillans and a raphidophyte, Chatonella ovata. In this paper, some of these HABs species were characterized morphologically and genetically, including their toxicity. Therefore, with the increase of coastal utilization and eutrophication, prevention, management and mitigation strategies, such as site selection, moving pens, clay spraying should be adopted to minimize the impact of these natural events.

Matched MeSH terms: Shellfish Poisoning
Lead poisoning

Hughes W

Journal of the Malaya Branch of the British Medical Association, 1937;1:134-47.

Matched MeSH terms: Lead Poisoning, Nervous System
Fulltext Early onset muscarinic manifestations after wild mushroom ingestion

Chew KS, Mohidin MA, Ahmad MZ, Tuan Kamauzaman TH, Mohamad N

Int J Emerg Med, 2008 Sep;1(3):205-8.
PMID: 19384518 DOI: 10.1007/s12245-008-0054-y

Despite being a favorite delicacy, only 200-300 of the 5,000 known mushroom species have been clearly established to be safe for consumption. Cases of mushroom poisoning have been reported with diverse clinical syndromes. A syndromic classification of mushroom poisoning has recently been developed to facilitate early interventions. We present a series of five cases of mushroom poisoning with muscarinic manifestations to highlight the difficulties we faced with exact species and toxin identification and the importance of this syndromic classification. The common symptoms in our case series are blurred vision, diarrhea, vomiting, and abdominal cramps.

Matched MeSH terms: Mushroom Poisoning
Fulltext Eleusine indica L. possesses antioxidant activity and precludes carbon tetrachloride (CCl₄)-mediated oxidative hepatic damage in rats

Iqbal M, Gnanaraj C

Environ Health Prev Med, 2012 Jul;17(4):307-15.
PMID: 22207570 DOI: 10.1007/s12199-011-0255-5

OBJECTIVES: The purpose of this study was to evaluate the ability of aqueous extract of Eleusine indica to protect against carbon tetrachloride (CCl₄)-induced hepatic injury in rats.
METHODS: The antioxidant activity of E. indica was evaluated using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay. The total phenolic content of E. indica was also determined. Biochemical parameters [e.g. alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde (MDA), glutathione (GSH), catalase, glutathione peroxidase, glutathione reductase, glutathione S-transferase and quinone reductase] were used to evaluate hepatic damage in animals pretreated with E. indica and intoxicated with CCl₄. CCl₄-mediated hepatic damage was also evaluated by histopathologically.
RESULTS: E. indica extract was able to reduce the stable DPPH level in a dose-dependent manner. The half maximal inhibitory concentration (IC₅₀) value was 2350 μg/ml. Total phenolic content was found to be 14.9 ± 0.002 mg/g total phenolic expressed as gallic acid equivalent per gram of extract. Groups pretreated with E. indica showed significantly increased activity of antioxidant enzymes compared to the CCl₄-intoxicated group (p < 0.05). The increased levels of serum ALT and AST were significantly prevented by E. indica pretreatment (p < 0.05). The extent of MDA formation due to lipid peroxidation was significantly reduced (p < 0.05), and reduced GSH was significantly increased in a dose-dependently manner (p < 0.05) in the E. indica-pretreated groups as compared to the CCl₄-intoxicated group. The protective effect of E. indica was further evident through decreased histopathological alterations in the liver.
CONCLUSION: The results of our study indicate that the hepatoprotective effects of E. indica might be ascribable to its antioxidant and free radical scavenging property.

Matched MeSH terms: Carbon Tetrachloride Poisoning/drug therapy*; Carbon Tetrachloride Poisoning/metabolism; Carbon Tetrachloride Poisoning/pathology
Fulltext Genotoxicity following Organophosphate Pesticides Exposure among Orang Asli Children Living in an Agricultural Island in Kuala Langat, Selangor, Malaysia

Sutris JM, How V, Sumeri SA, Muhammad M, Sardi D, Mohd Mokhtar MT, et al.

Int J Occup Environ Med, 2016 Jan;7(1):42-51.
PMID: 26772597 DOI: 10.15171/ijoem.2016.705

BACKGROUND: Agriculture is an important sector for the Malaysian economy. The use of pesticides in agriculture is crucial due to its function in keeping the crops from harmful insects. Children living near agricultural fields are at risk of pesticide poisoning.
OBJECTIVE: To evaluate the genotoxic risk among children who exposed to pesticides and measure DNA damage due to pesticides exposure.
METHODS: In a cross-sectional study 180 Orang Asli Mah Meri children aged between 7 and 12 years were studied. They were all living in an agricultural island in Kuala Langat, Selangor, Malaysia. The data for this study were collected via modified validated questionnaire and food frequency questionnaire, which consisted of 131 food items. 6 urinary organophosphate metabolites were used as biomarkers for pesticides exposure. For genotoxic risk or genetic damage assessment, the level of DNA damage from exfoliated buccal mucosa cells was measured using the comet assay electrophoresis method.
RESULTS: Out of 180 respondents, 84 (46.7%) showed positive traces of organophosphate metabolites in their urine. Children with detectable urinary pesticide had a longer tail length (median 43.5; IQR 30.9 to 68.1 μm) than those with undetectable urinary pesticides (median 24.7; IQR 9.5 to 48.1 μm). There was a significant association between the extent of DNA damage and the children's age, length of residence in the area, pesticides detection, and frequency of apple consumption.
CONCLUSION: The organophosphate genotoxicity among children is associated with the amount of exposure (detectability of urinary pesticide) and length of residence in (exposure) the study area.

Matched MeSH terms: Organophosphate Poisoning/genetics*; Organophosphate Poisoning/epidemiology*; Organophosphate Poisoning/urine
Validation of ELISA test kits for detection of beta-agonist residues in meat

Ponniah J, Muhammad K, Abdullah S, Ganapathy KK, bt Sheikh Abdul Hamid N

Southeast Asian J Trop Med Public Health, 2004 Jun;35(2):481-7.
PMID: 15691160

Three ELISA test kits, the Randox ELISA beta-agonist test kit, Euro-Diagnostica test kit, and Ridascreen beta-agonist test kit, were evaluated for screening of meat and liver for beta-agonist residues in fortified and field-incurred samples. It was found that the Randox beta-agonist test kit was more suitable as a screening tool due to its accuracy, ease of use, and lower cost. The tests were able to detect beta-agonist residues at the minimum level of detection, as claimed by the suppliers. The performance of the method as assessed through recovery rates of beta-agonists in fortified samples was satisfactory with a low coefficient of variation (1-3%). Repeatability, as measured through the coefficient of correlation was also satisfactory. For field-incurred positive samples, the test kit showed a sensitivity of 100% and a low rate of false positives for goat and cow tissues. However, a high rate of apparent false positives was obtained for tissues of swine.

Matched MeSH terms: Adrenergic beta-Agonists/poisoning; Drug Residues/poisoning; Veterinary Drugs/poisoning
Factors influencing the toxicity, detoxification and biotransformation of paralytic shellfish toxins

Tan KS, Ransangan J

Rev Environ Contam Toxicol, 2015;235:1-25.
PMID: 25376112 DOI: 10.1007/978-3-319-10861-2_1
Matched MeSH terms: Shellfish Poisoning/etiology
Capillary electrophoresis for the analysis of paralytic shellfish poisoning toxins in shellfish: comparison of detection methods

Keyon AS, Guijt RM, Gaspar A, Kazarian AA, Nesterenko PN, Bolch CJ, et al.

Electrophoresis, 2014 May;35(10):1496-503.
PMID: 24591173 DOI: 10.1002/elps.201300353

Paralytic shellfish toxins (PSTs) are produced by marine and freshwater microalgae and accumulate in shellfish including mussels, oysters, and scallops, causing possible fatalities when inadvertently consumed. Monitoring of PST content of shellfish is therefore important for food safety, with currently approved methods based on HPLC, using pre- or postcolumn oxidation for fluorescence detection (HPLC-FLD). CE is an attractive alternative for screening and detection of PSTs as it is compatible with miniaturization and could be implemented in portable instrumentation for on-site monitoring. In this study, CE methods were developed for C(4) D, FLD, UV absorption detection, and MS-making this first report of C(4) D and FLD for PSTs detection. Because most oxidized toxins are neutral, MEKC was used in combination with FLD. The developed CZE-UV and CZE-C(4) D methods provide better resolution, selectivity, and separation efficiency compared to CZE-MS and MEKC-FLD. The sensitivity of the CZE-C(4) D and MEKC-FLD methods was superior to UV and MS, with LOD values ranging from 140 to 715 ng/mL for CZE-C(4) D and 60.9 to 104 ng/mL for MEKC-FLD. With the regulatory limit for shellfish samples of 800 ng/mL, the CZE-C(4) D and MEKC-FLD methods were evaluated for the screening and detection of PSTs in shellfish samples. While the CZE-C(4) D method suffered from significant interferences from the shellfish matrix, MEKC-FLD was successfully used for PST screening of a periodate-oxidized mussel sample, with results confirmed by HPLC-FLD. This confirms the potential of MEKC-FLD for screening of PSTs in shellfish samples.

Matched MeSH terms: Shellfish Poisoning/metabolism*
Hair arsenic levels and prevalence of arsenicosis in three Cambodian provinces

Hashim JH, Radzi RS, Aljunid SM, Nur AM, Ismail A, Baguma D, et al.

Sci Total Environ, 2013 Oct 1;463-464:1210-6.
PMID: 23759330 DOI: 10.1016/j.scitotenv.2013.04.084

Natural, inorganic arsenic contamination of groundwater threatens the health of more than 100 million people worldwide, including residents of the densely populated river deltas of South and Southeast Asia. Contaminated groundwater from tube wells in Cambodia was discovered in 2001 leading to the detection of the first cases of arsenicosis in 2006. The most affected area was the Kandal Province. The main objective of this study was to determine the prevalence of arsenicosis in Cambodia based on acceptable criteria, and to investigate the use of hair arsenic as a biomarker not only for arsenicosis-related signs but also for associated symptoms. A cross-sectional epidemiological study of 616 respondents from 3 purposely selected provinces within the Mekong River basin of Cambodia was conducted. The Kandal Province was chosen as a high arsenic-contaminated area, while the Kratie Province and Kampong Cham Province were chosen as moderate and low arsenic-contaminated areas, respectively. The most prevalent sign of arsenicosis was hypomelanosis with a prevalence of 14.5% among all respondents and 32.4% among respondents with a hair arsenic level of ≥1 μg/g. This was followed by hyperkeratosis, hyperpigmentation and mee's lines. Results also suggest a 1.0 μg/g hair arsenic level to be a practical cut off point for an indication of an arsenic contaminated individual. This hair arsenic level, together with the presence of one or more of the classical signs of arsenicosis, seems to be a practical criteria for a confirmed diagnosis. Based on these criteria, the overall prevalence of arsenicosis for all provinces was found to be 16.1%, with Kandal Province recording the highest prevalence of 35.5%. This prevalence is comparatively high when compared to that of other affected countries. The association between arsenicosis and the use of Chinese traditional medicine also needs further investigation.

Matched MeSH terms: Arsenic Poisoning/epidemiology*
Fulltext Effectiveness of fresh frozen plasma as supplementary treatment in organophosphate poisoning

Pazooki S, Solhi H, Vishteh HR, Shadnia S, Beigi MJ

Med J Malaysia, 2011 Oct;66(4):342-5.
PMID: 22299554

With the establishment of the inadequate efficiency of atropines and oximes in reducing morbidity and mortality of patients poisoned by organophosphates, more attention is given to using other methods such as Fresh Frozen Plasma (FFP) as a bioscavenger to mop up organophosphate toxins. This randomized clinical trial was conducted on 56 organophosphate poisoned patients who were randomly assigned to the FFP and control groups in order of admission. The routine treatment in both groups included atropine and, in moderate to severe cases of poisoning, pralidoxime. The FFP group received four packs of FFP as stat dose at the beginning of treatment. No significant difference was seen between the two groups on the atropine and pralidoxime dosage, hospitalization length and mortality. The present study showed that using four packs of FFP as stat dose at the onset of treatment had no significant effect on the clinical course of organophosphate poisoned patients.

Matched MeSH terms: Organophosphate Poisoning*

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