Cholinesterase, Amylase, Lipase and Neutrophil-to-lymphocyte Ratio in Acute Pesticide Poisoning Cases

April 1, 2022 updated by: Asmaa AbouBakr Ahmed, Assiut University

Diagnostic and Prognostic Values of Cholinesterase, Amylase, Lipase and Neutrophil-to-lymphocyte Ratio in Acute Pesticide Poisoning Cases

To estimate diagnostic levels of amylase, lipase, pseudocholinestrase and neutrophili lymphocytic ratio to different pesticide poisoning.

In addition to detect prognostic values of theses enzymes & NLR and its relation to the outcome of all pesticide poisoning.

To assess descriptive sociodemographic criteria of these poisoned cases, mode of toxicity, type of pesticide poisoning at emergency room, any other associated toxicity as well as the clinical outcome.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Acute pesticide poisoning is a global health problem responsible for majority of deaths in poisoning cases.

There is a study estimated that about 385 million cases of unintentional acute pesticide poisoning occur annually world-wide including about 11,000 fatalities.

Thirty percent of global suicides are due to pesticide poisoning as they are of low cost and easily accessible.

Most common suicidal pesticide are classified according to WHO to organophosphorus insecticides, carbamate insecticide, and methyl parathion /or the herbicide paraquat.

. Aluminum phosphide(ALP) becomes one of the commonest causes of poisoning. It is extremely toxic after self-poisoning, with a case fatality often exceeding 70% after ingestion.

Severe poisoning also has the potential to induce multi-organ failure. The exact site or mechanism of its action has not been proved in humans. Rather than targeting a single organ to cause gross damage.

organophosphorus pesticides inhibit acetylcholine esterase enzyme so that lead to accumulation of Ach and muscarinic, nicotinic and central nervous system (CNS) receptor overstimulation. The severity of acute poisoning depends on level of cholinesterase.

Detection of pseudocholinestrase is a good biomarker and the most specific lab test of acute pesticide poisoning.

There is a relative relationship between plasma cholinesterase and manifestation and final outcome so that level of PChE is a good prognostic value and could help in treatment plans.

Cholinergic stimulation of pancreas leads to hyperamylasemia so amylase could be used as a prognostic tool of acute pesticide poisoning, lipase can be helpful with amylase for early detect of pancreatitis as well as determination of severity of poisoning.

The neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of short- and long-term mortality in critically ill patients, and measurement is simple, cheap, and fast Furthermore, the NLR is a powerful prognostic predictor of cardiovascular affection, acute ischemic stroke, and many other diseases. So high NLR is associated with the risk of mortality of acute toxicity.

laboratory evaluation through using rapid, simple, cheap tests plays an important and vital role for confirmation of poisoning, diagnosing the first acute organ damage as well as assessing the severity of poisoning.

Emergency physicians can help in improvement of these patient and reduce deaths by accurate assessment of lab markers.

Study Type

Observational

Enrollment (Anticipated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • ADULT
  • OLDER_ADULT
  • CHILD

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

  • Sociodemographic criteria: age, gender, residence, occupation, level of education,
  • Toxicity associated data: mode of exposure, time of exposure, symptoms appear, any measures done to reduce the toxicity before reaching the hospital
  • Medical history (HR, BP, kidney function, liver function and blood glucose level)

  • Clinical lab result of pseudocholinesterase, amylase, lipase and neutrophil-to-lymphocyte ratio at three times.

    • the first with 6 hrs. of admission
    • the second after 24 hrs. of the treatment regimen taken
    • the third after 48 hrs

Description

Inclusion Criteria:

  • All ages
  • Both sex
  • Any possible route of exposure to pesticides

Exclusion Criteria:

  • Exposure to medications or toxic chemicals other than pesticides.
  • Patients with chronic comorbidities, including liver cirrhosis, symptomatic heart failure, end stage CKD(on regular hemodialysis) and COPD.
  • Patients with gallstone history or DM
  • Recent abdominal trauma
  • Open abdominal surgery within one year ago

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diagnostic and prognostic values of cholinesterase in acute pesticide poisoning cases
Time Frame: baseline
clinical lab result of pseudocholinesterase
baseline
diagnostic and prognostic value of amylase in acute pesticide poisoning cases
Time Frame: baseline
blood level of amylase
baseline
diagnostic and prognostic value of lipase in acute pesticide poisoning cases
Time Frame: baseline
blood level of lipase
baseline
diagnostic and prognostic value of neutrophil-to-lymphocyte ratio in acute pesticide poisoning case
Time Frame: baseline
blood level of neutrophil-to-lymphocyte ratio
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Study Director: Doaa Mohammed Abd EL-Rahman, Ass.Prof, Assiut University
  • Study Director: Hanan Sharaf El_Deen Mohammed, Ass.prof, Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ANTICIPATED)

April 1, 2022

Primary Completion (ANTICIPATED)

February 1, 2023

Study Completion (ANTICIPATED)

March 1, 2023

Study Registration Dates

First Submitted

March 1, 2022

First Submitted That Met QC Criteria

April 1, 2022

First Posted (ACTUAL)

April 4, 2022

Study Record Updates

Last Update Posted (ACTUAL)

April 4, 2022

Last Update Submitted That Met QC Criteria

April 1, 2022

Last Verified

April 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Acute pesticide poisoning

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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