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Correlation between Demographic Variables, Treatment Modalities and Outcome in Acute Copper Sulphate Poisoning in a Tertiary Care Hospital in Bangladesh

Richmond Ronald Gomes, Debasish Dutta, FM Monjur Hasan, Seema Saha, Md. Mamun Newaz

Background: Ingestion of copper sulphate is a common mode of poisoning in the Indian subcontinent. Cases are mainly suicidal in nature. The clinical course of the copper sulphate intoxicated patient is often complex involving intravascular hemolysis, jaundice and renal failure. The treatment is mainly supportive. Mortality is quite high in severe cases if treatment is not adequate and prompt.

Methods and materials: This cross sectional, observational, prospective studywas conducted on 50 patients with acute copper sulphate poisoningattended in Medicine department of Khulna Medical College Hospital from January 2020 to June 2020.

Results: The study showed that age frequency 25(50%) were from 11-20 years, 15(30%) were from 21-30 years, 5 (10%) were from 31-40years, 3 (6%) were from 41-50 years, 1 (2%) were from 51-60 years, and 1 (2%) were from 61-70 years of age. Out of 50 patients, 17 (34%) were male and 33 (66%) were female patients. poisoning is more common in married (68%) person than unmarried (32%); among low educational background population as 37 (74%) of the study population having educational qualification of primary or below primary; among housewife 23 (46%), student 12 (24%) and farmer/day labour 8 (16%); among rural population 33 (66%) than urban 17 (34%); among poor people 40 (80%) than solvent 10 (20%). History of familial disharmony/stress 36 (72%) and depressive illness 13 (26%) are common than others. Moderate to severely raised serum ALT (p-value=0.05), presence of hemolysis on peripheral blood film (p-value=0.035) and raised serum creatinine (p-value=0.035) demonstrated significant statistical association with the outcome of patients. All the patients were treated conventionally. With supportive treatment, 48 (96%) of patients were improved and 2(4%) of patients had died where penicillamine was used as chelating agent in about all patients 49(98%).

Conclusion: Acute copper sulphate poisoning is common in our country which is mainly suicidal in nature. As death occurs due to multi organ failure, while gastrointestinal, intravascular haemolysis, hepatic and renal toxicities significantly contribute to it. Management in High dependency unit is also required.