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Evaluation of the effect of hemodialysis on paraquat poisoning in patients in a Tertiary Care Hospital, West Bengal, India: A cross-sectional study

Kanai Lal Karmakar, Swapan Kumar Mandal, Abhik Saha, Sangita Bhattacharya, Rania Indu, Anjan Adhikari.


Background: Among the class of organophosphates, paraquat remains the commonly used herbicidal compound for self-poisoning in developing countries. Ingestion of paraquat is a leading cause of fatal poisoning in many parts of the world. The absence of any standard guidelines on the treatment of patients with paraquat self-poisoning remains an area of scientific research. The treatment varies from various combinations of immune-modulation, antioxidant therapy, hemoperfusion, and hemodialysis (HD).

Aims and Objectives: The present study was undertaken to evaluate the role of early initiation HD in the determination of prognosis in the case of paraquat poisoning.

Materials and Methods: This cross-sectional study was conducted on the patients suffering from paraquat poisoning, attending the Medicine ward of R. G. Kar Medical College, Kolkata. The patients were subjected to HD and blood was collected before and after therapy. Demographic characteristics of the patients, mortality rate, hepatic, and renal markers in serum were estimated.

Results: In the present study, 61 patients with paraquat poisoning were considered following all the inclusion and exclusion criteria. Of 61 patients, 16 patients (26.2%) survived 2 weeks of hospital stay, whereas 45 (73.8%) patients expired. Among the survivors, the mean value of the day of starting dialysis was 1.13 days in contrast to 2 days among the non-survivors. These data showed a significant correlation with mortality with P < 0.0001.

Conclusion: The present study, thus, highlighted the fact that early detection and immediate therapeutic action can reduce the risk of mortality in patients suffering from paraquat poisoning.

Key words: Hemodialysis; Paraquat; Poisoning; Tertiary Care

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