الفهرس 
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Abstract
Background: Poisoning with OP compounds is responsible for great morbidity and mortality all over the world especially in developing countries including Egypt. There are no validated scoring systems for categorizing severity or predicting the outcome of acute OP poisoning. So, this could be potentially hazardous for a poisoned patient. Poisoning severity score (PSS) has been shown to be effective in determining the severity of cases of various intoxications. Prolongation of the corrected QT (QTc) interval is one of the most common electrocardiogram (ECG) abnormalities associated with OP poisoning. QTc might be indicative of a poor prognosis for patients exposed to OP. There are emerging options for new cheaper and/or easily quantifiable biochemical markers in relation to OP poisoning like creatine phosphokinase (CPK), lactate dehydrogenase (LDH) and C-reactive protein (CRP) facilitate the prediction the severity and/ or the outcome. The aim: This work aimed to study the role of the some indices in the assessment of the severity and outcome of acutely OP intoxicated cases. These indices include; poison severity score (PSS), corrected QT interval (QTc), Creatine phosphokinase (CPK), Lactate dehydrogenase (LDH), C- reactive protein (CRP) and difference in C-reactive protein (D-CRP) value between initial and after 24 hours. Method & Subjects: This was a cross sectional study carried out at Poison Control Center Ain Shams University (PCCASU) and it included one hundred acutely OP intoxicated patients who presented to PCCASU within 6 hours without receiving prior treatment. The diagnosis was confirmed by history of exposure, clinical manifestation and measurement of cholinesterase level. The study has been approved by Institutional ethical committee. An informed written consent has been obtained from each patient or from his/her caregiver for inclusion in the study. Patients with history of any diseases or conditions that may alter results of CPK level and CRP (e.g. myocardial infarction and post arrest), severe chronic illness (e.g. liver cell failure, end stage renal disease) and patients with any conditions that reduce pseudocholinestrease level (e.g. early pregnancy) or affect QTc interval (e.g. antipsychotic agents) were excluded from the study. Every patient were subjected to clinical examination, laboratory investigation of CPK, LDH, CRP carried out on admission after initial stabilization, after 24 hours and for patients admitted more than 24 hours just before discharge or after complete one week. Electrocardiogram (ECG) was done on arrival to PCCASU and after initial stabilization and PSS was calculated for every patient on admission and reevaluated during the study before discharge or after complete one week. Conclusions: Qtc interval prolongation is the best predictor for both severity and mortality followed D-CRP also initial CPK level can predict the severity, development of complications, need of more antidotes in OP intoxicated patients and its follow up can predict the bad prognosis and mortality. High initial LDH level can only predict the severity of the OP intoxicated patients. Poisoning Severity Score can’t be used as a reliable predictor for the mortal