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Dear Editor,  The recent report on acute organo-phosphorus pesticide poisoning, oxidative damage, haemoglobin level and total leukocyte is very interesting1. Hundekari et al. noted that “cholinesterase inhibition may initiate cellular dysfunction leading to acetylcholine induced oxidative damage1.” This work is very useful information in clinical toxicology. However, there are many points to be considered.  First, there is no control group in this report and it is not possible to tell whether the observed finding is significantly different from general population in the same area. In many rural areas in developing countries, the exposure to organo-phosphorus pesticide is common and the abnormal cholinesterase activity can be seen2. Focusing on the present study, the question is on whether there is any underlying disease affecting haemoglobin among the subjects. It should be reminded that the hemoglobinopathy can affect haemoglobin level and show the figure of abnormal oxidative status3.  Sincerely,   Viroj Wiwanitkit  Visiting Professor: Hainan Medical University, China; Faculty of Medicine, University of Nis, Serbia; adjunct and Professor Joseph Ayobabalola University, Nigeria. Special Lecturer, Chulalongkorn University, Bangkok Thailand

Response to: Acute organo-phosphorus pesticide poisoning in North Karnataka, India: Oxidative damage, haemoglobin level and total leukocyte