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Background: In a developing country such as India, intentional poisoning is associated with a high degree of morbidity and mortality. Historically, the use of agricultural poisons for attempted deliberate self-harm (DSH) has taken precedence. However, urbanization and stringent laws governing sale of agricultural chemicals, in recent years, may have shifted the focus of seekers toward commercially available therapeutic medications. Further, urbanization, high health-care seeking behavior, and poor regulation on sale of medicines, in Kerala, provide a conducive environment for such attempts. Aims and Objectives: The objective of this study was to determine the contribution of therapeutic medication toward acute poisoning as a means of DSH and the factors contributing to the same. Materials and Methods: Patients who obtained treatment for acute poisoning after DSH, between 2017 and 2023, were screened, those who employed therapeutic medication for the same were further determined. Sociodemographic details, clinical profile, and history of previous such attempts and treatment history including toxicological screening report were gathered and analyzed. Results: In our study of 154 patients arriving at the emergency department with history of DSH, 41% used therapeutic medicines for the same. Majority were women (75%) and most had a high school education (64%) or above. The most common agents were determined as paracetamol (23%) and benzodiazepine (10.6%). Tox screen was performed for 45% of patients. Organ failure developed in 36% patients with drug levels above and 42% of those with levels below the therapeutic range. However, 48% of those who did not undergo toxicological screening developed organ failure. Organ failure developed in 42% of patients, with acute liver injury being the most common culprit (25%). Management was symptomatic unless an antidote was available. Conclusion: Prescription drugs utilization for DSH was common in women and patients with higher educational status. Over-the-counter drugs and psychiatric medication were frequently used. Lack of prompt access to healthcare may contribute to organ failure. Tox-screen is recommended for drug detection. [ABSTRACT FROM AUTHOR]

Acute poisoning from a variety of substances is common in every part of the world. The sooner the initial resuscitation, decontamination, and use of specific antidotes, the better the outcome. The main objective of this study was to describe the clinical profile and outcome of poisoning cases admitted to SKIMS Medical college, a tertiary care hospital located in central part of Jammu and Kashmir India. Descriptive cross sectional evaluations were conducted on all cases that were admitted to the hospital's emergency room over a period of one year from March 2022 to February 2023. The following parameters were examined using data taken from hospital medical records: socioeconomic factors, substances consumed, routes of intake, clinical symptomatology and severity of poisoning.300 patients were included in the study with different poisonings of which 35% were males and 65% were females. The most common form of poisoning was due to pesticides followed by rodenticides and opioid intoxication respectively. Majority of the patients had suicidal intent followed by accidental ingestion reported mainly in children. Few patient required intensive care admissions rest all were managed in general ward depicting mild severity of poisoning in majority of the patients. Three patients were brought dead to hospital secondary to opoid overdose and one patient died in hospital who had pesticide ingestion complicated by ventilator associated pneumonia. The less mortality in this study was likely due to mild severity of poisoning, early gut lavage and easy access to hospital. The effects of poisoning on the human body are negative regardless of the agents or method used and this has an impact on the treatment and outcome. Due consideration must be given to clinical, toxicological and epidemiological profiles. Therefore precise and prompt diagnosis, adequate treatment and effective preventative efforts are required. This study highlighted the importance of awareness and for the establishment of poison information centre for the better management and prevention of all poisoning cases. [ABSTRACT FROM AUTHOR]

Introduction: Acute poisoning in children is an important public health problem. It is a significant paediatric emergency in both developing and developed countries, leading to preventable morbidity and mortality. While there is substantial research literature on acute childhood poisoning from developed countries, there is a lack of data from developing countries like India due to inadequate and poor surveillance of poisoning-related data. Aim: To investigate the clinical and epidemiological profile, as well as the outcome, of acute poisoning in children admitted to the paediatric emergency department of a tertiary care hospital in Northeast India. Materials and Methods: This prospective cohort study was conducted in the Paediatrics department of Assam Medical College and Hospital, Dibrugarh, Assam, India, from April 1, 2021, to March 31, 2022. All children under the age of 12 years who presented to the paediatric department with a history of exposure to toxic substances were included in the study. The admitted children were assessed in terms of demographic variables, type of poison, route of poisoning, time of presentation, circumstances of poisoning, storage place of poison, clinical presentation, and interventions provided. Data were presented as mean and frequency. Results: A total of 78 children under 12 years of age were enrolled in the study, with a mean age of three years and three months at presentation. The majority of cases (96.2%) involved accidental poisoning, while a small proportion (3.8%) was due to suicidal poisoning. Of the two reported cases of suicidal poisoning, one involved a male child and the other involved a female child. Both children were above six years of age. The most common causes of poisoning were kerosene (34.6%), organophosphorus compounds (10.3%), and liquid mosquito repellents (9.1%). Conclusion: This study revealed both unintentional and intentional poisoning cases, with a high prevalence of accidental poisoning observed in children below three years of age. Kerosene was identified as the most common cause of childhood poisoning. [ABSTRACT FROM AUTHOR]

Background: Acute poisoning is a major health problem with significant morbidity and mortality affecting people of all age groups. Acute poisoning approximately constitutes 10% admissions in medical emergency departments in India. Objective: Present study was aimed at finding out the clinical pattern and outcome of acute poisoning at a tertiary care hospital, Karnataka. Materials and methods: A prospective observational study was conducted over a period of 18 months. Information like name of poisonous substances, mode of poisoning, investigation reports and outcome was collected in the pre-structured proforma and analysed using SPSS version 20. Results: Out of 100 acute poisoning cases, 49 were males and 51 females. Most common age group involved was 21-30 years of age (38%). Organophosphate poisoning was the most common type of poisoning. Mortality was highest in paraquat poisoning (100%). Overall mortality was 15%. Conclusion: Current study showed increase in incidence of poisoning in younger generation. Organophosphate poisoning was the most common type of poisoning. Low cost and easy accessibility of OP compounds may be one of the reasons. Rat poisoning, usage of household cleansing agents and corrosive poisons (paraquat) are also in increasing trend. [ABSTRACT FROM AUTHOR]

Background and Objectives: Organophosphorus compounds have assumed considerable importance in most parts of the world. Though these compounds were discovered a century ago, even now they are the widely used insecticides all over the world. Aims and objectives of these study was to assess serum creatine phosphokinase level in OP poisoning. Material and Methods: The present study was conducted on a sample of 50 patients who were admitted to Department of General Medicine, SVS Medical College and Hospital Yenugonda, Mahbubnagar, Telangana, 509001, India, exhibiting a documented history and clinical manifestations consistent with organophosphate poisoning. Study was conducted between the April 2023 to September 2023. Results: Organophosphorus chemicals are often employed substances for self-harm due to their widespread accessibility. The primary determinants of death encompass the specific toxic chemical employed, the extent of poisoning, the timing of treatment initiation, and the availability of intensive care resources. Although acetylcholinesterase has several advantages, it can result in an overstimulation of muscarinic and nicotinic receptors. The clinical presentation of cholinergic crisis typically manifests rapidly, serving as the primary basis for clinical diagnosis. Confirmation of this diagnosis is typically achieved by the patient's medical history and the use of demonstrative monitoring. Conclusion: The study observed that following treatment, levels of creatine phosphokinase returned to baseline levels, accompanied by a subsequent enhancement in the patient's clinical state. The optimization of the mean dose and duration of Atropine and pralidoxime treatment is a topic of interest, as it has been seen that greater doses are required in severe instances. [ABSTRACT FROM AUTHOR]

Introduction: Poisoning in children is an important paediatric emergency and a worldwide problem. Poisonings from intentional substance abuse, as well as unintentional toxic exposures, remain significant health concerns for hospital emergency admissions. Understanding the precipitating causes and providing timely counseling play a key role in preventing intentional poisoning in adolescents. Aim: To study the profile of acute self-poisoning in adolescents and factors associated with poisoning. Materials and Methods: A hospital-based prospective cohort study was conducted at Vanivilas Hospital, which is affiliated with Bangalore Medical College and Research Institute in Bengaluru, India. The study duration was from November 2018 to June 2020. The study included 100 adolescents, aged 10-18 years, who were admitted with a history of poisoning during the 18-month study period. Informed consent was obtained, and participants were followed-up until discharge. Data was collected using a proforma that included demographic details, information about poisoning, examination findings, investigations, and treatment given. The data was analysed using descriptive statistics, and the Chi-square test was used to determine associations between variables. Results: The mean age of the study participants was 15.48 years. The maximum number of cases, 53 (53%), were seen in the 13-16 years age group, followed by 36 (36%) in the age group of 17-18 years, and 11 (11%) in the age group 10-12 years. There were 33 (33%) male children and 67 (67%) female children. In the present study, 43 (43%) children belonged to the insecticide group, 30 (30%) to the drugs group (most of them were in combination), 14 (14%) to the household group, 4 (4%) belonged to both the plant and unknown group, and 2 (2%) belonged to the corrosive, and 1 (1%) each for herbicide, hydrocarbon, and metal groups. A total of 87 (87%) cases were discharged after completion of treatment, 8 (8%) cases were discharged against medical advice, and the mortality rate was 5 (5%). The majority of the cases, 79 (79%), consumed poison as an impulsive act secondary to conflicts among family members. Conclusion: The present study found that acute poisoning in adolescents is mostly intentional, with insecticides being the most commonly implicated agents. [ABSTRACT FROM AUTHOR]

Setting: Paraquat is a highly toxic, herbicide, extensively used in various parts of India. There is no effective treatment for paraquat poison and carries a very high mortality. In India, this compound can be misused for harmful purposes. Objective: A retrospective time-bound descriptive study of paraquat-consumed patients was conducted at Kasturba Hospital, Manipal, from January 1, 2014 to January 31, 2016. Materials and Methods: All the data were analyzed using the SPSS version 16. All the categorical data are expressed in terms of frequency and percentage. Continuous normal variables were expressed in terms of mean ± standard deviation, and skewed variables were expressed in terms of median and quartiles. Chi-square test was used to find the association between the categorical independent variables across the outcome in survivors, nonsurvivors, and those patients who were discharged from the hospital against medical advice. Similarly, Fisher's exact test was performed for those variables, for which 20% of the expected cell count was <5%. Kruskal--Wallis test was used to compare the relationship between the continuous skewed variables across the outcome. Results: A total of 55 paraquat-consumed patients were admitted, out of which 67.27% (n = 37) of patients were men. Only 32.7% (n = 18) of patients were farmers. Oral ulcers were seen in 43.6% (n = 24) of patients. About 65.5% (n = 36) of patients underwent hemoperfusion, 27.3% (n = 15) of patients survived, 47.3% (n = 26) of patients expired, and 25.5% (n = 14) of patients were discharged against medical advice in a critical condition. The presence of respiratory failure, hypotension, need for ventilator supportive therapy, the elevation of levels of blood urea, serum creatinine, and liver enzymes AST and ALT levels were statistically significant in three groups (P < 0.001). Conclusion: Paraquat poisoning is highly fatal. Treatment is expensive and available only in tertiary care hospitals in India. Central and state governments should ensure that it should not be readily accessible to ordinary people and it should be banned progressively. [ABSTRACT FROM AUTHOR]

Introduction: The WHO 2021 data estimate that 2 million lives and 53 million disability-adjusted life-years were lost in 2019 due to exposures to selected chemicals. It is important to know the pattern and outcome of acute poisoning cases for proper planning, prevention and management. Knowing the pattern will also help in designing training modules for primary care physicians to make them aware about newer poisons and their management. Awareness regarding newer poisons consumed is necessary for early identification, initial management and timely referral to higher centres by primary care physicians. This study was performed to see the pattern and outcome of acute poisoning cases in North Indian population and various factors related to outcome. Materials and Methods: This study was conducted in department of medicine of a teaching institute in North India after approval by the Institutional Review Board. Patients admitted in the department during the study and fulfilling the inclusion criteria were enrolled in the study after obtaining consent. Results: A total of 417 patients with poisoning were recruited in the study. Out of 417 patients, majority were males (59.5%). Maximum number of patients were in the age group of 21-30 years (33.8%), and rural population (79.9%) was found to be more affected. Most of the patients were students and private employees. Most common types of poisoning were snakebite (n = 109, 26.1%), organophosphate (n = 49, 11.8%) and aluminium phosphide (n = 39, 9.3%). Out of 417 patients, 349 (83.69%) improved, while 68 (16.3%) expired. Requirement of ventilatory support was most commonly associated with aluminium phosphide poisoning (30.12%) followed by organophosphate poisoning (24.1%). Conclusion: Poisoning was more common in young males and more prevalent in rural population. Pesticides and snakebite were major causes of poisoning. Among suicidal cases, family conflict (problem/altercation with family members/marital discord) was main reason for the consumption of poison. There is need for creation of poison information centre along with separate toxicological units in tertiary care hospitals. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this was to present our firsthand observations and findings pertaining to the occurrence of acute kidney injury (AKI) subsequent to exposure to toxic substances. Methods: This retrospective study involved the collection of data from patient case records at a prominent nephrology hospital situated in central India. Patient records were carefully examined to obtain information regarding the ingested substance, symptoms observed upon presentation, basic laboratory test results obtained upon admission, the treatment modality employed, and the ultimate outcome. It is important to note that patients who developed AKI following snake envenomation or scorpion stings were specifically excluded from this study. Results: A total of 200 cases involving AKI resulting from poisoning were identified. The largest group within this cohort consisted of patients who were affected by paraphenyline diamine poisoning. Additionally, there were cases of methanol poisoning, organophosphorus compounds, paraquat, and copper sulphate poisoning, tartaric acid poisoning, phenobarbitone poisoning. Notably, 9 patients had ingested a combination of multiple substances. Among the affected patients, 95% required renal replacement therapy. Overall, 70% of patients achieved complete recovery, while 30% succumbed to the acute phase of the illness. Conclusion: The reporting of toxic substances that lead to the failure of vital organs is of utmost importance in order to enhance awareness among the general population and healthcare providers. By providing comprehensive documentation and dissemination of information regarding these substances, the understanding of the potential hazards associated with them can be improved. [ABSTRACT FROM AUTHOR]

Yellow oleander (Thevetia peruviana) is a commonly found shrub in India which produces multiple alkaloids which are cardiotoxic. Numerous cases of yellow oleander poisoning have been reported in humans. The spectrum of toxicity due to this plant ranges from nausea, vomiting, diarrhoea, electrolyte abnormalities and arrhythmias in humans. No case of bowel necrosis due to yellow oleander has been reported in humans to the best of our knowledge. We present a case of 45-year-old female with suicidal consumption of crushed yellow oleander seeds. The patient was admitted and observed for arrhythmias. On day 2 of admission, she developed bloody stools, hematemesis and abdominal pain. Abdominal examination showed rigidity and per rectal examination showed blood-stained mucoid stools. A CECT was done which showed findings suggestive of gastric necrosis with perforation. The patient was taken up for surgery and stomach was found to be gangrenous with a perforation at the greater curvature. Total gastrectomy was performed. The post operative biopsy showed extensive transmural coagulative necrosis of the stomach and lymphoplasmacytic infiltration of the submucosa. Necrosis of bowel has been reported in experimental settings in animals and in cattle poisoning but no reported case of stomach necrosis and perforation due to yellow oleander has been reported in humans. As yellow oleander is a commonly used suicidal poison in Southern Asia, an eye needs to be kept out for gastrointestinal symptoms. We conclude with recommendations on management of yellow oleander poisoning in the light of these new manifestations. [ABSTRACT FROM AUTHOR]

Poisoning deaths are a major public health concern in India because of intentional consumption of toxic substances to commit suicide. Poisoning related mortality is huge compared to the morbidity in our country. This is one of the reasons for more number of poisoning cases in our autopsy work. Undoubtedly, autopsy is a very essential tool in knowing the exact cause of death in all these cases. The gross and histopathological examination of postmortem specimens is crucial for the accurate identification of the cause of poisoning-related deaths along with chemical analysis. In this autopsy-based study, we investigate the gross and histopathological changes in the stomach associated with poisoning caused by various substances, including pesticides, corrosive substances, and medications. The study included 118 poisoning fatality cases autopsied at Osmania General Hospital, Hyderabad. The main objective of this study was to investigate the effects of different poisonings on the stomach wall by conducting gross and histopathological examination of gastric tissue. In addition, the study aimed to evaluate the potential use of stomach pathology findings as a diagnostic criterion for various poisonings and to establish a correlation between these findings and the chemical analysis of viscera data. The sociodemographic data, circumstances of poisoning and reasons for suicide were also studied. The study revealed that the major gross changes observed in the stomach were congestion, erosion, haemorrhage, and paleness, listed in descending order of occurrence. Similarly, the major histopathological findings identified in the stomach were congestion, gastritis, necrotic changes, and submucosal haemorrhages, listed in descending order of frequency. In conclusion, this study provides valuable insights into the effects of different poisonings on the stomach wall through gross and histopathological examination of gastric tissue. The findings indicate that while gross and histopathological findings alone may not be sufficient for diagnosis, they can be used in conjunction with other diagnostic tools to accurately identify the cause of poisoning-related deaths. Moreover, the study suggests that the development of gastric mucosa specific immunohistochemistry techniques may offer a promising on-spot diagnostic tool for poisoning cases. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The prognosis of acute aluminum phosphide poisoning is usually based on toxidrome features, with little focus on poison-related factors. We aimed to study the prognostic significance of poison-related factors, consumption patterns, and time delays to treatment. METHODS: We performed a prospective cohort study in an academic hospital in North India in patients aged = 13 with aluminum phosphide poisoning from July 2019 to December 2020. During data collection, a particular emphasis was made on the poison formulation, the ingested dose, the reconstitution of poison, vomiting, and time intervals to initiate various treatments. The primary outcome was inhospital mortality. RESULTS: Fifty-eight patients were enrolled (median age, 32 years; 37 males). The mean dose of the ingested poison was 6.56 (±5.42) g. The predominant formulation of poison was pellet (n = 41), followed by powder (n = 16). Twenty patients performed reconstitution of poison before consumption, and 13 stirred the poison while reconstituting. All patients but three developed vomiting after consumption. Inhospital mortality (n = 23, 39%) was significantly high with a higher ingested dose (P < 0.001), nonstirred reconstitution before consumption (P = 0.042), fewer vomiting episodes (P = 0.010), a delay in detection of the victim by someone (P = 0.001), and delayed initiation of intravenous fluids (P = 0.043). The secondary outcomes (shock and requirement of vasopressor or ventilation) remained unaffected by the stirring in the reconstitution group. CONCLUSIONS: Poison-related factors and time intervals determine early risk stratification at admission in aluminum phosphide poisoning. [ABSTRACT FROM AUTHOR]

Background: This prospective study aimed to assess the clinical and demographic profile of adolescent poisoning cases admitted to the Department of Pediatrics at HIMS Hassan, India. Methods: A total of 105 patients aged between 10 and 17 years were included in the study, with data collected regarding their clinical-demographic profile and consumption details. Results: The majority of cases were female (79%) and from a rural area (63.8%). In terms of socioeconomic status, the largest proportion of cases were from the upper lower class (32.3%). Insecticide (26.6%), rat paste (13.3%), acid (11.4%), and tablet consumption (24.7%) were the most common poisons consumed by the adolescents. Suicidal consumption accounted for 85.7% of cases, while 14.2% were accidental. Regarding treatment, 80% of patients received supportive and symptomatic management, while 20% received a specific antidote. Conclusion: The study provides valuable information about the clinical and demographic profile of adolescent poisoning cases in India, which can be used to inform prevention and management strategies. [ABSTRACT FROM AUTHOR]

Poisoning is a major public health problem globally, with thousands of deaths occurring every year, & those who survived the same, live with a life long suffering. In a developing country like India where more than half of the population is still engaged in occupational activity of agriculture, accessibility to toxic substances is not much hard. That is the reason, organophosphorus compounds are the most commonly used poisonous substance creating a burden of poison related morbidity & mortality. Objective: 1) To determine sociodemographic profile of poisoning cases brought for autopsy. 2) To assess their pattern. Methodology: A cross sectional study was conducted for a period of 1 year (January 2021 - December 2021), in cases of poisoning brought for autopsy at Tertiary care teaching hospital, Thoothukudi. All the data were regarding age, gender, residence, type of poison, manner, duration of hospitalisation & outcome was collected based pre structured proforma & further chemical analysis report. Data was analysed using standard statistical method. Results: Of the total, 140 cases, poisoning studied, 77% cases were males, 23% females. Maximum case was noted in age group of 31-40 years (22.9%), majority belong to lower socioeconomic class (88%), Organophosphorus compounds contribute 60% of cases, & majority of it is suicidal poisoning - 89%., the maximum duration of treatment taken was between 1-7 days(51.4%). Conclusion:- Males contribute majority of poisoning cases. It is the middle age group, with suicidal poisoning tendency more contributing to total cases. Early& proper treatment care in acute poisoning cases, with increasing mental health awareness among the common public can help in reducing the mortality due to poisoning. [ABSTRACT FROM AUTHOR]

Introduction: Death due to acute poisoning is one of the most vital health challenges to cope-up. It is very essential to have a better understanding regarding the patterns of these deaths in order to prepare the relevant remedies for the same. Aim: The aim of the present study is to assess the patterns of deaths due to poisoning in a tertiary care center and to study the autopsy related findings of these deaths. Materials and Method: It is an autopsy based retrospective study conducted in a tertiary care center. The ethical clearance was obtained from the institutional ethical committee. Descriptive statistics to study the distribution of the cases among different age groups, sex, type of poison compounds was computed and analyzed using SPSS software version 20 Results: A total of 206 cases were recorded and maximum number of cases were done in 2018. Maximum patients were youngsters in the age group of 21-30 years (36.9%). Males dominated the study (62.6%). 95.1% were living in the rural areas and 62% of the cases belonged from lower socio-economic status. Majority of the patients were hospitalized (52.4%). Almost all the bodies (98.9%) of the dead bodies were fresh and cyanosed. Congested gastric mucosa was seen in 80.9% of the cases. In majority of the cases, the poisonous compound seen was aluminum phosphide (69.4%). Suicidal tendencies contributed to majority of the cases (87.4%). Conclusion: The findings imply that recommendations for the proper handling, storage, and transportation of poisonous compounds should be defined while taking into account the groups of young teenagers without considering their sexual orientation. To manage poisoning cases, it is important to keep in mind that the most recommended agent in acute poisoning is the organophosphate. [ABSTRACT FROM AUTHOR]

Poisoning is a very common way to commit suicide. It is more common in low- and middle-income countries. Aluminium phosphide is a very commonly available pesticide in such countries including India. Aluminium phosphide is a very toxic compound. Ingestion of aluminium phosphide can cause severe toxicity to various cells, and mortality is very high. We are presenting a case of rare survival of acute aluminium phosphide poisoning, who presented with signs and symptoms of severe toxicity including metabolic acidosis and shock. During hospitalisation, he developed ventricular tachycardia, acute kidney, and liver failure. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the sociodemographic characteristics of patients based on the poison chosen and different types of organophosphorus compounds. The data were collected to explore the sociodemographic characteristics of organophosphate (OP)-poisoned patients based on the source, site, and route of poisoning, education level, occupational status, and the purpose of poisoning. Furthermore, we estimated the serotonin and dopamine levels in the plasma samples of patients, and survival plots were also described. During the study of OP pesticide poisoning in 116 human subjects and 5 healthy volunteers, we observed, based on the survival plot, that75.9% of the patients were discharged, and the remaining patients died (24.1% of the patients) due to respiratory failure followed by cardiac arrest. Our findings suggest that the serotonin levels significantly (p < 0.01 and p < 0.001) decreased from 12 to 36 h, whereas the dopamine levels slightly increased from 12 to 36 h in the group with OP poisoning compared to the control group. Based on these findings, this study may aid in deciphering the precise mechanism by which pesticides cause behavioural changes that influence serotonin and dopamine levels in OP-poisoned patients. The purpose of this work was to serve as a small reminder of the risk to public health associated with organophosphate pesticides. [ABSTRACT FROM AUTHOR]

Pesticide poisoning is one of the most common instances of poisoning deaths in every agriculture-dependent country may it be in form of suicidal or homicidal cases. Traditional classes of pesticides like the Organophosphates, Organochlorides and Carbamates have given way to the newer class of pesticides known as synthetic Pyrethroids. Some of the synthetic Pyrethroids like Cypermethrin, Deltamethrin and Fenavalerate are increasingly being encountered as routinely used poisons in rural India. In the instance of poisoning detecting the class of Pyrethroids uses a complex and costly instruments which is not very user friendly and also expensive. In the present article Thin Layer chromatography which is classical method of seperation science has been used as tool to identify the class of Pyrethroids, identification of Cypermethrin pesticide is analyzed using different solvent system for qualitative analysis with suitable spray reagent to identify the movement of the spot. [ABSTRACT FROM AUTHOR]

Background: Hazardous materials have become a popular home item in many developing countries over the last few decades. It has become a huge global health problem due to their simple availability, marketing, accessibility, and lack of knowledge. According to current figures, unintentional and domestic poisoning is the 13th biggest cause of mortality in India in an urban setting in India; Patil et al. (2014) identified home items to be the most common poisoning agents. Data sources Study selection: This is a review paper. All the content in this article is taken from several reviews and guidelines published by WHO, HSRA etc. Conclusion: To lower the prevalence of poisoning in urban settings, it is crucial to educate and raise awareness among the general public about chemical poisoning from home chemicals. Early diagnosis of suspected poisoning symptoms, implementing effective preventive measures and providing fast, focused treatment will help you win the war against poisoning in India. [ABSTRACT FROM AUTHOR]

Introduction: According to data available from National Poison Information Centre India, suicidal poisoning with household agents (organophosphates, carbamates etc.,) is the most common modality of poisoning. There are reports suggesting relationship between prolonged corrected QT interval and the severity of Organophosphate (OP) poisoning. Corrected QT (QTc) interval is measured in 12 lead electrocardiograms taken on admission. Aim: To assess prognosis of acute organophosphate poisoning patients by studying association of corrected QT interval with its complications and mortality. Materials and Methods: The present cohort study was conducted at Medicine Department of Medical College, Baroda and Sir Sayaji General Hospital, Vadodara, Gujarat, India, from December 2017 to November 2018. The study included 60 patients with a history of OP poisoning. The QTc interval in electrocardiogram was determined by using the Bazett formula. Prognostic importance of QTc interval was assessed by correlating it with Paradeniya Organophosphorus Poisoning Scale score, hospital stay, atropine requirement, requirement of ventilatory support and mortality. Data was analysed by using descriptive statistics and Chi-square test. Results: The organophosphate poisoning was seen more in younger age group, between 18-29 years (68.4%). The QTc prolongation was seen in 12 (80%) of patients in moderate grade of Paradeniya Organophosphorus Poisoning Scale and in 9 (20%) patients among mild grade of Paradeniya Organophosphorus Poisoning Scale (p-value=0.0001). Amongst patients who needed hospital stay for more than seven days, QTc prolongation was seen in 43% of patients, and in patients who needed hospital stay for less than seven days QTc prolongation was seen in 9% of patients (p-value=0.0223). Statistically significant association was seen between atropine ampule requirement and QTc prolongation. Total 29 (48.3%) patients developed respiratory depression, and amongst them 19 (65.5%) had QTc prongation (p-value <0.0001). Out of, 13 (22%) patients died and amongst them 12 (92.31%) had QTc prolngation. In those who survived 47 (78%) only 9 (19.15%) had QTc prolongation (p-value <0.0001). Conclusion: Prolonged QTc interval in electrocardiogram is a good prognostic indicator in patients with organophosphorus poisoning. Early identification of prolonged QTc interval and subsequent timely shifting of patients to Intensive Care Unit (ICU) and subsequent intensive management in a patient of OP poisoning would be of profound value at any level of health care setting for favourable outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Poisoning is the second frequent cause of suicide in India. To plan an effective intervention and awareness program, it is essential to know the sociodemographic profile, pattern, and reasons for suicide. Objective: We conducted this study to find the sociodemographic profile, pattern, and reasons for fatal suicidal poisoning. Methods: We conducted a record-based study in a tertiary hospital in Puducherry. We reviewed autopsies conducted between January 2010 and December 2014 for fatal suicidal poisoning. We extracted data using a data collection sheet for age, gender, marital status, occupation, residence, the reason for suicide, time of injury, time of death. We entered data in Microsoft Excel, and we did a descriptive analysis by using R software version. Results: We reviewed 3996 medicolegal autopsies, out of which 595 cases were of fatal suicidal poisoning. The mean age of the cases was 35.8 years (SD-14.6). The majority of the cases were married (74.8%) for 20–30 years (31.8%). Most of the victims were agriculture workers (22.2%), lived in a rural setting (84.4%), died during the daytime (61.2%), and in the summer season (54.5%). The most common poison used was organophosphates (48.7%), and the most common reason was family problems (30.2%). The median survival time (h) for the cases (n = 564) was 45.8 h (IQR: 16.4 to 110.6). Conclusion: We found fatal suicidal poisoning was common among males, young adults, married, agriculture workers/laborers, and in a rural setting. The findings help plan an effective intervention for suicide prevention in India. [ABSTRACT FROM AUTHOR]

Introduction: Organophosphate compounds (OPC) cause most self-poisoning deaths in India due to their easy availability and lack of stringent laws. Aim: To evaluate the clinical profile and outcome of the patients presenting with OPC poisoning and to study the prognostic value of Peradeniya Organophosphorus Poisoning Scale (POPS) in predicting the clinical outcomes. Methods and Materials: This was a prospective study involving 100 patients of OPC poisoning admitted to Tata Main Hospital from June 2018 to May 2020 based on the inclusion criteria. Demographic profile, clinical features, treatment details, and need for ventilatory support were noted. POPS was applied on admission, and the patients were followed up for the outcome in terms of morbidity and mortality. Observations: Of the 100 patients, most patients were between 20 and 29 years with male to female ratio being 1.2:1. Vomiting (94%), followed by excessive secretions (84%) were the most common symptoms. Overall mortality was 22%. On grading of severity as per the POP scale, 27% of the patients had mild poisoning, 37% patients had moderate, whereas 36% had severe poisoning. Only 11.11% of the patients with POPS 0–3 required ventilator support, whereas 16.2% of the patients with POPS 4–7, and 100% of patients with POPS 8–11 required ventilator assistance (P < 0.0001). Similarly, the total dose of atropine required (P < 0.0001), length of intensive care unit (ICU) stay, complications, and mortality (P < 0.0001) were significantly associated with higher POPS. Conclusion: POPS at admission, correlated well with the need for ventilator support, the total dose of atropine required, length of stay in the ICU, complications, and mortality. It can thus be used for prognostication and risk stratification of patients with OPC poisoning. [ABSTRACT FROM AUTHOR]

Introduction. Aluminum phosphide (rice tablet) was first introduced as a pesticide in India. Rice tablets are commonly used in Iran due to their high efficacy against rodents and insects, low cost, and availability. Aluminum phosphide is a lethal poison without antidote and causes cardiocirculatory collapse and has negative inotropic cardiac effect. Human and animal studies showed that high dose insulin had positive cardiac inotropic effects. GIK (glucose, insulin, and potassium) assists heart uptake of carbohydrates that are the major fuel substrate of the myocard muscle under stressed conditions and leading to correction of acidosis, increased myocardial contractility, and peripheral vascular resistance. Case Presentation. In this manuscript, a young woman with aluminum phosphide poisoning was described to have presented with hypotension, hypoxemia, and severe metabolic acidosis. In contrast to our previous experiences that approximately all rice tablet poisoning patients with shock were dead despite full conservative treatment, this patient miraculously was saved with high dose intravenous regular insulin infusion and was discharged from the hospital with good condition and without any complications. Conclusion. Rice tablet poisoning has high fatality rate, and to date, no antidote is available. GIK is suggested as a potential life saving treatment for critical rice tablet poisoning patients with symptoms and signs of shock. [ABSTRACT FROM AUTHOR]

Background: Poisoning is the major health problem in developing countries like India. Rodenticides are the substances used to kill rats. Rodenticides are one of the commonest substances used for poisoning in India one of the reasons is that it is easily available and cheaper than other pesticides They differ from chemical composition and toxicity profile. Prognosis mainly depends on chemical content of poison. Methods: A retrospective descriptive 6 -year review of data from 597 rodenticide poisoning autopsies performed by the Department of Forensic Medicine at Vijayanagar Institute of Medical Sciences (VIMS), Ballari, Karnataka, India between January 1, 2015, and December 31, 2020, was carried out. Data were obtained from judicial requisitions, autopsy reports, toxicology, and histology results. Different variables like the gender, age-wise distribution of cases, marital status, profession, antemortem laboratory investigations and manner of death were analysed. The data were analysed using Statistical Package for Social Sciences (SPSS) version 27.0. Results: Out of 597autopsy cases, majority of the cases 492 (82%) were male, 105 (18%) were female. Most common age group was 51 to 60 years 152 (45.23%) cases, followed by 41 to 50 years 140 (26.19%) cases. Most victims were married 469 (79%) and by profession were farmers 292 (48.91%) cases. Majority of the cases were mostly reported in the night 454 (76.04%). Antemortem laboratory investigations data like prothrombin time (PT), activated partial thromboplastin time (APTT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin waselevated in majority of the cases. Manner of death was suicidalin 497(83%) cases. Conclusions: Rodenticide poisoning is quite common and treatable, most of the time it is suicidal in nature. Public should be educated regarding consequences of poisoning. Family support and proper counselling for high-risk groups may decrease these incidences. [ABSTRACT FROM AUTHOR]

Background: Poisoning is a global health issue and one of the leading causes of morbidity and mortality in India. Pattern of poisoning depends on factors, such as availability of poisons, socioeconomic status of the population, religious and cultural influences, thus creating varied epidemiological trends across time and regions. The present study is planned to address the epidemiological profiles of fatal poisoning cases, with reference to the gastric findings during autopsy. Methods: This is a descriptive, observational, cross-sectional study analysing 184 fatal poisoning cases, who attended to R.G. Kar Medical College Police Mortuary during the period of 2014-2015. Conclusion: People of age group 20-29 years were mostly affected, with a male preponderance and an incidence of 8.03%. People from the rural regions constituted more than 80% of the study sample, with suicide as the commonest manner of death. Organophosphorus compounds and acids were the mainly detected, with mucosal congestion and submucosal hemorrhage of stomach as the most reported findings. The authors feel that a prospective study is an option, which could accurately identify the cases and deaths, which could formulate stringent measures so as to decrease the morbidity and mortality due to poisoning. [ABSTRACT FROM AUTHOR]

Background: Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years.Methods: We performed a systematic literature review in Medline, Embase and Google Scholar (1999-2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study.Results: We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999-2003), the number of deaths declining thereafter (to n = 1714 in 2014-2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths.Conclusion: Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter's lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions. [ABSTRACT FROM AUTHOR]

Backgrounds: Paraquat is a major cause of fatal poisoning in agro-based countries like India. Being, a veiled offender it is often deluded for its relatively less fatal counterpart i.e organophhosporous compounds. It is a highly lethal herbicide, contributing to a majority of the pesticide poisoning related deaths & Disability Adjusted Life Years (DALY) globally. Methods: A retrospective record review of the patients presenting with paraquat poisoning to the Emergency Medicine Department of a tertiary care center in South India, between August 2014 to August 2016 was done. Demographics, clinical presentation, and laboratory data of patients were analysed to study risk factors associated with morbidity & mortality. Results: 91 case were evaluated, of which 65.9% were male and majority (78.1%) belonged to the age group 20-30 years and 31 (34%) being agriculturists. 85 (93.4%) attempts were suicidal in nature. Most common presenting symptom was vomiting 72 (79.1%), 27% of the patients had hypoxia (pao2<70%) however the initial mean circulatory assessment were within stable limits (HR- 84/min, BP- 124/78mmhg). Investigations revealed average serum creatinine of 2.8mg/dL (+ 3.16) and bicarbonate of 17.6 mg/dL (+ 4.47). Treatment measures included gastric lavage (67%) and haemoperfusion (49.5%) amongst others.47 (51.6%) patients died with the most common cause of death being Multiorgan dysfunction syndrome -MODS (61.7%) and Acute Kidney Injury-AKI (29.7%). To determine predictors of mortality, univariate and multivariate analysis [adjusted odds ratio (95% confidence intervals)] was done which revealed low bicarbonate6.174[1.20-31.59] and hypokalemia4.79 [1.08-21.19] to be significant risk factors. Conclusion: Paraquat poisoning has a high disease burden and concerning mortality ratesespecially in young and middle aged adults. Risk factors for mortality include low bicarbonate, hypokalemia and increased serum creatinine with AKI and MODS being the most common causes of death. [ABSTRACT FROM AUTHOR]

Acute poisoning is an important and common medical emergency. Acute poisoning is one of the major health challenges both in developing as well as developed countries2, 3 Aim of the Study-We had conducted a study with the objective to investigate the pattern of acute poisoning cases by utilizing the toxidromic approach in a tertiary care hospital in Uttar Pradesh. Material & Methods We had done an observational study on acute poisoning patients presenting in the Emergency, Medicine, and Pediatrics department of Dr RMLIMS from January 2020 to January 2021.All consenting patients of both sexes with suspected poisoning were studied. Toxidromic approach based on clinical presentation of poisoned patients was utilized in identification of the type of poisoning. Observations & Results –total 82 cases were studied, we came across a total of 82 poisoning cases seen over a period of 1 year in the emergency, medicine and paediatric wards of RMLIMS. There were 40 males and 42 females, with Cluster A containing 28 males and 27 females, whereas Cluster B had 12 males and 15 females, The relative risk and Odd’s ratio of total cases came out as 0.49 and 0.45 respectively. Majority of the cases in Cluster A &B showed features of Cholinergic Toxidrome, followed by corrosives and sympatholytics, anticholinergic toxidromes and medical toxins. Conclusion: we need to develop appropriate medical facilities like extracorporeal membrane oxygenation (ECMO) as a rescue modality for patients with acute reversible life threatening cardiopulmonary conditions. Poison control centre with Analytical Toxicology laboratory should be developed to handle and assist in advising the specific and appropriate management of poisoning cases. [ABSTRACT FROM AUTHOR]

Background: Poisoning constitutes a major number of hospital admissions among different types of hospital admission cases in India. Several factors like development of science along with invention of strong insecticides and change in life style of human beings added with mental & social stress and easy availability of poisons are few factors responsible for increasing number of poisoning cases. The cause and the nature of poisoning cases which are admitting in different hospitals many times remain unknown to us. This problem can be solved by examining different autopsy findings of different poisoning cases & chemical analysis of different organs as early as possible. The main objective of the study is to study both the external and internal autopsy findings in case of death due to poisoning. Methods: 74 poisoning cases were studied over a period of one year who were first admitted in NRSMCH and subsequently died at the said Hospital. Brought death and nursing home/other Hospital admission cases/ cases referred from other Hospital are excluded from this study. The study is a prospective, cross sectional and descriptive study. Conclusion: Corrosive poisoning is the commonest type of poison followed by ophitoxaemia. Face was congested in most cases of death. No significant findings found in most of the victim’s oesophagus. Majority of internal organs were congested. [ABSTRACT FROM AUTHOR]

Background: The profile of acute poisoning cases is fast changing in last few years, due to advancements in agriculture, construction, sanitation, cosmetic industry and not the least in pharmacology. The advancements and invention of new chemical agents in these industries have increased the access to wide range of materials with quite varied chemical nature, which is reflected in the profile of acute poisonings. Methods: The study is a prospective observational study for a period of 18 months .The study population included all the patients presenting to the emergency department with history of acute poisoning excluding accidental non-self- poisoning. Conclusion: In the current study, highest proportion of subjects in the overall study group was between 26 to 40 years. The proportion of males and females were almost equal whereas in OPC poisoning group the proportion of males was much higher than females. Majority of the affected population were married, living in urban areas, educated,belonged to lower class. Highest proportion was constituted by housewives and students. Organophosphorous poisoning was the most common poisoning reported followed by benzodiazepines and rat killer in the study. The overall mortality rate in the study was 10.53%. Mortality was highest when the subjects were presented beyond 6 hours. Among the type of poisons OPC poisoning had highest mortality. [ABSTRACT FROM AUTHOR]

Background: Hexaconazole is a category 3/4 of poison as per the W.H.O Expert Group on Pesticide Residues. Hexaconazole is used to control infection by fungi in paddy and other crops. Apart from destroying the target species, it can also cause damage to humans. There have been discrete reports of instances of human poisoning due to hexaconazole. Methodology: A patient record-based cross-sectional study was carried out in Konaseema Institute of Medical Science & Research Foundation, Amalapuram, Andhra Pradesh, India during a period from March 2014 to April 2020 on 26 confirmed cases of hexaconazole poisoning. The clinic-demographic data, hematological, and biochemical parameters at the time of admission and at 72 hrs as well as the outcome were recorded and analyzed using descriptive statistics and paired t test. Result: The prevalence of hexaconazole poisoning was 4.79% of all poisoning cases. The major clinical presentation was gastrointestinal symptoms with vomiting being commonest. There was no significant change in the biochemical and hematological parameters. The mean duration of hospitalization was 4.93+1.39 days. The recovery rate was 100% without any major sequel. Conclusion: Poisoning due to hexaconazole is uncommon in comparison to poisoning by other pesticides in the agricultural community. The clinical manifestations of hexaconazole poisoning indicated that it is of non-serious nature and its recovery was without any sequel. [ABSTRACT FROM AUTHOR]

Introduction: The Kodo Millet crop is known by different names in different regions such as Varagu, Harka and Arikelu. It is predominantly grown in India and commonly consumed. When infected by certain fungus species, the compound cyclopiazonic acid causes the crop to be toxic to humans. Case Report: The following article discusses a case of Kodo Millet poisoning, which is presented with episodes of vomiting, sweating, giddiness and dysphagia. Upon examination, Sinus bradycardia and hypotension were the major findings. The electrocardiograph (ECG) showed sinus brady arrhythmia, which is rarely presented in Kodo Millet poisoning. The emergency physician team treated the patient symptomatically and he was discharged after 24 hours as the symptoms and the ECG findings were reverted. Discussion: Kodo Millet poisoning often occurs due to accidental consumption of infected crops. Its occurrence is rare and the treatment involves only supportive care and monitoring. However, it is important to rule it out as a possible differential diagnosis in similar cases due to other causes. Conclusion: Sinus bradyarrhythmia is a rare condition associated with Kodo Millet poisoning. Emergency physicians should be aware of this toxicity to rule out all other possible differential diagnoses and to provide patients with early treatment. [ABSTRACT FROM AUTHOR]

Background. Paraquat is an inexpensive herbicide used in agriculture because it is easily available and the cost of labour for manual clearance of weeds is prohibitive. Paraquat is toxic to human beings and is also used for committing suicide. We studied the reasons for under-reporting of paraquat poisoning including those related to the training of doctors. Methods. In this mixed-methods study, we describe a series of patients with paraquat poisoning. We recorded their demographic data, clinical features, treatment and outcome with an intention to explore the reason for an initial misdiagnosis. We also explored whether deficiencies in curricula contributed to the misdiagnosis. Results. The patients of paraquat poisoning (n=28) were mostly young illiterate men driven by impulsive behaviour rather than chronic depression. Paraquat was consumed by patients from non-agricultural background as well, implying easy access to the poison. Many patients could not name the agent and so initial treatment was directed at organophosphorus poisoning. The diagnostic signs included paraquat tongue, renal failure and jaundice. Most of the casualty medical officers and residents were unfamiliar with the symptoms and signs of paraquat poisoning as was evident by their answers to the questionnaire. Knowledge of medical students about paraquat poisoning was not assessed in the theory examinations and viva. Conclusion. Factors contributing to the limitation in establishing the diagnosis are illiteracy and ignorance of the patients, lack of specific signs and lack of training of medical officers in treating patients with paraquat poisoning. [ABSTRACT FROM AUTHOR]

Introduction: In developing countries like India the ingestion of poison (most commonly used are pesticides) with an intent to suicide is most common because of easy availability, low cost, efficacy of action and rapid death incidence. In spite of availability of number of treatment options, gastric decontamination is the treatment of choice in Indian scenario irrespective of time of poison consumption. Different methods are used to give first aid at home setting to induce emesis in poisoning patients before reaching hospital which can increase the risk of complications such as aspiration if GCS of patient is less than 12. The present study was designed to assess the effect of first aid provided at home (to decontaminate the gastric contents) and its effect on patient's outcome. Objective: To assess the first aid practices amongst the Indian population related to poisoning and its impact on patient's outcome. Methods: A descriptive study was conducted at the medicine emergency of a tertiary care teaching hospital, Chandigarh, India. Total 62 patients consented and enrolled in the study and confirmation of aspiration was done by taking X-ray before starting lavage at the hospital. Data was collected by interviewing either the patient if conscious or the attendants by using (1) an interview schedule having two parts (a) Socio-demographic profile of patients with acute poison ingestion (b) Proforma consisting of information related to first aid practices, (2) An observation checklist related to outcomes filled till discharge or death. Results: Out of 62 patients, 34 (54.8%) didn't receive any first aid at home to induce vomiting. Out of these 34 patients, 02(5.8%) had aspiration even without any kind of first aid. On the other hand 28(45.2%) patients who were provided the first aid included plain water (2 patients) and salt water (26 patients). Seven (25%) patients had aspiration on reaching the hospital. Conclusion: Although it is a long term practice to give first aid to poisoning patients in the form of salt water to induce vomiting at home but if it's given to patients with altered sensorium it can further deteriorate the condition of patients due to aspiration and can worsen the prognosis. [ABSTRACT FROM AUTHOR]

Death due to poisoning has been known since time immemorial. Poisoning is a major problem all over the world, although its type and the associated morbidity and mortality vary from country to country. According to the WHO, more than three million poisoning cases with 251,881 deaths occur worldwide annually, of which 99% of fatal poisonings occur in developing countries, particularly among agricultural workers. Pattern of poisoning in any region depends on availability of poisons, socio economic status of the population, religious and cultural influences, occupation prevalent in the region and likewise. Organophosphorus poisoning occurs very commonly in southern India, where farmers form a significant proportion of the population who commonly use organophosphorus compounds like parathion as insecticides. A retrospective analysis of all poisoning cases admitted to Saveetha Medical College Hospital, Chennai from Jan 2019 to Dec 2019 was done to study the pattern of poisoning reported. Acute poisoning is a common medical emergency and one of the important causes of morbidity and mortality in developing countries due to easy availability of poisonous substances and its low cost. So, it was necessary to know the demo-graphic profile & pattern of poisoning cases at Saveetha Medical College Hospital, Chennai. Data was collected using a pretested proforma from case records, MRD department & Emergency Medicine department and the data was analyzed and presented. [ABSTRACT FROM AUTHOR]

Background: It is estimated that poisoning accounts for over 1 million morbidities worldwide annually. Poisoning is a significant problem in rural India. The objective of this study was to understand the pattern and demographic profile of poisoning in a tertiary care teaching hospital. Method: A retrospective cross-sectional record based study was carried out at Kamineni Institute of Medical Sciences, Nalgonda, India in the year 2019. Demographic details such as age, sex, type of poison consumed, route of exposure, factors affecting morbidity (need for ventilator support) and outcome of the patient were collected and documented in a structured format. Results: A total of 255 acute poisoning cases were admitted during the year 2019. The ratio of males (56.47%) and females(43.53%) was nearly 1:1. Poisoning was seen highest in the age group of 14-30 years (36%) followed by the 31-50 years age group (23.92%). The most common route of exposure was by ingestion. Overall, the mortality rate was 11.76%. The common poisonous agents consumed were insecticides(26.66%) followed by pharmaceutical products(15.68%). Conclusion: Insecticides were the most common agent for poisoning in our setting. It was found that the younger age group of 14-30 years is most vulnerable to acute poisoning and consequent mortality. Efforts should be made to create awareness and to educate the population regarding the importance of early admission and its effect on reduction in mortality. Poison-associated morbidity and mortality rates vary by region and may change over a certain period of time as new drugs and chemicals are introduced. Further studies to understand the reasons for coming into contact with poisons could possibly contribute to the prevention and early treatment of poisoning. [ABSTRACT FROM AUTHOR]

Background: A flowering plant seen widely in Southeast Asia and India is gloriosa superba. The poisoning most commonly caused by it is self-poisoning. All part of the plant is toxic. The toxic substance in the seeds and tubers of this plant is colchicine. Case report: In this report, a case of self-poisoning of gloriosa superba poisoning by ingestion of the tuber with an intention of deliberate self-harm is reported. A 29 year old female, had presented with features of Leukocytosis, Pancytopenia, Metabolic disturbance, Alopecia and Acute Toxic encephalopathy. Conclusion: The patient was managed with multi dose activated charcoal MDAC, N -acetyl cysteine (NAC), antiemetics, proton pump inhibitors (PPIs), IV Fluids, Inj. Potassium chloride and Magnesium sulphate, G-CSF (granulocyte colony stimulating factor) injection, plasmapheresis, 3%Nacl and antiepileptic medications, patient clinically improved. [ABSTRACT FROM AUTHOR]

An 18-year female presented with an alleged history of the conception of liquid paraquet of an unknown quantity on 3rd August 2021. On examination, the patient was unconscious and disoriented. She was further diagnosed with Multiple Organ Dysfunction Syndrome. She had no pallor, icterus, cyanosis, clubbing, pedal adeno, and no lymphadenopathy. Paraquet is basically a toxic herbicide. It is a brown colored syrup liquid. It has chronic toxicity because of its rapid deactivation in contact with soil. After the ingestion, the herbicide is liable for further causative lesions. A very low dose or as little as one mouthful is very severe and dangerous. Although, Herbicides poisoning cases are very uncommon in India. [ABSTRACT FROM AUTHOR]

Introducion: Poisoning is the cause of substantial morbidity and mortality globally. Acute poisoning in children is an important pediatric emergency. It accounts for 0.33% to 7.6% of total admissions in pediatric wards at different hospitals across India. Most of the cases of poisoning in children are accidental and they are preventable. The profile and consequence of poisoned patients differ from place to place. So, the aim of this study was to study the profile and outcome of poisoning in Pediatric age group in tertiary care hospital in south India. Materials and Methods: We retrospectively reviewed the last 1 year (August 2016-August 2017) cases of pediatric poisoning. We looked into the profile of all cases and noted their outcome. Later all the results were calculated using regular statistics methods. Results: Most common age group involved was 1-5 year (38.82%). Most poisoning cases were seen in boys (56.47%). Poisoning was seen most commonly in rural children (70.58%) and mostly at home (49.41%). In 22.35% of cases 2-4 hours was the time interval between exposure and admission to Hospital. Most common poisoning seen was by snake bite in 27.05% of cases. Conclusion: From our study it was clear that the leading causes of poisoning was snake bite and children under the age of <5 years are most vulnerable. Following measures may help in reduction of Pediatric poisoning: educating the parents, storage of poisonous substances at a safe place and their proper disposal, providing basic health education to children. [ABSTRACT FROM AUTHOR]

Introduction: Acute Poisoning forms one of the commonest causes of emergency hospital admissions. Poisoning both accidental and intentional are a significant contributor to mortality and morbidity throughout the world. A complete review of the risk factors decreases incidence and significant morbidity and mortality rates. The present study aims to characterize contemporary trends in the pattern of poisonings in a tertiary care hospital in Chennai, Tamil Nadu. Materials and Method: The study was conducted in tertiary care hospital [Saveetha Medical College and Hospital] for a period of one year [from January 2018 to December 2018]. The data was obtained retrospectively from medical case sheets and various parameters such as sex ratio, occupation, poison type, etc., were analyzed and compared with other studies. Results: The study population consists of 294 cases, among which 232 were suicidal and 62 were accidental. Female predominancy was reported in the present study, with the prevalence of poisonings more common among the age group 21-30y years. Household poisons like insecticides and rodenticides were the most commonly administered. Most of the patients admitted were skilled workers and homemakers. Conclusion: Poisoning was more common in young adults, particularly females. Insecticides and rodenticides were major causes of poisoning, with the higher incidence among skilled workers. Highly equipped treatment facilities and establishment of poisoning centers have become the need of the hour. [ABSTRACT FROM AUTHOR]

Background: Patients presenting to Emergency department following consumption of toxic substances is not an uncommon phenomenon globally. It becomes essential for the Emergency physicians to have in-depth knowledge of all the toxic products available in their locality. In rural parts of South India, the most common method of poisoning is by consumption of pesticides, followed by plant poisons, because of its easy availability. Gloriosa superba is an important medicinal plant growing in several parts of Southeast Asia. All parts of this plant contain several alkaloids including colchicine with the highest concentration in seeds and tubers. Acute intoxication following ingestion of G. superba is indistinguishable from colchicine overdose. Clinical presentation: The symptoms of intoxication can be classified in three phases. Phase 1:(2-24 hours) early gastrointestinal symptoms mimicking gastroenteritis, volume depletion, hypotension, peripheral leucocytosis; Phase 2:(24 to 72 hours) mental status changes, oliguric renal failure, hematopoietic problems, electrolyte imbalance, acid-base disturbance, shock, bone marrow suppression, liver failure, ARDS, arrhythmias, cardiovascular collapse, encephalopathy and neuromuscular involvement; and Phase 3:(1-3 weeks) Recovery typically occurs within few weeks of ingestion but with rebound leucocytosis and alopecia. Case report: We present a patient who ingested Gloriosa superba tubers with suicidal intent and developed acute fulminant liver failure a week after ingestion. Two weeks later, he also developed alopecia. Liver functions gradually improved and normalized after three weeks of hospitalisation. He was provided supportive treatment and he improved remarkably. At discharge, total bilirubin was 1.3 mg/dL, direct bilirubin 0.6 mg/dL, serum urea 15mg/dL and serum creatinine 0.9 mg/dL. On follow-up visits, alopecia showed an improving trend. Conclusion: Colchicine exerts a multiorgan toxicity. Acute fulminant hepatic failure can be a life threatening manifestation of Gloriosa superba poisoning. Hepatic failure can be due to colchicine induced direct hepatic injury with cytolysis. Management is essentially supportive with anecdotal reports showing benefit in plasmapheresis. [ABSTRACT FROM AUTHOR]

Poisoning is a common medical emergency and one of the important cause of mortality and morbidity in developing countries like India due to easy availability of poisonous substances and its low cost. This study was carried out on poisoning cases reported to casualty of Saraswathi Institute of Medical Sciences, Hapur, UP in eighteen-months duration from 1st January 2017 to 30th June 2018. In this study, incidence was more among men (58.70%) compared to women (41.30%) and maximum cases were of age group 21 - 30 years (48.91%). More cases from rural area (89.13%) were reported and highest number of poisoning cases were admitted in the month of June 2018 (10.87%) followed by May 2017 (8.70%). Maximum cases (60.87 %) reported to casualty between 8am to 4pm. Aluminium phosphide poisoning (44.26%) constituted the highest number of cases and in maximum cases manner of poisoning was of suicidal in nature (59.78%). Majority of cases 53.26% were discharged after improvement and 3.26% cases died. [ABSTRACT FROM AUTHOR]

Background: The nature and profile of different modes of poisoning vary significantly in different parts of India. The assessment of the magnitude of suicidal poisoning is an area of paramount importance not only for appropriate management but also for raising social awareness and framing government policies for the prevention of same.Objectives: We aimed to determine the pattern of poisoning, the sociodemographic profile of patients who poison themselves, and the in-hospital outcome of self-poisoned patients over a 1-year period.Methods: This was a cross-sectional observational study conducted between May 2015 and April 2016 that included 492 patients >12 years of age who were admitted to our hospital after consuming poison with the intention of deliberate self-harm. Relevant history with respect to the nature and amount of poison ingested were taken and recorded, and the patients' sociodemographic profiles and outcome (as either discharge or death) were noted.Results: Most of the patients were 13-28 years of age (69%). Males (n = 293 [59.55%]) predominated over females and the majority were farmers (n = 193 [39.23%]). Rural cases (n = 373 [75.81%]) outnumbered urban cases. The major causes of deliberate self-harm attempts were impulsive actions (n = 442 [89.84%]). Pesticides (n = 393 [79.88%]) were the most commonly consumed poison. The overall mortality rate was 12%, with paraquat (94.74%) topping the list of fatal substances.Conclusion: Young adults and males constitute majority of the population in this study. Agricultural poisons made up the bulk of the cases, mostly taken by rural population. Paraquat, an herbicide banned in several countries, had the highest mortality rate in this study. [ABSTRACT FROM AUTHOR]

Introduction: India has one of the largest agrarian societies in the world with the majority of the population dependent on agriculture both for income and survival. Agriculture as an occupation has seen a lot of technological advancements along with an increased use of chemicals for better agricultural returns. This inadvertent overexposure to chemicals has led to human morbidities and its complications. Among agricultural poisons, paraquat is found to be one of the common chemicals causing deaths among agriculturists. Materials and Methods: This study was conducted in VIMS Bellary, Karnataka, India with the data collected from the postmortem report of the bodies brought in for autopsy with confirmation of poison involved based on chemical analysis reports issued by the forensic science laboratories. The study was a retrospective one done on 235 deaths due to paraquat poisoning. Results: In this study it was found out that male mortality was higher in comparison to females. The vulnerable or susceptible age group was found to be individuals aged between 41-50 years among the studied sample and those involved in the agricultural profession. Conclusion: The study gives us an understanding about the population and the occupation of the population in the region studied with respect to the chemical paraquat. It brings into focus the young and middle-aged productive group exposed to paraquat and hopefully can give directions for various preventive steps to be taken in future. [ABSTRACT FROM AUTHOR]

Objective: To ascertain the trend of poisoning cases admitted to the Government District Headquarters Hospital, a secondary care center in Udhagamandalam, Nilgiris District, Tamil Nadu, India, over a five-year period. Materials and Methods: The number of cases that presented to the hospital annually (incidence, mortality, and case fatality rates), socio-demographic pattern, and the nature of the poison were noted. Results: A total of 1860 poisoning cases (80 deaths) were reported during the period from October 2008 to September 2013. The incidence of poisoning was found to increase every year. The average incidence was 1.60 per 1000 population, while the average case fatality rate and mortality rates were 40.51 and 0.07, respectively. A total of 1148 (62%) were males. The majority of cases were seen in the 21-30 age group (41.24%). The poisonings were largely deliberate self-harm [n = 1,755; 94.35%), followed by accidental [n = 85; 4.57%). Agrochemicals were the main choice of poisoning agents and among these, organophosphates were the major cause. Conclusion: The data generated can help policy makers take decisions on the sale and availability of pesticides in this region. [ABSTRACT FROM AUTHOR]

India, with its huge human population and fragmented wildlife habitat, is plagued with human-animal conflicts. In conflict areas, large carnivores are often primary targets for malicious poisoning. The effects of certain poisons do not stop with the target animal but also affects other species of wildlife in the form of secondary poisoning. This paper describes incidences of secondary poisoning of a tiger ( Panthera tigris) and a black panther (melanistic Panthera pardus) in the Nilgiri Biosphere Reserve. Wild boars ( Sus scrofa), which are considered pests in horticultural plantations, were the primary targets in both cases and were poisoned using phorate, a highly toxic organophosphorus compound. Tigers and leopards hold significant position in the upper most trophic level of the ecological pyramid and are grouped in schedule I of the Wildlife Protection Act of India. The tiger, as a species, is currently waging a grim battle of survival in the wild. The world over, leopard populations are also dwindling. The implications of the death of these endangered apex predators due to the increase in population of the ubiquitous wild boars are analysed. The merits of introducing a policy of selective culling of wild boars in conflict areas are discussed. [ABSTRACT FROM AUTHOR]

Background and Objective: Acute poisoning is a medical emergency. It is important to know the nature, severity and outcome of acute poisoning cases in order to take up appropriate planning, prevention and management techniques. This study aimed to assess the pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka. Materials and Methods: This is a retrospective hospital record-based study conducted in a tertiary care hospital attached to a medical institution in Karnataka. The study included 136 cases and data regarding age, sex, time elapsed after intake; circumstances of poisoning, name of the poisonous substance, chemical type, duration of hospitalization, severity and outcome were collected in the prestructured proforma. Results: Incidence was more common among males (75.4%) compared to females (24.3). Most cases of acute poisoning presented among 20- to 29-year age group (31.2%) followed by 12- to 19-year age group (30.2%). A majority of poisoning cases (36.0%) were due to organophosphorus compound (OPC). Total mortality was found to be 15.4%. Mortality rate due to corrosives was significantly high compared with OPC poisoning (χ2 = 4.12, P = 0.04). Of the 56 patients of OPC and carbamate poisoning, 13 patients (23.2%) had respiratory arrest and required respiratory support. Time lapse had a significant role on the mortality in cases of acute poisoning (χ2 = 10.9, P = 0.01). Conclusion: Poisoning is more common in young males. The overall mortality is substantially high, mainly contributed by self-poisoning with insecticides and corrosives. Early care in a tertiary care center may help to reduce mortality in India. [ABSTRACT FROM AUTHOR]

Intentional or unintentional intake of anticholinesterase pesticides became common due to their extensive use in agricultural and domestic purposes, resulting in numerous poisoning cases. A simple, accurate, and sensitive gas chromatography-ion trap mass spectrometry-based method for the quantification of 12 anticholinesterase pesticides (monocrotophos, dimethoate, dichlorvos, azinphos-methyl, carbofuran, chlorpyrifos, dialifos, diazinon, malathion, parathion, methidathion, and terbufos) in serum was developed, and its utility in patients with alleged pesticides poisoning was assessed. The quantification was performed using liquid-liquid extraction by toluene/chloroform (4:1,v/v) with 500 μL of serum. On column limit of detection and limit of quantification were less than 50.00 μg/L. The recovery ranged from 97.54 to 103.23%. The calibration curves were linear (R2 > 0.9937). Accuracy was found to be between – 7.1 and 7.2%. Intra-day and inter-day reproducibility was less than 17% for the spiked quality control serum samples. The level of pesticide in serum quantified by the validated method correlated with clinical signs and symptoms, pseudo-cholinesterase activity, total atropine dose, length of hospital stay, and clinical outcome in 15 patients with alleged pesticide poisoning. The validated method may be used for monitoring and prognosis in patients with pesticide poisoning and diagnosis of poisoning in forensic toxicology. [Display omitted] • Intentional or accidental anticholinesterase pesticide poisoning is common in India. • Twelve pesticides were validated on gas chromatography–ion trap mass spectrometry. • The application of the method was assessed on 15 patients with pesticide poisoning. • The method may be used for the diagnosis and prognosis of pesticide poisoning. [ABSTRACT FROM AUTHOR]