Paraquat Poisoning: A case series from tertiary care hospital (MIMS), Mandya, Karnataka.

Introduction:Paraquat is a commonly used herbicide in India. It is classified as a viologen. It is a quickly acting non-selective herbicide widely used in Asia. It is highly toxic to humans and can cause multisystem involvement. No specific antidote is available for its treatment till now. Because of its toxicity, it has been forbidden in western countries. Material and Methods: The data of 10 cases of paraquat consumption admitted in past 1 year were collected from MIMS medical record section. On admission to casualty, diagnosis of paraquat consumption was established by clinical history and documentation of paraquat compound from consumption bottle. The amount of compound consumed was documented. Detailed clinical examination was done and relevant investigations were done. Patients were classified to have renal dysfunction if the serum creatinine was above 1.2 mg/dl Acute Kidney Injury if serum creatinine increases by 1.5-1.9 times baseline or if urine output less than <0.5ml/kg/hr for 6-12 hours. RESULTs:A total of 10 patients were included in this study and their details have been tabulated. Eight patients were admitted within 6 hours of paraquat ingestion. The commonest symptoms were burning sensation in throat, chest region (90%) followed by vomiting (80%), oral ulceration or dysphagia (70%), altered sensorium (60%), dyspnea (50%), chest pain or palpitations (10%). Hypotension was documented in four patients. Lung injury was document in 6 patients, of the 6 patients who had undergone chest x ray 5 had infiltrates. Seven patients needed dialytic support. During hospitalization, 8 patients died and 2 survived. Conclusion:Paraquat poisoning is life-threatening with multi-organ failure and pulmonary fibrosis which is having high fatality rate. Our study showed that in-hospital mortality rate of 80%. In the absence of effective antidote and specific treatment, paraquat continues to cause very high mortality rates and if not monitored closely for few weeks, the patient may succumb to multiorgan failure. [ABSTRACT FROM AUTHOR]