A study of socio clinical, biochemical and electrocardiographic changes of yellow oleander seed poisoning in India

Abstract

Yellow oleander (Thevetia peruviana), which belongs to the Apocyanaceae family, is a common shrub seen throughout the tropics. All parts of the plant contain high concentrations of cardiac glycosides, which are toxic to cardiac muscle and the autonomic nervous system. The main objective of this study was to socio-clinical, biochemical and electrocardiographic changes of yellow oleander seed poisoning. This prospective observational study was conducted over a period of 6 months (March 2022 to September 2022). Oleander seed poison in most prevalent in the 21–40 years age. More the crushed seeds consumed and the delay to admission to the hospital for treatment poorer was the outcome. The most common GI symptoms of yellow oleander poisoning were vomiting (58 %), abdominal pain (28%), diarrhoea (9%), and palpitations (20%), dizziness (18%).Serum potassium levels that were measured during the admission were directly related to the ECG changes. ECG changes were more observed with patients those who consumed seeds in crushed form and this difference is statistically significant (P = 0.0001). Higher incidence of cardiotoxicity was noted with patients those who consumed poison on empty stomach compare to who consumed after food. The Electrocardiographic manifestations was found even with consumption of one seed, number of seeds consumptions independent of cardiotoxicity.Additonally higher mean Potassium value observed in patients who had cardiotoxicity when compared to patient who had no cardiotoxicity. Death of the patients in yellow oleander seed poisoning was independent of quantity of the seeds they have ingested.