Acute Yellow Oleander Poisoning-Its Cardiotoxicity and Clinical Profile: A Study on Eastern India Population

Abstract

Background: Yellow oleander/Cerebra thevetia/Pila kaner a plant widely cultivated in the plains in india is highlypoisonous. Kernels of the seeds contain glycosides thevetin, thevetoxin, cerberin, and peruvoside. Poisoningusually leads to gastrointestinal and cardiac toxicity.Aims and Objectives: Our aim was to determine the clinical profile of yellow oleander poisoning with specialemphasis on cardiac toxicity, neurotoxicity if any and outcome of management using currently available treatment.Materials and Methods: We studied 60 patients with yellow oleander poisoning prospectively admitted inHospital. A 12 lead electrocardiogram 3 min rhythm ECG strip and blood sample for measurement of electrolytes,Serum calcium, urea and creatinine and liver function tests were taken before treatment. ECG was also done inevery patient on 2nd day of admission and at the time of discharge. Serum cardiac glycosides could not be donedue to lack of facilities.Results: Toxic manifestations included were Gastrointestinal, cardiac toxicity in the form of cardiac arrhythmia butSome patients developed neurological symptoms in the form of tremor (6 patients -10%), ataxia( 8 patients-13.33%)at the end of first week, and focal seizure (only four patients-6.66%).Conclusion: In our study we found gastrointestinal symptoms(vomitting, loose motion with dehydration) andcardiological symptoms (sinus tachycardia, sinus bradycardia, AV block and nodal rhythm, ventricular ectopicsare more commonly present in Yellow oleander poisoning. Moreover we have found some Neurological symptomsin our study in the form of tremor,ataxia and focal seizures.