Complications and management of hair dye poisoning in Khartoum

Abstract

Introduction: Paraphenylenediamine (PPD) is the major cause of intoxication in Sudan with high morbidity and mortality rate among the intoxicated victims. We here PPD poisoning studied in terms of mode of poisoning, case fatality rate, clinical presentation, management and complications. Methodology: This is a retrospective prospective study on 200 patients with hair dye poisoning who presented to Khartoum teaching hospital in the period from June 2008 to December 2008. Results: We reached to results that in the sample of 200 patients studied, (80.5%) were females and (19.5%) males. The ages of these patients ranged between 6 month - 57 years. Most of them were from Khartoum state (98.5%) and most of them were single (74%). About 51% had history of psychological problems. Most of them arrived immediately to the hospital (90%). Oral route is common route of administration of PPD (96%). The main causes of poisoning were suicidal attempts which occurred in (76%), accidental (22.5%) and homicidal (1.5%). The accessibility of dye to those patients was from local market accounts for about (47.9%), home (23.5%), relatives (22%) and other places (7.5%). Types of dye used were Indian (38.5%), Stone (42%) and Began account about (19.5%). PPD was detected in urine in (36%). There was impairment of renal function test using urea in (22%). Creatinine was abnormal in (23%). Serum electrolytes (sodium, potassium, Calcium) were abnormal in (11%).Uric acid was abnormal in (19.5%) and those who developed renal failure were (20.5%). The most common presentations were ingestion of dye (85.5%), tachycardia in (58%), tachypnea in (31.5%), vomiting in (31%), angioneuratic edema in (22.5%), abdominal pain (22%), enlarge tongue (18%), facial edema (14%) and loin pain in (7%) of the cases. The complications were respiratory distress in (22.5%), acute renal failure in (20.5%), cardiac problem in (1%) and liver problem in (0.5%). The medical treatment and emergency tracheostomy tend to decrease the mortality rate to only (3.5%). Relationship too many parameters were discussed. Recommendation: We recommended that may assist in decreasing the number of cases as health education about the danger of Hair dye that should be provided at the level of the community through all methods of mass media. Restriction should be made on the trade of Hair dye with more support analytical equipments in hospitals.