Consumption Of Poison Research Articles

Evaluation of Recovery Rate in Poison Patients with or Without Standard Antidote Treatment

Aim: To evaluate the recovery rate of poisoning with regards to the availability and administration of standard antidote. Introduction: Poison consumption is one of the most common causes of death across the world. The reason is its easy availability and impulsive behaviour associated with suicidal thoughts. Antidotes are the agents which counteract the harmful effects of poison. Poisoning can be treated with antidotes but not all poisons have antidotes, this study helps to analyze the effectiveness of antidotes in early recovery from poisoning accompanied by stabilization techniques implemented. Methodology: A prospective observational study was conducted in the inpatient department of General Medicine, Gandhi Hospital, Secunderabad from October 2021 to March 2022. Results: Poison consumption was more predominant among males, and young adults are the most affected age group. Suicide was identified as the primary reason for poison intake, while accidental poison ingestion was mostly seen in children. Pesticides were the most commonly consumed poisons. The antidote was administered in approximately 33% of cases, while it was not provided in 15%. For the remaining cases, an antidote was not available. The overall recovery rate was 77%, with females showing higher recovery rates than males. Adolescents had the highest recovery rate, followed by middle-aged adults. Conclusion: Our study concludes that the recovery was rapid in cases where a standard antidote was available and administered. Performing decontamination techniques within a few hours of poison consumption was also efficient.

Profile and Outcome of Patients Presenting to the Emergency Department with Yellow Phosphorus Poisoning

ABSTRACT Background: Yellow phosphorus-containing rodenticide poisoning as a means of deliberate self-harm is being widely encountered in South India. Hence, a comprehensive study delineating its profile and patient outcome is required to implement measures to control the persistent threat. Materials and Methods: This is a single-center, retrospective observational study of all patients presenting to the emergency department with a history of consumption of yellow phosphorus rodenticide poisoning between 2014 and 2020. Institutional review board approval was obtained before commencement. Results: During the study period, 164 patients who presented with consumption of yellow phosphorous were included in the analysis. The mean age with standard deviation of patients was 27.5 (10.6) years, with a female preponderance (87/164: 53.1%). N-acetyl cysteine (NAC) was administered in 87.2% (143/164), and its administration within 48 h of poison consumption showed a significant correlation with good outcomes (72.3% vs. 50%; OR: 0.38; 95% CI: 0.18–0.80; P-value = 0.012). Altered sensorium, hypoxemia, transaminitis, hyperbilirubinemia, and hypoalbuminemia had significant correlations with bad outcomes. The in-hospital mortality rate was 9.7% (16/164), and 21.4% (35/164) of the patients left against medical advice. Conclusion: Yellow phosphorous poisoning is associated with significant mortality. NAC given within 48 h of patient presentation had a significant correlation with good outcomes.

Socio-Demographic Profile of Suicidal Death at Manikganj District, Bangladesh: A One Year Autopsy Based Study

Background: Suicide is one of the leading causes of death in many countries and also a major public health concern. When a person dies by suicide the effects are felt by Family, Friends, and communities. The number of suicidal deaths is increasing worldwide day by day and Bangladesh is also facing this situation alarmingly.Objective: To evaluate the Socio-demographic profile of suicidal deaths. Materials and Methods: This cross-sectional study was carried out at Manikganj sadar hospital mortuary, from January 2019 to December 2019.Total 133 suicidal death cases were collected by using a pre-designed format from mortuary register book. The inquest report provided comprehensive information about the deceased. Postmortem examinations documented the method of suspension used and in cases of poisoning, chemical analysis was conducted to determine the type of poison. Results: During this study majority of the deceased were Female (50.38%). The age distribution of the deceased from 01 year to above 51 years, the highest occurrence observed in the age group 11-20 years (33.08%). Most of the deceased were House wife (40.00%). Majority of deceased were Muslims (88.72%). Total 30.08% cases were reported under Manikganj sadar Thana. The most prevalent technique observed for suicide were by Hanging (65.41%) and common consumption of poison is Organo-phosphorous compound (OPC) (65%). Conclusion: The collected data has the potential to facilitate the identification of individuals who are at an elevated risk of engaging in suicidal behaviors. Moreover, this information can be effectively used to support individuals through the implementation of a comprehensive nationwide suicide prevention initiative that adopts a collaborative and interdisciplinary approach. KYAMC Journal Volume: 14, No: 04, January 2024: 210-214.

A Retrospective Study to Assess the Clinico-Epidemiological Profile of Acute Poisoning Patients Admitted in a Tertiary Care Hospital, Karnataka, India

ABSTRACT Background and Objectives: Acute poisoning is one of the most common medical conditions which requires emergency management. This study was aimed to generate the clinico-epidemiological profile of acute poisoned patients admitted to the emergency department in a tertiary care hospital. Methods: A retrospective research study was conducted in between June 2018 and September 2019. All acute poisoned patients admitted in KH hospital Manipal were included in the study. Collected data were analyzed using descriptive and inferential statistics. The obtained results were stated as frequency, percentage, and Chi-square analysis. Results: Among 324 poisoned patients, 47.5% were organophosphate poisoning, with 48.9% belonging to the age group of 19–35 years. Apparently, 59.2% were male patients. The most common route of poisoning seen is 96.60% ingestion. Suicidal poisoning was noted in majority of the patients 92.90%. A large number of poisoned patients, 61.11%, were conscious while reporting to emergency department. The main reason for poisoning was marital disharmony 54.32%, and 14.5% patients were put on ventilator life support during treatment. Recovered and discharged from the hospital was seen in 76.54% of patients and death witnessed in 12.34% of poisoned patients. The patient outcome was found to be significantly associated with type of poisoning (P < 0.001) and motive of poison consumption (P < 0.001). Conclusion: This study has succeeded to contribute added evidence concerning the clinico-epidemiological profile and consequence of acute poisoning patients admitted in a tertiary care hospital. Increased treatment expenses and admission in intensive care make burden to the family.

Prevalence and Incidence of Intentional and Unintentional Poisoning in a Tertiary Care Hospital, Erode, India

AbstractPoisoning is a significant burden in developing countries, with high fatality rates due to deliberate self-harm and unintentional exposures. This study aimed to raise awareness and provide guidance on poison consumption in a tertiary care hospital in Erode. A cross-sectional study over 6 months involved 377 poisoning cases. Females aged 21 to 30 years, semi-urban residents, and illiterate individuals were found to be the vulnerable groups. Rat killers and tablets were common poisoning agents, often linked to family problems. Comprehensive approaches, addressing mental health, family support, and health care access, are needed. Raising awareness, counseling, and educating high-risk individuals are essential preventive measures. Interventions enhanced poisoning management knowledge and coping strategies, emphasizing the importance of integrated efforts to combat poisoning's socioeconomic impact.

A retrospective study of attempted self-harm in a secondary care setting in rural India

Background: Suicides and non-suicidal self-injuries (NSSI) pose a serious public health problem, affecting communities all over the world. Adolescents and young adults are particularly vulnerable to commit self-harm (SH). SH causes serious emotional, physical, and economic repercussions, and leads to long-term health impacts. Methods: A retrospective study was conducted in a rural secondary care hospital from Feb 2020 to March 2022. Data regarding demographics, cause and type of SH, and treatment provided to 190 patients were analysed. Results: Majority of patients were in the 16-35 years age group. Poison consumption was the commonest method used. Pesticides and pills were the commonly-used agents. Agricultural activities and pre-existing illness in families facilitated access to these agents, as did the unregulated availability and unsafe storage. 31 patients disclosed the reason for SH, with the commonest reason being strained relationships. Emotional states described by the patients which pushed them to SH included dejection, hopelessness, anger, recklessness, altered mood, lack of purpose in life, cynicism and a sense of lack of support. 16% were discharged against medical advice. Conclusions: The study identified the need for methodical documentation, referral and follow-up of patients, with adequate psychiatric and counselling support. Access to care for SH patients is lacking especially in rural areas, and is at best available only for management of the SH event. SH should be considered not as a disease by itself, but as an outcome of stress due to socio-economic and other factors. Multi-stakeholder convergent approaches are needed to tackle this challenge in a holistic manner.

Study of pattern and outcome of acute poisoning cases at tertiary care hospital in North India.

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. 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. 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%). 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.

DESCRIPTIVE STUDY ON SUICIDE ATTEMPTERS ATTENDING CONSULTATION-LIAISON PSYCHIATRY SERVICES AT A TERTIARY CARE HOSPITAL

Aims and Objectives: Suicidal attempts are more common than suicides. Knowing the sociodemographic profile of patients, psychological causes, and mode of attempts helps gain insight into suicide attempts. This study aims to describe the profile of suicide attempters attending consultation-liaison psychiatry services. Methods: This was a prospective observational study conducted at the psychiatry clinic, Government Villupuram Medical College and Hospital, Tamil Nadu on suicide attempters between June 2019 and November 2019. Beck’s suicide intent scale was used to assess the level of intent. Results: Of the total of 610 study individuals, the mean age was 28.73±11.73 years, majority were females (57.70%), suicide attempt was more in young adults (59.18%), more in married (64.91%), more in those with secondary school education (54.91%), and more in skilled workers and homemakers. Poison consumption was the most common mode of suicide attempt (92.62%), predominantly insecticides. Alcohol intoxication (39.14%) was the most common psychiatric derangement. Interpersonal conflict (63.44%) was the most common precipitating factor. About 74.92% had less suicidal intent. Conclusion: Marital conflicts, interpersonal conflicts, and alcohol-related illnesses were the major precipitating factors. Restriction of the availability of alcohol and toxic insecticides can help reduce the incidence of suicide attempts and deaths. The promotion of healthy coping mechanisms and community-based mental care activities can help in suicide prevention.

Risk factors associated with suicide attempts in patients with schizophrenia: an observational study from South India

BackgroundAs a suicide attempt is an important predictor of suicide in patients with schizophrenia, it is essential to assess risk factors to prevent suicides. This study aimed to assess the clinical factors and reasons associated with suicide attempts in patients with schizophrenia. A chart review of the patients diagnosed with schizophrenia from January 2014 to December 2019 was conducted at a tertiary hospital in South India. Socio-demographic and clinical details were extracted using a pro-forma. Details of suicide attempts were collected for all the patients.ResultsOut of 300 patients, 54 patients (18%) had at least one suicide attempt. Comorbid depression (p < 0.001,φ = 0.32) and substance abuse (p = 0.043,φ = 0.1) were significantly more in patients with suicide attempts. The group with suicide attempts had a significantly higher record of poor treatment compliance (p = 0.001, φ = 0.19). The most common methods of suicide attempts were drug overdose and consumption of poison (20.3% each). The most common reasons were the presence of depressive symptoms (24.1%) and delusions (24.1%). Hallucinations contributed to 22.2% of the suicide attempts.ConclusionsSuicide attempts were common among schizophrenia patients in up to 18%. Evaluation and early treatment of depressive symptoms and substance abuse and improvement of treatment adherence may help prevent suicide in patients with schizophrenia.

Sociodemographic characteristics of women who died by suicide in India from 2014 to 2020: findings from surveillance data

Women in India have twice the suicide death rate (SDR) compared with the global average for women. The aim of this study is to present a systematic understanding of sociodemographic risk factors, reasons for suicide deaths, and methods of suicide among women in India at the state level over time. Administrative data on suicide deaths among women by education level, marital status, and occupation, and reason for and method of suicide were extracted from the National Crimes Record Bureau reports for years 2014 to 2020. We extrapolated SDR at the population level for Indian women by education, marital status, and occupation to understand the sociodemography of these suicide deaths for India and its states. We reported the reasons for and methods of suicide deaths among Indian women at the state level over this period. SDR was higher among women with education of class 6 or more (10·2; 95% CI 10·1-10·4) than those with no education (3·8; 3·7-3·9) or education until class 5 (5·4; 5·2-5·5) in India in 2020, with similar patterns in most states. SDR declined between 2014 and 2020 for women with education until class 5. Women currently married accounted for 28 085 (63·1%) of 44 498 suicide deaths in India, 8336 (56·2%) of 14 840 in less developed states, and 19 661 (66·9%) of 29 407 in more developed states in 2020. For India, women currently married had a significantly higher SDR (8·1; 8·0-8·2) than those never married in 2014. However, women who never married had a significantly higher SDR (8·4; 8·2-8·5) in 2020 than those who were currently married. Many individual states in 2020 had similar SDR for women who never married and those who are currently married. Housewife as an occupation accounted for 50% or more of suicide deaths from 2014 to 2020 in India and its states. Family problems was the most common reason for suicide from 2014 to 2020, accounting for 16 140 (36·3%) of 44 498 suicide deaths in India, 5268 (35·5%) of 14 840 in less developed states, and 10 803 (36·7%) of 29 407 in more developed states in 2020. Hanging was the leading mean of suicide from 2014 to 2020. Insecticide or poison consumption was the second leading cause of suicide, accounting for 2228 (15·0%) of all 14 840 suicide deaths in less developed states and 5753 (19·6%) of 29 407 in more developed states, with a near 70·0% increase in the use of this method from 2014 to 2020. The higher SDR among women who have received an education, similar SDR between women currently married and never married, and variations in the reasons for and means of suicide at the state level highlight the need to incorporate sociological insights into how the external social environment can matter for women to better understand the complexity of suicide and determine how to effectively intervene. Bill & Melinda Gates Foundation.

Indoxacarb poisoning induced methemoglobinemia-a rare presentation in paediatric age group

Indoxacarb, an oxadiazine insecticide, has high insecticidal and low mammalian toxicity. The insecticidal activity of indoxacarb is attributed to its ability to block sodium channels in the insect nervous system. Several cases of indoxacarb-induced methemoglobinemia have been reported in adults, but presentation in paediatric age group is rare. Methaemoglobinaemia occurs after indoxacarb ingestion because its aromatic metabolites are biotransformed to active intermediates that produce methaemoglobin. The case involved is an adolescent girl who presented to the PICU 3 hours after suicidal ingestion of 10-15 ml of indoxacarb. After 15 min of consumption of poison she developed pain abdomen and vomiting. At PICU, she complained of nausea, vomiting and dizziness. Her vital signs were heart rate 96/min, BP 110/80 mmHg, oxygen saturation 78% on room air and GCS 15/15. Despite receiving 10L/ min of oxygen via NRBM mask. Her ECG showed normal sinus rhythm without ischaemic change, and CXR showed no specific abnormality. Initial arterial blood gas analysis revealed pH-7.413, pO2-123.6 mmHg, pCO2-37.7 mmHg, HCO3 23.5 mmol/L. Other laboratory results were normal. Methaemoglobinemia is a rare clinical presentation of indoxacarb poisoning. The treatment plan includes timely administration of injection methylene blue.

Submucosal Haemorrhage in Celphos Poisoning: Postmortem Study and Chemical Analysis

Poisons are commonly involved in homicidal, accidental or suicidal cases. In India Aluminum Phosphide (ALP) is available as white tablet of Celphos commonly used as grain preservative. After ingestion on coming in contact with moisture ALP librates Phosphine gas (PH3) having pungent odour. The chemical reaction is accelerated by the presence of HCL in the stomach. Phosphine is rapidly absorbed from gastric mucosa by simple diffusion and cause damage to the internal organs. Several studies reported 100% necrosis of mucosa in ALP poisoning but still no specific antidote are available for it. ALP poisoning was found to be the major cause of death among all cases of poisonings. Several suspected visceral samples for detection of poison were examined in Forensic Science Laboratory, Bihar, Patna. The present study was conducted on those 25 visceral samples in which mucosal haemorrhage was reported in their postmortem finding and gave positive result in preliminary examination of Celphos. Other parameters such as age, sex, causes of consumption of poison (suicidal, homicidal or accidental) as mentioned in FIR was also studied. Chemical analysis was done using Thin layer Chromatography technique. Aluminium Phosphide was found positive in all 25 visceral samples. Aluminium Phosphide poisoning has become the commonest poison in most of the cases of suicidal consumption. In India Despite its alleged high toxicity ALP is frequently used as grain preservative, which can be replace by using old traditional medicinal techniques like Neem leaf(Azadirachta indica),Turmeric(Curcuma longa),Tulsi(Ocimum tenuiflorum)etc. Aluminium phosphide (ALP) poisoning (Celphos) has emerged as a common cause of accidental poisoning in children with mortality ranging from 37-100%.These pesticides should not easily available. Sale of poison should be control by strict law. Any negligent conduct with respect to poison resulting in damage to a person is punishable. Since, it has no specific antidote so management remains primarily supportive care. Toxicologists, Biotechnologists and other research scientists should work on such antidote that quickly counteract the effects of poison.

Unnatural Death Among Covid-19 Tested Positive Individuals: A Retrospective Study

Introducction:- Covid 19 started out as a fast-spreading viral disease, in Wuhan in 2019. Soon, it spread acrossthe globe and WHO declared it a Pandemic. Various countries took various measures to control its spread andtransmission. By the time, countries recovered from it, a new wave would come along with different expressionsand pathophysiology.When Covid 19 began, various health agencies in India started making protocols and standard ooperatingprocedures including conducting autopsies in COVID-19 infected bodies.Aims and Objectives:- Aim of our study is to analyze cause of death among all covid 19 positive cases broughtfor medicolegal autopsies from the time of lockdown for a period of one year. Our aim is to see if there were anyfactors which could have prevented these deaths.Materials and methods: A retrospective study of 1 year conducted from 25th March 2020 to 24th March 2021,(1st wave of Covid 19) was done in a tertiary care hospital in Bangalore. (Bowring and Lady Curzon hospital)Results: 39 Covid-19-positive unnatural deaths were handled with the youngest being 18 years old and the oldestbeings 83. The majority turned out to be suicides (51.28%), then RTAs, falls, and natural death. The commonestmethod of suicide was hanging (35.89%), followed by poison consumption, and falling from a height.Conclusion: COVID -19 is a viral infection with variable clinical signs and variable fatality rates. There is much tolearn about it. However, suicides in COVID -19 cases might not have ended death if some care, timely diagnosis,and treatment were provided.

Improving Transplant-free Survival With Low-volume Plasma Exchange to Treat Children With Rodenticide Induced Hepatotoxicity

In a prior report, no patient with rodenticidal hepatotoxicity who met Kochi criteria (MELD score ≥36 or baseline INR ≥6 with hepatic encephalopathy) (PMID: 26310868) for urgent liver transplantation survived with medical management alone. Plasma exchange (PLEX) may improve survival in these patients. We describe our experience with low-volume PLEX (PLEX-LV) in treating rodenticide ingestion induced hepatotoxicity in children. From prospectively collected database of rodenticidal hepatotoxicity patients managed as in-patient with department of Hepatology from December 2017 to August 2021, we retrospectively studied outcomes in children (≤18 years). Hepatotoxicity was categorized as acute liver injury (ALI, coagulopathy alone) or acute liver failure (ALF, coagulopathy and encephalopathy). Kochi criteria was used to assess need for urgent liver transplantation. The primary study outcome was one-month survival. Of the 110 rodenticidal hepatotoxicity patients, 32 children (females: 56%; age: 16 [4.7-18] years; median, range) constituted the study patients. The study patients presented 4 (1-8) days after poison consumption (impulsive suicidal intent:31, accidental:1). Twenty children (62%) had ALI [MELD: 18 (8-36)] and 12 (38%) had ALF [MELD: 37 (24-45)].All children received standard medical care, including N-acetyl cysteine; ALF patients also received anti-cerebral edema measures. None of the patient families opted for liver transplantation. Seventeen children (ALI: 6, ALF: 11) were treated with PLEX-LV (3 [1-5] sessions, volume of plasma exchanged per session: 26 [13-38] ml/kg body weight) and peri-procedure low dose prednisolone.At 1 month, 28 of the 32 children (87.5%) were alive (4 ALF patients died). Of 10 children who met Kochi listing criteria for urgent liver transplantation, two children were ineligible for PLEX-LV (due to hemodynamic instability) and of the remaining 8 children treated by PLEX-LV, 6 (75%) survived. PLEX-LV shows promise as an effective non-liver transplant treatment in children with rodenticidal hepatotoxicity.

Comparative study on suicides due to poisoning during pre-pandemic &amp; pandemic period in a rural tertiary care center

Background: Suicide or self-harm is an important public health issue; it may be due to multi-factorial life events affecting the lives that may trigger individuals to end their life. Mental health was severely affected by the COVID-19 pandemic leading to suicides. Poison consumption is one of the most common modes of suicide. In the present study, our objectives were to compare the number of reported poisoning cases before &amp; during the COVID-19 pandemic and to describe the clinical profile &amp; outcome of reported poisoning cases. Objectives: The objectives were to compare the number of poisoning cases reported before &amp; during the COVID-19 pandemic, and also to describe the clinical profile and outcome of reported cases. Methodology: This is a retrospective observational and comparative study of poisoning cases reported to Emergency Medicine Department in PES institute of medical sciences and research, Andhra Pradesh, India, during the pre-pandemic &amp; pandemic phases. A total of 122 cases were reported. Google forms were used to collect the data from the medical records section. Data was compiled &amp; analyzed using the SPSS 20 version.

A cross-sectional study of frequency, type, and lethality of deliberate self-harm in bipolar affective disorder patients presenting to tertiary care center

Introduction: Deliberate self-harm (DSH) is one of the leading causes of death and a major public health problem worldwide. According to the World Health Organization, DSH has increased by 60% over the past 50 years, of which 90% of victims had a psychiatric disorder. Aims and Objectives: The aim is to analyze the frequency, type, and lethality of DSH in bipolar affective disorder (BPAD) patients. Materials and Methods: This study included 150 patients diagnosed to have BPAD. Specially designed sociodemographic pro forma was used to record basic profile. DSH inventory was administered on BPAD patients who presented with DSH to analyze the type and lethality. Diagnosis of BPAD was made according to the International Classification of Diseases, tenth revision. Data were recorded, compiled, and analyzed using frequency and percentage with the IBM SPSS Statistics for Windows, Version 24.0. Results: The frequency of DSH was found to be 33%, out of which 38 (35%) patients had manic episode and 11 (30%) patients had depressive episode. The most common type of DSH was found to be cutting self with sharp or blunt objects and consumption of poison with frequency of 12 (24.5%) each. The second most common DSH was banging head, which was present in (11) 22.4% of patients. Conclusion: BPAD is associated with increased risk of DSH compared to the general population. The most common type of DSH was cutting self with sharp objects followed by consumption of poison. Patients who presented with DSH in depressive episode and severe mania had more lethal modes of DSH.

Pesticide Poisoning among All Poisoning Cases Presenting to the Emergency Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: Acute pesticide poisoning is a significant global public health issue that contributes to one of the leading causes of emergency department visits. There is no national data on the incidence of acute pesticide poisoning or the pesticides that cause deaths. The purpose of this study is to find the prevalence of pesticide poisoning among patients who presented to the emergency department with acute poisoning. Methods: This was a descriptive cross-sectional study undertaken in a tertiary care hospital from April to September 2021 among patients who presented to the emergency department with acute poisoning. Ethical clearance was obtained from (reference number: 123/2077-78). Convenient sampling was done. Sociodemographic factors, types of poison consumed, route of consumption, reason, motive, and place of poison intake, time elapse in the presentation to the hospital were studied along with psychological factors associated with poisoning. Statistical analysis was done using Statistical Package for the Social Sciences version 23. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 85 cases studied, the prevalence of pesticide poisoning was 60 (70.58%) (61.28-79.88 at 90% Confidence Interval). Insecticides 41 (68.33%) was mainly responsible for poisoning with organophosphate compounds 33 (42.30%), being the commonest chemical constituent. Fifty-three (88.33 %) incidents occurred at home. Domestic disputes 26 (43.33%) were the main reason behind poison consumption and suicide 43 (71.66%) was the main motive. Conclusions: The prevalence of pesticide poisoning among all cases of poisoning presenting to the emergency department was slightly higher than studies done earlier in similar settings.

Clinico- etiological profile of acute poisoning and intoxication in children in western Nepal

Background: Pediatric poisoning is a common emergency. The present study was done to assess the incidence, clinico-etiological profile of acute poisoning and intoxication in children.Methods: This study was conducted in the Department of Pediatrics, Lumbini Medical College and Teaching Hospital, Nepal in which children aged less than 18 years, with history of consumption of poison accompanied or unaccompanied by container or poison or with doubtful history of consumption of poison but with definite signs and symptoms of acute poisoning we included. We also included children with history of bites by poisonous creatures like snakes, scorpions, bees and insects or with doubtful history of bites due to poisonous creatures but with definite acute onset of signs and symptoms locally or systemically.Results: In the present study, during the study duration, 68 children were included. The most common age group of included children was 1 to 5 years (59%). Accidental poisoning was reported in 93% of the cases, while the rest had suicidal poisonings. The most common type of poison used were different types of pesticides (46%). We observed that vomiting was the most common clinical presentation (79%). In our study sample, arrival of 46% of the children was delayed by 30 minutes to 2 hours. Majority of the patients arrived in the afternoon to the hospital (51%).Conclusions: The findings of the present study would enable emergency physicians to identify clinical features of common poisonings among children, which would enable manage the cases better.

Socio-demographic Profile of Deaths due to Poisoning at a Tertiary Care Hospital in Bangalore

Background: Deaths due to poisons form inexorable part of all unnatural deaths in the current era of social,cultural and personal dilemma existing among mankind. Stress, poverty, financial insecurities, personal conflicts,unemployment, ill health, psychological disturbances, difficulties in psycho-social adaptability and lonelinesscontribute significantly to the ever-increasing mortality in poison deaths.Methods and results: A 20-month prospective descriptive study was conducted at the Department of ForensicMedicine and Toxicology, Victoria Hospital, Bangalore Medical College and Research Institute on cases ofdeath due to poisoning. Out of 110 cases, maximum number of cases were male (63.63%), in the age groupof 21-30 years (33.63%). 92.72% belonged to Hindu religion and 55.45% belonged to the upper lower class.54.54% belonged to urban areas and 60% were married victims. Maximum numbers of cases (38.18%)were recorded in winter, commonly between 5pm – 10 pm (39.09%) and 84.54% occurred at the placeof residence. 84.54% of cases were suicidal in nature with psychological causes being the most commonmotive (30.90%). 81.81% of cases received treatment and 34.53% succumbed to death within 1-7 daysof consumption of poison. Organophosphorus group of insecticide (50%) was the most common poisonencountered, followed by Phosphide ions (30%).Conclusion: Poisoning is a major epidemic of non-communicable disease in the present century. Suicidaland accidental poisoning are significant contributors to morbidity and mortality throughout the world.

Profile of Fatal Cases of Organophosphosphorus Poisoning at a Tertiary Care Centre, Mandya

Organophosphorus Compound (OP) poisoning is the most common and the highest amongst fatal cases of poisoning consumption deal in MIMS hospital. It is the commonly abused poison amongst rural and urban population more so amongst our Farmers. Fatal cases of organophosphorus poisoning were analyzed during the study period from 01.01.2016 to 31.12.2018. The analysis was done on age, sex, occupation, socio economic status, motive of poison consumption and result. Mandya District being dominated by agriculturists and sugarcane being the cash crop, drought, insufficient rain fall, raising costs of living, high debts, Cauvery water non available for agricultural use due to water sharing between neighboring states like Tamilnadu, Pondichery etc., increasing number of bore wells and ground water depletion, leading to crop failures and thereby resulting in Farmers suicide. The major cause of death in these cases treated at MIMS were Respiratory failure.