Diagnosis Of Acute Poisoning Research Articles

Мониторинг результатов химико-токсикологических исследований наркотических средств в Свердловской области в 2021-2023 годах

Introduction. Rapid changes are taking place in the illegal drug market, characterized by dominant positions of new psychoactive substances. In order to describe the structure of the consumption of narcotic drugs and other psychoactive substances in the Sverdlovsk region, it is relevant to study the data obtained during chemical-toxicological researches as part of a medical examination for intoxication, in laboratory diagnostics of acute poisoning and forensic chemical examinations. Aim of the study. Retrospective assessment of the detection of cases of use of various types of narcotic drugs, psychotropic substances and new psychoactive substances during chemical-toxicological and forensic chemical studies in the Sverdlovsk Region in 2021-2023. Materials and methods. Logical, retrospective, comparative and content analysis of data from the results of chemical and toxicological studies of the Regional Narcological Clinic (Ekaterinburg), Sverdlovsk Regional Clinical Psychiatric Hospital and Psychiatric Hospital No. 7 for 2021-2023 was carried out. Statistical processing of the results was performed using MS Excel for Windows and Statistica for Windows. Results. The leading position among the substances detected during a medical examination for intoxication is occupied by synthetic cathinones and cannabinoids. The largest number of acute poisonings is associated with the use of narcotic drugs, psychostimulating substances (α‑pyrrolidinovalerophenone and mephedrone), as well as opiates and opioids. Discussion. A retrospective analysis of the results of chemical and toxicological studies of biological fluids of drug users showed that the detectability of various compounds changes over time in the Sverdlovsk region according to data for 2021-2023. During a medical examination for intoxication and during the diagnosis of acute poisoning, «traditional» narcotic drugs are still identified in all areas of chemical and toxicological research, but at present new psychoactive substances of synthetic origin predominate in illegal circulation. Conclusion. Analysis of the results of chemical-toxicological in the Sverdlovsk region in 2021–2023 allowed us to conclude that the detection of new psychoactive substances is prevalent while the detection of «traditional» drugs is stable.

Retrospective Analysis of Poisoning Cases in the Pediatric Intensive Care Unit

Aim: According to the World Health Organization (WHO) data, poisonings are still a significant reason for mortality and morbidity in the childhood group. The rapid technological developments and the change in socio-cultural structures have caused an increase in chemical substances in homes, and the easy access of children to these chemicals has increased the possibility of poisoning. We aimed to make a retrospective analysis of patients with a diagnosis of poisoning hospitalized in the pediatric intensive care unit (PICU). Materials and methods: The current clinical study is a retrospective, observational, single-center study and contains children adopted to the tertiary PICU of the 16-bed Batman Training and Research Hospital between March 2021 and March 2022 with a diagnosis of acute poisoning. Results: Forty patients were female (56.3%), and 31 patients were male (43.7%). All patients were admitted to the intensive care unit for advanced and supportive treatment. Supportive treatment was sufficient for 42 patients (59.2%). As advanced treatment; N-acetylcysteine infusion was given to 14 patients (19.7), oxygen to 3 patients (4.2%), inotropic support to 2 patients (2.8%), mechanical ventilatory support to 1 patient (1.4%), and antidote to 1 patient (1.4%). No mortality was observed, but some patients progressed morbidly and needed a mechanical ventilator and inotropic agent support. Conclusion: No mortality was observed, but some patients progressed morbidly and needed mechanical ventilatory support and inotropic agents. For this reason, the physician who first encounters the patient in the emergency department should evaluate each patient and the poison separately.

Сучасна семіотика синдромів гострих отруєнь хімічної етіології: токсидроми

Актуальність дослідження обумовлена постійними змінами в структурі гострих отруєнь хімічної етіології, що потребує від лікарів швидкого прийняття рішень стосовно призначення антидотів або засобів фармакологічної корекції, особливо на догоспітальному етапі. З метою прискорення процесу прийняття рішень щодо причин отруєння та виду токсиканту у токсикологічних центрах багатьох країн світу широко використовується синдромологічний підхід.Метою цього дослідження було вивчення та узагальнення сучасних підходів до практичного застосування основних токсичних синдромів (токсидромів) у практиці лікаря-токсиколога.Матеріал і методи дослідження. Досліджені класифікації токсичних синдромів, що використовуються в практичній роботі лікарів-токсикологів США, країн Євросоюзу, Російської Федерації протягом останніх 30 років.Результати та їх обговорення. З середини 1970-х років у процесі діагностики гострих отруєнь широко використовується поняття токсидрому, що відображає сутність та масштаб медіаторних змін в організмі під впливом однiєї або декiлькох токсичних речовин. Визначення основних токсидромів (адренергічного, антихолінергічного, холінергічного, опіоїдного, седативно-гіпнотичного та серотонінового) дозволяє лікарям своєчасно розпочати посиндромну терапію, що в багатьох випадках при отруєннях збігається з патогенетичною. Синдромологічний підхід прискорює процес прийняття лікарями рішень стосовно вибору антидоту або засобу фармакологічної корекції функціональних порушень, що особливо важливо на догоспітальному етапі.Висновки. Сьогодні є актуальним впровадження сучасних наукових підходів, що стосуються діагностики гострих отруєнь на догоспітальному етапі за допомогою основних токсидромів, у навчальнi програми до- та післядипломної підготовки лікарів екстреної медичної допомоги та лікарів-токсикологів в Україні.

Methods of forensic medical analysis of acute intoxications with ethyl alcohol (review of literary sources)

The article presents an overview of current literature on the problem of forensic diagnosis of acute poisoning by ethanol and its surrogates. Morphological and forensic chemical criteria for the diagnosis of ethanol intoxication are presented, variants of patho- and thanatogenesis are described, as well as modern methods for diagnosing these poisonings. Aim of the work. Review of current literature data on the problem of forensic diagnosis of acute poisoning by ethanol and its surrogates. Conclusion. In our opinion, it is necessary to introduce into the practical work of the bureau of forensic examinations new promising technologies for the diagnosis of acute intoxication with ethyl alcohol and its surrogates.

Comparative Study of Ethanol Intoxications in the Context of Covid-19 Pandemic Reported to the Year of 2019

Excessive alcohol consumption that causes disorders of social conduct, causes a rejection reaction with the intervention of the authorities. The paper compares trends related to people with the diagnosis of acute intoxication (F10.0) admitted to the "Elisabeta Doamna” Psychiatry Hospital in Galati, from the 1st of January to the 31th of December 2020 with the period from the 1st of January to the 31th of December 2019. In the retrospective study we selected people discharged with acute intoxication, code (F10.0), and harmful use (F10.1), excluding all patients with other psychiatric diagnoses from the database of the "Elisabeta Doamna" Psychiatry Hospital from 2020 to 2019. ICD-10 (Classification of mental and behavioral disorders) was used for diagnosis of psychiatric disorders. The data was processed statistically using: Microsoft Office-Excel, The Jamovi Project (2021). jamovi (Version 1.6) [Computer Software]. In 2020 there were 39.58% fewer discharges by a total of (7973 cases) compared to (13197 cases) in 2019. In 2020, acute intoxication (F10.0) accounted for 7.41% of total discharges compared to a percentage of (8.27%) in 2019, showing a decline by a percentage of 45.92%. Comparing the years 2020 with 2019 by gender (of the total number of discharges with acute intoxication (F10.0), there is an increase in the percentage of discharges by 1.16% (from 86.98% in 2019 to 88.14% in 2020), while in the female gender, the percentage trend has decreased by a percentage of 1.16% (from 13.02% in 2019 to 11.86% in 2020).

Diagnosis of acute poisoning by addictive and psychotropic substances based on the toxidrome

Diagnosis of acute poisoning by addictive and psychotropic substances based on the toxidrome

STATISTICAL ANALYSIS OF VERATRUM ACUTE POISONINGS DURING 2014-2018 IN MOSCOW, SAINT PETERSBURG, OMSK, CHITA, AND KHANTY-MANSIYSK AUTONOMOUS OKRUG – UGRA

Acute hellebore poisoning is characteristic for the Russian Federation because of the use of this plant for the treatment of alcoholism at home. The varying severity of clinical symptoms, which sometimes become lifethreatening, the lack of anamnestic reliable information about the use of hellebore and the difficulties of chemical and toxicological confirmation of its use complicate the diagnosis of acute poisoning, and do not allow timely medical care. In addition, there is no classification of hellebore poisoning in ICD-10, block (T51-T65), which also affects the assessment of the actual frequency of this acute intoxication. The purpose of this work is to clarify the number of acute hellebore poisoning in the Russian Federation. The analysis of medical records of patients hospitalized with acute hellebore poisoning in toxicological departments of a number of subjects of the Russian Federation for 2014 - 2018 was carried out. The dynamics of such acute poisoning over the specified period, the gender and age composition of victims, and the circumstances of poisoning were revealed. The relevance of developing methods of chemical and toxicological analysis for the determination of hellebore alkaloids is confirmed, which will increase the reliability of diagnosis and detection of cases of hellebore poisoning.

Investigation of acute intoxication cases followed-up in the intensive care unit: A retrospective study

Objective: Intoxication cases are increasing in societies day by day. Intoxication cases are followed-up and treated in Intensive Care Units (ICU). In our study, the intoxication cases followed in the intensive care unit; it is aimed to evaluate demographic data, prognosis, causing agents, mortality rates retrospectively.
 Material and Methods: In the intensive care unit between the dates of January 1, 2016 and March 10, 2020, the patients who were admitted with the diagnosis of acute intoxication, age, gender, the drug is taken for poisoning or the substance they are exposed to, Glasgow Coma Scale (GCS), the number of days hospitalized, mechanical ventilation support day and the number and mortality status were evaluated retrospectively.
 Results: The 88 patients applied to ICU with the diagnosis of acute intoxication, 55(62%) of them are female and 33(37%) of them are male. According to all gender data, the intoxication was found to be the highest between the ages of 17 and 30 (n: 69) and the least under 17 age (n: 2). Half of the patients (n: 44 50%) were treated in less than 2 days. With a single drug, intoxication was seen as the highest with antidepressants.
 Conclusion: Intoxications occur mostly with medications and among these drugs, they are mostly seen with anti-depressive medications for psychiatric treatment. When treatment is started quickly after the poisoning, the duration of hospital stay is shortened and the prognosis is better. Since poisoning varieties differ by region, this information should be known and updated by the people who treat it.

Chemical and Toxicological Diagnosis of Acute Poisonings with Phenazepam

Background. The relative availability of Phenazepam makes it a frequent cause of overdose, suicide and non-medical use. At the same time, it remains insufficiently studied in chemical and toxicological terms.The aim of study. to create an accessible, rapid method for detecting Phenazepam in biological matrices of patients with acute poisoning.Materials and methods. We used thin-layer chromatography (TLC), gas chromatography with a mass selective detector (GC-MS), high performance liquid chromatography with a tandem mass-selective detector (LC-MS/MS) and immunochromatographic analysis (ICA). The preparation of samples of intact urine with the addition of standard solutions of Phenazepam and real urine samples of patients with acute poisoning with Phenazepam was carried out using liquid-liquid extraction or precipitation of related components of the sample with acetonitrile. Hydrolysis and derivatization were also added in GC-MS analysis.Results. The analysis of statistics of the Department of Acute Poisonings of the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2014-2016 showed that Phenazepam poisonings averaged 9.2% of the total number of admissions and mainly occurred as suicidal attempts. A technique has been developed for the detection of Phenazepam by TLC, which gives more objective results than ICA. For confirmatory analysis, it is advisable to use LC-MS/MS method for the native substance and GC-MS for the products of hydrolysis after derivatization. Compared to confirmatory methods, the developed TLC-screening technique is expressive, does not require the use of expensive high-tech equipment, difficult sample preparation, and makes it possible to reliably detect toxic and lethal concentrations of Phenazepam.

Blood plasma level determination using an automated LC-MSn screening system and electronically stored calibrations exemplified for 22 drugs and two active metabolites often requested in emergency toxicology.

Fast and comprehensive qualitative and quantitative methods preferably by gas chromatography-mass spectrometry (GC-MS) and/or liquid chromatography-mass spectrometry (LC-MS) are needed to support the (differential) diagnosis of acute poisonings in emergency toxicology. One option is a commercially available qualitative screening solution based on LC-MSn (Bruker Daltonik Toxtyper™, TT). Identified and toxicologically relevant compounds should be quantified to assess severity of poisonings. The aim of the present study was to test the TT system for quantification simultaneous with the screening process in blood plasma exemplified for 22 relevant drugs and two active metabolites. A standard liquid-liquid extraction was used for sample work-up followed by 1:5 dilution of the final extracts. They were analyzed using the TT system consisting of a Bruker amaZon speed ion trap and a Thermo Fisher Dionex Ultimate 3000 LC system. Plasma levels were assessed using full-scan data and an electronically stored five-point calibration. The calibration model was linear for the studied ranges and could be used for at least two months. The method was validated according to international guidelines. The acceptance criteria recommended for emergency toxicology for accuracy and precision were fulfilled for all tested compounds, but bromazepam, lorazepam, oxycodone, and prothipendyl could reliably be determined only above the therapeutic range. In conclusion, the presented procedure allowed the combination of a comprehensive LC-MSn screening with fast automated assessment of plasma levels for emergency toxicology of tested compounds.

Diagnosis of Heroin Overdose in an 8-Year-Old Boy: Reliable Contribution of Toxicological Investigations.

Toxicological investigations are often required by clinicians in comatose patients with suspected poisoning. However, the usefulness of toxicological analyses to support a diagnosis of acute poisoning is debated among clinicians and the interpretation of laboratory tests is challenging given the wide diversity of analytical techniques available. We report the case of an 8-year-old boy who was admitted to an intensive care unit with severe respiratory depression and neurological impairment. In order to formulate appropriate hypothesizes about the diagnosis and circumstances of intoxication, clinicians consulted toxicologists for a comprehensive toxicological screening. Routine blood immunoassays were negative for common toxicants but urine tests were positive for opiates. A general unknown screening using liquid and gas chromatography combined with mass spectrometry detection confirmed the presence of morphine, codeine and related glucuronides metabolites in plasma and urine. Subsequently, morphine and codeine were quantified in plasma samples by online-SPE-LC-MS-MS. In addition, analyses performed with GC-MS and LC-MSn identified compounds used as markers when profiling illicit heroin, namely noscapine, dextromethorphan and codeine. In conjunction with the patient's history, clinical picture and circumstances of intoxication, toxicological findings strongly suggested an acute pediatric opioid overdose as a collateral damage of parental heroin abuse in the home. This case highlights the significant contribution of toxicological investigations in sensitive legal cases and the critical role of communications between clinicians and toxicologists.

Clinical Profile of Children Presenting with Intoxication on Emergency Departement Soetomo Hospital in 2011

Introduction: Acute poisoning in children is an important pediatric emergency and is a world wide problem, the majority of these poisoning incidents are unintentional and preventable. Based on data from WHO, the mortality of children under 4 years varies between 0.3–7% per 100,000 population in some countries in the world. The incidence, clinical profile and the type of poison and the output of poisoning cases in children in Surabaya until now there is no definitive data. The objective of the study was to study the clinical profile and outcome of childhood poisoning and intoxication in Soetomo hospital.Method: Design used in the study was a retrospective study done in children between 1 month and 18 years old of age who were admitted in emergency departement Soetomo hospital with diagnosis of acute poisoning between January until Desember 2012. Patients were profiled according to age, sex, poison consume and outcome.Result: There were 12 patients enrolled in the study. Male: female ratio was 2:1. The mean age of presentation was 53 months. Hydrocarbon poisoning was the commonest poisoning seen in (41.7%) patients followed by organophospat (33.3%) poisoning. During treatment, 58.3% received antibiotics, 25% patients who poisoning with organophosphat received antidots and 50% from all sample received antagonist histamin H2 because of stomached. Overall survival was 91,6%.Discussion: Hydrocarbon is the commonest agent involved in childhood poisoning. Overall, the outcome is good with 91,6% survival in our hospital.

Alternative sampling strategies for the assessment of alcohol intake of living persons

Monitoring of alcohol consumption by living persons takes place in various contexts, amongst which workplace drug testing, driving under the influence of alcohol, driving licence regranting programs, alcohol withdrawal treatment, diagnosis of acute intoxication or fetal alcohol ingestion. The matrices that are mostly used today include blood, breath and urine. The aim of this review is to present alternative sampling strategies that allow monitoring of the alcohol consumption in living subjects. Ethanol itself, indirect (carbohydrate deficient transferrin, CDT%) as well as direct biomarkers (ethyl glucuronide, EtG; ethyl sulphate, EtS; fatty acid ethyl esters, FAEEs and phosphatidylethanol species, PEths) of ethanol consumption will be considered. This review covers dried blood spots (CDT%, EtG/EtS, PEths), dried urine spots (EtG/EtS), sweat and skin surface lipids (ethanol, EtG, FAEEs), oral fluid (ethanol, EtG), exhaled breath (PEths), hair (EtG, FAEEs), nail (EtG), meconium (EtG/EtS, FAEEs), umbilical cord and placenta (EtG/EtS and PEth 16:0/18:1). Main results, issues and considerations specific to each matrix are reported. Details about sample preparation and analytical methods are not within the scope of this review.

Dispersive liquid-liquid microextraction based on solidification of floating organic drop and high-performance liquid chromatography to the analysis of cocaine's major adulterants in human urine.

A simple method has been proposed for the determination of cocaine's major adulterants (caffeine, levamisole, lidocaine, phenacetin, diltiazem, and hydroxyzine) in human urine by dispersive liquid-liquid microextraction based on solidification of floating organic drop (DLLME-SFO) in combination with high-performance liquid chromatography - photodiode array detector (HPLC-PDA). The reversed-phase chromatographic separation was obtained with a column C18 extended (250×4.6mm; 5μm; 80Å) in gradient elution mode using acetonitrile-trifluoroacetic acid 0.026% (v,v) (pH=2.5) at 1mLmin-1 as mobile phase, at 25°C, and detection at 235nm. The analysis time was 25min. This condition had the best resolution factors (>1.15), retention factors (>0.68), number of plates (>2094.9), and separation factors (>1.05) for all targets, indicating a good separation. The kind of extraction and dispersive solvent were investigated for unifactorial design. The buffer pH, the volume of extraction and disperser solvent, and the amount of salt were optimized for full factorial design. Under optimum conditions, human urine samples were alkalized with 0.5M sodium phosphate buffer (pH 10) and added to sodium chloride (20%m/v). Acetonitrile (150μL) and 1-dodecanol (30μL) were used as dispersive and extraction solvent, respectively. The method presented linear range of 312.5-3125ngmL-1 to caffeine and levamisole and 187.5-1875ngmL-1 to lidocaine, phenacetin, diltiazem, and hydroxyzine. The limit of quantification was 187.5ngmL-1 to lidocaine, phenacetin, diltiazem, and hydroxyzine and 312.5ngmL-1 for caffeine and levamisole. The recovery mean values were between 6.0 and 42.6%. The method showed good precision and accuracy, with within- and between-run relative standard deviation and relative error less than 15%. The samples were stable after freeze-thaw cycle and short-term room temperature stability tests. Besides, this method was satisfactorily applied in urine of cocaine users. It is expected that this method, which was the first to combine the use of DLLME-SFO and HPLC-PDA for the determination of cocaine's major adulterants in human urine, will contribute to the accuracy in the diagnosis of acute intoxication, the proper planning of therapeutic measures, as well as to the favorable prognostic of cocaine intoxicated patients.

A Hospital-Based Epidemiologic Study on Acute Pediatric Poisonings in Chennai, India

Background: Toxic exposures in childhood are major health concern. In this hospital-based study, we sought to investigate socio-epidemiological factors contributing to acute pediatric poisoning in Chennai, Tamil Nadu, India. Methods: This prospective cross-sectional study was conducted at the Kanchi Kamakoti CHILDS Trust Hospital (KKCTH), a tertiary care hospital for children in Chennai. Children and adolescents less than 18 years of age with diagnosis of acute poisoning during June 2014 to January 2015 were included in the study. Results: During the study period, 10500 children were admitted to emergency department of the hospital; among which, 34 children presented with diagnosis of acute poisoning (0.32% of admissions). Eighteen patients (52.9%) were boys. The greatest proportion of patients (52.9%) aged 1 to 3 years. Regarding the intention of poisoning, 27 cases (79.4%) occurred following unintentional ingestion by children, 5 cases (14.7%) following inadvertent administration of medication(s) by a caregiver and 2 cases (5.9%) following inadvertent administration by a sibling. Children had relatively equal chance of being poisoned with medications (n = 18, 52.9%) and common household agents (n = 16, 47.1%). The most common medicines responsible for the poisonings were neuropsychiatric medicines (n = 6, 17.6%). None of the medications responsible for poisoning had childproof containers. On admission, only 14 children (41.2%) were symptomatic. Fifteen patients (44.1%) required admission to hospital wards and 4 patients (11.8%) required intensive care. The remaining patients only needed close observation for a few hours. All children made complete recovery and there was no mortality. Conclusion:Children especially toddlers of either gender are vulnerable to unintentional exposures and need constant supervision by an adult. Educating caregivers about the fatalities associated with unprotected storage of medications, and dangers of placing hazardous chemicals in the reach of children will reduce a great number of poisoning in children.

Pattern of Acute Pediatric Poisonings in Birjand City, East of Iran

Background : Acute pediatric poisoning represents a frequent cause of admission to the emergency departments. This descriptive and retrospective study was conducted in Birjand, eastern Iran, with the aim of evaluating the pattern of pediatric poisoning in this region. Methods: During the 6-year period from 21 st March 2006 to 20th March 2012, all files of pediatrics poisoned patients admitted to the emergency department of Vali Asr teaching hospital was reviewed and the data were recorded in a pre-designed form. The results were analyzed by relevant statistical tests. Results: During this period, 246 cases (41.1% female and 58.9% male) were admitted with a diagnosis of acute poisoning. The mean age was 37.6 +/-32.64 (range: 0.06-156) months. The majority of poisonings occurred in the children aged about 2 to 5 years. The most common agents involved were opioids (39.43%), pharmaceuticals (22.76%) and envenomations (15.9%). Most of the patients were living in urban areas (56.91%). There was a significant correlation between older age and intentional poisoning (P<0.01). There were also significant correlations between the toxic agent and either the season (P<0.0001), or patients’ age (P<0.0001), residential status (P=0.008) and or consciousness (P<0.0001). Moreover, we introduced Majoon Birjandi as a new cause of poisoning in the literature. Conclusion: Acute opium poisoning was the most common in terms of morbidity and mortality in this region. Health authorities should consider preventive programs in this regard. Moreover, Majoon-e-Birjandi as a new cause of poisoning should be considered in this region, which is not previously reported in the literature.

Four-Year Study on Acute Poisoning Cases Admitted to a Tertiary Hospital in Bangladesh: Emerging Trend of Poisoning in Commuters

Background:The pattern of poisoning has a regional variability. This study was carried out to describe the epidemiological profile of acute poisoning in northeastern Bangladesh and to evaluate the mortality. Methods:In this retrospective cross-sectional study, medical records of poisoned patients treated at department of medicine of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet, Bangladesh during 1st January 2008 to 31st December 2011 were reviewed. Patients aged 10 years and above with diagnosis of acute poisoning were included. Data collected were gender, age, place of residence, type of poison and intention of poisoning. Results:A total of 4435 (58.7% men) were included. Patients aged 21 to 30 years were the most common age group involved with poisoning (41.6%). The majority of patients (55.4%) lived in rural areas. Commuter poisoning (43.3%) was the most frequently occurring type of poisoning in both men and women in all 4 years followed by OP poisoning (25.7%). Men were found to be significantly more affected in commuter, organophosphate and alcohol poisoning (P < 0.001). Intention of poisoning in the greatest number of patients (54.5%) was suicidal followed by 1919 patients (43.3%) who were poisoned by homicidal/stupefying intents. Among the homicidal cases, men were significantly more victimized (67% vs. 33%, P < 0.001). Overall, 224 patients (5.1%) died. The highest number of deaths was due to OP poisoning (46.9%) followed by commuter poisoning (45.5%). Case fatality rate was the highest in the snakebite victims (23.3%) followed by alcohol poisoning (11.4%). Conclusion:Commuter or travel-related poisoning is an emerging public health threat in this part of Bangladesh. Public awareness should be raised and school-based educational programs should be emphasized regarding the commuter poisoning and the consequence of accepting and eating food from strangers.

Assessment of Poisoning Cases in a Tertiary Care Hospital.

Background: Poisoning isacommonday-to-dayevent. It is important to know the nature, severity and outcome of acute poisoning cases in order to take up appropriate planning, prevention and management techniques. Objective : The objective of this study was to assess the poisoning cases admitted to the tertiary care hospital, VIMS, BELLARY. Materials and Methods: Data from case records of 100 patients admitted with the diagnosis of acute poisoning during 6 months were collected. Information demographic features, name of poisonous substances, mode of poisoning, time elapsed after intake, mode of treatment given, duration of hospitalization, severity and outcome was collected in the prestructured proforma and subjected to statistical analysis. Results: Out of 100 study subjects, 48 were males and 52 Females, 21-30 years of age group is more among males compared to females. The most common type of poisoning is OP Poisoning 58%. After treatment 76% recovered and 24% were discharged against medical advice. Only 21% had developed complications. The relation between age, locality, marital status, SES mode of poisoning outcome, duration of hospital stay and type of poisoning are found to be statistically significant. Conclusion: OP poisoning cases accounts for majority of the admission. Appropriate emergency care is being given inspite of the delay in transit to the hospital .

English

Acute poisoning is one of the common causes of admission in emergency department of various hospitals. This is a common socio medical problem. Green revolution has increased the production of food grain but the wide spread use of organophosphorus compounds has increased incidence of its poisoning to the human kind by accidental or suicidal. Around one hundred fifty six patient admitted in Konaseema Institute of Medical Science and General Hospital with diagnosis of acute poisoning. The present study showed that majority of the patients was of young age with females outnumbering males.

Poisoning in children: Experience at a tertiary care hospital in Mangalore

Background: Acute poisoning in children is a major preventable cause of morbidity and mortality. The accessibility of different poisonous substances also depends upon demography, social beliefs and customs, education, economic status of family as well as the ease of availability. Aims & Objectives: This retrospective study analyses the clinical profile of poisoning patients admitted in Fr. Muller Medical College Hospital Mangalore. Materials and Methods: Hospital records of all children < 15 years, admitted with a diagnosis of acute poisoning between January 2010 and July 2012 were included. Patients with poisonous bites and stings were excluded. The results were analysed statistically by percentage, Fischer exact test (p value). Results: A total of 56 children were included. Types of poisoning: kerosene (21.4%), rat poison (16.07%), organophosphorous Poison (7.14%), pyrethroids (12.5%), others (37.5%) which included medications and fertilizers and unknown substances in 5.35%. Kerosene poisoning was more common in < 1 year whereas rat poison was between 1 and 5 year of age. There was no significant difference between the sexes in relation to type of poisoning except for kerosene poisoning which was significantly higher in males. Though majority was accidental, 5 cases involving adolescents were suicidal. Vomiting, drowsiness, unconsciousness, pain abdomen, convulsions, and shock were the presenting symptoms. Antidotes were available only in 4 cases. 55 cases survived and one patient succumbed (Zinc Phosphide). Conclusion: The study highlights the pattern of poisoning in this area. Increasing the awareness and proper preventive measures go a long way in decreasing poisoning in children.