Insecticide Poisoning Research Articles

Estimation of chlorpyrifos distribution in forensic visceral samples and body fluids using LCMS method

The ingestion of the insecticide chlorpyrifos leads to fatal intoxication in suicidal cases, and its distribution can be assessed only after post-mortem. This study attempted to investigate the distribution of chlorpyrifos in forensic visceral tissue samples like stomach, liver, kidney, heart, brain, lung, spleen, muscle and body fluids like blood and urine by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) with the liquid-liquid extraction method. An analysis time of 8.77 min with 1 μl as an injection volume was chosen. The results obtained are analysed using Labsolutions insight LCMS software, considering Multiple Reaction Monitoring (MRM) and Retention Time (RT). Our findings depict that the stomach tissue has very high concentrations of chlorpyrifos, which suggests the possibility of high distribution and aspiration in the stomach tissue. The concentration of chlorpyrifos in stomach tissue ranged from 816 to 901 μg/g in male cadavers and from 443 to 612 μg/g in female cadavers. Among all the tissues, the stomach tissue showed the highest concentration, while the lowest concentration was found in muscle. Metabolic distribution of chlorpyrifos from the stomach contents to the other surrounding organs may occur and hence the concentrations of CPF were also seen in other organs like the liver, lung, kidney, brain, and muscle. These toxicological results from autopsy findings, together with LC-MS/MS indicate that stomach tissue examination gives an accurate profile of insecticide poisoning in forensic samples with acute poisoning.

Analysis of Clinical Characteristics of Severe Pneumonia in Children Under Regular COVID-19 Outbreak Prevention and Control

Objective — To investigate the clinical characteristics of severe pneumonia in childhood under the regular prevention and control of the COVID-19 epidemic in 2021. Methods — The clinical data of 132 children with severe pneumonia in our pediatric intensive care unit from January 1, 2021, to December 31, 2021, were counted. Results: There were 132 children diagnosed with severe pneumonia, including 49 with different underlying diseases: 12 with airway dysplasia, 13 with genetic metabolic diseases, 11 with congenital heart disease, 10 with malnutrition, 2 with drowning, and 1 with insecticide poisoning. Pathogenesis includes viruses: 33 cases of respiratory syncytial virus, 10 cases of influenza virus, 5 cases of cytomegalovirus, 3 cases of human rhinovirus, 2 cases of bocavirus, 1 case of adenovirus; 19 cases of Mycoplasma pneumoniae. Bacteria: 7 cases of Pseudomonas aeruginosa, 6 cases of Escherichia coli, 4 cases of Klebsiella pneumoniae, 3 cases of Staphylococcus aureus, including 1 case of methicillin-resistant Staphylococcus aureus, 2 cases of Streptococcus pneumoniae, 2 cases of Haemophilus influenzae, 2 cases of Acinetobacter baumannii, 1 case of Cattamora, and 1 case of Serratia marcescens. There were 6 cases of fungi, and 107 strains were detected, with a detection rate of 81.0%. Conclusion — Children with combined underlying diseases are more likely to develop severe pneumonia, such as malnutrition, congenital heart disease, airway malformations, and congenital inherited metabolic diseases. The top three pathogens are respiratory syncytial virus, Mycoplasma pneumoniae and influenza virus, and the top three bacterial infections are Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae. Among them, small infants are mainly respiratory syncytial virus, older children are mainly Mycoplasma pneumoniae, and those who are positive for bacterial infections are mostly mixed infections. After active standardized treatment, the cure rate of severe pneumonia in infants and children is high.

Lung injury caused by aspiration of organophosphorus insecticide and gastric contents in pigs

Introduction Patients who require mechanical ventilation after self-poisoning with ingested organophosphorus (OP) insecticides often die. Aspiration of stomach contents may contribute to lung injury and lethality. This study was designed to assess the severity of direct and indirect pulmonary injury created by pulmonary instillation of mixtures of OP insecticide, solvent (Solv) and porcine gastric juice (GJ) compared to controls. Methods Terminally anaesthetised minipigs (groups n = 5) were exposed to sham bronchoscopy or given mixtures (0.5 mL/kg) of: saline, GJ, OP insecticide and GJ (OP + GJ), or Solv and GJ (Solv + GJ), placed into the right lung, and monitored for 48 h. Lung injury was assessed through analysis of bronchoalveolar lavage fluid (BALF), computed tomography and histopathology. Results OP + GJ created a direct lung injury consisting of neutrophil infiltration, oedema and haemorrhage, as well as indirect injury to the other lung. OP + GJ directly-injured lung parenchyma had increased concentrations of BALF protein, albumin, IL-6, IL-8 and C-reactive protein (CRP) at 24 h (p < 0.05), and BALF protein, albumin and CRP at 48 h (p < 0.05), when compared with controls. Aspiration of GJ produced similar direct effects to OP + GJ but less indirect lung injury. Lung injury was less severe after Solv + GJ, for combined lung histopathology scores (vs. OP + GJ, p < 0.05) and for the proportion of directly-injured lung that was poorly/non-aerated at 48 h. Conclusion Pulmonary instillation of OP + GJ created more lung damage than controls or Solv + GJ. In patients with severe OP insecticide poisoning and reduced consciousness, early airway protection is likely to reduce pulmonary damage.

CON: Oximes should not be used routinely in organophosphorus insecticide poisoning.

Organophosphorus (OP) insecticide poisoning causes respiratory failure due to acetylcholinesterase (AChE) inhibition. The AChE reactivating antidote pralidoxime was developed in the 1950s and was soon noted to benefit patients occupationally poisoned with the highly potent OP insecticide parathion. Routine use of pralidoxime and other oximes such as obidoxime then became widely recommended. However, nearly all severe cases of OP poisoning now result from self-poisoning with large volumes of less potent (WHO hazard class Ib and II) insecticides and co-formulated solvents. Unfortunately, oxime clinical trials have never shown benefit from their use for these patients, and some have shown that pralidoxime may be associated with harm, including increased mortality. Oximes should not be used routinely for the care of OP insecticide-poisoned patients until translational and clinical studies have identified a safe and effective oxime regimen and identified the patients who benefit.

Diagnostic value of red blood cell distribution width in patients with organophosphate poisoning in emergency department of Sina hospital in 2019

Introduction: Organophosphates are pesticides used for agricultural purposes, and their poisoning has critical complications. The purpose of this study was to determine the estimated Red Blood cell distribution width (RDW) prognostic role in patients with organophosphate poisoning in the emergency department. Materials and methods: In this Descriptive-analytical study, patients with acute organophosphate poisoning referred to the emergency department of Sina Hospital in Tabriz from March 2019 to March 2020 were enrolled. The primary outcome of the patients including, organophosphate-induced RDW changes, and the secondary outcome including, organophosphate-induced death were recorded. Results: Eighty two patients with organophosphate poisoning were enrolled in this study. The mean age was 36.21 years. Of 82 patients, insecticidal poisoning, herbicide, fungicides, and acaricide were seen in 62 (76.8%), 16 (19.5%), 1 (1.2%), and 1 (1.2%) patients respectively. There were no statistically significant difference observed between types of pesticides and patients’ outcomes (p&gt; 0.05). There was no statistically significant difference between different organophosphates in terms of pH, HCO3 , PCO2 , WBC, Hb, platelets, RDW, sodium, potassium, PT, PTT, INR, urea, creatinine, and cholinesterase (p&gt; 0.05). Conclusion: Generally, RDW in patients with organophosphates toxicity does not have prognostic value and is not affected by the severity of poisoning.

Ginsenoside Rg3 Alleviates Rotenone-induced Lung Injury in Mice by Its Anti-oxidative Properties

Objectives: Acute lung injury is commonly found in patients with insecticide poisoning and the pathogenesis is related to oxidative stress. Ginsenoside Rg3, one of the main constituents of Panax ginseng C.A. Meyer, shows an anti-oxidative activity. The aim of this study was to evaluate whether ginsenoside Rg3 can alleviate lung injury induced by rotenone in mice.&#x0D; Methods: C57BL/6J male mice were divided into five groups (n=11). The mice in ginsenoside Rg3 groups were treated with ginsenoside Rg3 at dose of 5, 10 or 20 mg/kg. Except for the control group, mice were challenged intragastrically with rotenone at dose of 30 mg/kg, once a day for 6 weeks. Subsequently, the lung tissues of mice were collected. The effect of ginsenoside Rg3 on rotenone-induced lung injury was observed by hematoxylin and eosin staining. The oxidative stress in lung tissues were also examined.&#x0D; Results: Rotenone induced substantial hemorrhage, alveolar wall thickness and neutrophils infiltration. These structural damages were attenuated significantly by ginsenoside Rg3 treatment. The lung injury induced by rotenone was associated with oxidative stress in lung tissues of mice. Compared with the control group, rotenone exposure resulted in the increase of malondialdehyde (MDA), the decreases of the activities of superoxide dismutase (SOD), glutathione peroxidase (GHS-Px), and the glutathione (GSH) content. Nevertheless, ginsenoside Rg3 treatment not only reduced MDA production but also increased the activities of SOD, GSH-Px, and the content of GSH in lung tissue of mice.&#x0D; Conclusion: Taken together, this study demonstrated that ginsenoside Rg3 has potential to ameliorate rotenone-induced lung injury and the mechanism of action of ginsenoside Rg3 is mediated by its anti-oxidative properties.&#x0D; &#x0D;

O-EV002. Auditory event-related potential changes over 6 months following acute organophosphate insecticide poisoning: A follow-up study

Introduction . Ingestion of organophosphate insecticides (OPIs) is a common method of self-harm and a major clinical problem is Asia. Apart from acute cholinergic effects, OPIs are also claimed to be associated with long-term neurobehavioural deficits. However, neurophysiological evidence for such long-term deficits is scarce in humans. We aimed to assess long-term changes in the pre-attentive (N1) and attentive (P3b) components of auditory event-related potentials (ERPs) following acute OPI self-poisoning. Methods . We recruited 203 patients (147 men) hospitalised following OPI ingestion (OP Group; all had significant red cell cholinesterase inhibition) and 50 patients (23 men) hospitalised with paracetamol overdose (Control Group) as a means of self harm. We recorded their EEG in an auditory oddball task and derived the averaged ERPs. The subjects underwent three testing sessions: on discharge from hospital (around 14 days post-ingestion), 6 weeks and 6 months post-ingestion. We compared the reaction time and ERP indices of the two groups at each time point, adjusting for sex, age, education and psychiatric comorbidities in multiple regression models. Results . After adjusting for covariates, OP Group had significantly slower reaction time than the Control Group on discharge (mean difference [SE] = 65[20] ms, p = 0.001) and at 6 weeks (mean difference [SE] = 45[20] ms, p = 0.024), but not at 6 months. Parietal (PZ) P3b amplitudes were significantly smaller in the OP group on discharge (mean difference [SE] = 2.23[0.84] V, p = 0.009) and at 6 months (mean difference [SE] = 3.34[1.43] V, p = 0.021). P3b latencies or frontal (FZ) N1 component did not show significant intergroup differences. Conclusion . Acute exposure to clinically significant doses of OPIs seem to cause impairment in behavioural and neurophysiological indices of stimulus discrimination, that outlast the cholinergic phase of intoxication. The behavioural impairment seems to disappear over months, but the underlying neurophysiological deficits of attentive processing seem to last even after 6 months post-exposure.

Atropine Induced Psychosis in Organophosphate Insecticide Poisoning and it's Management: A case series

Atropine is an established antidote in organophosphorus poisoning. It is an anticholinergic that inhibits the muscarinic actions of acetylcholine at postganglionic parasympathetic neuroeffector sites including secretory glands, smooth muscle, and CNS sites. In the literature, the cases of atropine intoxication are not uncommon. We report a case series of five cases of atropine induced psychotic disorder in patients, who manifested with delirium, hallucinations, nervousness, drowsiness, weakness, irrelevant talk, flushing along with tachycardia, and non-reactive dilated pupils suggesting possible anti-cholinergic abuse. The patients reported at the Department of Medicine-Unit II, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from January to June 2019. The patients were managed symptomatically by titrating down the atropine's dose, administration of benzodiazepine, and antipsychotics.

The Dynamic of Insect Population Succession in Bird Poisoned by Pyrethroid Insecticides

Insecticide poisoning is one of the causes of death in wild birds. One of the insecticides that are often used is a pyrethroid. This study aims to determine the succession of insects in birds intoxicated by pyrethroid pesticide. This research was conducted in Dramaga campus, IPB University, Bogor, Indonesia. One quail (Coturnix coturnix japonica) was used as a control which was killed by manual neck dislocation, and one bird was treated orally treated with acute dose pyrethroid pesticide. Cadavers are placed in insect traps until they reach the skeletal stage of decomposition. Insects that enter the trap are collected every 6 hours for 24 hours, from the first day until the whole process of decomposition of the carrion reaches the skeletal stage. Then the insects are identified and counted. The results showed that the cadaver decomposition process in the treatment group took longer than the control group. In the control group, insects arrived for approximately 138 hours after the cadaver was placed, while the treatment group took approximately 324 hours. The types of insects in these two groups are relatively the same, namely flies (Order Diptera: Calliphoridae, Muscidae), cockroaches (Order Dictyoptera: Blattidae and Blaberidae) and Sarcophagidae), beetles (Order Coleoptera: Scarabidae), ants (Order Hymenoptera: Formicidae), earwigs (Order Dermaptera: Anisolabididae). Chrysomya megachepala was the dominant insect over the others and was always present from the early stages to post-decay in control and pyrethroid treatment.

Misuse, perceived risk, and safety issues of household insecticides: Qualitative findings from focus groups in Arequipa, Peru.

BackgroundThe current body of research on insecticide use in Peru deals primarily with application of insecticides offered through Ministry of Health-led campaigns against vector-borne disease. However, there is a gap in the literature regarding the individual use, choice and perceptions of insecticides which may influence uptake of public health-based vector control initiatives and contribute to the thousands of deaths annually from acute pesticide poisoning in Peru.MethodsResidents (n = 49) of the Alto Selva Alegre and CC districts of peri-urban Arequipa participated in seven focus group discussions (FGD). Using a FGD guide, two facilitators led the discussion and conducted a role-playing activity. this activity, participants insecticides (represented by printed photos of insecticides available locally) and pretended to “sell” the insecticides to other participants, including describing their qualities as though they were advertising the insecticide. The exercise was designed to elicit perceptions of currently available insecticides. The focus groups also included questions about participants’ preferences, use and experiences related to insecticides outside the context of this activity. Focus group content was transcribed, and qualitative data were analyzed with Atlas.ti and coded using an inductive process to generate major themes related to use and choice of insecticides, and perceived risks associated with insecticide use.ResultsThe perceived risks associated with insecticides included both short- and long-term health impacts, and safety for children emerged as a priority. However, in some cases insecticides were reportedly applied in high-risk ways including application of insecticides directly to children and bedding. Some participants attempted to reduce the risk of insecticide use with informal, potentially ineffective personal protective equipment and by timing application when household members were away. Valued insecticide characteristics, such as strength and effectiveness, were often associated with negative characteristics such as odor and health impacts. “Agropecuarios” (agricultural supply stores) were considered a trusted source of information about insecticides and their health risks.ConclusionsIt is crucial to characterize misuse and perceptions of health impacts and risks of insecticides at the local level, as well as to find common themes and patterns across populations to inform national and regional programs to prevent acute insecticide poisoning and increase community participation in insecticide-based vector control campaigns. We detected risky practices and beliefs about personal protective equipment, risk indicators, and safety levels that could inform such preventive campaigns, as well as trusted information sources such as agricultural stores for partnerships in disseminating information.

A Case Report on Deliberate Self-poisoning with Imidacloprid in a Young Female - Overview of a Newer Insecticide Poisoning

Imidacloprid is a newer insecticide of the group Neonicotinoids. It is safer to humans and hence considered a better alternative to organophosphorus compounds, especially in areas like Nepal with higher incidence of deliberate self-poisoning. There has been an increase in the number of reported cases of imidacloprid poisoning from South-East Asian countries, but none from Nepal. We report a case admitted in Intensive Care Unit with neurological manifestations, respiratory failure and development of Acute Kidney Injury following acute imidacloprid poisoning.

A Case Report on Deliberate Self-poisoning with Imidacloprid in a Young Female - Overview of a Newer Insecticide Poisoning

Imidacloprid is a newer insecticide of the group Neonicotinoids. It is safer to humans and hence considered a better alternative to organophosphorus compounds, especially in areas like Nepal with higher incidence of deliberate self-poisoning. There has been an increase in the number of reported cases of imidacloprid poisoning from South-East Asian countries, but none from Nepal. We report a case admitted in Intensive Care Unit with neurological manifestations, respiratory failure and development of Acute Kidney Injury following acute imidacloprid poisoning.

Ameliorative Effects of Boswellic Acid on Fipronil-Induced Toxicity: Antioxidant State, Apoptotic Markers, and Testicular Steroidogenic Expression in Male Rats.

Simple SummaryFipronil (FPN) is an insecticide that can be used in insect control in various cereal crops in agriculture, veterinary activities, and public health management. Boswellic acid (BA) is a pentacyclic triterpene, which is a compound isolated from Boswellia serrata gum resin. This study was designed to determine BA’s potential protective impact against oxidative and testicular damage caused by FPN insecticide poisoning on the male rat model. BA significantly improved the reproductive parameters assessed, such as the number of pregnant females, index of pregnancy and the number of litters, weights of the reproductive organ, sperm cell quality, morphological alterations of testes, epididymis, and sex glands by accessory caused by FPN oxidative stress, as well as the improvement of steroidogenesis, antioxidants, and antiapoptotic marker.The study investigated the ability of boswellic acid (BA) to alleviate the testicular and oxidative injury FPN insecticide intoxication in the male rat model. Rats were randomly assigned to six equivalent groups (six rats each) as the following: control rats orally administered with 2 mL physiological saline/kg of body weight (bwt); boswellic acid (BA1) rats orally administered 250 mg BA/kg bwt; boswellic acid (BA2) rats orally administered 500 mg BA/kg bwt; fipronil (FPN) rats orally administered 20 mg FPN/kg bwt; (FPN + BA1) rats orally administered 20 mg FPN/kg bwt plus 250 mg BA/kg bwt, and (FPN + BA2) rats orally administered 20 mg FPN/kg bwt plus 500 mg BA/kg bwt. After 60 days, semen viability percentage and live spermatozoa percentage were decreased, and a considerably increased abnormality of the sperm cells in FPN-administered rats improved substantially with the co-administration of BA. BA had refinement of the histological architecture of testes and sexual glands. Quantitative analysis recorded a noticeable decline in the nuclear cell-proliferating antigen (PCNA) percentage area. FPN triggered cell damage, which was suggested by elevated malondialdehyde and interleukin 6, tumor necrosis factors alpha, and decreased glutathione level. Proapoptotic factor overexpression is mediated by FPN administration, while it decreased the antiapoptotic protein expression. Similarly, BA has shown significant upregulation in steroidogenic and fertility-related gene expression concerning the FPN group. Pathophysiological damages induced by FPN could be alleviated by BA’s antioxidant ability and antiapoptotic factor alongside the upregulation of steroidogenic and fertility-related genes and regimented the detrimental effects of FPN on antioxidant and pro-inflammatory biomarkers.

English

Fipronil is an N-phenylpyrazole insecticide, a second-generation insecticide which is relatively new and now commonly used in cotton growing community of rural Central India. Farmer suicide and deliberate self-poisoning is menace to the Vidarbha region of rural Central India. There is paucity of research published on fipronil poisoning, clinical features, complications and treatment data. It is scarcely documented worldwide. Agricultural insecticides are common household items in rural areas of developing countries. Because of their easy availability, insecticides became a major source of deliberate self-poisoning. As per World Health Organization (WHO), around 3 million poisoning cases with around 0.2 million deaths are noted annually in the world. 1 About 99 % of these deaths occur in developing countries. Insecticide poisoning is an important public issue in India.Around 168,000 deaths occurred from pesticide self-poisoning which totals to almost 19.7 % of the global suicides.2 The most common cause of self-poisoning in Central India is ingestion of organophosphorus compounds (OPC). Poisoning with organophosphorus compound insecticides has high mortality rate.1 In the last 20 years, there is development of a new class of insecticides in view of mortality due to accidental exposures of organophosphorus and organochlorine compounds. Fipronil being one of these chemicals, is considered less harmful to humans. According to WHO classification fipronil is class II moderately hazardous pesticide.3 Fipronil, an N-phenylpyrazole with a trifluoromethyl sulfinyl substituent, one of the first second generation insecticides, acts at the γ-aminobutyric acid (GABA) receptor and blocks the chloride channel. Fipronil is often used to control pests, fleas and ticks on pets. There is, however, very less evidence or research on human beings on their toxicity; thus, post marketing surveillance is important to detect any undesirable health issues associated with these chemicals. Until now only 3 case reports are published regarding fipronil poisoning, two cases form India and others from Sri Lanka. Hence, we are reporting a case of acute fipronil poisoning which presented as acute gastritis and sinus bradycardia.

EFFICIENT CHROMATOGRAPHIC APPROACH FOR THE ANALYSIS OF INSECTICIDES AND ECO-TOXICOLOGICAL ASPECTS

In today's rapid growing industries and technology, the frequent use of various insecticide in agriculture sector can be commonly encountered. Insecticides such as carbamate, organochlorine and pyrethroids helps protecting the crop from various insects, which ultimately leads to the better yield of agricultural products. But the main concern that comes out in such frequent practice is the adverse effects to the adjacent ecosystems. Especially, the very commonly used carbofuran, DDT, Cypermethrin and its adverse effects can be put forwarded as a potential example in this article. Apart from this, the scope of this article covers the mechanism of toxicity by insecticides to nontargeted organisms in the ecosystem, the recent developments in the analytical techniques considering HPLC and GC, the method of extraction and quantication of active component in sample. A comparison between GC and HPLC is done and the preferred instrumentation is concluded while considering the analysis of Insecticide. Scope of this review also covers the symptoms and treatment of insecticide poisoning.

A comprehensive study on insecticide poisoning patients brought to a tertiary government hospital in north eastern region of India

The commonest cause of poisoning in India and other developing countries are insecticide and pesticide, which are agriculturally based economics, poverty and easy availability. This study collected gastric lavage from all suspected and confirmed insecticide poisoning cases brought to the hospital. They are being analysed by the thin-layer chromatography method for the detection of the type of insecticide. This is a cross-sectional study, and statistical analysis is done by correlation and regression analysis method. Total 182 cases of insecticide poisoning were brought to the emergency services of a Government Hospital at Agartala, Tripura, during the period January 2013 to June 2014, out of which 79.1% were within the age group of 21 years to 40 years, 78.6% of the victims are male, 50% of the victims were farmers, 98% of the times the mode of poisoning were suicidal, 74% of the cases the insecticide involved was organophosphorus group of poison (OP), while 19% of the cases were Organochlorine group of poisons (OC), and only 7% of the cases were Carbamate group of poison (CAR). Due to undue pressure for performance and good lifestyle and failure to comply, the young productive age group tends to take such irreversible steps of committing suicide using easily available material. The need of the hour is a very restricted supply of insecticides with proper documentation and proper counselling sessions for survivors of such incidents.

Linking landscape composition and biological factors with exposure levels of rodenticides and agrochemicals in avian apex predators from Germany

Intensification of agricultural practices has resulted in a substantial decline of Europe's farmland bird populations. Together with increasing urbanisation, chemical pollution arising from these land uses is a recognised threat to wildlife. Raptors are known to be particularly sensitive to pollutants that biomagnify and are thus frequently used sentinels for pollution in food webs. The current study focussed on anticoagulant rodenticides (ARs) but also considered selected medicinal products (MPs) and frequently used plant protection products (PPPs). We analysed livers of raptor species from agricultural and urban habitats in Germany, namely red kites (MIML; Milvus milvus), northern goshawks (ACGE; Accipiter gentilis) and Eurasian sparrowhawks (ACNI; Accipiter nisus) as well as white-tailed sea eagles (HAAL; Haliaeetus albicilla) and ospreys (PAHA; Pandion haliaetus) to account for potential aquatic exposures. Landscape composition was quantified using geographic information systems. The highest detection of ARs occurred in ACGE (81.3%; n = 48), closely followed by MIML (80.5%; n = 41), HAAL (38.3%; n = 60) and ACNI (13%; n = 23), whereas no ARs were found in PAHA (n = 13). Generalized linear models demonstrated (1) an increased probability for adults to be exposed to ARs with increasing urbanisation, and (2) that species-specific traits were responsible for the extent of exposure. For MPs, we found ibuprofen in 14.9% and fluoroquinolones in 2.3% in individuals that were found dead. Among 30 investigated PPPs, dimethoate (and its metabolite omethoate) and thiacloprid were detected in two MIML each. We assumed that the levels of dimethoate were a consequence of deliberate poisoning. AR and insecticide poisoning were considered to represent a threat to red kites and may ultimately contribute to reported decreased survival rates. Overall, our study suggests that urban raptors are at greatest risk for AR exposure and that exposures may not be limited to terrestrial food webs.

Changes in method specific suicide following a national pesticide ban in India (2011–2014)

BackgroundThis paper investigates whether declines in suicide by insecticide poisoning in India following a national ban on endosulfan in 2011were associated with changes in other methods of suicide and total suicide rates. MethodMethod-specific suicide rates between 2001–2014 were calculated using National Crime Records Bureau (NCRB) data by sex, age group and region, with observed rates compared to expected rates for the period post-2011. ResultsThere were an estimated 20,146 fewer male and 8,418 fewer female suicides by insecticide poisoning and 5542 fewer male and 2679 fewer female suicides by all other methods following the national endosulfan ban. Contemporaneously, an estimated 92% (23,812) of male and 60% (6,735) of female suicides prevented by insecticide poisoning and all other methods were offset to increases in suicides by hanging and other poisoning. Joinpoint regression indicated a decrease in suicide by insecticide poisoning following the endosulfan ban (annual percentage change (APC) of -12.18 among males and -11.89 among females between 2010–2014) while an increase in male suicide by hanging was noted between 2009–2014 (APC of 7.05). LimitationSuicide rates based on the NCRB data might be an underestimation of the true suicide rates. ConclusionDeclines in suicide by insecticide poisoning were largely offset by an increase in hanging suicides among males, however, this phenomenon was much less prominent in females and contributed to declines in total female suicide rates. Prevention strategies must continue to focus on pesticide bans with simultaneous attention on hanging prevention policies to reduce overall suicide rates in India.

Clinico-demoghraphic profile and outcome of critically ill poisoning patient admitted in the ICU of the largest tertiary care government hospital in Dhaka, Bangladesh

Background: Acute poisoning is a common chief complaint leading to emergency department visits andhospital admissions in developing countries such as Bangladesh. Aim: To study the demographic and clinical profiles of patients admitted to the ICU with acute poisoningand to study the factors that predict their mortality. Methodology: This observational study recruited all eligible 74 poisoning patients admitted in theintensive care unit from 1st July 2019 to 30th June 2020. This study is conducted in the Intensive CareUnit of Dhaka Medical College Hospital, Dhaka, Bangladesh. Result: Total 74 poisoning patients were admitted in the intensive care unit, of them female (55.54%)was more than male(44.59% ). Among the patients 67( 90.54 %) patient were Muslims and 43(58.10%)were married. The highest incidence of poisoning 28 (37.83%) were observed in the age group 11 to 20year and the mean age was 23.74 years. The majority of poisoning cases was suicidal intension(87.83%),accidental was 6.75% and homicidal or street poisoning was 5.40%.The most common type of poisoningwas organophosphorus compound (52.70%) followed by Drug overdose (16.21%), Paraquat poisoning(9.45%), rat killer( 5.4%),Insecticide poisoning (4.05%),Corrosive poisoning (2.74%).The most commonroute of poisoning was ingetion. Mechanical ventilation required 52.70% patients, majority of patientsrequired shorter period (1 to 5 days) of mechanical ventilation and mean duration of mechanical ventilationis 6.33 days . 83% patient were shifted /dischared from the ICU within 1 to 5 days. Mean duration was8.13 day in case of mechanical ventilated patients, but in non-ventilated patients, ICU stay was much lessthan ventilated patients. In this study, the mortality rate was 31% . Conclusion: Early ICU admission and appropriate management of patients after ingestion of poisonousagent results in reduced morbidity and mortality. JBSA 2020; 33(2): 85-91

Demographic Trends and Outcome of Acute Poisoning in a Rural Tertiary Care Hospital of Nalgonda District, Telangana

Background: World Health Organization (WHO) estimates that, globally more than three million of acute poisoning cases with 2,20,000 deaths occur annually. Of these, 90% of fatal poisoning occurs in developing countries particularly among agricultural workers. It has been reported that acute poisoning approximately constitutes 10% of admission in medical emergency departments in India. Objectives: 1. To assess the patterns of socio-demographic variables of patients admitted with acute poisoning in a rural tertiary care hospital 2. To determine the various poison related factors in relation to the outcome of patients admitted with acute poisoning in a rural tertiary care hospital of Nalgonda district. Methodology: This was a retrospective record based study conducted using patient’s discharge summaries comprising of the patients admitted to the emergency medicine department for acute poisoning from July 2019 to January 2020. Data was entered and analyzed using Microsoft Excel 2010. Results: During the study period, a total of 77 acute poisoning cases were admitted, with 5 deaths, resulting in a mortality rate of 6.5%. Acute poisoning was most seen in males (58.4%) and in the 14 to 30 years (62.3%) age group. Majority of the patients were admitted for ingestion of poison (89.6%) and the most commonly consumed poison was insecticides (40.3%). Conclusion: Insecticide poisoning is the most common form of poisoning with high mortality among males. There is a need for appropriate training and counselling sessions of preventive strategies for individuals who are at risk of acute poisoning especially the younger age groups.