Lethal Intoxication Research Articles

The Correlation of Bile Duct Dilatation in Postmortem Computed Tomography of Lethal Intoxication Cases for Different Drug Types—A Retrospective Study

Purpose: To assess (I) whether, in autopsy-proven lethal intoxications with opiates/opioids, a dilatation of the common bile duct (CBD) is still visible in postmortem computed tomography (PMCT) and (II) if a dilatation of the CBD might also be measurable for other substance groups (e.g., stimulants, hypnotics, antipsychotics, etc.). Methods: We retrospectively measured the CBD using PMCT in cases with lethal intoxication (n = 125) and as a control group in cases with a negative toxicological analysis (n = 88). Intoxicating substances were classified into the subgroups (opiates, opioids, stimulants, hypnotics, antipsychotics, gasses, and others). Significance between the study and control groups was tested with the Mann–Whitney U test, and correlations were examined by using crosstables. Results: There was a statistically significant difference between the CBD diameters in the intoxication group overall, when compared to the CBD diameter in the control group (p < 0.001). For both subgroups of “opiates” and “opioids”, there was a strong statistically significant difference between the CBD diameter (being wider) in those groups compared to the control group (both p = 0.001). For the three subgroups “hypnotics”, “stimulants”, and “psychotropic drugs”, there was no statistically significant difference between the CBD diameters in the intoxication subgroups when compared with the control group. The other subgroups were too small for statistical analysis. Conclusion: A dilated common bile duct in postmortem computed tomography might be used as an indication for a lethal opioid or opiate intoxication only in regard to the specific case circumstances or together with other indicative findings in a postmortem investigation.

Post mortem chiral analysis of MDMA and MDA in human blood and hair

Drug-related fatalities in the EU are predominantly associated with opioids. MDMA (Ecstasy) consumption results in fewer lethal intoxications despite its widespread use. This study investigates MDMA-related fatalities, focusing on enantiomer ratios of MDMA and its metabolite MDA to explore the role of metabolism in fatal outcomes.MDMA induces euphoria, increased empathy, and physiological effects such as tachycardia, hypertension, and hyperthermia. Metabolism mainly involves CYP1A2 and CYP2D6, with polymorphism of the latter influencing metabolism rates. Our institute observed several MDMA-related fatalities, which prompted an investigation into the potential role of inefficient drug metabolism in these cases.A novel quantitative chiral analysis method was developed and validated for MDMA, MDA, amphetamine and methamphetamine enantiomers in human blood. Analysis of post mortem blood samples from eleven MDMA-related fatalities exhibited a wide range of concentrations and enantiomer ratios. Variability in R/S MDMA ratios, however, could be linked to the time period of metabolism. Hair analysis revealed high MDMA concentrations in all segments, irrespective of prior drug abuse anamnesis. Therefore, hair analysis may not be suitable for the assessment of past drug use in ecstasy-related fatalities.The results indicated that elevated levels of the MDMA enantiomer are correlated with longer survival times in cases of intoxication. However, there was no clear evidence for slowed MDMA metabolism as a cause of lethal intoxications. While challenges remain due to the diversity of cases, this study contributes valuable insights into ecstasy intoxications, aiding future interpretation of post mortem analysis.

2,4-dinitrophenol intoxication and its morphological findings as an indication of substance intake

Lethal intoxications can only very rarely be recognized during an external examination of corpses, as poisoning does not leave any characteristic findings on the deceased. The present study is a retrospective review on 2,4-dinitrophenol (2,4-DNP) intoxications in human subjects from the beginning of the 20th century until today, as well as a case report on a fatal intoxication of a 50-year old obese man in Rostock (Germany) and an introduction for toxicological analysis in post-mortem specimens of the substance ingested in these rare cases.Via selective literature search, the information on occurrence and localization of abnormal pathomorphological external and/or internal findings in cases of 2,4-DNP ingestion/ intoxication was gathered. By 2021, a total of 13 case reports with information on morphological findings due to 2,4-DNP ingestion/intoxication were found. The external findings were dominated by yellowing of the skin, followed by exanthemas/rashes and yellowing of the sclera. The internal findings included yellowing of the internal organs, yellow color of the stomach contents, yellowing of the mucous membranes and an intense yellow color of the urine. Yellowish discoloration of the skin, sclera, mucous membranes, internal organs, sweat and/or an intensive yellow discoloration of the urine are not observed in every 2,4-DNP intoxication. However, when they do occur, they are a characteristic indication of 2,4-DNP ingestion and, if localized to the skin, indicate prolonged consumption. A fatal case from Rostock in 2016 due to prolonged intake of 2,4-DNP for weight loss is exemplified. A simple, fast and cost-effective workup combined with HPLC-DAD for post-mortem toxicology ultimately delivers reliable analysis results.

Enhanced autopsy triage (EA-Triage) in drug-related deaths: integrating quick toxicological analysis and postmortem computed tomography.

The objective was to assess the diagnostic accuracy of an enhanced autopsy triage (EA-Triage) setup consisting of postmortem computed tomography (PMCT), simulated quick toxicological analysis (sQTA), external examination, and case information in determining cause of death (COD) in persons with past or current use of illegal drugs (drug-related deaths). Information on drug-related deaths selected for medico-legal autopsy in 2020-2021 at the Department of Forensic Medicine, Aarhus University, Denmark, was analyzed retrospectively. The included cases underwent conventional autopsy, PMCT, and systematic toxicological analysis. A board-certified forensic pathologist, who was blinded to the internal examination and COD from the medico-legal autopsy, determined COD based on the EA-Triage setup. 154 cases with a median age of 40.6 years (range 17-70 years, 82% males) were included. The COD determined by medico-legal autopsy and that determined by EA-Triage matched in 113 cases (73%), including those with an unknown COD. EA-Triage and medico-legal autopsy determined unknown COD in 45 (29%) and 5 cases (3%), respectively. Excluding cases with an unknown COD, EA-Triage predicted COD in 109 cases (71%); of those, 72 (66%) had no unexplained case circumstances or suspicion of a criminal act. In these 72 cases, the CODs determined by EA-Triage and medico-legal autopsy matched in 71 cases (99%), and the sensitivity and specificity for detecting lethal intoxication were 100% and 90%, respectively. EA-Triage showed strong diagnostic accuracy for determining COD in drug-related deaths. This method may be suitable for enhancing preautopsy triage and guiding police investigations at an early stage.

E-cigarettes, e-liquids and drug vaping – forensic perspectives on electronic nicotine delivery systems

Electronic cigarettes are devices that produce an aerosol by heating e-liquid. Their history can be traced back to the 20th century but their popularity exponentially increased in the 21st century. Multiple generations and types of e-cigarettes are available on the market with an astounding choice of e-liquids. They gained popularity in almost all countries and among all age groups. The regulation concerning them varies drastically across the world. The health impact is still not fully understood. Although e-cigarettes contain less toxic substances compared to regular cigarettes their use is still not harmless. Some studies suggest a correlation between e-cigarettes and cardiovascular diseases and a potential cancer risk. However, the most noticeable is the effect on the respiratory system. There have been reported cases of fatal respiratory failure caused by e-cigarette use. There has been an increased interest in using e-cigarettes for recreational drug use, notably cannabinoids. E-liquids have been used in suicide attempts. They are usually ingested causing potentially lethal poisoning. Furthermore, lung biopsy and extensive medical history analysis should be the cornerstone of forensic examination of deaths involving e-cigarettes.

Identification of a murder caused by brodifacoum poisoning based on clinical examinations and LC-MS/MS results.

Brodifacoum exerts its antagonistic effect against the metabolism of vitamin K, an essential component in the synthesis of blood coagulation factors. This effect ultimately hinders the blood's capacity to clot effectively, rendering it a commonly employed rodenticide. Instances of lethal poisonings are exceedingly rare owing to expeditious medical intervention and treatment. Within this report, we present a case of brodifacoum-induced homicide, wherein the patient exhibited distinct clinical examinations and symptoms. Moreover, the patient's blood sample exhibited a noteworthy brodifacoum concentration of 0.681µg/mL even after a period of 43 days following the incident of poisoning. Although an autopsy was not conducted due to religious restrictions, we endeavor to reasonably deduce the cause of death and furnish corroborative evidence for clinical diagnosis, treatment, and forensic examination in instances involving brodifacoum poisoning.

Pulmonary Radiological Manifestations of Paraquat Poisoning: A Pictorial Essay.

Paraquat (1,1'-dimethyl-4,4'-dipyridylium) is a liquid herbicide, linked to both accidental and intentional ingestion, which can result in severe and frequently lethal poisoning. It has been known to cause injury to the lungs, kidneys, and liver. We retrospectively reviewed five cases over the last 4 years with a history of paraquat ingestion. The time duration between ingestion and high-resolution computed tomography (HRCT) was assessed. HRCT chest scan was variable, ranging from 4 to 18 days postexposure. The follow-up of the patients was also reviewed.

The study of the features of the determination and nature of the localization of 2-amino-4.6-dinitrophenol in the body of warm-blooded animals in case of lethal poisoning

The aim of the work is to study the nature of the distribution of 2-A-4.6-DNP in the organisms of warm-blooded animals with intragastric administration of a toxicant. The study was carried out using the methods of TLC, UV-Visible spectroscopy, and GC-MS using derivatives of 2-A-4.6-DNP. Male Wistar rats at the age of 4 months were considered as a model of the body of a warm-blooded animal. An oily suspension of 2-A-4.6-DNF was administered intragastrically in an amount of three times the LD50. Extraction of the target substance from the biomaterial was carried out by double infusion (30 minutes each) with a mixture of acetone-acetonitrile (1:1), the amount of the mixture exceeded the weight of the biomaterial by 2 times. Extractions were purified by TLC method using «Sorbfil» plates and acetone-chloroform (7: 3) mobile phase. Preliminary identification was carried out at the same time using a standard substance. Confirmatory identification was carried out by the absorption of dimethylformamide eluates in «SF-2000», as well as by the retention time and mass spectra of the major compound of the corresponding chromatographic peaks after GC-MS analysis. The quantitative content was determined spectrophotometrically, in DMF, by optical density at the analytical wavelength (490 nm). 2-Amino-4.6-dinitrophenol was found unchanged in the blood and in all the studied hollow and parenchymal organs of poisoned rats. The largest amount of 2-amino-4.6-dinitrophenol (mg/100 g) was found in the stomach walls (199.39±25.43) and stomach contents (143.14±22.63), a significant amount of the substance was found in the heart (33.49±3.66), skeletal muscles (30.70±2.64), as well as in the spleen (24.30±1.96).

A cross-sectional study of the clinical profile of children admitted with yellow phosphorous poisoning in a tertiary care hospital

Background: Yellow phosphorous (YP) is a protoplasmic poison that is mainly used as a rodenticide. Aims and Objectives: The aim of the study is to describe the clinical profile of YP poisoning in children in a tertiary care hospital. Materials and Methods: This is a cross-sectional study done in a tertiary care hospital in Tamil Nadu. A convenience sample of all the cases admitted during the year 2022 was done. Demographic and clinical data were collected and analyzed. Results: The male: female ratio was 1.16:1 (n=13). The mean age of the children was 4.0769±1.373 years. About 84.61% of the children reported to the hospital within 6 h. On admission, fever (30.76%), vomiting (30.76%), abdominal pain (30.76%), bleeding (15.38%), and altered sensorium (15.38%) were the common symptoms. All the children ingested YP accidentally. Leukocytosis was observed in about 30.76%. The mean peak serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 516.9231±685.976 IU/L and 161.9231±215.107 IU/L, respectively. There were no alterations in the Electrocardiographic tracings, levels of serum electrolytes, blood glucose, and serum creatinine in children with YP poisoning. Significant differences were observed between children who survived and children who died in the levels of mean peak AST, mean peak ALT, INR, and in the presence of encephalopathy and bleeding manifestations. Conclusion: YP is an uncommon but lethal poison in children. Creating awareness among parents about the dangers of YP and nationwide prohibition of the sale of YP will be an important step in eliminating deaths in children who are accidental victims.

A Forensic Case of Suicide Ingestion of Paraquat Herbicide: New Histological Insights and Revision of the Literature.

Paraquat (PQ) is one of the most widely used herbicides in the world, and poisoning is generally associated with accidental, suicidal, or homicidal events. Therefore, in the forensic context, PQ could be in various ways involved as a possible cause of death of a subject. However, even though its systemic toxicity is known, the biological effects exerted on individual viscera have been explored only to some extent, especially in case of victim's survival. Therefore, a case concerning a suicidal ingestion of PQ with survival of 3 days was deemed of interest. Clinical toxicological analyses confirmed acute PQ intoxication, and after the death of the victim, an autopsy was performed showing local and systemic signs of ingestion of a caustic substance. Histologic examination revealed marked cellular damage to the major viscera, particularly the gastroesophageal tract, liver, kidneys, and lungs, with initial alveolar fibrosis noted despite the patient's short survival. This finding represents a new element in the context of PQ lung injury, as it has not been previously documented in the literature. Thus, histological findings in lethal intoxications after survival can reveal specific peculiarities still unknown and, therefore, assume transversal relevance not only at forensic but also clinical level.

“Horrendous”: People’s Experience of Their Dog’s Death From 1080 Baiting

ABSTRACT Human–animal relationships are often significant and intimate, with dogs having a meaningful presence in many people’s lives. This study investigated the impact of 1080 poisoning on dogs and their humans. 1080 (sodium fluoroacetate) is a common lethal poison used in Australia to control animal populations, including in parks and reserves bordering residential areas. People and their companion dogs may use these areas for leisure and exercise, with unintended harm and death caused to dogs who consume 1080 baits. Seven Australian participants shared their experience of their dog’s death from 1080 poisoning via in-depth semi-structured interviews. We applied Reflexive Thematic Analysis using a phenomenological perspective to identify themes and subthemes within and across participant accounts. People's and dogs’ experiences with 1080 influenced individual and broader human–animal relationships. Three themes and associated subthemes were identified: Responsibility, Horror, and Traumatic Grief. Before their dog’s poisoning, people recognized animal control methods were necessary; after their dog’s experience, people saw 1080 as an inhumane and horrific lethal control method. This is the first qualitative study to give voice to people and their dogs who have been unintentionally harmed by 1080. This study can inform decision-making of government agencies, conservation organizations, and animal carers of the impacts of 1080 baiting.

Venoarterial extracorporeal membrane oxygenation in aluminum phosphide poisoning

Aluminum phosphide (ALP) poisoning is one of the most common and lethal poisonings with no antidote available till now. Inhalation or ingestion of ALP leads to the production of phosphine gas when exposed to moisture. We here report an adolescent female with alleged consumption of ALP available as celphos tablet, followed by severe metabolic acidosis and cardiogenic shock. Rapid timely initiation of venoarterial extracorporeal membrane oxygenation leads to intact neurological outcome and survival. Timely referral to higher center with extracorporeal life support facility is a key.

The Concept of Resistance to Substance Use and a Research Approach: The Resist! Project.

Illicit substance use is dangerous in both acute and chronic forms, frequently resulting in lethal poisoning, addiction, and other negative consequences. Similar to research in other psychiatric conditions, whose ultimate goal is to enable effective prevention and treatment, studies in substance use are focused on factors elevating the risk for the disorder. The rapid growth of the substance use problem despite the effort invested in fighting it, however, suggests the need in changing the research approach. Instead of attempting to identify risk factors, whose neutralization is often infeasible if not impossible, it may be more promising to systematically reverse the perspective to the factors enhancing the aspect of liability to disorder that shares the same dimension but is opposite to risk, that is, resistance to substance use. Resistance factors, which enable the majority of the population to remain unaffected despite the ubiquity of psychoactive substances, may be more amenable to translation. While the resistance aspect of liability is symmetric to risk, the resistance approach requires substantial changes in sampling (high-resistance rather than high-risk) and using quantitative indices of liability. This article provides an overview and a practical approach to research in resistance to substance use/addiction, currently implemented in a NIH-funded project. The project benefits from unique opportunities afforded by the data originating from two longitudinal twin studies, the Virginia Twin Study of Adolescent and Behavioral Development and the Minnesota Twin Family Study. The methodology described is also applicable to other psychiatric disorders.

Correlation of a distended urinary bladder volume with lethal intoxication in general and for different substance subgroups in particular: A retrospective study

Correlation of a distended urinary bladder volume with lethal intoxication in general and for different substance subgroups in particular: A retrospective study

REVIEW ON CYANIDE POISONING

Cyanide is one of the most lethal poison. It leads to death within a few minutes to a few hours sometimes. Depending upon the dose and route of administration or exposure the symptoms develop. The area of exposure is manufacturing and industrial sources such as insecticides, photographic solution, fumigation and electroplating work, plastic manufacturing and jewelry cleaners etc. History shows the common use of cyanide poisoning in suicidal and homicidal cases and also use as chemical warfare agent for terrorist attack. Incidence of cyanide poisoning is rare but the occurrence of death is seen instant in some cases. It causes histotoxic anoxia and inhibits oxidative phosphorylation, a process where oxygen is utilized for the production of essential cellular energy sources in the form of ATP. It does so by binds to the enzyme cytochrome C oxidase and blocks mitochondrial transport chain. This results in cellular hypoxia and the depletion of ATP occur, leading to metabolic acidosis. Symptoms such as headache, dizziness, vertigo, spasmodic closure of jaw and clawing of hands, tonic type of convulsions of the limb and trunk, muscular weakness and flaccidity, muscular paralysis, intense cyanosis, hypertension followed by hypotension, coma etc leads to death. Death is mainly due to cardiovascular failure and respiratory failure. Thus, rapid treatment to be started in such patients. The 100 % oxygen support and rapid therapy of antidotal treatment is necessary for life saving. Very efficient antidote is Hydroxocobalamin and other antidotes are also important in cyanide poisoning in the treatment as life saver. Survivors of cyanide poisoning may develop neuropathies.

3,5-Dimethoxyphenol identification from urine by GC-MS after a lethal intoxication with Taxus baccata: A case report

Taxus baccata, also known as English or European yew, is an evergreen conifer shrub or tree that is traditionally used in ornamental landscaping, woodwork and pharmaceutical purposes. The toxic nature of the yew plant has been known for more than 2000 years. All parts of the plant, except for the red pulp of its berries, contain taxine alkaloids. Minimum lethal doses are reported in the range of 0.6-1.3 g of leaf/kg body weight, which means that for a 70-kg adult this vary between 42 and 91 g of yew leaf. Intoxication is known to be resistant to standard treatments with no effective antidote. The aim of this study was the confirmation of Taxus poisoning by 3,5-dimethoxyphenol determination. A case of an intentional fatal poisoning of a 39-year-old man is presented, hypothesized by the forensic autopsy and confirmed by application of gas chromatography-mass spectrometry. Postmortem urine sample was analysed, after liquid-liquid extraction with dichloromethane from acidic and basic environment. The autopsy has not revealed any significant traumatic injuries or specific pathological lesions. Suggestive content was found in the oral cavity, esophagus and stomach, containing partially digested food mixed with fragmented needle-shaped, green leaves. During toxicological analysis, 3,5-dimethoxyphenol (3,5-DMP), the aglycone of taxicatine metabolite, considered as a marker of Taxus poisoning, was identified in the urine using the NIST spectra library database. Taxine alkaloids are the active constituents of Taxus sp. that cause cardiotoxicity. This occurs via the dose-dependent blockade of sodium and calcium channels in cardiac myocytes, leading to atrioventricular block, evidenced by prolonged PR and QRS intervals on ECG. The clinical severity is dependent on quantity, type an route of exposure, clinical signs usually occur within 3-4 h after ingestion. Yew tree poisoning has a high mortality rate, but remains a rare occurrence, with only a few case reports in literature. Analysis of taxine alkaloids can be used to confirm the diagnosis.

Lethal intoxications of medical staff with substances used in the profession – Presentation of a group of cases

The access medical staff has to special drugs through the nature of the job can lead to undesirable situations (illicit consumption, abuse and addiction, accidental overdoses, suicide, homicide). We focus on identifying situations of lethal intoxication of the medical staff with substances used within the profession and we propose a forensic approach to these types of cases. We made a review of the literature using MEDLINE, EMBASE, Scopus, Cochrane and internet search data of deaths among nurses and doctors due to intoxication with special regime drugs used in the profession. Five cases of autopsies performed at INML “Mina Minovici” Bucharest and Ilfov Medical-Legal Service, Romania, are presented (a veterinarian, a nurse and three anesthesiologist doctors). A 27-year-old female, a veterinarian, was found dead in bed, in her apartment, next to a 10-mL syringe with an attached branch, containing 4 ml of transparent liquid. It's a case of intravenous self-administration of T61, with a suicidal intention. T61 is a solution used for animal euthanasia, a mixture of 3 substances: embutramide (opioid analgesic), mebezonium iodide (curare-compound) and tetracaine hydrochloride (local anesthetic). A 38-year-old man, a male nurse, was found dead in his home, surrounded by several empty containers of Fentanyl and Mialgin. A bag with partially empty containers of medicines was found in his car: Enalapril, Telmisartan, Mialgin, Diazepam, Fentanyl, Acupan (nefopan chloridate), Dormicum (Midazolam), syringes and needles, used, but also sealed. The cause of death was an acute intoxication with a cocktail medication (opioid analgesics and benzodiazepines), stolen from the workplace. A 37-year-old man, an anesthesiologist doctor, was found by a colleague, at 7.00 a.m, in the on call room of the hospital, at the end of his shift. The cause of death was the acute intoxication with morphine (0.448 μg/mL). A 34-year-old woman, anesthesiologist doctor, was found dead by her father, on the bathroom floor of her apartment. Next to the body were found: a 5 mL syringe with 3 mL liquid content and 2 ampoules of tramadol hydrochloride (Mabron). In the trash, there was an empty bottle of ketamine hydrochloride (Ketamidor, for veterinary use) and fragments of ampoules of Midazolam and Calypsol. More than 150 ampoules labeled with various substances used in anesthesia were found in the house. In the last period, the woman doctor was exhausted as she had been working both in the public and private system. Female, 51 years old, anesthesiologist doctor, known as a consumer of analgesic substances for about 3 years, was found dead at home by her husband, on the bedroom floor. Cause of death was acute pulmonary edema, the consequence of an acute intoxication with drugs (pethidine > 2/mL μg/mL and nordazepam 0.03 μg/mL). The paper analyzes all the findings: the on-site investigations (extremely important to gather information), the necropsy data and the results of the histopathological, toxicological, tanatochemical and serological examinations. The analytical methods currently used for highlighting and dosing the identified substances are also presented. Autopsy findings were nonspecific, except for the stigma of chronic injectable drug use. That is why an algorithm for step by step approaching these types of cases could be very useful in order not to go beyond the possibility of an acute drug intoxication of medical staff. Nurses and doctors are vulnerable to chemical dependence due to the high work-related stress associated with easy access to medicines. This must always be suspected by the forensic doctors when they perform an autopsy of a medical staff person and they must follow a special algorithm in such cases.

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Natural active ingredients used in topical cosmetic formulations for anti- ageing: A systematic review

Smooth, even-complexed and radiant skin without wrinkles and dark spots characterizes healthy skin. Ageing is a natural biological process of becoming older. As a largest organ in the body, skin is prone to aging due to exposure to the external and internal damages. Skin ageing is characterized by wrinkles, fine lines and dark spots that appear on the skin surfaces. Cosmetics nowadays not only associated with beauty but also younger looking skin. The demand for anti- ageing cosmetics with natural ingredients are projected to boost the cosmetics industry contributing to global market growth due to an increase in global ageing populations. There are many cosmetics in the market offered product line for anti-ageing. Despite giving positive result in a longer period, natural ingredients are more preferred as active ingredients compared to synthetic ingredients which are notoriously known for causing complications as mild as minor irritations to more severe anaphylactic reactions, lethal poisonings, or long-time effects to users due to accumulated toxins. In this study, natural active ingredients will be discussed in terms of their sources, mechanisms, and anti-ageing properties. Systematic searches of PubMed, ScienceDirect, NCBI and Medline databases were carried out using various keywords. Through screening, 40 studies out of 70 studies were selected. Based on this review, a large variety of natural active ingredients could be obtained from plants, animals, and marines compared to singly synthesized artificial alternatives. The benefits, safety and efficacy of the ingredients were also evaluated, and it is found that they are indeed better constituents compared to synthetic ingredients to be used in cosmetic formulations.

Analysis of Poisoning Cases at a Tertiary Care Hospital in Bahawalpur

Objectives: The objective was to analyse the poisoning cases coming at A&E Department B.V Hospital Bahawalpur with regard to demographic profile and fatality. Study Design: Cross Sectional Study (Descriptive) Setting and Duration of Study: This study was carried out at A&E Department B.V Hospital Bahawalpur, covering a span of one year. i.e 1st January 2017 to 31st December 2017. Materials and Methods: A total of 2261 cases were included in this study. After, history was taken, perusal of treatment notes was done, performa was filled and the demographic profile with type of poison was noted. Results: Out of 2261 cases, 1625 (72%) were male and 636 (28%) were females. Most common age group affected was 21-40 years n=1080(48%), while least number of cases noted in above 60 years of age n=95(4%). Maximum number of Black Stone (PPD) n=1093 (48.4%) cases were examined while wheat pills poisoning was recognised as highest toxic agent (45% mortality). Conclusion: In conclusion, our study shows predominant ages were between 21-40 years and males accounted for maximum number of cases. Suicidal intention was commonest manner and PPD was the most frequent one. Wheat pills surfaced as the most lethal poison. Keywords: Poisoning, Paraphenylene Diamine (PPD), Aluminium Phosphide (Wheat pills). Drugs of Addiction