Outcome Of Acute Poisoning Research Articles

ACUTE POISONING AND ENVENOMATION IN CHILDREN: CLINICO-EPIDEMIOLOGICAL PROFILE AND OUTCOME IN CENTRAL NEPAL

Background: Acute poisoning and envenomation are significant concerns among children, demanding specialized approaches. This study aimed to assess the current scenario, clinico-etiological profile and outcome of acute poisoning and envenomation in children within Bagmati province, excluding the valley area. Methods: A retrospective observational analysis was conducted involving children aged 28 days and above to 18 years admitted to Chitwan Medical College’s Pediatric department between July 2020 to January 2023. Cases involving poison exposure or envenomation regardless of signs and symptoms, were included. Demographics, triage, interventions and outcomes were collected in predesigned data proforma and descriptive analysis was performed using SPSS 20. Results: Results revealed, 179 admissions (3.49% of total) with most cases being accidental (87.3%), frequently among boys (64.8%) and age group 1-5 years old (53.1%) and median (IQR) age of 3 (2-8) years. Common presenting symptoms included vomiting (48%) and altered sensorium (21.2%). The median (IQR) time to hospital presentation post exposure was 3.75(2-7) hours. Organophosphorus (17.3%) and kerosene poisoning (8.4%) were the commonest poison, along with 11 cases of envenomation. Treatment included supportive care with antidote used in 17.9%. A majority (58.88%) only required 24- hour observation. There were a total of 5 deaths (2.79%) and 6 (3.35%) left against medical advice. Conclusions: Our results align with previous similar studies conducted in Nepal and across Asia. Accidental cases predominated, particularly among young children. Organophosphorus remained a significant poison, while cypermethrin and alcohol poisoning were new observations. Basic supportive care saves more lives than all the antidotes put together.

Demographic Profile and Outcome of Acute Poisoning and Envenomation among Children in Tertiary Care Hospital: An 8-Year Ambispective Study

Background: Poisoning and Envenomation in children are quite common medical emergencies requiringhospitalization. Different regions may have different profiles depending on location and standards of living. Toknow the profile and outcome of acute poisoning and envenomation among children at our region this study wasundertaken.Methods: The ambispective study from year 2014 -2021 reviewed all maximum possible cases of pediatricpoisoning and envenomation by retrieving files from the medical record department and pertinent informationcollected.Results: Out of 188 analyzed data, 97 (51.3%) were males. Median (Q1, Q3) age in years was 9.5 (2.7, 15.3). Totalcases of acute poisoning were 91(48.4%), 80(42.6%) snakebite/scorpion/other bites whereas 17(9%) drowning& hanging. In outcome, deaths were in 7(3.7%) whereas 167(88.8%) discharged, 12(6.3%) LAMA and referral2(1.1%). Accidental and suicidal poisoning cases were 123(65.4%) & 39(20.8%) respectively. Among substancepoisoning, the top 2 causes were organophosphorus poisoning 37(41.1%) & kerosene 13(14.4%). Ventilatorsupport, vasoactive drug support, debridement and dialysis were required in 58(30.9%), 21(11.2%), 14(7.5%) &3(1.6%) cases respectively. Metabolic acidosis and hyponatremia in 25(13.3) & 16(8.5%) cases whereas mortalitywas significantly associated with the need for vasoactive support and aluminum phosphide poisoning.Conclusion: In children, acute accidental poisoning was commonest followed by envenomation at our tertiarycare canter. Vasoactive support and aluminum phosphide poisoning were predictors of poor outcomes.

An Epidemiological Study of Acute Poisoning In a Tertiary Care Centre

Introduction: Acute poisoning represents a real health threat in the world. It is a common cause of admission to emergency department and in intensive care unit. Periodic clinical and epidemiological studies are required to understand the pattern of poisoning. This study aims to analyze epidemiological aspect, clinical profile, and outcome of acute poisoning in a tertiary care hospital. Material and Methods: A cross sectional study was conducted at Government Medical College Hospital, Kota, Rajasthan. 102 admitted patients were taken for study from January 2020 to August 2020. Epidemiological variables age, sex, type of poison, mode of exposure, clinical presentation and outcome were studied. Results: The median age was 30.23 years with a male predominance (54.9%). The circumstances of poisoning were suicidal, accidental and unknown in 88.2%, 9.8%, and 1.96% respectively. Ingestion was the major route of exposure (98%) followed by inhalation (1.96%). The majority 33(32.4%) of cases were of Organophosphorus poisoning followed by 17(16.7%) cases of Rodenticide poisoning. The main symptoms were nausea and vomiting in 90(88.2%) cases. Convulsions were noted in 3(2.9%) patients. Gastric lavage was done for 92(90.19%). 8 patients (7.84%) were needed mechanical ventilation. 7 patients (6.86%) were needed vasoactive drugs. The rate of mortality was 8.82%. The aluminium phosphide poisoning was responsible for 44.4% deaths. Conclusion: Study revealed the high mortality associated with acute poisoning. Appropriate approach towards poisoning at tertiary care center and prevention remains the best strategy for reducing morbidity and mortality.

PATTERN AND OUTCOME OF ACUTE POISONING IN CHILDREN OF 1-12 YEARS AGE GROUP ADMITTED IN THE PAEDIATRIC WARD OF A TERTIARY CARE HOSPITAL

BACKGROUND: Acute poisoning, a common, yet an important preventable cause of morbidity and mortality in children, is a paediatric emergency globally, responsible for 0.33% to 7.6% of the total paediatric admissions among various hospitals of India. This study was done to assess the changing trends, in the pattern and outcome of poisoning among 1-12 years children. METHODS: This is an institution-based descriptive epidemiological study with cross-sectional design that includes a hundred children of one to twelve years age, conducted over a period of one and half years in the paediatric department of a tertiary care hospital in India. RESULTS: In the study period, majority of the patients out of 100 admitted, were male (65%).Most of those (68%) belonged to the 1-3 years age group. The share of hydrocarbon poisoning (46%) was highest with 26 cases of Kerosene ingestion being the most in it. Important presenting complaints were vomiting, pain abdomen, tachypnoea, and pneumonitis. Only 1 patient died during the course, the cause of which remained unknown. CONCLUSION: The pattern and outcome of acute poisoning in children was quite similar when compared to other studies from different hospitals in India. Survival rates have been increasing due to ongoing improvement in medical infrastructure, which one hopes, shall keep improving along with focus on preventive measures at community levels.

Risk Factors and Outcome of Acute Poisoning in Childrens

Objective: To determine the risk factors and outcome of acute poisoning in children at a tertiary care hospital of Karachi.
 Study design: Cross sectional study
 Place and duration of study: Department of Emergency Medicine, Dr Ziauddin Hospital, Karachi, Pakistan. From January 2019 to January 2021
 Methodology: The patients (n=136) were selected of either gender with the precise age group of twelve years. All the patients selected were meeting the inclusion criteria and enrolled with a history of poisoning exposure within 24 hours of arriving at the hospital's emergency department. The name of the toxin, the time since ingestion of the toxic substance, factors prompting coincidental harming like age, ill-advised capacity of hurtful specialists, for example, lamp oil and blanch in soda bottles, simple access of kids to meds utilized by different individuals from the family, mother's schooling, working moms, financial status were completely assembled from the guardians or orderlies as referenced in the Performa. In general, people were poisoned primarily from within their own homes. Non-accidental poisoning cases were omitted. SPSS version 22 was used to analyze the data.
 Results: Out of 136 patient enrolled in this study mean age was 5.2+2.9 years, 77(56.6%) were male and 59(43.4%) were female and mean time of presentation was 2.3+1.7 hours. Most common risk factor was unsafe storage of chemicals (n=98) (72.1%), followed by education level of mother (n=)65 (47.8%), inadequate supervision of child (n=60) (44.1%), non authorative parenting (n=51) (37.5%), working mothers (n=41) (30.1%), lack of family support (n=30) (22.1%), developmental delay (n=11) (8.1%) and poisonous plant in home garden (n=6) (4.4%). Outcome mainly depends upon type of poisoning and time interval between poisoning and presentation to the hospital, 26 (19.11%) were discharged safely from ER, while 45 (33.08%) admit in wards and 48 (35.29%) were admitted in Intensive Care and 17 (12.5%) were expired in ER.
 Conclusion: In this study we have concluded that number of accidental poisoning are often occur in toddler and school going children. The major risk factor of acute poisoning found was unsafe storage or easy accessibility of house hold chemicals, second one was low level of education of parents, than non-authorative parenting, and working mothers and lack of family support. The outcome mainly depend upon time interval from ingestion of poison to presentation at hospital and type poisonous agent taken, that can lead to the need of specialized care, prolong hospital stay and sometimes results in death of a child.

The pattern of acute poisoning in hospitalized children under 18 years old of Yazd, Iran

Acute poisoning is a common cause of emergency department visits in childhood and can increase children’s morbidity and mortality. Since the causes of child poisoning in different parts of Iran may differ due to cultural differences, this study was conducted to evaluate the most common causes of poisoning in Yazd. This retrospective cross-sectional study is based on the medical records of children less than 18 years of age admitted to the pediatric emergency department at Shahid Sadoughi Hospital in Yazd during 2018. The collected data included demographic information, the cause, and the outcome of acute poisoning. Out of 105 cases, 61.9% were boys. The highest poisoning rates were in the age group of 1 to 4 years (55.2%). In 50% of the participants, the family size was five or more, and 91% had Iranian nationality. Drugs were identified as the most common causes of poisoning (51.4%), and opioid analgesics were the most frequent drugs. The most common complaint at the time of referral in patients was the loss of consciousness (33%). The mean hospital stay was 56 hours, and no death was reported. According to the findings of this study in Yazd, the probability of accidental poisoning in boys under four years and due to different types of drugs, especially opioids, was higher than others. It seems that increasing parents’ awareness about keeping drugs used by family members in a safe place and out of children’s reach is essential in preventing poisoning.

Clinical profile and immediate outcome of acute poisoning in children admitted to RIMS teaching hospital

Clinical profile and immediate outcome of acute poisoning in children admitted to RIMS teaching hospital

Study of the pattern, intent behind and outcome of acute poisoning in a tertiary care centre

Background: Acute poisoning is one of the major medical emergencies with significant morbidity and mortality. Appropriate planning, prevention and management techniques can be designed by knowing the nature, severity and outcome of acute poisoning cases. Most of the poisoning is due to the intention of deliberate self-harm. This study aimed to study the pattern and outcome of acute poisoning and the intent behind poisoning. Methods: This is a cross sectional study which included 100 acute poisoning cases in a tertiary care hospital. The study includes data regarding age, sex, time elapsed after intake of poison; name of the poisonous substance, duration of hospitalization, severity and outcome were collected in the prestructured proforma. Intent behind poisoning was calculated using Beck’s suicide intent score. Results: Incidence was more common among males (69%) but there was no significant correlation between gender and mortality. Mean age of presentation was 35.66 years but age of presentation and mortality correlation was not statistically significant (t=0.92, p=0.3). Organophosphorous compound poisoning (36%) was the most common type of poisoning. Total mortality was found to be 12%. Beck’s suicide intent scores were higher in patients who died and statistically significant (t=8.96, p=0.0001). Maximum patients expired when there was a delay in admission to hospital by more than 8 hours after exposure. Conclusions: Poisoning is more common in young males. The overall mortality depends on type of poison, time elapsed since exposure to hospital arrival, suicidal intent and many other factors. Early care in a tertiary care center may help to reduce mortality in India.

AN OBSERVATIONAL STUDY ON ACUTE POISONING IN PAEDIATRIC POPULATION IN A RURAL MEDICAL COLLEGE.

Backgound: In paediatric emergencies acute poisoning is frequently encountered and is the leading cause of morbidity and mortality in developing countries. There is natural division of acute poisoning in paediatric population in to two groups i.e. young children and adolescents. The first group comprises of young children who innocently ingest small amount of single substances. Second group comprises of adolescents who purposefully ingest substantial quantity of multiple substances secondary to emotional outburst or psychiatric illness. This study aimed to study the clinical, toxicological profile and outcome of Acute poisoning in paediatric population in Adichunchanagiri institute of medical sciences, Mandya, Karnataka, India. Subjects and methods: This is a retrospective observational study done from January 2018- December 2019, in Adichunchanagiri institute of medical sciences, Mandya, Karnataka, India, involving childhood poisoning. Data was noted on a predesigned proforma, it was compiled and entered in MS Excel spread sheet; descriptive statistics was applied. Results: Out of 50 cases 24 cases (48%) were males and 26 cases (52%) were females. Majority of cases were distributed in the age group of 1-4 years 24 cases (48%), followed by 15-18 years 19 cases (38%). Suicidal poisoning was more seen in adolescent females 15 cases (30%). Pesticide and insecticide remains the most common toxic agent i.e. 21 cases (42%), followed by hydrocarbons 16 cases (32%). 42 cases (84%) got improved, 5 cases (10%) got referred and there was 1 (2%) death. Majority of the cases (52%) got discharged between 1-3 days. Conclusions: Pesticides and hydrocarbons remains most easily accessible toxins in rural area hence, are most commonly implicated toxins in childhood poisoning. Though poisoning remains worrisome problem, it is preventable.

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.

Effect of haloperidol on centrilobular vein and portal triad of liver in the albino rats during intrauterine life

Background: Acute poisoning in children is the third most common emergency with significant economical burden. Objectives: This study was carried out to elucidate the clinical and demographic pattern and outcome of acute poisoning in children at local University Hospital of South Punjab. Study Design: Retrospective study. Setting: Pediatric Medicine Department of Nishtar Medical University, Multan. Study Period: January 1st – December 31st 2016. Materials and Methods: This one year hospital based study included 74 children up to 12 years admitted with acute poisoning. The data was extracted from clinical charts. Clinical, demographic and outcome data was extracted and analyzed. Mean and standard deviation are calculated for continuous variables and frequencies with percentages for categorical variables. The data is presented in tables and figures. Results: A total of 74 children with poisoning were admitted during study period (total admission–3107) giving annual incidence of 2.38 %. Males predominated (n=49, 66 %) the study population. Fifty four percent (n=40) of the children were in 13 – 59 months age group. Majority of the children were admitted due to accidental poison ingestion (n=65, 87.8%), through emergency (n=68, 92%) department, brought from urban areas (n=38, 51.4%), and within 1 hour of exposure (n=41, 55.4%). Most common poisons ingested were pesticides (n=29, 39%), kerosene oil (n=13, 17.57%) and Paraphenylene diamine (Kala pathar) (n=11, 14.86%). Most common system specific symptoms belonged to cardiovascular system (54 %) followed by nervous system (51 %) and respiratory system (42 %). Median hospital stay of the poisoning cases was 2 days (min. 1, max. 17). Poisoning associated mortality rate was 16.2 % (n=12). Kala pathar ingestion was the only significant factor associated with mortality (p-value 0.04). Conclusion: Accidental ingestion of non – pharmacological agents at home is most common in children < 5 years of age at our set – up. Mortality rate due to acute poisoning is high in children. Parents education for safe placement of poisoning agents, set – up of regional poison control centers and healthcare workers training on management of such cases will help curtailing this problem.

Favorable Outcome of Severe Poisoning by Snake Green Mamba (<i>Dendroaspis viridis</i>) Clinical Case

This clinical case of acute poisoning due to bite of snake Dendroaspis viridis seems interesting to share because of its rare incidence inRussiaand management peculiarities: the critical care was conducted without specific antidote therapy due to absence of the antidote.The prevailing clinical presentation included signs of toxic myopathy combined with paresis of skeletal and breathing muscles that led to development of acute respiratory failure and metabolic disorders. The processes described were induced by the action of snake poison dendrotoxins featuring the activities of potassium channel blockers and acetyl cholinesterase inhibitors.The proper critical care included conduct of syndrome therapy aimed at maintaining life support systems adequately to condition (replacement of the breathing and circulation functions), antibiotic therapy and desensitizing treatment and metabolic care by administration of drugs characterized by antihypoxant/antioxidant mechanism of action.The comprehensive therapy applied has resulted in a favorable outcome of acute poisoning by snake green mamba without development of possible complications even when the specific antidote drug has not been included into the treatment protocol.

The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients

BackgroundHuman aging is a universal and regular process characterized by uneven and steady progression, inevitably affecting to some extent all levels of biological organization. In the structure of acute exotoxicosis, patients of gerontological age range from 10.3 to 12.9%. After 60, with an increase of years, there is a growth of mortality rate from 9.8% in elderly patients to 25.5% in long-livers. A certain role in its genesis is played by the premorbid background, i.e. somatic diseases preceding and accompanying acute exotoxicosis.Aim of studyTo identify the role of concomitant diseases in the course and outcome of acute poisoning by psychoactive drugs in patients over 60. MATErIALS AnD METhODS We retrospectively analyzed hospital records of 99 patients aged 60 to 90 years who died from poisoning with psychoactive drugs at the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2013–2016, as well as their autopsy, forensic and histological research data.ResultsIn gerontological patients with acute poisoning with psychoactive drugs, the main premorbid background (100%) is atherosclerotic lesion of the heart and vessels of different degree and extent. In case of lethal outcomes, in toxicogenic stage of poisoning on primary electrocardiograms, myocardial ischemia was revealed in 76.9% of cases, heart rhythm disturbances were detected in all patients, most often in the form of supraventricular extrasystoles (38.4%) and atrial fibrillation (23.1%). In the deceased patients during the somatogenic stage of poisoning, cardiac conduction disorders (31.3%) prevailed. Concomitant chronic lesions of the bronchopulmonary system, including terminal bronchi, contributed to the development of hypostatic pneumonia and its long, migratory course. In 50% of cases, large and small droplet fatty liver disease was detected, which could have a negative effect on the course of poisoning, altering biotransformation of toxicants.ConclusionAtherosclerotic lesion of the heart and vessels, as well as chronic bronchopulmonary disease and fatty liver disease are the main premorbid background factors, which have a negative effect on the course and outcome of acute poisoning with psychoactive drugs.

Patterns and outcome of acute poisoning among children in rural Sri Lanka

BackgroundThe burden of poisoning among children is largely underexplored in rural Sri Lanka. This study describes the patterns of demographic characteristics, poison related factors, clinical management and outcome following acute poisoning among children (9 months- 12 years) in rural Sri Lanka.MethodThis hospital based multi-center study included Anuradhapura Teaching hospital, Polonnaruwa District General hospital, and 34 regional hospitals within Regional Director of Health Services in North Central province of Sri Lanka. The study assessed clinical profiles, poison related factors, clinical management, complications, harmful first aid practices, reasons for delayed management, complications and outcomes following acute poisoning over 7 years.ResultsAmong 1621 children with acute poisoning, the majority were in preschool age group. Household chemicals were accountable for 489 acute poisonings (30.2%). The most common poison was kerosene oil, followed by paracetamol. Most events occurred within their own domestic premises. Potentially harmful first aid measures were practiced by approximately one third of care givers. Reasons for delayed presentation at emergency center included lack of concern by family members regarding the urgency of the situation and lack of knowledge regarding possible complications. Complications were observed in 12.5% and the most common complication was chemical pneumonitis.ConclusionsChildren with acute poisoing in rural Sri Lanka were predominantly preschoolers. They are poisonined mostly within their own housing premises. Kerosene oil, in addition to being the most common poison, had additional risks of aspiration pneumonia following potentially hazadrous first aid measures practised by the care givers. Complications though rare were potentially preventable by community education and awareness on timely attention to seek medical care, and avoidance of harmful first aid practices.

Clinical profile and outcome of acute poisoning in children and adolescent in a tertiary care center

Background: Childhood poisoning is a significant public health problem. It is a common worldwide health problem and a preventable cause of morbidity and mortality. Epidemiological studies on accidental poisoning in children show a consistent pattern with respect to sex and age.Aims and Objectives: To determine the changing pattern of clinical profile and outcome of acute poisoning in children and adolescent. Materials and Methods: All children aged 1-18 years with h/o poisoning, attending pediatric and medicine emergency department of College of Medicine and Sagore Dutta Hospital, Kolkata from March 2014 to February 2016 were the subjects of our study. Profiles of all cases and their outcome were noted.Results: Seventy-five patients were presented with acute poisoning during our study period. Majority of the children were between 12 to 18 years (45 cases, 60%). Most of the patients were residents of urban areas. Most frequent agents were drugs (44%), hydrocarbon (21.33%) and insecticides (22.66%). Almost all cases in 1-6 years age group were accidental in nature.Conclusion: Poisoning in children and adolescents are common problems. Incidences of acute poisoning in childhood remained more or less unchanged temporally. Poisoning by agents like drugs and organophosphorus compounds are alarming phenomena and these occur mostly during adolescence. Free availability of these compounds, co-morbid conditions of adolescents and adolescent stressors have to be addressed in this respect. Asian Journal of Medical Sciences Vol.8(3) 2017 76-80

Clinico-demographic Profile and outcome of acute poisoning among children- a single Centre observational study

Background: Poisoning in children is a global problem and no part of the world is exempt from this calamity. It is one of the commonest preventable emergencies encountered in pediatric practice. Methods: This prospective observational study was done from November 2015 to October 2016. Patients admitted with clear history of poisoning/bite were enrolled during the study period and were carefully monitored for the course, complications and outcome. Patient details like age, sex, socioeconomic status, symptoms, signs, type of poison/bite, mode, reason for poisoning, any prior treatment received and reasons for delayed treatment if any were collected during the hospital stay. Results: A total of 119 cases of poisoning/bite were enrolled. Organophosphorus (OP) poisoning outnumbered the poisoning agents and Snake bite out numbered in Bites and Stings. Majority of cases were in the age group of 13-18 years. Male to female ratio 1.2 : 1. Rural to urban incidence of poisoning was 2.7:1. Highest incidence was observed in children from lower socioeconomic nuclear families and parents with lower educational status. Accidental poisoning outnumbered the suicidal poisoning. Vomiting, Pain, bleeding, Swelling, cough, pain abdomen, drowsiness, nausea, diarrhea, breathlessness, excessive salivation, sweating were observed in majority of the cases. Average hospital stay was 3.5 days (2 to 7 days). There was no mortality in this study. Conclusions: Parental health education will decreases the occurrence of childhood poisoning. Along with the parents and teachers, media also should take active steps to educate the rural population about the preventive measures from bite, stings and handling of poisonous agents.

Profile of Acute Poisoning In Paediatric Age In District Moradabad: A Hospital Based Study

Rapid socioeconomic development in India during the last decade may have led to changes in the profile of child hood poisoning. To determine the profile and outcome of acute poisoning in paediatric patients presenting to the tertiary care centre in Moradabad we retrospectively analysed the children admitted to the ward of TMMC & RC and district hospital of Moradabad. The median age of the children was 5.5 and standard deviation was 5.84 in the age range of 9 month to 17.5 years. Male: Female ratio was 1.3:1. 77.19% patients reached the hospital within six hour. Insecticides & Pesticides (55.04%), household cleaners (21.48%) and drugs (11.41%) were the most frequent implicated agents. Vomiting (63.75%) was the most common presenting symptom followed by altered sensorium (38.92). Almost two third (63.76%) were accidental in nature whereas (32.89%) was suicidal. Median duration of stay was 2 day with stay of 1–3 day commonest in 55.03% of cases. One twenty six (84.56%) patients were discharged after the treatment. 10.73% leaved against the medical advice and seven (4.71%) died during the treatment.

Acute poisoning in children under the age of six: a two‐decade study of hospital admissions and trends

To evaluate the incidence, clinical features and outcome of acute poisoning in children of less than 6 years of age in northern Finland. Children hospitalized with acute poisoning at the Oulu University Hospital between 1991 and 2010 were retrospectively evaluated from hospital records. There were 334 hospital admissions due to acute poisoning during the study period, with an overall incidence rate of 5.2 per 10 000 per year, decreasing slightly from 6.7 in 1991-1995 to 4.5 in 2006-2010. Mean length of a hospital stay was 1.2 (SD ± 1.26) days. The most common substances ingested were terbutaline (12.3%), benzodiazepines (12.0%) and dishwasher powder (9.3%). Almost half of the patients were admitted to the paediatric intensive care unit, but most only required supportive care. Specific antidotes were administered in 16 cases. Three patients suffered from aspiration pneumonia as a result of ingesting poison, but no children died during the study. Poisoning is a fairly common cause of hospital admission in children under the age of six. In most cases, their clinical condition is good, and they can be discharged after a short surveillance period.

Acute poisoning in children.

To determine the frequency, etiology, clinical presentation and outcome of acute poisoning in children presenting to a tertiary care hospital. Descriptive and observational study. Emergency Department of the Children's Hospital and the Institute of Child Health, Lahore. Over five years from September 1998 to August 2003. All cases of suspected or confirmed acute poisoning in children (1 month to 15 years) were retrospectively analyzed by retrieving data from hospital records and from patients files where possible. Variables like demographic data, season of presentation, type of agent, route of exposure and outcome were studied for all cases. Detailed files were available for 90 patients in whom place of exposure, risk factors and clinical features were also studied. Three hundred and forty-six cases of acute poisoning were registered during the study period, which constitute 0.93% of all ER admission. Most (59%) were less than 2 years of age with median age of 18 months (SD+ 32.6). Majority (80%) belonged to urban areas and presented during summer and monsoon season (57%). Pharmaceutical products were the leading cause (51%) followed by petroleum products (23%), chemicals (8.4%), household substances (7.6%) and unidentifiable agents in 10% cases. Anti-diarrhoeal drugs and kerosene oil were the two most frequent agents involved and ingestion remained the primary route of exposure. Gastrointestinal system was primarily involved in 40% patients. Eighty percent patients were discharged, 6% with residual damage while 11% patients died of poisoning or its complications. Acute poisoning carries a significant impact as regards morbidity and mortality. Awareness and education about the potential toxicity of commonly used drugs and household substances may help in reducing the burden of acute poisoning in children.