Original communication
A profile of acute poisoning at Mangalore (South India)

https://doi.org/10.1016/j.jcfm.2005.09.005Get rights and content

Summary

Background

The aim of this study was to characterize the poisoning cases admitted to the Government Wenlock Hospital (a teaching hospital of Kasturba Medical College) Mangalore, India.

Study design

All cases admitted to the emergency department of the hospital between January 2001 to May 2003 evaluated retrospectively. Data obtained from the hospital medical records and included the following factors: socio-demographic characteristics, agents and route of intake, and time of admission of the acutely poisoned patients.

Results

Of the total 33,207 patients admitted in the hospital for treatment, 325 patients were for to acute poisoning. This was 1% of all emergency admissions. Of these 70% were males and 30% females. The majority (36%) cases were from age group of 21–30 years. Most (72%) poisonings were intentional and only 27% were unintentional. The most important agents of acute poisoning were agrochemical pesticides (49%) followed by drugs (17%), and alcohols (13%). Forty-eight (15%) patients died. The poisons responsible for most of the mortality were organophosphate pesticides (65%) and aluminium phosphide (15%). In summary, the prevention and treatment of poisoning due to organophosphate and aluminium phosphide should merit high priority in the health care of the indigenous population of South India (Dakshina Kannada district).

Introduction

It has estimated that some form of poison directly or indirectly is responsible for more than 1 million illnesses worldwide annually.1 This figure could be just the tip of the iceberg since most cases of the poisoning actually go unreported, particularly in the third world countries. The problem is getting worse with time as newer drugs and chemicals are developing in huge numbers. Poisoning cases are increasing day-by-day due to changes in life style and social behavior. The causes of poisoning are many – civilian and industrial, accidental, and deliberate. Deliberate self-poisoning has reached epidemic proportions in parts of the developing world where the toxicity of available poisons and sparse medical facilities ensure a high fatality rate.2, 3 Fatality rates of 20% are common and the World Health Organization 4 has estimated that more than 200,000 people die each from pesticide poisoning only.4 Recently, it is reported in a review article that the number of intoxications with organophosphate pesticides (OPs) only is estimated at some 3 million per year, and the number of deaths and casualties some 300,000 per year worldwide.5 The poison associated morbidity and mortality varies from place to place and changes over a period, due to the use of new chemicals. Organophosphate pesticides are one of the most important causes of poisoning in this part of India, as in many developing countries.6, 7 The mortality rate of organophosphate pesticides poisoning is high, fatal issue is often related to delay in diagnosis or an improper management. Early correct diagnosis and appropriate treatment, conversely, are often lives saving. Therefore, the knowledge of the general pattern of poisoning in a particular region would help in early diagnosis and management of poisoning, which in turn should result in a reduction of morbidity and mortality.

Section snippets

Materials and methods

The study comprises 325 cases of acute poisonings; admitted to the Govt. Wenlock Hospital, Mangalore, South India during the period of January 2001 to May 2003. It is a tertiary level hospital, which caters to wide variety of people of Karnataka and border district of Kerala. Patients with idiosyncratic or adverse reaction to prescribed drugs, snakebites and food poisoning excluded from this study. The data regarding the age, gender, marital and socio-economic status, agents and route of

Results

Thirty-three thousand two hundred and seven patients admitted in the hospital during the period of 2 years and 5 months (January 2001 to May 2003). Of these, 325 patients admitted with acute poisoning. This was 1% of the total admission. The majority of the cases were young adults from the age group of 21–30 years accounting for 1/3rd of the cases followed by 31–40 years. The ratio of male and female was 2.4:1. Of these, males constituted 22% from age group of 21–30 years and females

Discussion

Morbidity and mortality due to acute poisoning is a worldwide phenomenon and has enormous medical, legal and social significance. The last quarter of the 20th century saw tremendous advances in the fields of agriculture, industrial technology and medical pharmacy. These advances have paralleled changes in the trends of acute poisoning in developing and developed countries. Self-poisoning is one of the oldest methods tried for committing/attempting suicide. There are reports available from

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