DOI: http://dx.doi.org/10.18203/2349-3933.ijam20190993

A retrospective study of clinical profile and outcome of patients with rodenticide poisoning in a tertiary care hospital

Kavitha Balasubramanian, Vinoth Kumar Sethuraman, Kandan Balamurugesan, Stalin Viswanathan

Abstract


Background: In developing countries, the substances most commonly used for self-poisoning are agricultural pesticides including rodenticides. Authors aimed to assess the clinical status and outcomes of patients with rodenticide poisoning in a tertiary care hospital.

Methods: This retrospective record-based study was carried over three years. Apart from demographic details, information regarding the time of ingestion, nature and amount of the compound. Other details included clinical features, complications, treatment and outcome of the patient. Descriptive analysis was carried out by the mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.

Results: Of the 120 study subjects, 85 (93.40%) participants self-harmed, 2 (2.20%) were homicidal, and 4 (4.40%) had accidentally consumed the rodenticide. About 52 (32.70%) participants had vomiting, 34 (21.38%) had giddiness, 32 (20.13%) participants had abdominal pain. On the whole, 85 (73.28%) participants recovered, 23 (19.83%) participants had absconded, 6 (5.17%) participants had referred and 2 (1.72%) of them expired.

Conclusions: Phosphorous compounds, particularly yellow phosphorous are the most lethal rodenticides followed by Coumadin. Symptomatic management of the patients at the earliest possible time is the mainstay, as there are no specific antidotes for any of the compounds.


Keywords


Rat killer poisoning, Rodenticide poisoning, Self-poisoning

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References


Kanchan T, Menezes RG. Suicidal poisoning in Southern India: gender differences. J Forensic Leg Med. 2008;15(1):7-14.

Gunnell DJ, Brooks J, Peters TJ. Epidemiology and patterns of hospital use after parasuicide in the south west of England. J Epidemiol Comm Heal. 1996;50(1):24-9.

World Health Organization. Causes of death 2008: data sources and methods Geneva: World Health Organization. 2011. Accessed at: https://www.who.int/healthinfo/global_burden_disease/cod_2008_sources_methods.pdf.

Michel K, Ballinari P, Bille-Brahe U, Bjerke T, Crepet P, De Leo D, et al. Methods used for parasuicide: results of the WHO/EURO Multicentre Study on Parasuicide. Soc Psychiatry Psychiatr Epidemiol. 2000;35(4):156-63.

Gunnell D, Ho D, Murray V. Medical management of deliberate drug overdose: a neglected area for suicide prevention?. Emerg Med J. 2004;21(1):35-8.

Eddleston M, Karalliedde L, Buckley N, Fernando R, Hutchinson G, Isbister G, et al. Pesticide poisoning in the developing world-a minimum pesticides list. Lancet. 2002;360(9340):1163-7.

Latha KS, Bhat SM, D'souza P. Suicide attempters in a general hospital unit in India: their socio‐demographic and clinical profile-emphasis on cross‐cultural aspects. Acta Psychiat Scandin. 1996;94(1):26-30.

Eddleston M. Patterns and problems of deliberate self‐poisoning in the developing world. QJM. 2000;93(11):715-31.

Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol. 2003;32(6):902-9.

Singh B, Unnikrishnan B. A profile of acute poisoning at Mangalore (South India). J Cinic Forensic Med. 2006;13(3):112-6.

Shashidhara KC, Marijayanth M, Reddy PK, Kaluvakuri S. Clinical profile and outcome of rodenticide poisoning in patients admitted to a tertiary care teaching hospital in Mysore, Karnataka, India. Int J Res Med Sci. 2016;4:5023-7.

Khurana P, Dalal JS, Multani AS, Tejpal HR. The study of aluminium phosphide poisoning in a tertiary care hospital, amritsar. J Ind Acad Forens Med. 2011;33(4):0971-3.

Mathai A, Bhanu MS. Acute aluminium phosphide poisoning: Can we predict mortality?. Indian J Anaesthes. 2010;54(4):302.

McCarron MM, Gaddis GP, Trotter AT. Acute yellow phosphorus poisoning from pesticide pastes. Clinic Toxicol. 1981;18(6):693-711.

Chugh SN, Kumar P, Aggarwal HK, Sharma A, Mahajan SK, Malhotra KC. Efficacy of magnesium sulphate in aluminium phosphide poisoning-comparison of two different dose schedules. J Assoc Physic India. 1994;42(5):373-5.

Khosya S, Meena SR. Current Trends of Poisoning: An Experience at a Tertiary Care Hospital Hadoti Region, Rajasthan, India. J Clinic Toxicol. 2015;6:298.

Chugh SN, Ram S, Arora B, Malhotra KC. Incidence & outcome of aluminium phosphide poisoning in a hospital study. Indian J Med Res. 1991;94:232-5.

Chugh SN, Ram S, Arora B, Malhotra KC. Incidence & outcome of aluminium phosphide poisoning in a hospital study. Indian J Med Res. 1991;94:232-5.

Bronstein AC, Spyker DA, Cantilena LR, Green JL, Rumack BH, Giffin SL. 2009 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 27th Annual Report. Clin Toxicol (Phila). 2010;48(10):979-1178.

Baumgardner JN, Shankar K, Hennings L, Albano E, Badger TM, Ronis MJ. N-acetylcysteine attenuates progression of liver pathology in a rat model of nonalcoholic steatohepatitis. J Nutrit. 2008;138(10):1872-9.

Nalabothu M, Monigari N, Acharya R. Clinical Profile and outcomes of rodenticide poisoning in tertiary care hospital. Int J Sci Res Pub. 2015;5(8):1-2.

Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, Ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatol. 2000;31(4):864-71.

Vincent JL, De Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Critical Care Med. 1998;26(11):1793-800.

Suneetha DK, Inbanathan J, Kannoth S, Reshma PK, Shashank MS. Profile of Rat Killer Poisoning Cases in a Tertiary Care Hospital at Mysore. Int J Sci Stud. 2016;3(12):264-7.

Morrissey B, Burgess J, Robertson WO. Washington’s experience and recommendations Re: anticoagulant rodenticides. Vet Hum Toxicol. 1995;37(4):362-3.

Yu HY, Lin JL, Fu JF, Lin JH, Liu SH, Weng CH, et al. Outcomes of patients with rodenticide poisoning at a far east poison center. Springerplus. 2013;2(1):505.

Park BK, Leck JB. A comparison of vitamin K antagonism by warfarin, difenacoum and brodifacoum in the rabbit. Biochem Pharmacol. 1982;31(22):3635-9.

Furie B, Bouchard BA, Furie BC. Vitamin K-dependent biosynthesis of γ-carboxyglutamic acid. Blood. 1999;93(6):1798-08.

Fernandez OU, Canizares LL. Acute hepatotoxicity from ingestion of yellow phosphorus-containing fireworks. J Clinic Gastroenterol. 1995;21(2):139-42.

Bachmann KA, Sullivan TJ. Dispositional and pharmacodynamic characteristics of brodifacoum in warfarin-sensitive rats. Pharmacol. 1983;27(5):281-8.