DOI: http://dx.doi.org/10.18203/2349-3933.ijam20200665

Study of impact of clinical and biochemical parameters in aluminium phosphide poisoning

Madhumathi R., Anugraha Durairaj

Abstract


Background: The aim of the study was to assess the relationship between clinical and biochemical parameters with outcome of aluminium phosphide toxicity.

Methods: Total 46 patients with aluminium phosphide poisoning admitted to the Hospitals attached to BMCRI between November 2018 and April 2019 were prospectively studied. After adequate history was obtained and immediate first aid measures given, clinical and biochemical parameters such as liver enzymes, serum creatinine, serum potassium and magnesium levels were studied. The patients were then followed up until outcome. Data was analysed using Descriptive statistics like mean, Standard deviation and percentages were calculated. Inferential statistics like Mann-Whitney test was used to compare the parameters between the two outcome groups (discharged and death) using SPSS software.

Results: Among the study population, between the two outcome groups males were 80.6% and females were 19.4%. the outcome was death in 10 patients and 36 patients were discharged. Tachycardia and hypoxia at presentation, Low Serum Magnesium and higher levels of serum creatinine at admission were found to be associated with higher mortality in patients with aluminum phosphide toxicity and were statistically significant.

Conclusions: These clinical and laboratory parameters can be considered as manifestation of hemodynamic compromise and are hence associated with poorer prognosis. Serum magnesium levels, can be used in prognostication of aluminium phosphide toxicity, owing probably to their effects of cardiotoxicity. Increased serum creatinine levels as a result of acute kidney injury, could also indirectly point to circulatory compromise. Hence these clinical and laboratory parameters at presentation have important implications. 


Keywords


Aluminium phosphide, Biochemical, Poisoning

Full Text:

PDF

References


Gupta S, Ahlawat SK. Aluminum phosphide poisoning--a review. J Toxicol Clin Xicol. 1995;33:19.

Ranga GS, Dwivedi S, Agarwal M, Kumar D. Aluminium phosphide poisoning in a young adult: A suicidal cardiotoxin simulating myocardial ischaemia. J Indian Acad Clin Med. 2004;5:369.

Chugh SN, Juggal KL, Sharma A, Arora B, Malhotra KC. Magnesium levels in aluminium phosphide poisoning [abstract]. J Assoc Physicians India. 1990;38:32.

Chopra JS, Kalra OP, Malik VS, Sharma R, Chandna A. Aluminium phosphide poisoning: a prospective study of 16 cases in one year. Postgrad Med J. 1986;62:1113-5.

Chugh SN, Chugh K, Ram S, Malhotra KC. Electrocardiographic abnormalities in aluminium phosphide poisoning with special reference to its incidence, pathogenesis, mortality and histopathology. J Indian Med Assoc. 1991;89:32-5.

Mathai A, Bhanu MS. Acute aluminium phosphide poisoning: Can we predict mortality?. Ind J Anaesthesia. 2010 Jul;54(4):302-7.

Taramsari RM, Badsar A, Shafaghi A, Namakchian NA, Ebrahimi A, Morteza FK. Alteration in Liver Enzymes in Aluminum Phosphide Poisoning, A Retrospective Study. Iran J Toxicol. 2013;7(21).

Singh Y, Joshi SC, Satyawali V, Gupta A. Acute aluminium phosphide poisoning, what is new?. Egypt J Intern Med. 2014;26(3):99.

Jaiswal S, Verma RK, Tewari N. Aluminum phosphide poisoning: Effect of correction of severe metabolic acidosis on patient outcome. Indian J Crit Care Med. 2009;13:21-4.

Ntelios D, Mandros C, Potolidis E, Fanourgiakis P. Aluminium phosphide induced leukopenia. BMJ. 2013.