A Study on Treatment Pattern and Outcomes of Poisoning Cases in a Tertiary Care and Government District Hospital

Objective: Suicide is known to be a phenomenon in low-, middle-, and high-income countries and occurs in all sociodemographic groups. It ranges from acute to fatal lethal attempts which occur in the context of a social crisis. Deliberate self-poisoning for suicide is a growing public health concern with frequent emergency department admissions. An epidemiological surveillance is essential for every region to understand the pattern, underlying psychological factors, and the scope of preventive measures. Methods:The 2-year retrospective study describes the epidemiology and influencing factors of suicides by self-poisoning in patients admitted to a Government Hospital and a Teaching Hospital in Pune, Maharashtra, from January 1, 2014 to December 31, 2015.Result: Out of 1010 poisoning cases reported, 539 were suicidal self-poisoning. Significantly males more than females were brought to the hospitals due to deliberate self-poisoning (1:0.86, χ 2 =38.05; p<0.001). The age group most recorded was 20-35 years (67.7%). Psychosocial factors were associated with increased risk of suicidal self-poisoning attempts (risk ratio 4.76, 95% confidence interval 4.07-5.57; p<0.001). Psychosocial factors were interpersonal conflict (52.4%), stress (30.4), dissatisfaction in life (6%), and alcoholism or mental disorders (11.1%). Household and agricultural products (71.8%) were the popular choices of the toxic agent in self-poisoning with phenols (20%) being the most common. 19 cases (3.5%) were severe, out of which 15 cases lead to death (2.8% mortality). Conclusion:There is an urgent need to develop and implement preventative and treatment strategies for high-risk groups attempting suicide by self-poisoning.

Section: Resultscontrasting

confidence: 82%

Psychosocial Factors as Risk Factor in Suicidal Poisoning: A Cross-Sectional Study

Raut

Shaj

Pawar

2017

“…Considering the result of this study, about 62.4% received first aid in which frequently administered techniques were gastric lavage along with activated charcoal and emesis irrespective of the nature and type of poison consistent with the results obtained in other studies [8,9]. People who did not receive first aid were probably brought to the hospital directly as they might have been geographically closer to the hospital and hence received appropriate treatment when compared to others.…”

Section: Discussionsupporting

confidence: 85%

“…Data from several national and international studies correlated with the present findings (Table 2), intentional poisoning is the main cause followed by accidental exposure (41.4%) which could have occurred due to consumption of poison mistaken as medicine, accidental spraying of chemical substances, and poisonous agents accidentally consumed by children [9][10][11][12][13][14][15].…”

Section: Discussionsupporting

confidence: 78%

“…Thus, the prospective observational study with a total of 133 patients aimed to provide the data regarding patterns and outcomes of poisoning. With regard to the demographic variables (Table 1), the findings of our study reported a mean age of 27.76±15.5 with higher incidence in age groups of <30 years (59.3%) that resembles to a study where 41% belonged to the same age group that could be related to factors of progression in younger generations, family members becoming less supportive of their choices pertaining to financial independence, marriage age, failure in examinations, premarital sex, rehabilitation, and physical and sexual abuse [9]. Contrary to our findings was a study conducted in Nepal where poisoning incidents were predominant in age groups of >40 years [10].…”

Section: Discussionsupporting

confidence: 77%

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Patterns of Acute Poisoning Among Patients Treated in the Emergency Wards of a Tertiary Care Hospital: A Cross-Sectional Study

Revathi

Reddy

Prasanna

et al. 2018

Objective: Poisoning is a growing health-care burden in developing countries like India. Predicting the nature of the intention behind poisoning and type of poisoning agent involved will help in facilitating appropriate treatment measures, hence, improving the patient’s quality of life.Methods: The prospective, observational study was conducted in a tertiary care multispecialty hospital for 6 months from November 2016 to April 2017 and involved a total of 133 patients. Treatment and outcomes of the patients were collected, documented in a data collection form. Chi-square test and logistic regression analysis were applied.Results: The mean age of the study participants was 27.76±15.5 with predominance seen in age groups of <30 years (59.3%), females (52.6%), and married (49.6%). Intentional poisoning (69.1%) through oral ingestion (81.2%) of medications (51.6%) in solid forms (60.2%) was predominant. Patients presenting with systemic manifestations (70.4%) arrived in a time duration >1 h (66.2%), received first aid (62.4%), and supportive care (52.7%). Higher ingestion of physical forms was significantly observed in both single (OR: 4.5) and married (OR: 3). The outcomes were correlated with poison severity score and patients with mild symptoms recovered (60.9%).Conclusion: The use of medicines for intentional poisoning continues to be rampant in younger age groups and married individuals. Educational programs with more accentuation on the data regarding toxic substances along with preventive measures are to be implemented to make mindfulness among the overall population.

“…Organophosphorus poisoning was observed to be the most common method. 21-30 year olds were most prone to suicidal poisoning, ascribed to their perturbation concerning the future issues [24]. Similarly studies on heavy metal poisoning have been done, but such studies with cartap is lacking [25].…”

Section: Discussionmentioning

confidence: 99%

An Observational Study of 11 Cases of Cartap Poisoning - A Rare Poisoning

Das¹,

Mohanty²,

Behera

et al. 2017

Objective: Cartap hydrochloride poisoning is an uncommon poisoning encountered in India. The aim of this study was to assess the characteristics, severity, management, and outcome of patients with Cartap poisoning, treated with N-acetylcysteine (NAC) in intensive care unit (ICU) of a tertiary referral hospital.Methods: This is a retrospective study where 11 cases of Cartap poisoning admitted to hospital ICU between 2011 and 2016 were identified from the case records. The demographic data, mode of ingestion, time to treat, ingested dose and severity of poisoning, presenting features, duration of mechanical ventilation (MV), dose of NAC used, complications, and outcome were noted.Results: Patients were scored as moderate or severe cases of poisoning. Severe cases consumed >10 g, underwent gastric lavage > 4 hrs, and took Cartap concomitantly with alcohol or in empty stomach. Duration of MV varied from 68-94 hrs in severe cases and 12-48 hrs in moderate cases. Average dose of NAC in severe case was 11.19 g and moderate case was 8.89 g. The most common presenting symptoms were vomiting, altered sensorium, and breathlessness. Severe cases had more complications, and the most common complication was hypotension followed by seizures. Survival was 100%.Conclusion: 50% of Cartap poisoning cases had good survival outcome. Severity of poisoning depends on amount of Cartap ingested, time taken for gastric lavage, and concomitant administration of alcohol. Duration of MV and dose of NAC and complications encountered correlates with the severity of poisoning.