Aluminum phosphide poisoning known as rice tablet: A common toxicity in North Iran

Hosseinian, A; Pakravan, Nasrin; Rafiei, Ali; Feyzbakhsh, S M

doi:10.4103/0019-5359.104777

Cited by 43 publications

(44 citation statements)

References 17 publications

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“…as compared to our study with mortality rate of 14.3%. 15,16 The initial toxicity of phosphine poisoning may be nonspecific and transient; however in severe exposure patients develop metabolic acidosis, cardiovascular collapse, oliguria, and proteinuria eventually leading to anuria, which may require hemodialysis. 7 Phosphine (Aluminum phosphide) in low doses has the potential to cause headache, dizziness, numbness, general fatigue, breathing difficulties (tightness around the chest, pain in the region of the diaphragm and cough) and gastrointestinal disturbances (pain, nausea, vomiting and diarrhea) while victims of chronic exposure exhibit lung irritation, persistent coughing, tremors and convulsions eventually leading to pulmonary edema, myocardial injury, kidney damage and coma.…”

Section: Discussionmentioning

confidence: 99%

Phosphine inhalation, case series of domestic unintentional poisoning commonly used as anti-bed bug chemical from a low income country

Afzal¹,

Siddiqui²,

Kazi³

et al. 2018

Int J Community Med Public Health

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Phosphine poisoning is an uncommon but hazardous public health issue. It is widely used chemical compound as insecticides domestically and exposure to this chemical is mostly accidental especially in children, which may lead to fatal symptoms if not managed immediately. Previous studies have explored the mechanism of its deleterious effect. However, literature on presentation of phosphine poisoning is sparse. Medical records, from January 2005 to September 2013, with patients presenting to ED of Aga Khan University Hospital were reviewed after successfully taking ERC approval from the hospital. Patients with confirm phosphine poisoning were identified and further details were noted from their medical records. We identified seven cases of phosphine poisoning during the study period. Majority patients presented with generalized weakness, diarrhea, vomiting and drowsiness after exposure to phosphine containing insecticides, mostly exposed within past two days of symptoms and presentation. Six out of seven patients were successfully managed and discharged while one of the patient couldn't be saved. The objective of this study was to investigate various presentations of phosphine poisoning to Emergency Department (ED) in a low-income setting in Karachi, Pakistan and bring it to attention of the need to replace insecticides with a safer chemical compound and keep children out of reach from such toxins. Moreover increase awareness program and proper labeling and precautions should be written on all commonly sold pesticides and the constituent of hazardous compounds they contain.

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Section: Discussionmentioning

confidence: 99%

Phosphine inhalation, case series of domestic unintentional poisoning commonly used as anti-bed bug chemical from a low income country

Afzal¹,

Siddiqui²,

Kazi³

et al. 2018

Int J Community Med Public Health

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“…In some other studies, those who died had taken higher amount of AlP tablet, presented with severe hypotension, and had poor liver function test compared with the patients who survived. It was claimed that time lag to medical attention can also influence the survival (3,5,9,10). As researches continue to achieve a standard effective treatment protocol in AlP poisoning, applying legal restrictions in order to curtail the access to this material may reduce the rate of exposure.…”

Section: Discussionmentioning

confidence: 99%

An interesting case of aluminum phosphide poisoning

Faridaalaee

Rahmani

Ahmadi

et al. 2015

Journal of Emergency Practice and Trauma

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Ingestion and inhalation of phosphine are 2 forms of toxicity and their clinical manifestation is extremely wide. A 22-year-old girl was admitted with complaints of nausea, vomiting and epigastric pain after eating lunch. She had a history of celiac disease. On arrival, she was alert and hemodynamically stable. There was not any abdominal tenderness or guarding. Food poisoning treatment initiated but after 1 hour her condition deteriorated with hypotension, tachycardia, and epigastric pain. Venous blood gas (VBG) showed severe metabolic acidosis. She denied any drug ingestion again. New Electrocardiogram (ECG) showed extensive inferolateral ST elevation myocardial infarction (STEMI). Bicarbonate plus dopamine was initiated. After 8 hours of admission, rhythm became ventricular fibrillation (VF) and cardiopulmonary resuscitation (CPR) began. Peritoneal dialysis was performed. Next morning frequent VF occurred again but CPR was unsuccessful. Family found aluminum phosphide (AIP) tablets in her purse. Early diagnosis and supportive treatment may be effective but the most important factor is the dose of ingestion.

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“…Evidence indicates that AlP is one of the most common causes of poisoning deaths in India, Sri Lanka, Iran, Oman and Morocco . More than 90% of these poisonings are related to suicide . A three‐gram tablet can produce one gram of phosphine (PH 3 ) gas, which is a colourless and odourless toxic gas …”

Section: Introductionmentioning

confidence: 99%

“…7 More than 90% of these poisonings are related to suicide. 8 A three-gram tablet can produce one gram of phosphine (PH 3 ) gas, which is a colourless and odourless toxic gas. 9,10 PH 3 is a highly reactive radical that penetrates freely into the intracellular space and increases the production of H 2 O 2 from mitochondria, which induces oxidant-derived cellular damage, due to the products of H 2 O 2 reduction, 11 such as the very reactive hydroxyl radicals.…”

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confidence: 99%

Adjuvant potential of selegiline in treating acute toxicity of aluminium phosphide in rats

Maleki

Hosseini

Rahimi

et al. 2019

Basic Clin Pharma Tox

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Aluminium phosphide (AlP) is a highly toxic substance with a high mortality rate and no effective antidote. Once exposed to the moisture and acidic conditions of the stomach, AlP releases toxic phosphine (PH3) gas, which results in severe toxicity in poisoned subjects. Selegiline is a monoamine oxidase inhibitor with antioxidant and anti‐apoptotic properties, which is mostly prescribed for the treatment of mood disorders and Parkinson's disease. Since AlP has detrimental effects on cardiac physiology and mitochondrial function, we tested the protective effects of acute selegiline treatment on cardiac mitochondrial function, redox status and electrocardiographic parameters in rats after AlP poisoning. To do this, AlP was given to rats by gavage to induce toxicity. Selegiline was injected intraperitoneally in the treatment groups 1 hour after AlP poisoning. Selegiline treatment after AlP intoxication was not associated with a significant difference in the mortality rate of animals. However, selegiline reduced oxidative stress (decreased the reactive oxygen species and malondialdehyde) and increased glutathione in the cardiac tissue of rats exposed to AlP. Further, the mitochondrial membrane potential (ΔΨm) collapse reversed after treatment with selegiline. Selegiline also improved the electrocardiographic (ECG) parameters and enhanced heart rate. The histopathological evaluation revealed that selegiline eliminated the inflammation and injuries induced by AlP in the stomach and duodenum, as well as cardiac tissue. In conclusion, selegiline treatment can ameliorate the AlP‐induced cardiac and gastrointestinal injuries in rats via boosting redox status and mitochondrial function with no significant effect on survival. We suggest that using selegiline, apart from other clinical treatments, may improve the quality of treatment process for AlP toxicity.

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Aluminum phosphide poisoning known as rice tablet: A common toxicity in North Iran

Abstract: ALP poisoning is a common toxicity in Iran causing high morality. This is a serious health problem in agricultural region where ALP is readily available. Withdrawal of ALP tablet from the market and introduction of safer products as rodenticides and insecticides is recommended.

Cited by 43 publications

References 17 publications

Phosphine inhalation, case series of domestic unintentional poisoning commonly used as anti-bed bug chemical from a low income country

Phosphine inhalation, case series of domestic unintentional poisoning commonly used as anti-bed bug chemical from a low income country

An interesting case of aluminum phosphide poisoning

Adjuvant potential of selegiline in treating acute toxicity of aluminium phosphide in rats

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