Supportive Measures in the Treatment of Aluminum Phosphide Poisoning as a Trial to Reduce Mortality at Assiut University Hospital, Egypt

Abstract

Aluminum phosphide (AlP) poisoning is a major problem, accounting for many Emergency Unit visits and hospitalization with increasing incidence of AlP toxicity in the last few years. In spite of the progress achieved in the field of toxicology and associated therapies, AlP is still responsible for a high rate of mortality due to the rapid onset of life-threatening symptoms, ineffective treatment and inadequate data on the efficacy of therapeutic interventions. AlP poisoning is a serious medical emergency demanding early and adequate management. In this prospective study of AlP toxicity, 44 patients admitted to emergency unit of Assiut university hospital in the period from 1st January to 30th June 2016 were included. There were 28 males (68.2%) and 16 females (31.8%). The majority of the cases were in the age group from 21 to 30 years (n=28, 54.6%). Thirty-six (81.8%) of admitted patients were from rural areas. Suicidal intake was the main mode of toxicity in 81.8% of cases. About 41% of the cases were shocked at their presentation and had metabolic acidosis. The mortality rate was 45.5%. The incidence of death in patients treated with N-acetyl cysteine to the incidence of death in non-treated patients was 1:12. AlP poisoning needs more attention due to associated fatality, the absence of an antidote, and a high number of youth victims. Supportive measures are vital in these patients. N-acetyl cysteine has a protective effect. 1211 patients have prompted the use of NAC as a therapeutic measure to replenish the glutathione. NAC also improved the hepatic manifestations and prevented hepatic necrosis. The NAC also delayed the mortality latency time [9]. This study was conducted to evaluate AlP toxicity among cases admitted to emergency unit of Assiut University Hospital and to prove the role of N-acetyl cysteine and adequate supportive measures in AlP management. 2. Methodology A descriptive cross-sectional (prospective) study was conducted on cases of AlP toxicity admitted to Assiut University Hospital emergency unit during the period from 1st

Outcome of Rodenticide Poisoning and Its Associated Factors Among Adult Patients Admitted with Rodenticide Poisoning at the Emergency Unit of Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, North Central Ethiopia

“…This finding was reinforced by investigations in Morocco and Egypt, which reported a death rate of 49% and 45.5%, respectively. 12,13 However, a study conducted at Felege Hiwot Referral Hospital Bahir Dar and Tehran-Iran found a lower mortality rate of 31.2% and 24.06%, respectively. 4,14 This disparity could be attributed to differences in study period, study population, medication availability, and both studies explain that most of the tablets were exposed to air or expired tablets, which have lower phosphide content due to gradual release of phosphine gas.…”

“…This was also the conclusion of an Egyptian study. 13,20 This is because rodenticide poisoning disrupts electrolytes, resulting in cardiac arrhythmia and cardiogenic shock. Hypotension, on the other hand, will cause tachycardia as a compensatory strategy.…”

Comparison between Gastric Lavage with Paraffin Oil versus Coconut Oil in Acute Aluminum Phosphide Poisoning: A Randomized Controlled Clinical Trial

“…Managements of ALP poisoned patients aim to prevent phosphine gas release and to keep people alive by administering proper resuscitation techniques until the phosphine has been eliminated from the body. Hence, early gastric lavage is crucial (Amiri et al, 2016;H. Abdel-Hady et al, 2019).…”