Impact on Morbidity & Mortality by Rodenticidal Poisoning.
Loading...
Date
2013-05
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background : Rodenticidal poisoning is a very common
clinical entity regularly encountered in outdoor & emergency
department in various parts of India. This is the commonest
type of poisoning. We present the prospective study of
clinical profile, course, complication & outcome of various
rodenticidal poisoning in 170 patients. Objectives : To
determine the clinical symptoms, morbidity and mortality
in various rodenticidal poisoning. To study the clinical profile
& laboratory investigations. To study the course,
complications & outcome. Methods : Study period was
from 01 May 2011 to 30 April 2012. Historically and
documented evidence of 170 patients of various rodenticidal
poisoning admitted in the emergency, medical wards &
I.C.U. under department of medicine, undergone for various
laboratory investigations and imaging study. Statistical
analysis was done in mean, range, standard deviation and
percentage. Results : A total of 170 cases of various
rodenticidal poisoning admitted in MBS hospital, Govt.
Medical College, Kota were studied. The age of patients
ranged from 10 to 65 years. Age groups were divided in
four group, 10-18, 19-30, 31-45 & 45-65. Most common
age group was ranged from 18-30 year. Most common
gender was female (females 92 males 78). Mode of
poisoning were suicidal, accidental & homicidal.
Commonest mode of poisoning was suicidal uptake of
poison. Route of poisoning was ingestion. Common
presenting signs & symptoms were nausea & vomiting
seen in 157(92.35%), Tachycardia in 156(91.7%),
Tachypnoea in 137(80.62%), & Abdominal pain 129(75.8%).
Few patients presented with Headache, Palpitation &
Sweating. Deranged laboratory findings on day third of
admission include Anemia in 21.76%, Leucocytosis in
20.59%, prolonged Prothrombin time (PT) in 16.47% &
increased serum Bilirubin in 11.18%. Morbidity developed
in 8 cases(4.71%), Of which four have Hemorrhagic
complication ( e.g. Bleeding gums, Purpura Melena &
Hematuria) by Dicoumarol , Bromadiolone and Brodifacoum.
Three patients of Zinc phosphide poisoning produced
cardiac insult and one patient of Barium carbonate poisoning
developed cardiac arrhythmia. Transient arrhythmias and
respiratory failure developed in other rodenticidal poisoning.
All patients treated symptomatically and according to
complications. Six cases of our study remained
asymptomatic for two to three days then they developed
delayed hemorrhagic complication ( Bleeding gums,
Purpura, Melena & Hematuria). These patients had deranged
liver function test (LFT) & prolonged Prothrombin time
(PT). Mortality was seen in 1.76%( 3 cases). By Zinc
phosphide in 2 patient and Barium carbonate in 1 patient.
Conclusion : We concluded that bleeding, bruising & other
hemorrhagic complications should be treated and monitored
according to Prothrombin time (PT) & INR. Awareness
should be increased especially for Zinc phosphide and
arrhythmia produced by Barium carbonate.
Description
Keywords
rodenticides, morbidity mortality, liver function test, prothrombin time
Citation
Pahadia Manish, Saluja Manoj, Bhushan Bharat, Meena S R. Impact on Morbidity & Mortality by Rodenticidal Poisoning. Indian Medical Gazette. 2013 May ; 147 (5): 170-174.