Cassia occidentalis poisoning as the probable cause of hepatomyoencephalopathy in children in western Uttar Pradesh.

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dc.contributor.authorVashishtha, V Men_US
dc.contributor.authorKumar, Amoden_US
dc.contributor.authorJohn, T Jacoben_US
dc.contributor.authorNayak, N Cen_US
dc.date.accessioned2007-06-21en_US
dc.date.accessioned2009-05-27T06:55:10Z
dc.date.available2007-06-21en_US
dc.date.available2009-05-27T06:55:10Z
dc.date.issued2007-06-21en_US
dc.description.abstractBACKGROUND & OBJECTIVE: Recurrent annual outbreaks of acute encephalopathy illness affecting young children have been reported for several years in many districts of western Uttar Pradesh (UP). Our earlier investigations over three consecutive years (2002-2005) proved that these outbreaks were due to a fatal multi-system disease (hepatomyoencephalopathy syndrome) probably caused by some phytotoxin and not due to viral encephalitis as believed so far. We conducted a case-control study to investigate the risk, if any, from various environmental factors and also to identify the putative toxic plant responsible for development of this syndrome. METHODS: Eighteen cases with acute hepatomyoencephalopathy syndrome admitted in 2005 in a secondary care paediatric hospital of Bijnor district of western UP were included in the study. Three age-matched controls were selected for each case. A semi-structured questionnaire was developed and applied to all 18 cases and 54 controls. All interviews were conducted within one week of discharge or death of each case. Quantitative data were analyzed using the relevant established statistical tests. RESULTS: Parents of 8 (44.4%) cases gave a definite history of their children eating beans of Cassia occidentalis weed before falling ill, compared with 3 (5.6% controls), the odds ratio being 12.9 (95% CI 2.6-88.8, P<0.001). History of pica was the other associated factor with the disease, odds ratio 5.20 (95% CI 1.4-19.5, P<0.01). No other factor was found significantly associated with the disease. INTERPRETATION & CONCLUSION: Consumption of C. occidentalis beans probably caused these outbreaks, described earlier as hepatomyoencephalopathy syndrome. Public education has the potential to prevent future outbreaks.en_US
dc.description.affiliationMangla Hospital, Bijnor (UP), and Christian Medical College, Vellore, India. vmv@manglahospital.orgen_US
dc.identifier.citationVashishtha VM, Kumar A, John TJ, Nayak NC. Cassia occidentalis poisoning as the probable cause of hepatomyoencephalopathy in children in western Uttar Pradesh. Indian Journal of Medical Research. 2007 Jun; 125(6): 756-62en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/18506
dc.language.isoengen_US
dc.source.urihttps://icmr.nic.in/ijmr/ijmr.htmen_US
dc.subject.meshBrain Diseases --chemically induceden_US
dc.subject.meshCase-Control Studiesen_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshDisease Outbreaksen_US
dc.subject.meshEnvironmenten_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshLiver Diseases --chemically induceden_US
dc.subject.meshMaleen_US
dc.subject.meshMuscular Diseases --chemically induceden_US
dc.subject.meshOdds Ratioen_US
dc.subject.meshPlant Extracts --metabolismen_US
dc.subject.meshQuestionnairesen_US
dc.subject.meshSenna Plant --poisoningen_US
dc.titleCassia occidentalis poisoning as the probable cause of hepatomyoencephalopathy in children in western Uttar Pradesh.en_US
dc.typeJournal Articleen_US
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