Pesticides are responsible for less than 1% of deaths from poisoning in the UK while various studies in India indicate that the figures range from 20% to a staggering 70% (Sharma, 1998). Organophosphorus compounds are reported to be the most commonly used substances for suicidal purposes (Dixit, 2007). Homicidal poisoning involving pesticides has always been rare owing to the disagreeable odour and taste rendered to them by their hydrocarbon solvents (Pillay, 2008). An unusual case of homicide using an organophosphorus compound is presented here. The body of a 28-year-old woman was brought for post-mortem examination at the mortuary of the Government Medical College and New Civil Hospital, Surat, Gujarat, India. It had been exhumed after forty-five days of burial under the supervision of a medical officer from the nearby primary health centre, the police and a magistrate. There was a history of marital discord between the deceased and her husband. Their ten-year-old daughter, who was the only witness to the incident, revealed later that her mother was struck by a wooden block and forcibly made to ingest some medicine. The 'medicine' was identified on chemical analysis as an organophosphorus compound (dichlorvos).
Introduction: Scorpion sting is a major public health problem in India with severe life threatening complications. Toxin can cause autonomic overstimulation leading to hypertension, arrhythmias and pulmonary edema with left ventricular dysfunction. Prazosin has been the ideal antidote for patients with mild to moderate envenomation. In patients with severe envenomation, dobutamine is found to be very useful to prevent morbidity and mortality. Materials and Methods: Retrospective study was done on patients admitted from March 2011 to November 2013 with a history of scorpion bite and adults aged between 20-60 yrs were included. All the patients were subjected to grading of envenomation as mild, moderate and severe degree. Prazosin was given to all 80 patients and dobutamine was given to those who did not show response to prazosin. Results: Majority of patients were in the age group of 31-40 years followed by 21-30 years. Mean age was 31.23±7.23 years. Fifty four patients (67.5%) were male and twenty six (32.5%) were female. 28 patients had mild envenomation, 36 had moderate envenomation and 16 had severe envenomation. 83.33% of patients responded to dobutamine infusion in prazosin resistant cases in our study. Conclusion: Early use of dobutamine should be considered in patients with severe envenomation with left ventricular dysfunction to prevent morbidity and mortality. 2D echo has to be considered to assess left ventricular dysfunction and need for early use of dobutamine.
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