Introduction: Any substance if taken in enough quantity can be defined as a poison provided it causes physiological or anatomical harm. It can range from food products to therapeutic medications to toxins and chemicals. Animals, plants, and insects also produce toxins, which are poisonous. While any route of ingestion is dangerous, most poisons are either taken by mouth or inhaled. Rarely intravenous access as in the case of heroin/opoids overdose is seen as well.Poisoning whether deliberate or otherwise is a growing problem of the modern world. Young people are disproportionally affected by it. Mostly household products such as insecticides, bleach, acid, etc. are used. Harmful ingestion of prescription meds, recreational drugs, psychiatric medicines, and opoids has been on the rise in recent times. This is one of the major sources of poisoning these days.Data with respect to Sindh and Pakistan is scarce. As the largest referral center in the country, Jinnah Postgraduate Medical Centre sees its fair share of poisoning cases. Here we evaluate the trends and increasing burden of poisoning cases seen at this center.Aims: To evaluate the epidemiological, poisoning characteristics and treatment outcomes of patients admitted to the National Poisoning Control Centre (NPCC) at Karachi, Pakistan.Materials and methods: This is a retrospective study, held from July 1st to December 31st 2018. Data were recorded from all patients admitted to the NPCC after complete medico-legal work up.Results: A total of 2546 patients were inducted into the study. The mean age of presentation was 26.57 ± 11.82 years. Nearly 80% of patients were aged 40 years or younger. Both genders were equally affected and most cases were referred from within the city. Organophosphates (OPs) were the most frequent (46.11%) cause of poisoning seen. Overall mortality was 3.61%.Conclusion: The burden of poisoning cases has risen sharply. Mostly young adults and teenagers are affected without gender bias. Mortality is high considering the young population involved.

Objective: Cirrhotic patients commonly undergo screening endoscopy for the existence of esophageal varices. The use of this invasive procedure which is expensive, poorly tolerable and generally not acceptable for the patients is increasing due to increasing number of patients with chronic liver disease and their enriched survival. In this study, our aim is to identify clinical, biochemical, and ultrasonography parameters which might noninvasively predict the presence of esophageal varices and risk of bleeding in patients with liver cirrhosis. Material and Methods: Total 150 Patientsof chronic liver disease admitted in ward-5, JPMC (Sep 2011-Feb 2012 with a complaint of hematemesis or melena were included in the study. Platelet counts of 75,000 to 150,000/µL was defined as grade 1 thrombocytopenia, 50,000 to <75,000/µL as grade II, 25,000 to <50,000/µL as grade III and below 25,000/µL as grade IV. The normal range for the INR is 0.8-1.2. Portal vein size of 1.2 cm or above was taken as dilated. Spleen of >13 cm was considered as enlarged in our study. Results: Out of 72 patients of variceal bleed 69 (46%) were males and 81(54%) were females. Thrombocytopenia was present in 64 (88%) patients with mean platelet count of 85.86/µL (±69.79). Deranged coagulation profile was present in 56 (77%) cases with mean INR of 1.63 (±0.5). Portal vein diameter (PVD) of >1.2 cm was found in 46(63.8%) of patients with mean PVD of 1.22(±0.3023) and splenic size of >13 cm was reported in 54 (75%) cases with mean splenic diameter of 14.5 cm (±2.39). Conclusion: Thrombocytopenia, deranged coagulation profile, large splenic size, and dilated portal vein strongly predict the risk of variceal bleeding.

How to cite this article

This study is designed to assess the mortality in OPP patients with low GCS scores. Study Design: Cross Sectional study. Setting: Jinnah Postgraduate Medical Center. Period: From 1st February 2018 to 31st August 2018. Material & Methods: Included patients with low GCS, both genders and age of 18-60 years diagnosed with OPP. Their GCS was calculated and the outcome was determined in terms of mortality. Results: Out of 70 patients, the mean age was 35.2+16.5 years with the majority (62.9%) <30 years. 62.9% of these were males. Most (57.1%) of them presented after ingestion of <15mL of OP, 60% had the poisoning for >60 minutes, and the majority (74.3%) had taken it orally. When the GCS was computed, 81.40% had that of >5, while the mean came out to be 6.64 ±1.43. The mortality rate here was 17.10%. Conclusion: GCS toll can be a helpful and practical tool in assessing the mortality among the patients of OPP. However, because of the limited literature on the subject further studies are recommended to improve its validity.

No abstract