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The aim of this study was to evaluate the pattern of acute organophosphorous (OP) poisoning cases including death, duration of hospitalization and time lapse before arrival at hospital. All OP poisoning cases admitted to the Emergency Department of MKCG Medical College Hospital and other fatal cases received at the mortuary between September 1999 and August 2001 were prospectively studied. Males outnumbered females and most OP poisoning occurred in the 21-30 year age group. In 68 (97.1%) cases the motive was suicide and more than 80% were from rural areas. Nearly one-third of cases occurred during the summer and in the later part of the day. Married females and unmarried males were most frequently affected. Most of the married females were housewives and the males were students or farmers. Fifty-four per cent of cases were admitted for treatment within three hours with a mean time lapse of 6.2 hours. The mean hospital stay for all OP poisoning cases was 5.1 days. Twenty-nine out of 66 admitted OP poisoning cases were fatal. There is a high incidence of OP poisoning with mortality in the region. OP compounds are readily available at low cost in the market. A time of stress and frustration can lead to their use as a common poison with which to commit suicide.

Paraphenylenediamine poisoning is among one of the emerging causes of poisoning in Asian countries, because it is a constituent of hair dye formulations and is easily available in market at low cost. Hair dyes are rampantly used in Asian households compared with the western world. Locally, hair dye constituents may have allergic adverse effects, and acute systemic poisoning presents with characteristic angioedema, upper airway obstruction, rhabdomyolysis, methemoglobinemia, myoglobinuria, and acute renal failure. This study reports about the death of a 24-year-old Indian housewife who committed suicide by taking hair dye emulsion. She had an argument with her husband, and because of fit of rage, took a bowlful (80 mL) of hair dye emulsion kept prepared for the use by husband. She developed angioedema, cervical swelling, and rhabdomyolysis and died of acute renal failure within 24 hours. Toxicological analysis of viscera and blood revealed varying levels of paraphenylenediamine. Histopathological samples of kidney showed features of acute tubular necrosis and myoglobin casts in renal tubules. The aim of the study is to create awareness about the adverse effects of the hair dye, its poisoning outcome, and possible preventive measures.