Clinico-Epidemiological Pattern of Poisoning in A Tertiary Level Hospital

Abstract

Poisoning is a common medico-social problem in our country causing around 300,000 episodes and around 2000 death per year. The number of poisoning cases is increasing in our country day by day. The common pattern of poisoning in our country is suicidal, homicidal/criminal and accidental. The incidence, nature, etiology, age group affected and the outcome of poisoning in our country is different from that of the western world. A prospective descriptive study of poisoning cases in Sir Salimullah Medical College and Mitford Hospital was attempted in 2004.Among 100 cases, age of the cases ranged from 15-65 years. Sixty four percent were male. Around 68 percent cases were found businessman, 48% were from low-income group and Fifty three percent cases were educated up to secondary level.Among male patients 57.81% of poisoning caused by suspected sedative poisoning (transport related poison), 28.12% by organophophorous, 3.12% by copper sulphate, 4.98 by benzodiazepines (attempted suicide), 4.98% by Acid and 1.56% by kerosene. Among female patients 41.66% of poisoning caused by organophosphorous compounds, 19.44% by rat killer, 11.11% by copper sulphate, 8.33% by benzodiazepines, 5.55% by acid, 5.55% by savlon, 5.55% by herpic and 2.77% by phenol.Transport related poisoning by short acting sedative-hypnotics for the purpose of hijacking the belongings of the travelers and agrochemicals-organophosphorous compounds for suicidal purpose are the most common poisoning in our country. The pattern and magnitude of poisoning are thus multidimensional and demanding multi-sectoral approach for facing the problem. The comprehensive patient care can improve the poisoning case management in our country. DOI: 10.3329/jdmc.v17i2.6593J Dhaka Med Coll. 2008; 17(2) : 111-115

Clinico-Epidemiological study of poisoning in a tertiary care hospital in Bangladesh

“…No patient in this series had datura poisoning; all were applied sedative-hypnotics. This finding is nearly similar to the finding of Azhar et al (14) and Howlader et al (17). About 23% patients used anxiolytic, antidepressant or antipsychotic.…”

“…Poisoning due to suicidal and homicidal intention is more common among female patients, whereas accidental and stupefying is common among male patients. It is similar with study of Howlader et al (17). About two-thirds (63%) of the poisoning cases were prompted by family disharmony.…”

“…There may be other causes of early leaving of hospital like lack of available bed (poisoning patient are kept in floor or 'veranda'), poor facilities and hospital environment and to avoid social embarrassment. Insecticide was found to be the commonest (67%) agent responsible for poisoning death and case fatality for insecticide in this series was 6.86%, which is very similar with the other studies in Bangladesh, India, Nepal, Pakistan and Sri Lanka (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). This data suggest that pesticide poisoning is one of the commonest cause of death in Bangladesh as well as in other South Asian countries which might be contributed by insufficient first-aid before hospital arrival, inappropriate dose of antidotes and non availability of ICU support facilities.…”

“…Another 20 patients (3.3%) also needed assisted ventilation as per criteria but ventilation was not available at that time and so could not be resuscitate the patients, which needs to be addressed seriously in order to reduce poisoning related deaths in major teaching hospitals in Bangladesh. This situation is likely to be worse in other small and peripheral hospitals where ICU is non existent (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Nearly three-quarter (73%) of the patients recovered completely and 21% patients were absconded.…”

Predictors of respiratory failure in acute organophosphorus compound poisoning

“…Poisoning has become a common social and medical problem worldwide causing significant morbidity and mortality. 1 According to World Health Organization (WHO) reports, ingestion of pesticides is now the most common method of suicide worldwide. 2 As per National Crime Records Bureau (2016) report, 27.9% of suicides were committed by consuming poisons in India in the year 2015.…”