Epidemiological, Poisoning Characteristics and Treatment Outcomes of Patients Admitted to the National Poisoning Control Centre at Karachi, Pakistan: A Six Month Analysis

Abstract

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.

Organophosphate Poisoning: Demographics, Severity Scores and Outcomes From National Poisoning Control Centre, Karachi

“…The commonest type of OP ingested were the "Off label products". This is consistent with previous data [6]. Liquid forms were also associated with increased mortality (see below).…”

Trajectories of vital status parameters and risk of mortality among acute organophosphorus poisoning patients – a latent class growth analysis

“…These findings suggest that routine clinical parameters, if observed repeatedly, might be useful clinical tools to identify high-risk groups of patients who might experience considerably high mortality. The mortality in our study is comparable to previously published papers on OP poisoning from different regions, including neighbouring countries [4,9,18,27,[40][41][42]; however, our study appeared to show higher (13.4%) mortality compared to a published paper (4.11%) [42] from another tertiary care setting in our metropolitan city. Although the average ages of patients in their study and our study were comparable, a significantly higher percentage of women (73%) was enrolled in the previously published study [42] than in our study (52.5%).…”

“…Among OP poisoning cases, the case fatality rate varies from 10 to 30% in developing countries [7,8]. In our urban city, the prevalence of OP poisoning among all poisoning cases is reported to be nearly 46.1%, with a mortality rate of 2.7% [9].…”

“…The prognosis of acute poisoning depends on the exposure to the toxin as well as the amount of toxin ingested and the physiology of compensation. In our country, it is difficult to judge the amount because patients ingest different brands, and there is a lack of description of the concentration of the poisonous substance [9,15]. In clinical settings, the prognosis of these patients is mainly assessed by vital status, including body temperature, blood pressure, heart rate and respiratory rate, levels of anticholinesterases, oxygenation and PaCO 2 for hypoventilation requiring intubation/ventilation.…”

Oxidative Stress and Analysis of Selected SNPs of ACHE (rs 2571598), BCHE (rs 3495), CAT (rs 7943316), SIRT1 (rs 10823108), GSTP1 (rs 1695), and Gene GSTM1, GSTT1 in Chronic Organophosphates Exposed Groups from Cameroon and Pakistan

“…Globally, thousands of peoples die each year due to pesticide poisoning [ 1 ]. Intoxication and maladies due to acute and chronic exposure in populations is regularly reported in literature [ 29 , 30 , 31 , 32 , 33 ]. Mixture of OPs even at low non-lethal dose may pose enhanced threat because of the possibility of synergistic effect between two OPs [ 34 , 35 ].…”