Wheat Pill (Aluminum Phosphide) Poisoning”;

Abstract

Purpose: The number of deaths due to wheat pill poisoning is enormous and despite aggressive management only a fewpatients survive the fatal effects of the wheat pill poison. Despite the growing number of patients appearing in the emergency departmentswith this easily available poison in the market, very little effort has been put forth to study the subject scientifically and to prevent theongoing loss of precious lives. This is a narrative review of the wheat pill poisoning, highlighting the important steps in diagnosis andmanagement. Methods: Data sources include Pubmed, Scopus, Medline (1996 to date), Cochrane library and Google scholar. Weincluded all clinical trials, systematic reviews and ongoing cohort studies. Conclusions: Wheat pill (Aluminum Phosphide) poisoning is alethal toxin and its effective treatment requires prompt diagnosis and early, time-efficient management. Early transfer to a healthcarefacility, good resuscitation, diagnosis, monitoring, gastric lavage and supportive therapy are the hallmarks of management and may resultin improved outcomes. The governmental and legislative authorities must take appropriate steps towards limiting its availability at thegrass-roots level. Aluminum Phosphide poisoning must be a part of the medical students’ curriculum and long-term, well-designedcomprehensive research studies are required to discover new modalities of treatment.

The Role of Pathological Examination of the Liver in Medicolegal Autopsy: A Tertiary Care Center Study From North India

“…Cause of death due to poison constituted 7% of cases significantly associated with MCH, with necrosis on histopathology in 43% of cases. This finding is consistent with studies by Sinha et al [ 57 ], Arora et al [ 58 ], and Ghazi [ 59 ] depicting congestion, fatty infiltration, and centrizonal necrosis in liver histopathology. Aluminum phosphide, also known as "wheat pill," is a poison that can be fatal and has quick-moving symptoms that lead to death.…”

Biochemical and histopathological changes in livers of rats poisoned with aluminum phosphide and treated with carrot extract

“…Toxicity to humans is most typically associated with AP intake. However, toxicity by inhalation and absorption through the skin are also possibilities [ 5 , 6 ]. As a result, systemic poisoning can be caused by diffusingPH3 through the digestive system and thus reaching different parts of the body [ 5 ].…”

“…However, toxicity by inhalation and absorption through the skin are also possibilities [ 5 , 6 ]. As a result, systemic poisoning can be caused by diffusingPH3 through the digestive system and thus reaching different parts of the body [ 5 ]. Activation of PH3 could lead to inhibit cytochrome C oxidase, thus inhibiting oxidative phosphorylation and cell respiration.…”

“…Acute AP poisoning is characterized by the presence of nausea, vomiting, abdominal discomfort, and hemodynamic instability which are all common symptoms [ 8 , 9 ]. Also, acute respiratory distress syndrome, hepatic, heart, and renal failure are all possible complications of AP poisoning [ 5 , 10 , 11 ].…”

“…The poisoning effect relates to phosphine gas (PH3) which is considered a highly poisoning agent that can be formed when AP contact with either moisture or water or hydrochloric acid (HCL) inside the stomach [3][4][5]. Toxicity to humans is most typically associated with AP intake.…”