Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards

Indira Madhavan; Santhosh L. K.; Vinu Thomas

doi:doi:10.11648/j.ajim.s.2015030601.12

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Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards

Indira Madhavan, Santhosh L. K., Vinu Thomas

Published in American Journal of Internal Medicine (Volume 3, Issue 6-1)

Received: 1 May 2015 Accepted: 7 October 2015 Published: 23 October 2015

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Abstract

Non-fatal deliberate self-harm (DSH) and suicides are serious global health problems in many low- and middle-income countries including India. We conducted a cross sectional observational study in patients admitted with deliberate self harm in a tertiary care centre to identify the common agents used for poisoning in our area, to know the common clinical features and the outcome of such cases. Of the 200 patients observed, there were 114(57%) males and 86(43%) females. In the study group, 53 (13males, 40females) patients were adolescents, 85 (60 males, 25 females) were young, 29(16males, 13 females) were middle aged and 33 (25males, 8females) were elderly. The pesticide group which included organophosphates, organochlorines, carbamates and pyrethroids constituted commonest substance used as poisoning agent (39%,n= 78) followed by plant poisons (28%,n=55 ) which included yellow oleander, oduku leaves and abrus precatorius. Rodenticides (10%, n=20), benzodiazapines (6%, n=11), kerosene (5%, n==9) and paracetamol (3%, n==6) were the other common exposure. Various drug combinations, copper sulphate, sulphuric acid, formic acid, fabric whitner, weedicides and homeopathic medications constitutes 11% (n==21) of cases. Mortality of study population was 6% (n==12, 11 men and 1 woman). Four patients expired after organophosphorus poisoning, four with carbamate poisoning, two with oduku, one each with rodenticide and yellow oleander poisoning. Pesticides and plant poisons are the common agents used for deliberate self harm in our study. Adoloscent and young persons are commonly involved in suicide attempts. Pesticides cause majority of deaths while plant and rodenticide poisonings can also be fatal.

Published in	American Journal of Internal Medicine (Volume 3, Issue 6-1) This article belongs to the Special Issue Toxicology
DOI	10.11648/j.ajim.s.2015030601.12
Page(s)	5-9
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Deliberate Self Harm, Pesticides, Plant Poisons, Rodenticide Poisoning, Drug Overdosage

References

[1]	Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. International Journal of Epidemiology. IEA; 2003. p. 902–9.
[2]	Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health . 2007 Jan; 7: 357.
[3]	Bose TK, Basu RK, Biswas B, De JN, Majumdar BC, Datta S. Cardiovascular effects of yellow oleander ingestion. J Indian Med Assoc. 1999 Oct; 97(10): 407–10.
[4]	Gautami S, Sudershan RV, Bhat R V., Suhasini G, Bharati M, Gandhi KPC. Chemical poisoning in three Telengana districts of Andhra Pradesh. Forensic Sci Int. Elsevier; 2001 Nov 1; 122(2-3): 167–71.
[5]	Manuel C, Gunnell DJ, van der Hoek W, Dawson A, Wijeratne IK, Konradsen F. Self-poisoning in rural Sri Lanka: small-area variations in incidence. BMC Public Health. 2008 Jan; 8: 26.
[6]	Eddleston M, Buckley NA, Eyer P, Dawson AH. Management of acute organophosphorus pesticide poisoning. Lancet. Lancet Publishing Group; 2008; 371(9612): 597–607.
[7]	Das RK. Epidemiology of Insecticide poisoining at A.I.I.M.S Emergency Services and role of its detection by gas liquid chromatography in diagnosis. Medico update. 2007; 7: 49–60.
[8]	Unnikrishnan B, Singh B, Rajeev A. Trends of acute poisoning in South Karnataka. Kathmandu Univ Med J (KUMJ) 2005; 3: 149–54.
[9]	Dash SK, Aluri SR, Mohanty MK, Patnaik KK, Mohanty S. Sociodemographic profile of poisoning cases. JIAFM. 2005; 27: 133–8.
[10]	Kora SA, Doddamani GB, Halagali GR, Vijayamahantesh SN, Umakanth B. Sociodemographic Profile of the Organophosphorus Poisoning Cases in Southern India. 2011; 5(5): 953–6.
[11]	Eddleston M, Mohamed F, Davies JOJ, Eyer P, Worek F, Sheriff MHR, et al. Respiratory failure in acute organophosphorus pesticide self-poisoning. QJM. 2006 Aug; 99(8): 513–22.
[12]	Indira M, Andrews MA, Rakesh TP. Incidence, predictors, and outcome of intermediate syndrome in cholinergic insecticide poisoning: a prospective observational cohort study. Clin Toxicol (Phila). 2013 Nov; 51(9):838-45.
[13]	Eddleston M, Persson H. Acute plant poisoning and antitoxin antibodies. J Toxicol Clin Toxicol. 2003 Jan; 41(3): 309–15.
[14]	Eddleston M, Warrell DA. Management of acute yellow oleander poisoning. QJM. 1999 Sep 1; 92(9): 483–5.
[15]	Shumaik GM, Wu AW, Ping AC. Oleander poisoning: Treatment with digoxin-specific fab antibody fragments. Ann Emerg Med; 1988 Jul 7; 17(7): 732–5.
[16]	Pirasath S, Arulnithy K. Yellow oleander poisoning in eastern province: an analysis of admission and outcome. Indian J Med Sci; 2013 Jan 1; 67(7-8): 178–83.
[17]	Rajapakse S. Management of yellow oleander poisoning. Clin Toxicol (Phila). 2009 Mar; 47(3): 206–12.
[18]	Cleistanthus collinus poisoning: an effective management with multidose activated charcoal. Available from: http://allsubjectjournal.com/vol2/issue1/PartF/pdf/20.1.pdf.
[19]	Parsons BJ, Day LM, Ozanne-Smith J, Dobbin M. Rodenticide poisoning among children. Aust N Z J Public Health [Internet]. 1996 Oct; 20(5): 488–92.
[20]	Kruse JA, Carlson RW. Fatal rodenticide poisoning with brodifacoum. Ann Emerg Med. 1992 Mar; 21(3): 331–6.
[21]	Eddleston M, Gunnell D, Karunaratne A, de Silva D, Sheriff MHR, Buckley N a. Epidemiology of intentional self-poisoning in rural Sri Lanka. Br J Psychiatry. 2005 Dec; 187: 583–4.
[22]	Chern C-H, Chern T-L, Wang L-M, Hu S-C, Deng J-F, Lee C-H. Continuous flumazenil infusion in preventing complications arising from severe benzodiazepine intoxication. Am J Emerg Med. Elsevier; 1998 May 5; 16(3): 238–41.
[23]	Reed RP, Conradie FM. The epidemiology and clinical features of paraffin (kerosene) poisoning in rural African children. Ann Trop Paediatr. 1997 Mar 1; 17(1): 49–55.
[24]	Wolfe BM, Brodeur AE, Shields JB. The role of gastrointestinal absorption of kerosene in producing pneumonitis in dogs. J Pediatr. 1970 Jun; 76(6): 867–73.

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APA Style

Indira Madhavan, Santhosh L. K., Vinu Thomas. (2015). Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards. American Journal of Internal Medicine, 3(6-1), 5-9. https://doi.org/10.11648/j.ajim.s.2015030601.12

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ACS Style

Indira Madhavan; Santhosh L. K.; Vinu Thomas. Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards. Am. J. Intern. Med. 2015, 3(6-1), 5-9. doi: 10.11648/j.ajim.s.2015030601.12

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AMA Style

Indira Madhavan, Santhosh L. K., Vinu Thomas. Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards. Am J Intern Med. 2015;3(6-1):5-9. doi: 10.11648/j.ajim.s.2015030601.12

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@article{10.11648/j.ajim.s.2015030601.12,
  author = {Indira Madhavan and Santhosh L. K. and Vinu Thomas},
  title = {Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards},
  journal = {American Journal of Internal Medicine},
  volume = {3},
  number = {6-1},
  pages = {5-9},
  doi = {10.11648/j.ajim.s.2015030601.12},
  url = {https://doi.org/10.11648/j.ajim.s.2015030601.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.s.2015030601.12},
  abstract = {Non-fatal deliberate self-harm (DSH) and suicides are serious global health problems in many low- and middle-income countries including India. We conducted a cross sectional observational study in patients admitted with deliberate self harm in a tertiary care centre to identify the common agents used for poisoning in our area, to know the common clinical features and the outcome of such cases. Of the 200 patients observed, there were 114(57%) males and 86(43%) females. In the study group, 53 (13males, 40females) patients were adolescents, 85 (60 males, 25 females) were young, 29(16males, 13 females) were middle aged and 33 (25males, 8females) were elderly. The pesticide group which included organophosphates, organochlorines, carbamates and pyrethroids constituted commonest substance used as poisoning agent (39%,n= 78) followed by plant poisons (28%,n=55 ) which included yellow oleander, oduku leaves and abrus precatorius. Rodenticides (10%, n=20), benzodiazapines (6%, n=11), kerosene (5%, n==9) and paracetamol (3%, n==6) were the other common exposure. Various drug combinations, copper sulphate, sulphuric acid, formic acid, fabric whitner, weedicides and homeopathic medications constitutes 11% (n==21) of cases. Mortality of study population was 6% (n==12, 11 men and 1 woman). Four patients expired after organophosphorus poisoning, four with carbamate poisoning, two with oduku, one each with rodenticide and yellow oleander poisoning. Pesticides and plant poisons are the common agents used for deliberate self harm in our study. Adoloscent and young persons are commonly involved in suicide attempts. Pesticides cause majority of deaths while plant and rodenticide poisonings can also be fatal.},
 year = {2015}
}

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TY  - JOUR
T1  - Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards
AU  - Indira Madhavan
AU  - Santhosh L. K.
AU  - Vinu Thomas
Y1  - 2015/10/23
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.s.2015030601.12
DO  - 10.11648/j.ajim.s.2015030601.12
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
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EP  - 9
PB  - Science Publishing Group
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UR  - https://doi.org/10.11648/j.ajim.s.2015030601.12
AB  - Non-fatal deliberate self-harm (DSH) and suicides are serious global health problems in many low- and middle-income countries including India. We conducted a cross sectional observational study in patients admitted with deliberate self harm in a tertiary care centre to identify the common agents used for poisoning in our area, to know the common clinical features and the outcome of such cases. Of the 200 patients observed, there were 114(57%) males and 86(43%) females. In the study group, 53 (13males, 40females) patients were adolescents, 85 (60 males, 25 females) were young, 29(16males, 13 females) were middle aged and 33 (25males, 8females) were elderly. The pesticide group which included organophosphates, organochlorines, carbamates and pyrethroids constituted commonest substance used as poisoning agent (39%,n= 78) followed by plant poisons (28%,n=55 ) which included yellow oleander, oduku leaves and abrus precatorius. Rodenticides (10%, n=20), benzodiazapines (6%, n=11), kerosene (5%, n==9) and paracetamol (3%, n==6) were the other common exposure. Various drug combinations, copper sulphate, sulphuric acid, formic acid, fabric whitner, weedicides and homeopathic medications constitutes 11% (n==21) of cases. Mortality of study population was 6% (n==12, 11 men and 1 woman). Four patients expired after organophosphorus poisoning, four with carbamate poisoning, two with oduku, one each with rodenticide and yellow oleander poisoning. Pesticides and plant poisons are the common agents used for deliberate self harm in our study. Adoloscent and young persons are commonly involved in suicide attempts. Pesticides cause majority of deaths while plant and rodenticide poisonings can also be fatal.
VL  - 3
IS  - 6-1
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Author Information

Indira Madhavan

Department of Medicine, Government Medical College, Thrissur, India
Santhosh L. K.

Department of Medicine, Government Medical College, Thrissur, India
Vinu Thomas

Department of Medicine, Government Medical College, Thrissur, India

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APA Style

Indira Madhavan, Santhosh L. K., Vinu Thomas. (2015). Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards. American Journal of Internal Medicine, 3(6-1), 5-9. https://doi.org/10.11648/j.ajim.s.2015030601.12

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ACS Style

Indira Madhavan; Santhosh L. K.; Vinu Thomas. Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards. Am. J. Intern. Med. 2015, 3(6-1), 5-9. doi: 10.11648/j.ajim.s.2015030601.12

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AMA Style

Indira Madhavan, Santhosh L. K., Vinu Thomas. Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards. Am J Intern Med. 2015;3(6-1):5-9. doi: 10.11648/j.ajim.s.2015030601.12

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@article{10.11648/j.ajim.s.2015030601.12,
  author = {Indira Madhavan and Santhosh L. K. and Vinu Thomas},
  title = {Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards},
  journal = {American Journal of Internal Medicine},
  volume = {3},
  number = {6-1},
  pages = {5-9},
  doi = {10.11648/j.ajim.s.2015030601.12},
  url = {https://doi.org/10.11648/j.ajim.s.2015030601.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.s.2015030601.12},
  abstract = {Non-fatal deliberate self-harm (DSH) and suicides are serious global health problems in many low- and middle-income countries including India. We conducted a cross sectional observational study in patients admitted with deliberate self harm in a tertiary care centre to identify the common agents used for poisoning in our area, to know the common clinical features and the outcome of such cases. Of the 200 patients observed, there were 114(57%) males and 86(43%) females. In the study group, 53 (13males, 40females) patients were adolescents, 85 (60 males, 25 females) were young, 29(16males, 13 females) were middle aged and 33 (25males, 8females) were elderly. The pesticide group which included organophosphates, organochlorines, carbamates and pyrethroids constituted commonest substance used as poisoning agent (39%,n= 78) followed by plant poisons (28%,n=55 ) which included yellow oleander, oduku leaves and abrus precatorius. Rodenticides (10%, n=20), benzodiazapines (6%, n=11), kerosene (5%, n==9) and paracetamol (3%, n==6) were the other common exposure. Various drug combinations, copper sulphate, sulphuric acid, formic acid, fabric whitner, weedicides and homeopathic medications constitutes 11% (n==21) of cases. Mortality of study population was 6% (n==12, 11 men and 1 woman). Four patients expired after organophosphorus poisoning, four with carbamate poisoning, two with oduku, one each with rodenticide and yellow oleander poisoning. Pesticides and plant poisons are the common agents used for deliberate self harm in our study. Adoloscent and young persons are commonly involved in suicide attempts. Pesticides cause majority of deaths while plant and rodenticide poisonings can also be fatal.},
 year = {2015}
}

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TY  - JOUR
T1  - Clinical Profile and Outcome of Deliberate Self Poisoning Cases in Medical Wards
AU  - Indira Madhavan
AU  - Santhosh L. K.
AU  - Vinu Thomas
Y1  - 2015/10/23
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.s.2015030601.12
DO  - 10.11648/j.ajim.s.2015030601.12
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 5
EP  - 9
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.s.2015030601.12
AB  - Non-fatal deliberate self-harm (DSH) and suicides are serious global health problems in many low- and middle-income countries including India. We conducted a cross sectional observational study in patients admitted with deliberate self harm in a tertiary care centre to identify the common agents used for poisoning in our area, to know the common clinical features and the outcome of such cases. Of the 200 patients observed, there were 114(57%) males and 86(43%) females. In the study group, 53 (13males, 40females) patients were adolescents, 85 (60 males, 25 females) were young, 29(16males, 13 females) were middle aged and 33 (25males, 8females) were elderly. The pesticide group which included organophosphates, organochlorines, carbamates and pyrethroids constituted commonest substance used as poisoning agent (39%,n= 78) followed by plant poisons (28%,n=55 ) which included yellow oleander, oduku leaves and abrus precatorius. Rodenticides (10%, n=20), benzodiazapines (6%, n=11), kerosene (5%, n==9) and paracetamol (3%, n==6) were the other common exposure. Various drug combinations, copper sulphate, sulphuric acid, formic acid, fabric whitner, weedicides and homeopathic medications constitutes 11% (n==21) of cases. Mortality of study population was 6% (n==12, 11 men and 1 woman). Four patients expired after organophosphorus poisoning, four with carbamate poisoning, two with oduku, one each with rodenticide and yellow oleander poisoning. Pesticides and plant poisons are the common agents used for deliberate self harm in our study. Adoloscent and young persons are commonly involved in suicide attempts. Pesticides cause majority of deaths while plant and rodenticide poisonings can also be fatal.
VL  - 3
IS  - 6-1
ER  -

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