Trends of poisoning cases in Melmaruvathur region of Tamil Nadu: A retrospective study of 3 years

Trends of poisoning cases in Melmaruvathur

International Archives of Integrated Medicine, Vol.

Copy right © 2014, IAIM, All Rights Reserved.

Original Research Article


region of Tamil Nadu: A retrospective study

O. Gambhir Singh1Associate Professor, Forensic Medicine Department,

2Professor and Head, Forensic Medicine Department,

*Corresponding author email:

How to cite this article: O. Gambhir Singh,

region of Tamil Nadu: A retrospective study of 3 years

Available online at

Received on: 21-11-2014

Abstract

Background: Poisoning cases is a significant contributor to mortality and morbidity all over the

world. Acute poisoning cases form one of the commonest causes of emergency hospital admissions.

Material and methods: It is a retrospective study of 106 poisoning cases admitted in M.A.P.I.M.S.,

which is a tertiary health care centre

Results: The incidence of poisoning

poison was insecticide/ rodenticide and cases were mostly suicidal in nature.

Conclusion: Trends of poisoning cases in

similar to other parts of India.

Key words

Poisoning, Insecticides, Yellow o

Introduction

Poisoning cases is a significant contributor to

mortality and morbidity all over the world.

Acute poisoning cases form one of the

commonest causes of emergency hospital

admissions. Pattern of poisoning in a reason

depends on variety of factors, such as

availability of poisons, socioeconomic status of

poisoning cases in Melmaruvathur

International Archives of Integrated Medicine, Vol. 1, Issue. 4, December, 2014.




of 3 years

O. Gambhir Singh1*

, A. M. Singh2

Forensic Medicine Department, S.R.M. Medical College, Tamil

Forensic Medicine Department, M.A.P.I.M.S., Tamil Nadu

*Corresponding author email: [email protected]

O. Gambhir Singh, A. M. Singh. Trends of poisoning cases in Melmaruvathur

retrospective study of 3 years. IAIM, 2014; 1(4): 27-31.

Available online at www.iaimjournal.com

2014 Accepted on:

Poisoning cases is a significant contributor to mortality and morbidity all over the

form one of the commonest causes of emergency hospital admissions.

It is a retrospective study of 106 poisoning cases admitted in M.A.P.I.M.S.,

which is a tertiary health care centre in Tamil Nadu, India from January 2010 to December 2012.

of poisoning was highest in the age range from 20-50 y

poison was insecticide/ rodenticide and cases were mostly suicidal in nature.

Trends of poisoning cases in Melmaruvathur region of Tamil Nadu

oleander, Suicide, Homicide.

Poisoning cases is a significant contributor to

mortality and morbidity all over the world.

Acute poisoning cases form one of the

commonest causes of emergency hospital

admissions. Pattern of poisoning in a reason

depends on variety of factors, such as

ilability of poisons, socioeconomic status of

population, religious and cultural influence and

availability of poisons. It has been estimated

that about 5-6 persons per lakh of population

die due to poisoning every

commonest poisoning in Indi

developing countries is due to pesticides, the

reasons being agriculture based economy,

poverty and easy availability of highly toxic

pesticides. The present study was conducted

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Page 27



S.R.M. Medical College, Tamil Nadu, India

M.A.P.I.M.S., Tamil Nadu, India

[email protected]


Accepted on: 27-11-2014

Poisoning cases is a significant contributor to mortality and morbidity all over the

form one of the commonest causes of emergency hospital admissions.

It is a retrospective study of 106 poisoning cases admitted in M.A.P.I.M.S.,

from January 2010 to December 2012.

years. Most common

f Tamil Nadu are more or less

population, religious and cultural influence and

availability of poisons. It has been estimated

6 persons per lakh of population

die due to poisoning every year [1]. The

commonest poisoning in India and other

developing countries is due to pesticides, the

reasons being agriculture based economy,

poverty and easy availability of highly toxic

pesticides. The present study was conducted




retrospectively to know the pattern of poisoning

cases in the region.

Material and methods

The present study was conducted

retrospectively in the tertiary health care centre

of MAPIMS, Melmaruvathur, Tami

the period of January 2010 to December

We selected 106 cases of poisoning for the

present study. All relevant information like

name, age, sex, religion, marital status,

education, profession, type of poison, manner of

poisoning, survival period, etc. we

from the available hospital case sheets and they

were tabulated for easy study and comp

with the works of other authors.

Observation

The incidence of poisoning wa

constitute about 11.6% of all medico

registered during the study period. The

incidence was highest in the age range from 20

50 years, with mean value of 35

outnumbered males with a sex ratio of 1: 1.3

(male: female). Age and sex wise distribution of

cases were as per Table - 1.

Male or female, the incidence was high in

married persons as per Table

cases were mostly suicidal in nature, seen in 74

cases (69.8%). There were two cases of

homicidal poisoning in one incident involving

two small children, the accused being mother of

the two children. There was not a single case of

homicidal poisoning in adults as per

Type of poison used was as per

of the patient died within the first 24

admission. In one case of alleged history of

rodenticide (Zinc phosphide) poisoning

patient expired on the 9th

day as per




retrospectively to know the pattern of poisoning

The present study was conducted

retrospectively in the tertiary health care centre

of MAPIMS, Melmaruvathur, Tamil Nadu during

the period of January 2010 to December 2012.

We selected 106 cases of poisoning for the

All relevant information like

name, age, sex, religion, marital status,

education, profession, type of poison, manner of

isoning, survival period, etc. were collected

hospital case sheets and they

re tabulated for easy study and comparison

with the works of other authors.

oning was high which

constitute about 11.6% of all medico-legal cases

registered during the study period. The

incidence was highest in the age range from 20-

lue of 35 years. Females

outnumbered males with a sex ratio of 1: 1.3

ex wise distribution of

Male or female, the incidence was high in

Table - 2. Poisoning

suicidal in nature, seen in 74

(69.8%). There were two cases of

homicidal poisoning in one incident involving

two small children, the accused being mother of

the two children. There was not a single case of

as per Table - 3.

per Table - 4. Most

of the patient died within the first 24 hours of

admission. In one case of alleged history of

rodenticide (Zinc phosphide) poisoning, the

as per Table - 5.

Discussion

In the present study, the incidence of poisoning

was 11.6% of all medico-legal cases.

there was some up and down, in average we can

say that the incidence does not

time. This finding was consistent with the works

of other authors [2, 3, 4].

poisoning in the individuals of younger age

group of 21-40 years can be explained by the

fact that this age group people are more

exposed to stress of life like family problems,

failure to get job, failure in love or exams, etc.

Our finding was also consistent with the studies

done by various authors [2, 3, 5]. Unlike the

studies conducted by other authors [6,

present study observed the higher incidence of

poisoning in female population.

Most of the studies including the

showed that majority of cases were suicidal in

nature, seen in 74 cases (69.8%) foll

cases of unknown manner, seen in

(16%). Similar findings were also reported by

other studies done by

Aggarwal BBL [5], Gargi J, et al

VP [10].

Most commonly encountered poisons we

insecticides including rodenticides, seen in 65

cases (61.5%). It may be due to their easy

availability in most of the family as it governs

village areas where agriculture is the main

occupation. Insecticides are also easily

purchasable from the market. It is also

consistent with the works of other authors.

Unlike other studies in the present study

were good numbers of cases of Yellow

seed poisoning. In south India

Yellow oleander seed poisoning is comparatively

high. Most of the deaths occurred within the

first 12-24 hours. Survival chance will be more if

the patient is brought within the fatal period of

the poison. The similar observation was also

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Page 28

, the incidence of poisoning

legal cases. Though

there was some up and down, in average we can

say that the incidence does not recede with

s consistent with the works

Higher incidence of

poisoning in the individuals of younger age

rs can be explained by the

fact that this age group people are more

exposed to stress of life like family problems,

failure to get job, failure in love or exams, etc.

s also consistent with the studies

done by various authors [2, 3, 5]. Unlike the

studies conducted by other authors [6, 7, 8], the

the higher incidence of

poisoning in female population.

Most of the studies including the present study

that majority of cases were suicidal in

cases (69.8%) followed by

cases of unknown manner, seen in 17 cases

(16%). Similar findings were also reported by

other studies done by Aggarwal NK and

et al. [9] and Shingh

t commonly encountered poisons were

insecticides including rodenticides, seen in 65

cases (61.5%). It may be due to their easy

availability in most of the family as it governs

village areas where agriculture is the main

occupation. Insecticides are also easily

purchasable from the market. It is also

consistent with the works of other authors.

Unlike other studies in the present study, there

were good numbers of cases of Yellow oleander

seed poisoning. In south India, incidence of

leander seed poisoning is comparatively

high. Most of the deaths occurred within the

24 hours. Survival chance will be more if

the patient is brought within the fatal period of

the poison. The similar observation was also




pointed out by Gupta, et al. [11] and Dhaval J.

Patel and Pawan R. Tekade [12].

Conclusion

Trends of poisoning cases in

region of Tamil Nadu are more or less similar to

other parts of India.

References

1. Reddy KSN. The Essentials of Foren

Medicine and Toxicology, 29

Saguna Devi, Hyderabad, 2010;

2. Gupta BD, Vaghela PC. Profile of fatal

poisoning in and around Jamnagar

JIAFM, 2005; 27(3): 145-

3. Das RK. Epidemiology of insecticide

poisoning at AIIMS emergency services

and role of its detection by Gas liq

chromatography in diagnosis.

legal update, 2007; 7(2): 7

4. Dhattarwal SK, Dalal SS. Profile of

Deaths Due to Poisoning in Roh

Haryana. JFMT, 1995; 14(1): 51.

5. Aggarwal NK, Aggarwal BBL.

poisoning in Delhi. JIAFM, 1998; 20(2):

32-36.

6. Sanjeev Kumar, Akhilesh Pathak, H. M.

Mangal. Trends of Fatal Poisoning In

Saurashtra Region of Gujarat. (A




. [11] and Dhaval J.

Pawan R. Tekade [12].

Melmaruvathur

are more or less similar to

The Essentials of Forensic

cine and Toxicology, 29th

edition, K.

Saguna Devi, Hyderabad, 2010; p. 449.

Gupta BD, Vaghela PC. Profile of fatal

poisoning in and around Jamnagar.

-48.

Das RK. Epidemiology of insecticide

poisoning at AIIMS emergency services

role of its detection by Gas liquid

chromatography in diagnosis. Medico-

2007; 7(2): 7-12.

Dhattarwal SK, Dalal SS. Profile of

Deaths Due to Poisoning in Rohtak,

JFMT, 1995; 14(1): 51.

Aggarwal NK, Aggarwal BBL. Trends of

JIAFM, 1998; 20(2):

Sanjeev Kumar, Akhilesh Pathak, H. M.

Mangal. Trends of Fatal Poisoning In

Saurashtra Region of Gujarat. (A

Prospective Study). JIAFM, 2011; 33(3):

197-199.

7. Sharma BR, Dasari H, Sharma V, Vij K.

The epidemiology of p

Indian view point. JFMT, 2000; 19(2): 5

11.

8. Dhattarwal SK, Singh H. Profile of death

due to poisoning in Rohtak, Haryana

JFMT, 2001; 18(2): 28

9. Gargi J, Rai H, Chanana A, Raj G, Sharma

G, Bagga IJS. Current Trends of

Poisoning - A Hospit

2003; 3: 41-45.

10. B. Maharani, N. Vijayakumari. Profile of

poisoning cases in a Tertiary care

Hospital, Tamil Nadu, India. Journal of

Applied Pharmaceutical Science, 2013;

3(1): 91-94.

11. Gupta, et al. Organophosphorus

poisoning-facts and mi

update, 1999; 1345-

12. Dhaval J. Patel, Pawan R. Tekade. Profile

of Organophosphorus Poisoning at

Maharani Hospital, Jagdalpur,

Chhattisgarh: A Three Years Study.

JIAFM, 2011; 33(2): 102

Source of support: Nil

Conflict of interest: None declared.

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Page 29

Prospective Study). JIAFM, 2011; 33(3):

Sharma BR, Dasari H, Sharma V, Vij K.

The epidemiology of poisoning - An

JFMT, 2000; 19(2): 5-

Dhattarwal SK, Singh H. Profile of death

due to poisoning in Rohtak, Haryana.

JFMT, 2001; 18(2): 28-29.

Gargi J, Rai H, Chanana A, Raj G, Sharma

G, Bagga IJS. Current Trends of

A Hospital Profile. JPAFMT,

B. Maharani, N. Vijayakumari. Profile of

poisoning cases in a Tertiary care

Hospital, Tamil Nadu, India. Journal of

Applied Pharmaceutical Science, 2013;

Gupta, et al. Organophosphorus

facts and mights. Medicine

-48.

Dhaval J. Patel, Pawan R. Tekade. Profile

of Organophosphorus Poisoning at

Maharani Hospital, Jagdalpur,

Chhattisgarh: A Three Years Study.

JIAFM, 2011; 33(2): 102-105.

Nil

None declared.




Table – 1: Age and gender wise d

Age in years Male (%)

0-10 0 (0%)

11-20 5 (4.7%)

21-30 10 (9.4%)

31-40 15 (14.2%)

41-50 11 (10.4%)

51-60 4 (3.8%)

61-70 1 (0.9%)

Above 70 1 (0.9%)

Total 50 (47.2%)

Table – 2: Cases distribution according to marital s

Marital status Male (%)

Married 27 (25.5%)

Unmarried 19 (17.9%)

Divorced 1 (0.9%)

Total 47 (44.3%)

Table – 3: Distribution according to manner of c

Manner Male (%)

Unknown 6 (5.7)

Suicidal 36 (34%)

Accidental 5 (4.7%)

Homicidal 0 (0%)

Total 47 (44.3%)

Table – 4: Distribution according to type of p

Type of poison Male (%)

Unknown 13 (12.3%)

Insecticide/ Rodenticide 29 (27.4%)

Phenyl/ Cleaning agent 2 (1.2%)

Yellow oleander 2 (1.2%)

Others 1 (0.9%)

Total 47 (44.3%)




gender wise distribution of cases.

Male (%) Female (%) Total (%)

2 (1.2%) 2 (1.2%)

5 (4.7%) 10 (9.4%) 15 (14.1%)

(9.4%) 16 (15.1%) 26 (24.5 %)

15 (14.2%) 12 (11.3%) 27 (25.5%)

11 (10.4%) 14 (13.2%) 25 (23.6%)

4 (3.8%) 3 (2.8%) 7 (6.6%)

1 (0.9%) 2 (1.2%) 3 (2.8%)

1 (0.9%) 0 (0%) 1 (0.9%)

50 (47.2%) 56 (52.8%) 106 (100%)

Cases distribution according to marital status.


27 (25.5%) 33 (31.1%) 60 (56.6%)

19 (17.9%) 21 (19.8%) 40 (37.7%)

1 (0.9%) 5 (4.7%) 6 (5.7%)

47 (44.3%) 59 (55.7%) 106 (100%)

Distribution according to manner of consumption.


11 (10.4%) 17 (16%)

36 (34%) 38 (35.8%) 74 (69.8%)

5 (4.7%) 8 (7.5%) 13 (12.3%)

2 (1.2%) 2 (1.2%)

47 (44.3%) 59 (55.7%) 106 (100%)

Distribution according to type of poison.


13 (12.3%) 7 (6.6%) 20 (18.9%)

29 (27.4%) 36 (34%) 65 (61.3%)

2 (1.2%) 5 (4.7%) 7 (6.6%)

2 (1.2%) 9 (8.5%) 11 (10.4%)

1 (0.9%) 2 (1.2%) 3 (2.8%)

47 (44.3%) 59 (55.7) 100 (100%)

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Total (%)

2 (1.2%)

15 (14.1%)

26 (24.5 %)

27 (25.5%)

25 (23.6%)

7 (6.6%)

(2.8%)

(0.9%)

106 (100%)

Total (%)

60 (56.6%)

40 (37.7%)

6 (5.7%)

(100%)

Total (%)

17 (16%)

74 (69.8%)

13 (12.3%)

(1.2%)

106 (100%)

Total (%)

20 (18.9%)

65 (61.3%)

7 (6.6%)

11 (10.4%)

3 (2.8%)

100 (100%)




Table – 5: Cases distribution according to survival p

Survival period Male (%)

0-12 hours 15 (14.1%)

12-24 hours 23 (21.7%)

24-48 hours 5 (4.7%)

3-7days 3 (2.8%)

More than 7 days 1 (0.9%)

Total 47 (44.3%)




Cases distribution according to survival period.


15 (14.1%) 21 (19.8%) 36 (34%)

23 (21.7%) 29 (27.4%) 52 (49%)

5 (4.7%) 7 (6.6%) 12 (11.3%)

3 (2.8%) 1 (0.9%) 4 (3.8%)

1 (0.9%) 1 (0.9%) 2 (1.9%)

47 (44.3%) 59 (55.7%) 100 (100%)

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Total (%)

36 (34%)

52 (49%)

12 (11.3%)

4 (3.8%)

2 (1.9%)

100 (100%)

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Trends of poisoning cases in Melmaruvathur region of Tamil Nadu: A retrospective study of 3 years