International Journal of Medical and Health Research

International Journal of Medical and Health Research


(MCI Approved Journal)

ISSN: 2454-9142

Vol. 4, Issue 9 (2018)

A prospective study of the salient features of Aluminium phosphide poisoning from northern part of India

Author(s): Dr. Rakesh Kumar, Onkar Nath Rai, P Nigam
Abstract:
Background: Aluminium Phosphide (AlP) poisoning is extremely lethal poisoning. Ingestion is usually suicidal in intention. Phosphine, which is liberated when AlP comes in contact with moisture, is injurious and effect the cellular respiration there by it became lethal. Absence of specific antidote results in high mortality.
Aims and objectives: To study the salient features and ways to combat the deleterious effect of poisoning.
Material and Methods: One hundred and twelve cases of proved AlP poisoning by AgNO3 Test constituted the clinical material. Each and every patient and /or relatives, friends were interrogated regarding amount of exposed or unexposed poison taken, when taken and the time when symptoms started appearing after ingestion of poison. They were submitted to relevant investigations to assess the severity of poisoning, hepato - renal and cardio respiratory status.
Results: The overall incidence of all type of poisoning was 0.29% i.e. 200 cases of poisoning out of total admission 67189. Amongst these 200 cases there was 112 cases (56%) of AlP poisoning. They were mainly from 3rd decade of life (mean age was 22.45± 5.3 years) with male to female ratio of 2.7: 1. 73.2%. Maximum were from rural area and mostly were educated from high school to Graduate level (85 cases or 75.6%). Main causes were set-back in life, unemployment, home conflicts etc. Presenting symptoms reflect the irritation of the mucous membrane of GIT, presented with nausea, vomiting (100%) increased thirst (71.1%), pain in abdomen (42.8%) with altered bowel habits, respiratory distress (23.2%) altered consciousness, dizziness (33.9%) and Cardio Vascular abnormalities (53.5%) in the form of tachycardia profound shock. Laboratory findings reflect the severity and prognosis of poisoning. Leucopenia was reported in 4.4% cases, two to three fold increase in serum transaminases (22.3%), hyper bilirubinemia (5.3%) and raised level of blood urea and serum creatinine in 32.1 of cases, hypomagnesemea was present in 16.18% of cases. Mortality in present study was 42.8%.
Conclusion: Good prognosis depends on the earliest the hospitalization with effective measures taken to combat the shock and promote the rapid excretion of poison through urine and gastro intestinal tract.
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