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Background: The pattern of poisoning has a regional variability. This study was carried out to describe the epidemiological profile of acute poisoning in northeastern Bangladesh and to evaluate the mortality. Methods: In this retrospective cross-sectional study, medical records of poisoned patients treated at department of medicine of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet, Bangladesh during 1st January 2008 to 31st December 2011 were reviewed. Patients aged 10 years and above with diagnosis of acute poisoning were included. Data collected were gender, age, place of residence, type of poison and intention of poisoning. Results: A total of 4435 (58.7% men) were included. Patients aged 21 to 30 years were the most common age group involved with poisoning (41.6%). The majority of patients (55.4%) lived in rural areas. Commuter poisoning (43.3%) was the most frequently occurring type of poisoning in both men and women in all 4 years followed by OP poisoning (25.7%). Men were found to be significantly more affected in commuter, organophosphate and alcohol poisoning (P < 0.001). Intention of poisoning in the greatest number of patients (54.5%) was suicidal followed by 1919 patients (43.3%) who were poisoned by homicidal/stupefying intents. Among the homicidal cases, men were significantly more victimized (67% vs. 33%, P < 0.001). Overall, 224 patients (5.1%) died. The highest number of deaths was due to OP poisoning (46.9%) followed by commuter poisoning (45.5%). Case fatality rate was the highest in the snakebite victims (23.3%) followed by alcohol poisoning (11.4%). Conclusion: Commuter or travel-related poisoning is an emerging public health threat in this part of Bangladesh. Public awareness should be raised and school-based educational programs should be emphasized regarding the commuter poisoning and the consequence of accepting and eating food from strangers. [ABSTRACT FROM AUTHOR]

Background: Organophosphate (OP) poisoning is the most common cause (27.64%) and has the highest death rate (13.88%) of poisoning in Bangladesh. It leads to three main syndromes notably acute cholinergic syndrome, intermediate syndrome, and delayed polyneuropathy. It rarely causes cardiac arrhythmia, pancreatitis and hepatic dysfunction. We present the case of a middle-aged Asian woman suffering from organophosphate poisoning with dual complications. Case presentation: A middle aged Asian woman with depression was brought to emergency attention after drinking of 60 milliliter of organophosphate insecticide in a suicidal attempt. She had vomiting, excessive retching, diarrhoea, miosis, hypersalivation and bilateral crepitation on chest during admission. After immediate resuscitation, atropinization was done and it required total of 36 milligram. The patient also received pralidoxime. While on maintenance, features of toxicity re-appeared and she again required atropine in bolus dose. On the fifth day of management she complained of generalized weakness, inability to control her neck and to sit or stand without support. But there was no respiratory muscle involvement and all deep tendon reflexes were normal. On the same day the patient also developed severe upper abdominal pain along with nausea and vomiting. Investigations revealed neutrophilic leucocytosis (30,000/cubic millimeter; 86%) with high serum lipase (770 Unit/Liter) and alanine transaminase (379 Unit/Liter) and low serum potassium (3.0 millimol/Liter). On the basis of above mentioned features organophosphate induced intermediate syndrome and pancreatitis was diagnosed. The patient recovered completely with appropriate management. Conclusion: Organophosphate poisonings causes up to 25% mortality worldwide. A major contributing factor for that are different complications. Awareness of these complications can reduce both mortality and morbidity. Early diagnosis of complications and timely therapeutic measures can improve prognosis. [ABSTRACT FROM AUTHOR]