Search

Background: Para-suicide by self-poisoning is a major public health concern throughout the world, especially in developing countries. It is a cause of considerable morbidity and mortality as well as consuming scarce medical resources which would have been used otherwise. The survival of such patients to a considerable extent depends on the competence of the attending doctors, nature of toxic agent consumed and the availability of specific antidote. Objective: The sole purpose of this study is to provide proper knowledge and awareness of health professionals on the common toxic agents used for self-poisoning. Material and methods: This prospective study was conducted by identifying and reviewing all self-poisoning cases that were presented at the emergency department of JNMCH, A.M.U Aligarh, over a span of 2 years. A total of 375 cases of self-poisoning were entered into the emergency department register, but only 315 files were considered for this study. Results: In this study majority patients belong to 15-24 years' age group i.e. 153(48.57%) with male dominance. The most ingested substance for non-fatal self-poisoning was a pharmaceutical drug 71(22.54%) followed by agrochemicals like rat poison 60 (19.05%), Aluminium phosphide 46(14.60%) and organophosphate 33(10.48%). There were significant (p<0.01) gender differences noted in type of substance used. Conclusion: Accessibility has been noted as a factor affecting the choice of drug used. Implementing the pesticide act strictly will allow the government to have control over the production, sale, distribution, storage, and use of pesticides. [ABSTRACT FROM AUTHOR]

Introduction: The WHO 2021 data estimate that 2 million lives and 53 million disability-adjusted life-years were lost in 2019 due to exposures to selected chemicals. It is important to know the pattern and outcome of acute poisoning cases for proper planning, prevention and management. Knowing the pattern will also help in designing training modules for primary care physicians to make them aware about newer poisons and their management. Awareness regarding newer poisons consumed is necessary for early identification, initial management and timely referral to higher centres by primary care physicians. This study was performed to see the pattern and outcome of acute poisoning cases in North Indian population and various factors related to outcome. Materials and Methods: This study was conducted in department of medicine of a teaching institute in North India after approval by the Institutional Review Board. Patients admitted in the department during the study and fulfilling the inclusion criteria were enrolled in the study after obtaining consent. Results: A total of 417 patients with poisoning were recruited in the study. Out of 417 patients, majority were males (59.5%). Maximum number of patients were in the age group of 21-30 years (33.8%), and rural population (79.9%) was found to be more affected. Most of the patients were students and private employees. Most common types of poisoning were snakebite (n = 109, 26.1%), organophosphate (n = 49, 11.8%) and aluminium phosphide (n = 39, 9.3%). Out of 417 patients, 349 (83.69%) improved, while 68 (16.3%) expired. Requirement of ventilatory support was most commonly associated with aluminium phosphide poisoning (30.12%) followed by organophosphate poisoning (24.1%). Conclusion: Poisoning was more common in young males and more prevalent in rural population. Pesticides and snakebite were major causes of poisoning. Among suicidal cases, family conflict (problem/altercation with family members/marital discord) was main reason for the consumption of poison. There is need for creation of poison information centre along with separate toxicological units in tertiary care hospitals. [ABSTRACT FROM AUTHOR]

Phosphine, as per several reports, is considered to be an ideal and effective alternative to methyl bromide (MB) fumigant, phased out globally honouring 'Montreal Protocol'. The food grains fumigated with phosphine are perceived to be residue-free; however, estimation of its residues is imperative. In the present study, the phosphine residues were estimated in grains of wheat, rice, green gram, chickpea and yellow pea fumigated with different formulations of phosphine under 7 and 10 days exposure periods at various locations in India. For efficacy studies, the conventional aluminium phosphide (AlP) tablet (56% @2 and 3 tablet/MT) and granular AlP (77.5% @1.0 and 1.5 g phosphine/m3) formulations were applied. Each treatment including untreated control was replicated thrice. The concentration was monitored every 24 h until the end of exposure periods. Food grain samples were drawn before and post fumigation following a certain waiting period for estimation of phosphine residues using gas chromatography equipped with FPD detector. Residues in fumigated food grains were observed in traces in all the experimental stacks, but below the MRL (0.1 ppm), fixed by Codex Alimentarius Commission (CAC). Phosphine can be considered safe for use as an alternate fumigant in quarantine and long-term storage of food grains leaving residues below MRL. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The prognosis of acute aluminum phosphide poisoning is usually based on toxidrome features, with little focus on poison-related factors. We aimed to study the prognostic significance of poison-related factors, consumption patterns, and time delays to treatment. METHODS: We performed a prospective cohort study in an academic hospital in North India in patients aged = 13 with aluminum phosphide poisoning from July 2019 to December 2020. During data collection, a particular emphasis was made on the poison formulation, the ingested dose, the reconstitution of poison, vomiting, and time intervals to initiate various treatments. The primary outcome was inhospital mortality. RESULTS: Fifty-eight patients were enrolled (median age, 32 years; 37 males). The mean dose of the ingested poison was 6.56 (±5.42) g. The predominant formulation of poison was pellet (n = 41), followed by powder (n = 16). Twenty patients performed reconstitution of poison before consumption, and 13 stirred the poison while reconstituting. All patients but three developed vomiting after consumption. Inhospital mortality (n = 23, 39%) was significantly high with a higher ingested dose (P < 0.001), nonstirred reconstitution before consumption (P = 0.042), fewer vomiting episodes (P = 0.010), a delay in detection of the victim by someone (P = 0.001), and delayed initiation of intravenous fluids (P = 0.043). The secondary outcomes (shock and requirement of vasopressor or ventilation) remained unaffected by the stirring in the reconstitution group. CONCLUSIONS: Poison-related factors and time intervals determine early risk stratification at admission in aluminum phosphide poisoning. [ABSTRACT FROM AUTHOR]

Poisoning is a very common way to commit suicide. It is more common in low- and middle-income countries. Aluminium phosphide is a very commonly available pesticide in such countries including India. Aluminium phosphide is a very toxic compound. Ingestion of aluminium phosphide can cause severe toxicity to various cells, and mortality is very high. We are presenting a case of rare survival of acute aluminium phosphide poisoning, who presented with signs and symptoms of severe toxicity including metabolic acidosis and shock. During hospitalisation, he developed ventricular tachycardia, acute kidney, and liver failure. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Evaluating local trends and continued monitoring of patterns of acute poisoning are essential for prompt recognition of the toxidromes, the establishment of immediate treatment facilities (e.g., antidote availability), and effective preventive strategies (e.g., governmental regulation on hazardous substances marketing). We aimed to describe the prevalence of the various types of poisoning and associated case fatality in our academic hospital in North India. METHODS: A prospective observational descriptive study was conducted, enrolling patients aged ≥13 years with acute poisoning for 17 months from December 2016 to December 2017 and from September 2019 to December 2019, for a total of 17 months. RESULTS: Four hundred and two patients were enrolled (median age 28 years; 63.2% males). Majority of the acute poisoning cases resulted from ingestion (n = 391, 97.3%) and the primary intention was most commonly self-harm (n = 314, 78.1%). The major types of poisoning were pesticide (n = 264, 65.7%), drug overdose (n = 77, 19.2%), and corrosive ingestion (n = 31, 7.7%). Pesticides included insecticides (n = 146, 36.3%; cholinesterase inhibitors, n = 91), fungicides (n = 76, 18.9%; all aluminum phosphide), herbicides (n = 22, 5.5%; paraquat, n = 19), and rodenticides (n = 20, 5.0%; coumarin-derived substances, n = 12). Benzodiazepines (n = 33) and opioids (n = 25) were frequent causes of drug overdose. 95.3% (n = 379) received preliminary treatment at the previous health-care center, including gastric lavage (n = 239) and antidotes (n = 73). In-hospital case fatality rate was 17.3% (n = 58). CONCLUSION: Herbicide ingestion and opioid overdose are emerging threats with a gradual decline in organophosphate and aluminum phosphide poisoning. Despite improving management of acute poisoning, the overall case fatality rate remains substantial. [ABSTRACT FROM AUTHOR]

Introduction. Aluminum phosphide (rice tablet) was first introduced as a pesticide in India. Rice tablets are commonly used in Iran due to their high efficacy against rodents and insects, low cost, and availability. Aluminum phosphide is a lethal poison without antidote and causes cardiocirculatory collapse and has negative inotropic cardiac effect. Human and animal studies showed that high dose insulin had positive cardiac inotropic effects. GIK (glucose, insulin, and potassium) assists heart uptake of carbohydrates that are the major fuel substrate of the myocard muscle under stressed conditions and leading to correction of acidosis, increased myocardial contractility, and peripheral vascular resistance. Case Presentation. In this manuscript, a young woman with aluminum phosphide poisoning was described to have presented with hypotension, hypoxemia, and severe metabolic acidosis. In contrast to our previous experiences that approximately all rice tablet poisoning patients with shock were dead despite full conservative treatment, this patient miraculously was saved with high dose intravenous regular insulin infusion and was discharged from the hospital with good condition and without any complications. Conclusion. Rice tablet poisoning has high fatality rate, and to date, no antidote is available. GIK is suggested as a potential life saving treatment for critical rice tablet poisoning patients with symptoms and signs of shock. [ABSTRACT FROM AUTHOR]

Background: Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years.Methods: We performed a systematic literature review in Medline, Embase and Google Scholar (1999-2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study.Results: We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999-2003), the number of deaths declining thereafter (to n = 1714 in 2014-2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths.Conclusion: Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter's lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions. [ABSTRACT FROM AUTHOR]

Introduction: Acute aluminum phosphide poisoning is common in low- and middle-income countries, and is associated with very high case fatality. The addition of glucose-insulin-potassium (GIK) infusion to the standard supportive care has been proposed to improve outcomes. We aimed to assess the effectiveness of GIK infusion in acute aluminum phosphide toxicity. Methods: We performed a prospective open-label pilot study in a tertiary care hospital in north India in patients over 13 years of age with acute aluminum phosphide poisoning, to determine whether the treatment with GIK infusion improved outcomes. The primary outcome was in-hospital case fatality, and the secondary outcomes were the duration of hospital stay, the requirement of mechanical ventilation, and the change in hemodynamic and metabolic parameters. Results: A total of 60 patients were randomly assigned to groups that received either GIK infusion with supportive care or supportive care alone. Baseline parameters in both groups were comparable. Treatment with GIK infusion was associated with significantly lower in-hospital case fatality compared with supportive care alone (46.7% versus 73.3%; p-value 0.03). It was associated with a longer duration of hospital stay (p-value < 0.01) and reduced requirement of mechanical ventilation (p-value < 0.01). The treatment improved blood pressure (systolic, diastolic, and mean arterial pressure) and Glasgow coma scale score at various time intervals; however, pulse rate and metabolic acidosis (blood pH and bicarbonate levels) remained comparable in both the groups. Hyperglycemia was significantly higher in the GIK group but was easily managed. Conclusion: Treatment with GIK infusion may improve survival and hemodynamics in patients with acute aluminum phosphide poisoning. [ABSTRACT FROM AUTHOR]

Despite improved yield in the field, wheat (Triticum aestivum L.) at storage is heavily attacked by numerous pests. The loss assessment studies carried on wheat in 2014 and 2015 revealed that household storage practice suffered highest grain damage and weight loss due to storage pests. Healthy grains were highest in treated samples over untreated control samples at all storage locations. Highest pest incidence was observed in treated household samples over PAU and Moga outdoor storage, whereas there was no incidence found in Moga indoor storage. The population build up of Rhyzopertha dominica was highest in untreated control followed by T. castaneum, S. oryzae and C. cephalonica. Among various storage protection strategies used at storage levels, Moga (outdoor) storage registered a highest use of aluminium phosphide as fumigation practice followed by Rampuraphul (indoor), household storage, Moga (indoor) and PAU practice. At the end of investigation period, farmers and Food Corporation of India (FCI) were advised to follow PAU practice. [ABSTRACT FROM AUTHOR]

Introduction: Aluminum phosphide (AlP) ingestion for self-harm is associated with a high case-fatality rate (CFR) in low- and middle-income countries. A reliable and accurate prognostic scoring tool is required for appropriate triaging, to guide clinical decision-making, and to evaluate the efficacy of therapeutic interventions for the patients with AlP toxicity. Materials and methods: We performed a prospective cohort study in a tertiary care hospital in north India in patients aged 15 years and over with acute AlP poisoning, investigating the parameters associated with CFR, and developing a reliable and simple prediction score. Results: The CFR was 51% in this cohort of 105 patients. Three parameters--pH <7.25, score on Glasgow coma scale (GCS) <13, and systolic blood pressure (SBP) <87 mm Hg were most robust predictors of CFR (odds ratio; 12.614, 18.621, and 17.600, respectively; area under the receiver operating characteristic curve--0.808, 0.796, and 0.776, respectively). Based on these parameters (with 1 point to each), a prognostic score was developed, ranging from 0 to 3 points. A total score of 3 had a 98.2% specificity and a positive predictive value of 96.4%, whereas a score ≤1 had a 100% sensitivity and 100% negative predictive value. Conclusion: A scoring system based on low pH (P), low GCS score (G), and impaired or low SBP (I) ("PGI" score) may provide a simplified predictive model for mortality in AlP poisoning. [ABSTRACT FROM AUTHOR]

Objective: To study the pattern of poisoning in Visakhapatnam and its demographic correlates. Materials & method: The study was retrospectively conducted in all poisoning cases admitted in Casualty department of Anil Neerukonda Hospital, Visakhapatnam and carried out during the period of 1st Jan 2014 to 31st Dec 2017. Results: Majority (47.37%) of the subjects were between the ages of 20-29years with slight preponderance towards female (52.63%) as compared to male (47.37%). Most of the cases belonged to lower socioeconomic status (94.74%). Place of occurrence was most commonly within the house (85.97%) & it was predominantly observed during winter season. Aluminum phosphide (21.05%) was the most commonly abused substance followed by Organophosphate compounds (14.04%). Conclusion: The government should take legislative steps to curb down the menace of poison in the hands of the vulnerable people in the society primarily focusing on developing the poisons with less toxicity or non-toxic to humans. [ABSTRACT FROM AUTHOR]

Background: N-acetyl cysteine (NAC) is a powerful antioxidant and has been used extensively in the treatment of paracetamol overdose with great success. Aluminum phosphide (ALP) ingestion results in significant oxidative stress. In this study, we evaluated the effects of NAC on mortality in patients with severe ALP poisoning. Subjects and Methods: This prospective intervention study was carried out in the emergency medical unit attached to the Nehru Hospital at PGIMER, Chandigarh, over a period of 1 year. All the patients presenting with severe ALP poisoning were randomized into two group. The treatment group received NAC in the dose of 150 mg/kg intravenous over 1 h, followed by 50 mg/kg over 4 h, followed by 100 mg/kg 16 h in 5% dextrose. The placebo group received 5% dextrose. The primary end point was mortality. Results: A total of 50 patients were recruited. The baseline parameters were comparable in both groups. The survivors in the treatment group received 19 g of NAC, but the nonsurvivors received only 12.15 g of NAC. The overall mortality in the study group was 88% with 87.5% mortality in the treatment group and 88.5% in the placebo group. Conclusions: Antioxidant therapy in the form of NAC in severe ALP poisoning did not confer any survival benefit. [ABSTRACT FROM AUTHOR]

Background: Suicide by poisoning is the second most common cause of death by suicide (27.9%) as per The National Crime Records Bureau (NCRB) India in 2015. Aluminum phosphide (ALP) is the leading agricultural poison used to commit suicide as where its availability is not properly regulated. ALP is a highly toxic solid fumigant pesticide, rodenticide and insecticide. Case presentation: A 40-year-old woman was brought by the police to the emergency section. Her extremities were cold and hypotonic, and her skin was pale. Patient’s vitals were unstable with pulse rate 112/minute irregularities, blood pressure 68/54 mm of Hg, respiratory rate 22/minute shallow and body temperature 30.1 ºC and characteristicly strong garlicky odor on her breath. During the suction of gastric contents, spontaneous ignition of gas with flames and white fumes with sound like a blast was observed by resident doctors and para-clinical staff. Gastric aspirate along with Ryle’s tube were immediately sent to the forensic department where the Silver Nitrate test was performed and it was found strongly positive for phosphine gas. Discussion: Aluminum phosphide readily reacts with water and hydrochloric acid in the stomach to produce phosphine (hydrogen phosphide, PH3) and a small amount of diphosphine. Conclusion: The present case report stresses on the need that the emergency physicians need to be highly alert and adequately prepared while handling such patients. Spontaneous ignition with the release of phosphine from ALP poisoned patients can not only affect the patient, but also pose a health hazard to emergency physicians and medical staff. [ABSTRACT FROM AUTHOR]

The article examines the spectrum of acute poisoning in a tertiary care hospital located in the northern region of India. Incidence of poisoning was found to be more in men as compared with women. The authors concluded that organophosphorous is a common type of poisoning and aluminum phosphide resulted in most of the deaths.

Context: Aluminum phosphide (ALP) is a highly toxic agricultural fumigant pesticide commonly implicated in poisoning. Aim: The aim of the study was to study the profile of patients presenting with ALP poisoning in Dr. RPGMC Kangra, Tanda, Himachal Pradesh. Settings and Design: This was a retrospective study conducted in the Department of Medicine at Dr. RPGMC Kangra, Tanda, Himachal Pradesh, from August 2011 to January 2014. Material and Methods: Case record forms of 117 patients were reviewed and analyzed. Data were collected for sociodemographic and clinical parameters. Outcome of patients was recorded as expired and improved. All the patients were managed symptomatically. Statistical Analysis: Statistical analysis was performed using SPSS version 15. P < 0.05 was considered statistically significant. Results: Out of the total 117 patients included in the study, 61 (52.1%) were males and 56 (47.1%) were females. Mean age ± standard deviation of presentation was 30.9 ± 12.2 years. About 70% of the patients were from rural background. Out of the total 117 patients, 68 (58.1%) patients had expired and 49 (41.9%) had improved. Most of the patients in the expired group consumed ALP in tablet form (54.7% of the total). Nearly 57% of the patients had leukocytosis at presentation and <5% had leukopenia. The mean pulse rate and mean systolic blood pressure in the expired group were 116.24 ± 14.3 per minute and 89.9 ± 16.83 mmHg which was statistically significant. The mean change in creatinine value (ΔCr) in the expired group was 1.03 ± 0.36 which was statistically significant. Conclusions: The prognosis of the patients can be anticipated on assessing the cardiac status and mean change in creatinine value (ΔCr) at the time of admission. [ABSTRACT FROM AUTHOR]

Background: Poisoning is an important cause of unnatural death, next to road traffic accidents in India even today. Incidence of aluminium phosphide poisoning is increasing day by day in western region of India including Gujarat. Demographic profile of aluminium phosphide poisoning cases is very helpful to be aware of current scenario and to implement preventive steps for betterment of health services. Objectives: The present study was undertaken to know the demographic profile of aluminium phosphide poisoning cases received as indoor or outdoor patient department of Gayatri Hospital, Gandhinagar, Gujarat, India. Material and methods: History taking, complete examination and necessary investigations of all cases of aluminium phosphide poisoning was done, during the period of two years from 01-01-2012 to 31-12-2013. A proforma was prepared to fill up details of the parameters used in the study like prevalence of age and sex, socio-economic status, marital status, religion, literacy status, occupational status, time of consumption, manner of poisoning, reasons for suicidal consumption etc. Results: During the study period, 40 cases were diagnosed as of aluminium phosphide poisoning. Majority of the victims were in the age group of 41-50 years (25%), 70% were married, 80% were Hindu, 65% were of lower socio economical class and 57.5% belonged to rural area. Occurrence of aluminium phosphide poisoning was more common in evening time between 5 pm to 11 pm (45%) and among housewives (27.5%). Suicidal cases (82.5%) were more common compared to others. Conclusion: Based on these findings, preventive measures like restriction of sale and availability of aluminium phosphide, good availability of investigation and treatment, promoting poison information centre etc have been put forward. [ABSTRACT FROM AUTHOR]

Background and Aim: There is scarcity of data from the Indian subcontinent regarding the profile and outcome of patients presenting with acute poisoning admitted to intensive care units (ICU). We undertook this retrospective analysis to assess the course and outcome of such patients admitted in an ICU of a tertiary care private hospital. Methods: We analyzed data from 138 patients admitted to ICU with acute poisoning between July 2006 and March 2009. Data regarding type of poisoning, time of presentation, reason for ICU admission, ICU course and outcome were obtained. Results: Seventy (50.7%) patients were males and majority (47.8%) of admissions were from age group 21 to 30 years. The most common agents were benzodiazepines, 41/138 (29.7%), followed by alcohol, 34/138 (24.63%) and opioids, 10/138 (7.2%). Thirty-two (23%) consumed two or more agents. Commonest mode of toxicity was suicidal (78.3%) and the route of exposure was mainly oral (97.8%). The highest incidence of toxicity was due to drugs (46.3%) followed by household agents (13%). Organ failure was present in 67 patients (48.5%). During their ICU course, dialysis was required in four, inotropic support in 14 and ventilator support in 13 patients. ICU mortality was 3/138 (2.8%). All deaths were due to aluminium phosphide poisoning. Conclusions: The present data give an insight into epidemiology of poisoning and represents a trend in urban India. The spectrum differs as we cater to urban middle and upper class. There is an increasing variety and complexity of toxins, with substance abuse attributing to significant number of cases. [ABSTRACT FROM AUTHOR]

This is a two years retrospective study from poisoning cases data record that were admitted in the emergency forensic department of Medical College, Faridkot. It is a study depicting the pattern of poisoning in the Faridkot region of Punjab. The association of age, sex, occupation, monthly income, place of resident in poisoning cases, was studied statistically among the cases brought to the emergency Forensic wing. [ABSTRACT FROM AUTHOR]

Aluminiun Phosphide is used as fumigant to keep the grains free from pests. Due to its free availability it is becoming agent of choice to commit suicides. Suicide is among the top 10 causes of deaths in India. During the last 10 years it has gained notoriety as an effective suicidal agent. [ABSTRACT FROM AUTHOR]

Presents a case study from India which defines factors which could predict the toxic outcome of aluminum phosphide ingestion. Description of physical illnesses suffered by patients ingesting the substance; Dose of the chemical which effected negative results; Demographics of study participants.

Reports on the rise in aluminum phosphide poisoning in Northern India. Health risks of aluminum phosphide poisoning used against rodents and pests; Diagnosis by clinical suspicion; Treatment; Recommendation of intravenous magnesium sulphate therapy.

Aluminium phosphide poisoning is very common in India. It is one of the most fatal poisons. The clinical spectrum of poisoning varies depending upon the dosage and duration of consumption. The main effect of the poison is due to the release of phosphine which inhibits cytochrome oxidase and thereby hampers cellular oxygen utilization. Almost any organ can be affected by aluminium phosphide poisoning. We report a case where the heart was the predominantly affected organ. We describe the clinical symptoms and signs and their correlation with electrocardiographic and histopathological examinations. [ABSTRACT FROM AUTHOR]

Aluminium Phosphide poisoning is one of the leading causes of suicidal deaths in India. Death may also occur due to accidental exposure to Aluminium Phosphide/Phosphine. A number of deaths due to Aluminium Phosphide poisoning are reported all over India. Here in this article, we have discussed about its passage through placenta and subsequently fatal effect on the fetus. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the prognostic significance of blood glucose levels and blood glucose alterations (i.e. hyper- or hypoglycaemia) among patients with aluminium phosphide (AlP) poisoning., Methods: This prospective observational study was conducted at the Postgraduate Institute of Medical Education & Research, Chandigarh, India, between January 2010 and June 2011. All patients presenting to the emergency department with a definitive history of AlP ingestion or symptoms compatible with AlP poisoning were included in the study. Blood glucose levels were recorded at presentation and every six hours thereafter. Alterations in blood glucose levels and other clinical and laboratory variables were subsequently compared between survivors and non-survivors., Results: A total of 116 patients with AlP poisoning were identified. Of these, 57 patients (49%) survived and 59 patients (51%) died. At presentation, the mean blood glucose levels of survivors and non-survivors were 119.9 ± 35.7 mg/dL and 159.7 ± 92.5 mg/dL, respectively ( P <0.001). In comparison to the survivors, non-survivors had significantly higher heart rates, total leukocyte counts, blood glucose level alterations and serum creatinine levels ( P <0.050). In addition, systolic blood pressure, Glasgow coma scale scores, arterial blood gas pH and bicarbonate values and duration of hospital stay was significantly lower compared to survivors ( P <0.001). However, neither blood glucose levels at admission nor blood glucose alterations correlated independently with mortality in a multivariate analysis., Conclusion: The role of blood glucose level alterations in predicting patient outcomes in AlP poisoning cases remains inconclusive. Further studies with larger sample sizes are required., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest.

Aluminum phosphide (ALP) is a grain insecticide commonly used in India. We are reporting a suspected case of poisoning, presenting with the symptoms of severe epigastric pain, nausea and vomiting. The diagnosis of ALP poisoning was confirmed by history, and toxicology screening. After 36 hrs of admission, a sudden rise in respiratory rate, pulse, blood pressure, temperature, messator spasm, and muscle rigidity was noted. Caffeine halothane contraction test later confirmed it to be malignant hyperthermia. Considering the poorly understood patho-physiology of malignant hyperthermia and ALP, further research is required regarding the possible association of ALP with malignant hyperthermia. [ABSTRACT FROM AUTHOR]

The article describes the case of aluminum phosphide self-poisoning in the state of Haryana, India, in which the toxic effects were complicated by intravascular hemolysis probably caused by glucose-6-phosphate dehydrogenase deficiency. The case involved a 22-year-old man who presented to the emergency ward after suicidal ingestion of one gram of aluminum phosphide.

Information about several papers discussed at the Ninth Annual Conference of Punjab Academy of Forensic Medicine & Toxicology (PAFMAT) in Punjab, India on December 4, 2010 is presented. Topics include the medico-legal aspects of clinical practice, cases on rape victim examination, and aluminum phosphide poisoning. The conference featured medical jurisprudence practitioners including Neeraj Nagpal, Sanjoy Dass, and Shiv Kochhar.