Refine your search
Collections
Co-Authors
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Sawlani, Kamal Kumar
- Role of Aggressive Management on Outcome in Patients of Acute Aluminium Phosphide Poisoning
Abstract Views :392 |
PDF Views:1
Authors
D. Himanshu
1,
Kamal Kumar Sawlani
1,
S. Deep Chandh Raja
1,
Shailendra Prasad Verma
2,
Nirdesh Jain
1,
Shyam Chand Chaudhary
1
Affiliations
1 Department of Internal Medicine, King George’s Medical University, Lucknow, IN
2 Department of Clinical Haematology, King George’s Medical University, Lucknow, IN
1 Department of Internal Medicine, King George’s Medical University, Lucknow, IN
2 Department of Clinical Haematology, King George’s Medical University, Lucknow, IN
Source
Toxicology International (Formerly Indian Journal of Toxicology), Vol 24, No 1 (2017), Pagination: 28-33Abstract
Aluminium phosphide poisoning is a common medical emergency in the Northern parts of India and South-East Asian nations. This poison is known to have high mortality ranging from 50% to 90% at various medical centres. In the absence of an antidote, an aggressive management is the need of the hour for reducing the mortality. A retrospective analysis of a set of variables was conducted on a group of 25 patients, followed by a prospective study of the same variables on a group of 25 consecutive patients who were enrolled into the study. Both the groups differed from each other principally in terms of management. The outcome of the management in both the groups were studied and analysed statistically. Factors strongly associated with mortality were consumption of fresh tablets, duration between consumption and treatment, low Glasgow coma scale (GCS), low mean arterial pressure (MAP) and metabolic acidosis. The group managed aggressively had lesser mortality rates than the group managed conservatively. Aggressive treatment benefitted even those individuals in whom prognostic variables were adverse. Aggressive management consisting of thorough gastric lavage, good fluid management, correction of metabolic acidosis, administration of magnesium sulphate, hydrocortisone and vitamin C has reduced the mortality rates in acute aluminium phosphide poisoning.Keywords
Celphos-Trade Name of Aluminium Phosphide, Lactic Acidosis, Bicarbonate Therapy.References
- Singh S, Dilawari., JB, Vashist., R, Malhotra., HS, Sharma BK. Aluminium phosphide ingestion in man. Br Med J 1985; 290: 1110-11.
- Siwach SB, Yadav DR, Arora B, Dalal S, Jagdish .Acute aluminum phosphide poisoning: An epidemiological clinical and histopathological study. J Assoc Physicians India. 1988;36:594-6
- Singh S, Wig N, Chaudhari D, Sood N K, Sharma B K. changing pattern of Acute poisoning in adults : Experiance of a large North West Indian hospital (1970 -1989), J Assoc Physicians India1997;45(3):194-7.
- Banjaj R, Wassir HS. Epidemic aluminium phosphide poisoning in northern India. Lancet 1988;1:820-1
- Chugh SN, Dushyant, Ram S, Arora B, Malhotra KC. Incidence and outcome of aluminium phosphide poisoning in a hospital study. Indian J Med Res. 1991;94:232–5.
- Mathai A, Bhanu MS. Acute aluminium phosphide poisoning: Can we predict mortality? Indian Journal of Anaesthesia. 2010;54(4):302-307. doi:10.4103/0019-5049.68372.
- Singh S, Bhalla A, Verma SK, Kaur A, Gill K. Cytochrome-c oxidase inhibition in 26 aluminum phosphide poisoned patients. Clin Toxicol (Phila) 2006;44:155–8
- Khosla SN, Handa R, Khosla P. Aluminium phosphide poisoning. Trop Doct 1992;22:155-7
- Gupta S, Ahlawat SK. Aluminium phosphide poisoning:A review. Toxicol Clin Toxicol 1995;33:19-24
- Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminum phosphide poisonings. Journal of Emergencies, Trauma and Shock. 2011;4(3):378-384.
- Chugh SN, Kumar P, Aggarwal HK, Sharma A, Mahajan SK, Malhotra KC.Efficacy of magnesium sulphate in aluminium phosphide poisoning. J Assoc Physicians India 1994;42(5):373-5
- Louriz M, Dendane T, Abidi K, Madani N, Abouqal R, Zeggwagh A. Prognostic factors of acute aluminum phosphide poisoning. Indian journal of medical sciences. 2009;63 (6) :227-34.
- Jaiswal S, Verma RK, Tewari N. Aluminium phosphide poisoning: Effect of full correction of severe metabolic acidosis on patient outcome. Indian J Critic Care Med 2009;13:21-4
- Prognostic Significance of Estimation of Pseudocholinesterase Activity and Role of Pralidoxime Therapy in Organophosphorous Poisoning
Abstract Views :180 |
PDF Views:0
Authors
Shyam Chand Chaudhary
,
Khemraj Singh
,
Kamal Kumar Sawlani
,
Nirdesh Jain
,
Arvind Kumar Vaish
,
Virendra Atam
,
Munna Lal Patel
,
Avinash Agarwal
Source
Toxicology International (Formerly Indian Journal of Toxicology), Vol 20, No 3 (2013), Pagination: 214-217Abstract
Background: Organophosphorous (OP) poisoning is one of the most common poisonings seen in India. OP compounds act through inhibition of enzyme acetylcholinesterase and estimation of pseudocholinesterase (PCE) activity strengthens the diagnosis in clinically uncertain cases of OP poisoning. The role of pralidoxime (PAM) therapy in OP poisoning has been controversial. Study Objectives: This study was aimed to determine the prognostic significance of estimation of PCE activity and also to assess the role of PAM therapy in OP poisoning. Materials and Methods: Patients of suspected OP poisoning of age >12 years admitted to emergency unit at a tertiary healthcare center of north India were enrolled. Patients were categorized into two groups; group A who were given intravenous atropine and group B who were given injectable PAM along with atropine. Serum PCE level was estimated at the time of admission in all patients and severity of OP poisoning was assessed according to PCE level. Requirement of atropine, oxygen inhalation, intubation and ventilatory support, total hospital stay, and mortality were compared between different classes of severity and also between Groups A and B. Results: This study included a total of 70 subjects, 35 in each group with mean age of 24.99 ± 8.7 years. Out of 70 subjects 49 (70%) were male and 21 (30%) were female. Forty nine patients (70%) of OP poisoning were with suicidal intent while 21 (30%) cases were accidentally poisoned. In all suicidal cases route of poisoning was ingestion whereas in all the accidental cases route of exposure was inhalational. PCE levels were reduced in all the cases and the mean level was 3,154.16 ± 2,562.40 IU/L. The total dose of atropine required, need for oxygen inhalation and need for intubation and ventilatory support, mean duration of hospital stay and mortality rate (P = 0.003) were higher in moderate to severe cases and did not have significant difference between Groups A and B. Conclusion: The study recommends estimation of PCE level at admission to classify severity of OP poisoning and to estimate prognosis. This study did not find any beneficial role of PAM therapy in reducing morbidity as well as mortality.Keywords
Atropine, insecticides, organophosphorous, pralidoxime, pseudocholinesterase- An Unusual Case of Refractory Metabolic Acidosis
Abstract Views :172 |
PDF Views:0
Authors
Kamal Kumar Sawlani
,
Shyam Chand Chaudhary
,
Malagouda Rajagouda Patil
,
Besthanahalli Errapa Yathish
,
Amit Chandra