Vol.20 Issue No.2 (2024): Journal of Indian Society of Toxicology <p style="padding-left: 80px;"><strong style="text-align: center;"><span style="font-size: 16.0pt;">Chemical Warfare: International Laws and Conventions</span></strong></p> <p style="padding-left: 280px;"><strong>Anand B. Mugadlimath</strong></p> <p style="padding-left: 280px;"><strong>Mandar R. Sane </strong></p> <p><strong>Introduction </strong></p> <p>Chemical warfare remains one of the most harrowing methods of combat, with the potential to cause indiscriminate suffering and long-term environmental damage. Despite international condemnation, instances of chemical weapon (CW) use persist, raising critical questions about the effectiveness of current global frameworks. Central to the right against chemical warfare is the Chemical Weapons Convention (CWC), an international treaty aimed at eliminating chemical weapons and preventing their re-emergence. However, loopholes in enforcement and geopolitical challenges continue to test its efficacy.[1]</p> <p><strong>Historical Context and the Evolution of International Laws&nbsp;</strong></p> <p>The use of chemical weapons dates back to World War I, where gases like chlorine and mustard gas were deployed with devastating consequences. In response, the Geneva Protocol of 1925 prohibited the use of chemical and biological weapons in warfare. However, it failed to address production or stockpiling, leaving a signicant gap exploited by states during subsequent conflicts. In 1997, the Chemical Weapons Convention (CWC) came into force, marking a major advancement in global disarmament. Unlike the Geneva Protocol, the CWC mandates the destruction of all chemical weapon stockpiles and prohibits their development, production, acquisition, and use. The Organisation for the Prohibition of Chemical Weapons (OPCW) was established to oversee compliance, providing robust verification through on-site inspections and investigations.[2]</p> <p><strong>Challenges in Implementation and Enforcement </strong></p> <p>Despite significant progress, the enforcement of the CWC faces persistent challenges. One primary issue is non-compliance by state actors, often shielded by political alliances. For example, Syria's repeated use of chemical weapons since 2013, despite being a CWC signatory, exemplifies how geopolitical interests can undermine enforcement. Similarly, the use of Novichok nerve agents in attacks linked to Russia highlights the difficulty of holding powerful states accountable.[3] Moreover, the rise of non-state actors, including terrorist organizations, poses a unique challenge. Groups like ISIS have demonstrated the ability to produce rudimentary chemical agents, exploiting gaps in monitoring and control. The dual-use nature of many chemical substances, which can serve both civilian and military purposes, further complicates regulation.&nbsp;</p> <p><strong>Technological Advancements and Future Vulnerabilities </strong></p> <p>Modern technological advancements introduce new vulnerabilities. The proliferation of synthetic biology and chemical synthesis techniques means that even non-experts can potentially produce hazardous substances. Additionally, the potential for cyber attacks on chemical facilities could lead to accidental releases or deliberate misuse.[4]</p> <p><strong>Strengthening Global Commitment and Compliance </strong></p> <p>To safeguard against the resurgence of chemical warfare, it is crucial to strengthen the CWC's implementation. This includes enhancing international cooperation , promo ti n g transparency among states, and reinforcing OPCW's authority to conduct independent investigations. Further, updating protocols to address emerging technologies and improving national readiness against chemical threats are essential.[5] Recent trends show an alarming rise in the use of chemical-warfare agents on civilians in urban centers, often by non-state actors. These attacks now involve agents such as sarin, VX, and Novichok, previously reserved for military use. Events like the sarin gas attacks in Syria, the VXbased assassination in Malaysia, and the poisoning of Sergei Skripal in the UK underscore how chemical agents are being repurposed for terror and political violence. Such incidents often unfold in densely populated areas, presenting unique challenges for rst responders and healthcare systems. Rapid toxidrome recognition becomes vital for triage, antidote administration, and responder safety, especially in chaotic, multimodal attack scenarios. These developments necessitate updated global response protocols and training initiatives for frontline medical teams. [6]</p> <p><strong>Conclusion </strong></p> <p>The global community must remain resolute in its commitment to eradicating chemical weapons. Strengthening the Chemical Weapons Convention , enhancing enforcement mechanisms, and fostering international collaboration are key to ensuring that chemical warfare remains a dark chapter of history rather than a recurring threat. As the nature of warfare evolves, so too must our commitment to peace and humanitarian principles.</p> <p><strong>References </strong></p> <p>1. OPCW (Organisation for the Prohibition of Chemical Weapons). (2023). The Chemical Weapons Convention: A Success Story in Disarmament and Non-Proliferation. Retrieved on 17/05/2025 [ https://www.opcw.org/] (https://www.opcw.org/)</p> <p>2. United Nations Ofce for Disarmament Affairs (UNODA). (2023). Chemical We apons Convention (CWC).Retrieved on 17/05/2025 [https://www.un.org/disarmament/](https://www. un.org/disarmament/)</p> <p>3. DH Joyner. International Law and the Proliferation of Chemical Weapons: Legal Aspects of Disarmament and Enforcement. Journal of Conflict and Security Law. 2021:26(2);149-167.</p> <p>4. GD Koblentz. Syria's Chemical Weapons: The Disarmament Challenge.International Security. 202:45(3);105-136.</p> <p>5. T Graham, M LaFleur. The Evolving Threat of Chemical Warfare: Lessons from the Syrian Conflict. Global Security Studies. 2019 : 10 (1); 33-46.</p> <p>6. Ciottone GR. Toxidrome Recognition in Chemical-Weapons Attacks. N Engl J Med. 2018;378(17):1611&ndash;1620.&nbsp;</p> 40 2025-06-30 20:42:37 A Study of Serum Creatine Phosphokinase Levels as a Prognostic Indicator in Acute Organophosphorus Poisoning 448 2025-06-30 20:42:37 <p><em><strong>Introduction :</strong> </em></p> <p>Organophosphorus compound (OPC) poisoning is a significant global health concern, particularly in developing countries, results in high mortality rates. Conventional markers such as serum cholinesterase levels have limitations in predicting disease severity, necessitating the exploration of alternative biochemical markers like serum creatinine phosphokinase (CPK).</p> <p><em><strong>Aims :</strong> </em></p> <p>To evaluate the significance of serum CPK levels as the prognostic indicator in acute OPC poisoning and assess its correlation with clinical severity using the Peradeniya OPC poisoning (POP) score.</p> <p><em><strong>Methodology : </strong></em></p> <p>A hospital-based cross-sectional study was conducted in a tertiary-care teaching hospital over 18 months, including 30 patients with confirmed OPC poisoning. Serum CPK levels were measured on day 0, 3, and 5 and correlated with POP scores and the need for mechanical ventilation. Statistical analysis was performed using SPSS. Ethics clearance was obtained.</p> <p><em><strong>Results :</strong></em></p> <p>A strong positive correlation was observed between POP scores and CPK levels (r on day 0 &ndash; 0.763, day 3 &ndash; 0.803, day 5 &ndash; 0.683; all p values &lt;0.001), indicating increased poisoning severity is associated with elevated CPK levels. Additionally, a significant negative correlation was found between the mechanical ventilation and both POP scores (r -1.000 on day 5) and CPK levels (r -0.683, p &lt;0.001).</p> <p><em><strong>Conclusion : </strong></em></p> <p>Serum CPK serves as a valuable prognostic marker in OPC poisoning, correlating with disease severity and the need for mechanical ventilation. The integration of CPK monitoring with POP scoring can enhance early risk stratification and guide clinical decision-making for better patient outcomes.&nbsp;</p>

<p><em><strong>Introduction :</strong> </em></p> <p>Organophosphorus compound (OPC) poisoning is a significant global health concern, particularly in developing countries, results in high mortality rates. Conventional markers such as serum cholinesterase levels have limitations in predicting disease severity, necessitating the exploration of alternative biochemical markers like serum creatinine phosphokinase (CPK).</p> <p><em><strong>Aims :</strong> </em></p> <p>To evaluate the significance of serum CPK levels as the prognostic indicator in acute OPC poisoning and assess its correlation with clinical severity using the Peradeniya OPC poisoning (POP) score.</p> <p><em><strong>Methodology : </strong></em></p> <p>A hospital-based cross-sectional study was conducted in a tertiary-care teaching hospital over 18 months, including 30 patients with confirmed OPC poisoning. Serum CPK levels were measured on day 0, 3, and 5 and correlated with POP scores and the need for mechanical ventilation. Statistical analysis was performed using SPSS. Ethics clearance was obtained.</p> <p><em><strong>Results :</strong></em></p> <p>A strong positive correlation was observed between POP scores and CPK levels (r on day 0 &ndash; 0.763, day 3 &ndash; 0.803, day 5 &ndash; 0.683; all p values &lt;0.001), indicating increased poisoning severity is associated with elevated CPK levels. Additionally, a significant negative correlation was found between the mechanical ventilation and both POP scores (r -1.000 on day 5) and CPK levels (r -0.683, p &lt;0.001).</p> <p><em><strong>Conclusion : </strong></em></p> <p>Serum CPK serves as a valuable prognostic marker in OPC poisoning, correlating with disease severity and the need for mechanical ventilation. The integration of CPK monitoring with POP scoring can enhance early risk stratification and guide clinical decision-making for better patient outcomes.&nbsp;</p>

 VVSB Thejaswini* Vignessh Raveekumaran* Filicide-Suicide - Foeticide : Can it be Termed as Triadic Death? 449 2025-06-30 20:42:37 <p>Murder-suicide, homicide-suicide, and dyadic death all refer to an incident where a homicide is committed followed by the perpetrator's suicide almost immediately or soon after the homicide. However, when there is occurrence of Homicidesuicide &ndash; foeticide aka Filicide- suicide - Foeticide then there is triad of event occurring in a single incidence. In present case, such triad of event occurred when there was female perpetrator, who killed her son and would be born child.</p> <p>The author wants to highlight that in such triad of event the deaths occurring can be termed as Triadic death.&nbsp;</p>

<p>Murder-suicide, homicide-suicide, and dyadic death all refer to an incident where a homicide is committed followed by the perpetrator's suicide almost immediately or soon after the homicide. However, when there is occurrence of Homicidesuicide &ndash; foeticide aka Filicide- suicide - Foeticide then there is triad of event occurring in a single incidence. In present case, such triad of event occurred when there was female perpetrator, who killed her son and would be born child.</p> <p>The author wants to highlight that in such triad of event the deaths occurring can be termed as Triadic death.&nbsp;</p>

 Soniya B Parchake* Nilesh Keshav Tumram** A Rare Case of Organophosphorus Compound Poisoning - induced Acute Necrotising Pancreatitis 450 2025-06-30 20:42:37 <p>One of the most recognized signicant health concerns is organophosphorus compound (OPC) poisoning, especially prevalent in India where these compounds are commonly used as pesticides.While OPC poisoning is linked to an array of complications affecting various bodily systems, the occurrence of acute necrotizing pancreatitis remains notably rare. we report a case of a 54-year-old male with intentional OPC ingestion, who developed acute necrotising pancreatitis a rare complication. We describe the early recognition of the complication and the successful management strategies employed to treat this rare and serious condition.&nbsp;</p>

<p>One of the most recognized signicant health concerns is organophosphorus compound (OPC) poisoning, especially prevalent in India where these compounds are commonly used as pesticides.While OPC poisoning is linked to an array of complications affecting various bodily systems, the occurrence of acute necrotizing pancreatitis remains notably rare. we report a case of a 54-year-old male with intentional OPC ingestion, who developed acute necrotising pancreatitis a rare complication. We describe the early recognition of the complication and the successful management strategies employed to treat this rare and serious condition.&nbsp;</p>

 MA Tharoon Kumar* Vignessh Raveekumaran* The Forensic Challenges of Poisoning Cases in India : Trend, Impact and Post-COVID-19 Insights 451 2025-06-30 20:42:37 <p>Poisoning is a significant medico-legal and public health issue in India, accounting for a considerable proportion of accidental and intentional deaths. This paper examines the trends in poisoning cases using data from the National Crime Records Bureau (NCRB), highlighting the common agents, Demographic patterns, and regional variations. It also explores the challenges faced by forensic toxicologists and medico-legal professionals in investigating and managing poisoning cases. Special attention is given to the surge in suicidal poisoning cases post-COVID19 and the absence of toxicological databases, which adversely impacts forensic investigations and policy making. The lack of centralized and comprehensive toxicological data complicates the identification of poisoning patterns, delays judicial proceedings, and hinders the formulation of targeted public health policies. Strengthening toxicological databases can significantly improve the quality of forensic investigations and provide actionable insights for regulatory frameworks. This paper provides r e commenda tions for improving for ensi c infrastructure, adopting advanced analytical techniques, and implementing preventive strategies to mitigate the incidence and impact of poisoning in India.&nbsp;</p>

<p>Poisoning is a significant medico-legal and public health issue in India, accounting for a considerable proportion of accidental and intentional deaths. This paper examines the trends in poisoning cases using data from the National Crime Records Bureau (NCRB), highlighting the common agents, Demographic patterns, and regional variations. It also explores the challenges faced by forensic toxicologists and medico-legal professionals in investigating and managing poisoning cases. Special attention is given to the surge in suicidal poisoning cases post-COVID19 and the absence of toxicological databases, which adversely impacts forensic investigations and policy making. The lack of centralized and comprehensive toxicological data complicates the identification of poisoning patterns, delays judicial proceedings, and hinders the formulation of targeted public health policies. Strengthening toxicological databases can significantly improve the quality of forensic investigations and provide actionable insights for regulatory frameworks. This paper provides r e commenda tions for improving for ensi c infrastructure, adopting advanced analytical techniques, and implementing preventive strategies to mitigate the incidence and impact of poisoning in India.&nbsp;</p>

 Pankaj Malia* Sheikh Mohammad Abdur Rahman* Gourav Panchal* Chloroform-the Quest for Oblivion : A Case Report 452 2025-06-30 20:42:37 <p>Chloroform is a halogenated hydrocarbon and is a colourless, volatile liquid with potent anaesthetic properties. Nowadays, the use of chloroform as an anaesthetic is abandoned, because it causes central nervous system depression, cardiac arrhythmias and delayed hepatotoxicity. However, it is used as an organic solvent in industry and in analytical laboratories. Most cases of chloroform toxicity are the result of inhalational exposures, and very few reports involve oral ingestion. A 35-year-old male microbiologist was working in a corn products manufacturing factory was found in anunresponsive state at his guest house which was found locked from inside. The police found a bottle of &ldquo;EMPURA Chloroform 500ml&rdquo; near the body and suspected consumption of about 300ml out of 500ml. Also recovered dried datura seed capsule/pods from the crime scene. Some colleagues of the deceased gave a history of chronic use of datura seeds by him. This case highlights the rare and incidental chloroform toxicity.</p>

<p>Chloroform is a halogenated hydrocarbon and is a colourless, volatile liquid with potent anaesthetic properties. Nowadays, the use of chloroform as an anaesthetic is abandoned, because it causes central nervous system depression, cardiac arrhythmias and delayed hepatotoxicity. However, it is used as an organic solvent in industry and in analytical laboratories. Most cases of chloroform toxicity are the result of inhalational exposures, and very few reports involve oral ingestion. A 35-year-old male microbiologist was working in a corn products manufacturing factory was found in anunresponsive state at his guest house which was found locked from inside. The police found a bottle of &ldquo;EMPURA Chloroform 500ml&rdquo; near the body and suspected consumption of about 300ml out of 500ml. Also recovered dried datura seed capsule/pods from the crime scene. Some colleagues of the deceased gave a history of chronic use of datura seeds by him. This case highlights the rare and incidental chloroform toxicity.</p>

 Kavya Jagadeesh* Aadamali Nadaf** Santosh Kumar P***