JIST

Abstract

Background: The insight into the trends and distribution of types of poisoning have paramount epidemiological importance to understand the fatality from different poisons in an area. It helps the clinicians, epidemiologists, and healthcare service enforcement agencies to develop appropriate measures and resource redistribution for different types of poisoning deaths.

Aim: analysis of demographic pattern and the of poisoning deaths. In addition, to understand the causes of death in fatal poisoning cases based on their clinical presentation and survival period in the hospital before death. Materials and methods: A five-year record-based study on 866 number of fatal poisoning cases received for autopsy at the Forensic Medicine and Toxicology Department. The anonymous data regarding demographic details of the cases (age, sex, and anthropometric parameters), type of poison, period of survival, season of occurrence, geographic distribution, clinical presentation and the cause of death of the fatal poisoning cases were collected from the hospital case records, police inquest reports, toxicology/serological reports, pathological and autopsy reports. The relationship between the period of survival and the results of toxicology reports was established to identify the disparity between the clinical presentation and the toxicology outcomes after death. The data entry and analysis of quantitative data was done using Epidata v2.0.

Results: Out of the 426 number of studied cases, males were 64.50% and female were 35.50%. Majority of the cases were in their 2nd (31.45%) and 3rd (31.12%) decade of life and were from semi-urban (47%) and rural areas (36%). Around 58% of the cases were reported during the summer season. Agrochemicals (64.7%), plant poisons (13.17%) and rodenticide (10%) were the commonly used agents. Among agrochemical poisons organophosphorus compound (75.4%),monocrotophos (8.3%), carbamates (4.1%) were commonly observed. Among plant poison oleander (64.7%) and oduvan (8.5%) were commonly observed. Majority of poisoning were suicidal (93.66%) followed by accidental (6.10%). In 39.43% of cases the toxicological analysis reports were negative. The relationship between the period of survival and the results of toxicology reports were assessed. The maximum numbers of positive results were noted among the patients survived for 13-24 hours and less than six hours. The maximum numbers of negative results were noted among the patients survived for more than 72 hours. The history, clinical, and toxicology findings were matching only 37.08% of the cases.

Conclusion: Compared to the poisoning census of India, the prevalence of fatal poisoning in this area showed a decline during the study period (2013-2017). The toxicological analysis may report negative for a poison in cases hospitalised beyond 3 days. Not necessarily all cases the history, clinical and toxicological outcome would be match each other; the actual cause of death should be made based on autopsy findings.