Demographic-clinical profile of poisoning patients in a tertiary care hospital of Kashmir, North India

Introduction: Poisoning is one of the most common medical emergency presenting to the hospitals in developing countries. Kashmir has high incidence of poisoning cases. According to WHO, three million acute poisoning cases with 2, 20,000 deaths occur annually. Of these, 90% of fatal poisoning occurs in developing countries particularly among agricultural workers1. It was estimated that almost 50,000 people die every year from toxic exposure in India2. The poisoning cases have increased due to the frequent use of pesticides in agriculture and exposure to hazardous chemical compounds as a result of industrialization. Aim and Objectives: This prospective observational study was conducted with an Aim to evaluate the demographic and clinical profile of acute poisoning in Kashmir region, Material and methods: The study was conducted from 1/6/17 to 30/12/17 among patients of acute poisoning brought to emergency department of GMC Srinagar included 330 cases of adults, with acute poisoning due to drugs and chemicals. Cases of Snake bite, insect bite, food poisoning and allergic reaction to drugs were not included in the study. Data regarding age, sex, marital status, occupation, locality, type of poison, route of exposure, and associated co-morbid conditions were collected from the hospital records and documented in the pre-structured proforma. Data were documented and statistically analysed. Results and Observation: 330 cases of acute poisoning presented to emergency department over period of six months. Female outnumber male with78.18 % (258 number of cases) while only 72 male patients. Most common poisoning presenting was organo-phosphate poisoning with total number of 58.78% (n 194)followed by rodenticides 10.54% (n 35) > benzodiazepines 7.87% (n26) > alcohol intake 4.84% (n16) > corrosive poisoning 4.57% (n15) > petrochemical compound 2.42% (n8) > Ayurveda compound 1.81%(n6) > carbon monoxide 1.51% (n5) > paracetamol 0.90% (n3), levothyroxine 0.9% ( n3) and unknown or miscellaneous 5.4% (n18). On retrospective analysis of data demographic profile of poisoning patients in Kashmir region was as under with highest number of cases were from Pulwama 16.9% (n56) followed by Shopian 15.15% (n 50), Kulgam 13.9%( n 46), Anantnag 12.7% (n 42), Bandipora 10% (n33), Srinagar 8.4% (n 27), Baramulla 8.48% (n27), Ganderbal 5.8% (n17), Kupwara 4.8% (n16 )and Budgam 4.2% (n14). Conclusion; The most common acute poisoning (60%) presenting was organo-phosphate compounds from districts of south Kashmir due to ready availability of these compounds among apple orchid farmers and lack of education and awareness among farmers about handling of these compounds. Thus, there should be proper education and laws regarding handling and use of these compounds.