Sudharson, T (2011) A Retrospective study of Hair Dye Poisoning cases in Govt Rajaji Hospital, Madurai. Masters thesis, Madurai Medical College, Madurai.
|
Text
201400311sudharson.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION : Poison is a quantitative concept, almost any substance being harmful at some doses but, at the same time, being without harmful effect at some lower dose. Between these two limits there is a range of possible effects, from subtle long-term chronic toxicity to immediate lethality. The definition of a poison, or toxicant, also involves a qualitative biological aspect because a compound, toxic to one species or genetic strain, may be relatively harmless to another. Exposure of humans and other organisms to toxicants may result from many activities: intentional ingestion, occupational exposure, environmental exposure, as well as accidental and intentional (suicidal or homicidal) poisoning. Poisoning is a major health problem in many countries, including India. In our country, the problem is getting worse with time, as newer drugs and chemicals are developed in vast numbers, and there are no stringent rules and regulations for their dispensing and use. There are more than 9 million natural and synthetic chemicals worldwide, and the list keeps growing inexorably. Pesticides are the commonest cause of poisoning and according to World Health Organization (WHO) The reason could be attributed to the increasing number of toxic chemicals and their large scale use without proper testing of their toxic properties. Banned products also continue to flow into the market. House hold products like medicines, cleaning products and cosmetics have further widened the spectrum of toxic products to which people may be exposed. AIMS AND OBJECTIVES : 1. To study the epidemiology and prevalence of suicidal hair dye Poisoning. 2. To analyze the presenting features of Hair dye poisoning. 3. To analyze the treatment modalities. 4. To study the postmortem findings. MATERIALS AND METHODS : Duration of study: 14 months. Period of study: July 2009 to August 2010. Selection of study subjects: Patients admitted with history of Hair dye poisoning at Government Rajaji Hospital, Madurai. Number of cases studied: 36 patients. Data Collection: Clinical, Biochemical, Postmortem, Histpathological and Toxicological analysis. Methods: Standard Clinical, Autopsy and Laboratory methods. Ethical clearance: Obtained. Inclusion Criteria: Patients with history of hair dye poisoning Design of Study: Retrospective study. Statistical Tools: The information collected regarding all the selected cases were recorded in a Master Chart. Data analysis was done with the help of computer using Epidemiological Information Package (EPI 2008) developed by Center for Disease Control, Atlanta. RESULTS : 36 cases of hair dye poisoning admitted in Government Rajaji Hospital, Madurai during July 2009 to August 2010 were studied. Various data like the background history, clinical features, investigations, treatment, outcome, postmortem findings and toxicological analysis had been analyzed in detail and the results are plotted. CONCLUSION : From our study we learn that the incidence of hair dye poisoning is increasing. Health authorities should call for the prevention of the use and trade of PPD in the market. PPD containing hair dyes should be classified under SCHEDULE H substance so as to restrict its supply and sale. There is a strong case for the regulation and restriction of sale of para-phenylenediamine. • More than 80% of the cases are in the adolescent age group and more than 80% of the cases were females. Efforts should be directed to create awareness among people by undertaking education of parents and caretakers, especially those taking care of children and adolescent age groups, by distributing educational leaflets, brochures and handouts on proper storage, use and disposal of various chemicals used at home. Campaigns in the media and educational programmes could also help in highlighting the preventive measures. • Rhabdomyolyis is the most common feature followed by angioedema. Laryngeal edema is the most common cause of death in first 2 days and Acute renal failure is the most common cause after 5 days. Whenever the characteristic triad of stridor due to upper airway edema, rhabdomyolysis and acute renal failure develops in a poisoning, hair dye should be considered. Early airway protection, alkaline diuresis and dialysis are the three management strategies helpful in this situation. There is no specific antidote available. Awareness about this condition is helpful in early intervention to reduce mortality. • There is a significant association between quantity consumed and outcome. Cases that developed angioedema and shock have poor prognosis. Timely Gastric lavage is associated with better outcome. There is a National Poisons Information centre functioning at the AIIMS, New Delhi, which functions round the clock, to direct medicos, paramedical staff and care takers in case of emergency. Such a Poison Information centre should be established in each district Headquarter hospitals and qualified personel should be appointed for early detection and management of various poisons to save precious lives. Also, it is important that the medical fraternity be aware of this devastating poisoning because the toxin involved is available quite freely and used extensively • Mortality rate is 38.9%. The scale of the problem is enormous due to the increased incidence of morbidity and mortality. Improvement in the preventive and management programme can be brought about by identification of high risk circumstances, susceptible groups within the population, chemical substances and commercial products involved in poisoning cases in the community.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Hair Dye Poisoning cases ; Govt Rajaji Hospital ; Madurai ; Retrospective study. |
| Subjects: | MEDICAL > Forensic Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 27 Feb 2018 17:17 |
| Last Modified: | 27 Feb 2018 17:17 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5897 |
Actions (login required)
 |
View Item |
