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POISONING CASES IN AND AROUND KARACHI AND THEIR MANAGEMENT ALONG WITH MEDICO LEGAL ASPECTS

Turabi, Aftab (2004) POISONING CASES IN AND AROUND KARACHI AND THEIR MANAGEMENT ALONG WITH MEDICO LEGAL ASPECTS. PhD thesis, University of Karachi, Karachi.

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Abstract

This study was carried out on the poisoning cases admitted in National Poison Control Centre, Jinnah Postgraduate Medical Center, Karachi, from January 1999 to December 2002. The poisoning cases dealt during this period were classified into 6 groups such as, chemicals, heavy metals, plant and natural alkaloids, animal bites, body packers, and unknown poisoning. Chemical group has been further classified into 7 subgroups, which were organophosphate, corrosives, rodenticide, kerosene oil, drug overdose, naphthalene, and alcohol. Heavy metals were sub grouped into mercury, lead arsenic, and copper sulfate. Plant group comprises of 2 sub groups, which were datura and opium and its derivatives. Lastly animal group was subdivided into snakebite and insect bite. Overall 14 subgroups were studied during this 4-year period. Total number of various poisoning cases admitted in NPCC was 4894. Chemicals constitute the largest group of poisoning that comprises of 3334 (68.12%) patients. In this study every patient was examined and his/her mode of presentation was noted, after which he/she was treated according to the said protocol. Each patient was subject to diagnostic evaluation in terms of blood picture and chemistry, urine analysis, radiological examination like X-ray and ultrasound and electrocardiogram. Specific examinations were also carried out as and when required. During the stay in the word, day to day evaluation was done in terms of their clinical response and laboratory data. It was noted that out of 4894 cases of poisoning the male population was 2956 (60.40%) in comparison to females, which was 1938 (39.60%). The male versus female pattern of suffering appears to change in the recent years. The medico legal aspect that comes to be apparent was that, suicidal attempt was the major cause of poisoning and it alone constitutes 2504 (51.16%) cases. Accidental poisoning comes next and had 1702 (34.78%) cases, whereas homicidal poisoning had the least number of patients which were 310 (6.33%) Significant increase in the incidence of poisoning in our social setup is definitely alarming and needs special attention. Above all the suicidal attempt reflects the social tendency was, economic crisis as well as joblessness or even the emotional urge of love and hatred. Intolerant behavior and decline in the family values/split families, is also a contributing factor. The media unfortunately is no saint, which plays an important role by displaying fiction serials and dramas, which has mostly no part in real life, but definitely may have a negative impact on the younger generation. The younger, especially and females are more demanding even beyond the means of the earning member in the family resulting in development of disputes, and leading to the unfortunate attempt of suicide. The majority of accidental cases were due to carelessness or preoccupied mind and also due to unawareness. Simple awareness programs for the publics can be much helpful in reducing the incidence of accidental poisoning. National Poison Control Center launches several awareness programs for the public on chemical safety, but still there is further need for more and a continuous flow of awareness either through seminars of through press and electronic media In this study we have introduced some new protocols of treatment according to our need, in reference to a developing country where most of the population is still unable to take care of their medical bills. Glycopyrrolate was cried in organophosphate poisoning in combination with atropine instead of pralidoxime, which is a costly drug, and found successful This was the first detailed study of poisoning cases in our country that included types of poisoning gender ratio, age group, route of administration, clinical presentations, diagnostic data analysis, complication of poisonings, outcome in terms of recovery and death, and medico legal aspects in terms of suicide, accident or homicide. No aspect of medical and social importance of poisoning was overlooked. A sincere effort to the best of our capability was made to attain the objectives and reach a conclusion to manage poiosoning cases along with reducing its rate of incidence while providing awareness and providing better medical care

Item Type:Thesis (PhD)
Uncontrolled Keywords:poisoning, medico legal, body packers, chemicals poisoning, heavy metals poisoning, plant poisoning, natural alkaloids poisoning, animal bites, body packers
Subjects:Biological & Medical Sciences (c) > Medical Sciences (c2) > Pharmacy(c2.5)
ID Code:1335
Deposited By:Mr. Muhammad Asif
Deposited On:27 Jan 2007
Last Modified:04 Oct 2007 21:06

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