Rahul Baburao Kamble¹, Nagaraj S Javali^2*

¹Assistant Professor, ²Professor & HOD, Department of Pediatrics, Raichur Institute of Medical Sciences, Raichur, Karnataka, INDIA.

Email: drrahulkamble84163@gmail.com, nagarajjavali@ymail.com

RESULTS

During study period, 80 children were admitted with history of poisoning cases due to ingested poisons or due to snake, insect and unknown bites. Most of patients were from 1-5 years age group (53.75 %) followed by 6-9 years (30 %). Boys (61.25 %) were more than girls (38.75 %) with boys : girls ratio of 1.6:1.

Table 1: Age and gender distribution

In present study most common symptoms were vomiting (61.25 %), drowsiness/altered sensorium (26.25 %), seizures (22.5 %), respiratory distress (13.75 %) while 11.25 % patients were asymptomatic.

Table 2: Presenting features

Most common route of administration was oral (86.25%).

Table 3: Distribution of the poisoning cases according to the route of administration.

Common causative substances in present study were unknown substances (21.25 %), kerosene (15 %), insecticides (15 %), unknown seeds (15 %), envenomation (12.5 %) and bleaching solution (10 %).

Table 4: Causative agents for poisoning

Aspiration pneumonia (16.25 %), respiratory failure (11.25 %), shock (6.25 %) and DIC/renal failure (3.75 %) were complications noted in children in present study.

Table 5: Complications associated with poisoning.

Most of patients required no treatment (46.25 %), while rest patients required oxygen (45 %), antibiotics (43.75 %), gastric lavage (20 %), atropine (10 %),

Table 6: Treatment required

Mortality was noted in 3 children.

Table 7: Outcome of children

DISCUSSION

Despite major advances in promoting and maintaining good health, unintentional pediatric injuries including acute oral poisoning and continues to be leading pediatric health problem partly because of their developmental process and inquisitiveness.^5,6 Acute childhood poisoning is an important cause of morbidity and mortality in children, which can be significantly and effectively controlled by preventive measures. Young children, due to their curious nature, close position to the floor and tendency to put things in their mouths are often victims of accidental poisoning.⁷ Although pediatric poisonings are considered emergencies, more than 85% of cases need no medical intervention because the ingested material is not toxic or the amount swallowed is not clinically significant.⁸ Tarvadi PV et al.,⁹ studied 214 cases of poisoning in children from Mangalore and observed that 33% of the victims were in age group less than 5 years and most common route of exposure was ingestion seen in 84%. Most common substance used was insecticide which was seen in 40.2% and mortality was seen in 4.7%. Similar findings were noted in present study. In study by Vasavada H et al.,¹⁰ with 176 cases aged less than 15 years, they noted that accidental poisoning was found in 98.59% and overall mortality was 5.1%. 87.5% were less than 5 years old. Snake bite was seen in 2.27% and unknown insect bite was seen in 3.97%. Randev S et al.,⁷ studied 263 cases less than 17 years of age in Chandigarh, among which 56.82% were due to organo phosphorous poisoning and overall mortality was 3.8%. 84.93% were from rural area and 75.34% were due to accidental cause. Lin YR et al.,¹¹ noted that incidence of poison exposure was highest among adolescents and preschool age children and the most common location of poison exposure was home which was seen in 85%. The major reason of poison exposure was accidental which was found in 61.4%. The most common symptom seen was neurological as in 34.3% followed by gastrointestinal seen in 25%. Budhatoki S et al.,¹² noted that organophosphorus poisoning was the most common poisoning seen in 45.1% followed by hydrocarbon 9.8%, scorpion sting was seen in 1.6% and overall survival was 87.4%. Gupta SK et al.,¹³ studied 995 cases from 1-18 years of age and concluded that 79.69% were accidental and the route of exposure was oral in 96.78%. 47.03% were due to household products among which the commonest agents involved were Pyrethroids as seen in 20.29%. Bites and stings were seen in 3.21%. Variation in the manifestations of symptoms following acute pesticide poisoning depends on the type and quantity of the poison ingested. Deliberate self-harm is not uncommon in adolescents age group, suicide or deliberate self-harm in >15 years of age group accounts for more than 3% of total deaths amounting up to 187,000 events in India.¹⁴ Interventions aimed at suicide attempters will, therefore, be a logical strategy for the prevention of deaths due to deliberate self-harm. Children over 5 years are at risk of snake bite because they are involved more in outdoor games. Most cases of snake bite occurring in rainy season and the incidence varies in India due to different pattern of rainfall and agricultural activities.¹⁵

CONCLUSION

Parental awareness and education are important measures to prevent accidental poisoning in children. Keeping medicines in child-proof containers and careful storage of common household products implicated in pediatric poisoning under lock and key may reduce such poisoning to a great extent.

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