Intent of Ingestion of
Poisonous Substances in India
Thakur Amit K.1*, Sahu A.2
and John Masih1
1Assistant
Professor, Medicine, Govt. Medical College, Jagdalpur
(Bastar)
2Assistant
Professor, Pediatrics, Govt. Medical College, Jagdalpur
(Bastar) India
ABSTRACT:
History: The
abuse of poisonous material is noted since long time.
Objective:
to analysis the intention behind abuse of various compound in the community.
Material and
methods: The study was carried out in a tertiary care hospital. 291 cases of
both sexes and 11 and above years of age of poisoning who were brought to
hospital for treatment taken as sample.
Variables:
suicidal, accidental etc.
Statistical
analysis: were expressed in simple terms of proportion
Findings:
Most common intent of poisoning was noted suicidal followed by accidental.
There were 12.72 % cases who didn’t disclose the intention behind the ingestion
of poison.
KEYWORDS: Suicidal, Accidental
INTRODUCTION:
Susruta, 350 BC,
described how the poison mixed with food and drink. Un-ointment oil ,perfumes
,medicine, bathing water, snuff or sprinkled over clothes ,shoes ,beds, jewellary or put in the eyes ,ears etc. Gradually these
arises a class of professional poisonous who could ingeniously mask the bitter
taste or strange odour of the poisons with sweet
tasting and pleasant substances. Bhoj Prabhada,980 AD,
has a reference to the inhalation of medicaments before surgical operations and
an anesthetic called "Sammohini" is said to
have been used in the time of Buddha, Reddy (1).The incidence of poisoning is
rising in India and intent of these poisoning cases vary from case to case
right from suicidal, accidental , undetermined etc.
Suicide: The
registrar General of England, consider suicide as a type of accidental death eg. poisoning, gasing,
strangulation etc.(2). Keeping in view the above and as per recommendations of
the World Health Organization (W.H.O.) study group in 1957,that in order to get
a comprehensive picture of a health problem / disease ,vital statistics is not
sufficient ,more and more such studies
have to be conducted, Garg Narendra
K.(3) and Garg Narendra K.and Sharma A.B.(4), the authors have under taken this
study with the objective to know the
intention of the victim for this act which put the life of the same in danger.
MATERIAL AND METHOD:
The study was
carried out in the S.S. Medical College and associated S.G.M. Hospital, Rewa (M.P.) between April 2003and April 2004. A total 291
cases of both sexes and 11 and above years of age group, who were admitted in
emergency ward of the department of medicine ,taken as sample. A complete
history was obtained from the patient or from his/her attendant if patient was
not in position to tell all the details.
OBSERVATIONS AND DISCUSSION:
On analysis
of the collecting data, it has been revealed that out of 291 cases 210 (72.16%)
cases ingested poisoning with the intention of committing suicide, while 44
(15.12 %) disclosed that it was just accidental and the remaining 37 (12.72%)
didn't disclose the intention because of one reason or the other ,the reason
best known to them (Table-I).
Table No.- I : Distribution of Cases according to Intent
in Overall Poisoning n=291
|
S.no |
Intent of Poisoning |
No. of Cases |
Percentage |
|
1 |
Suicidal |
210 |
72.16 |
|
2 |
Alleged
Accidental |
44 |
15.12 |
|
3 |
Not Disclosed |
37 |
12.72 |
|
Total |
291 |
100.00 |
|
On further
exploring the data as per poisonous material, it came to know that in case of aluminium phosphide (ALM) the
suicidal rate was 86.21% in comparison to the 56.00% in Organo
Phosphrous (O.P.) compound. On further analysis it
was revealed that alleged accidental was higher (34.00%) in OP in comparison to
07.76% in ALP, while the proportion of those who didn't disclose the intention
were more or less equal i.e.06.03 % in cases of ALP while 10.00% in
O.P.(Table-II and III).
table- II-deaths due to poisoning in
india (1992-94)
|
Nature of poisoning |
Sex |
1992 |
1993 |
1994 |
|
Accidental |
M |
7510 |
7903 |
8133 |
|
|
F |
5263 |
5231 |
5619 |
|
|
Total |
12773 |
13134 |
13752 |
|
Suicide |
M |
16406 |
17180 |
18784 |
|
|
F |
11680 |
11562 |
12234 |
|
|
Total |
28086 |
28742 |
31018 |
|
Others |
M |
3959 |
4318 |
4247 |
|
|
F |
1960 |
2154 |
2273 |
|
|
Total |
5919 |
6472 |
6520 |
|
Grand Total |
|
46778 |
48348 |
51290 |
Siwach et al (5)
reported 75.5% of cases with suicidal intent. In a study by Chugh
et al (6) 70.6% cases were suicidal and rest 29.4% were accidental. A study conducted by Aggrawal
et al (7) also reported most common intent of poisoning as suicidal. Goel et al (1998) also reported majority (96.1%) with
suicidal intent. Aggrawal et al (7) reported their
data from Patna (1996) revealed accidental ingestion as the most common mode of
poisoning in children 57.7% due to Kerosene, 10.2% miscellaneous, 8.5% unknown,
6.2% organophosphates, 3.5% rodenticides and other
insecticide table-II.
A detailed
analysis of death due to poisoning in the year 1992, 93 and 94 shows that the
most intent of poisoning is suicidal (table-II).Further in 1994 maximum number of
death due to poisoning were reported from West Bengal, Aggrawal
et al (7).
Poisoning
was much more common in people with low socio-economic status.
TABLE-III: DEATHS DUE TO
POISONING IN INDIA (1994; n= 51290)
|
State/UT |
Accident |
Suicide |
Other |
Total |
|
West Bengal |
2025 |
5474 |
750 |
8222 |
|
Maharashtra |
2560 |
3736 |
865 |
7161 |
|
Tamilnadu |
2064 |
3885 |
411 |
6360 |
|
Madhya Pradesh |
1616 |
1714 |
1941 |
5271 |
|
Karnataka |
1102 |
3510 |
500 |
5112 |
|
Andhra Pradesh |
482 |
3137 |
370 |
3989 |
|
Kerala |
94 |
3298 |
51 |
3441 |
|
Uttar Pradesh |
975 |
1023 |
230 |
2228 |
|
Gujarat |
459 |
1337 |
257 |
2053 |
|
Orissa |
338 |
1065 |
450 |
1853 |
|
Rajasthan |
641 |
629 |
110 |
1380 |
|
Delhi |
86 |
164 |
24 |
274 |
TABLE-IV-
POISONING IN ADULT DATA FROM CHANDIGARH (1970-79)
|
Socio economic Status |
Cause |
Rural |
Urban |
||
|
Male |
Female |
Male |
Female |
||
|
Upper (n = 29) |
Accidental |
02 |
02 |
01 |
01 |
|
Suicidal |
12 |
09 |
- |
- |
|
|
Undetermined |
02 |
- |
- |
- |
|
|
Lower (n = 283) |
Accidental |
29 |
09 |
30 |
05 |
|
Suicidal |
87 |
50 |
42 |
05 |
|
|
Undetermined |
07 |
- |
- |
- |
|
The most
common intent of poisoning was suicidal followed by accidental. Over the next decade i.e. 1980 to 1989 Aluminium phosphide became the
most commonly encountered agent in poisoning cases (31.35%) with an increase in
mortality rate to 58%, Aggrawal et al(7), female
ratio was nearly 2:1,Aggrawal et-al(7).
From above observations and discussion the authors reached to the
conclusion that the findings of the present study and those of others are more
or less similar in nature.
CONCLUSION:
Most common
intent of poisoning was noted suicidal while as per poisonous material there
was higher proportion in cases of Aluminium phosphide in comparison to Organophosphorus
this may be because of easy availability of the compounds.
ACKNOWLEDGEMENT:
The authors expresses their sense of gratitude to
Prof. A.K. Bansal, Ex- H.O.D., Department of
Community Medicine, Late Baliram Kashyap
Memorial Govt. Medical College, Jagdalpur (Bastar) 494 001, India, for his expert guidance in
preparing this manuscript
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Received on 21.09.2012
Modified on 22.03.2013
Accepted on 12.04.2013
© A&V Publication all right
reserved
Research J. Pharmacology and
Pharmacodynamics. 5(2): March–April 2013, 140-142