Seasonal variation of childhood acute poisoning

Acute poisoning is a common medical emergency in paediatric unit. This was a retrospective study to see the seasonal variation of acute poisoning in children in a tertiary hospital. The study was done in Khulna Medical College Hospital from January 2004 to December 2005. The cases were studied to see the seasonal variations and other epidemiological and clinical parameters. One hundred ninety three patients enrolled in the study were divided in four groups. Prevalence and type of poisoning was observed in winter, spring, summer and rainy seasons respectively. A total of 193[4.7%] cases of childhood acute poisoning were admitted. Out of them 107[55.4%] cases were male and rest 86[44.6%] were female. 1-3 years was the most vulnerable age group to be affected [P<.005]. Kerosene was the commonest form of ingredient used. Poisoning cases were more common during summer season [P<.005]. Overall mortality rate was 4.66%. Poisoning was common during the summer season and kerosene was found to be most common ingredient. It was possibly due to easy availability of kerosene and during the summer months thirsty children took this substance which was sometimes kept in the discarded container of soft drinks and mineral water bottles etc. People should be warned not to keep these toxic ingredients in such containers and within reach of the children

Drug defaulters in pulmonary tuberculosis

To recognize the factors behind premature stoppage of anti-tuberculous drugs in drug defaulters. Cases of pulmonary tuberculosis who discontinued anti-tuberculous drugs for atleast on month, developed tuberculosis again and anti-tuberculous drugs had to be resumed were labelled as drug defaulters and studied in details. In-patients of Tuberculosis Hospital, Khulna [A Divisional Tuberculosis Hospital], Bangladesh. One hundred and seventy nine cases of drug defaulters who discontinued anti-tuberculous drugs earlier were studied during the period January 1996 to June 1998. Clinical characteristics, anti-tuberculous and associated drugs prescribed and reasons behind premature stoppage of drugs in drug defaulters. The age of 179 [males 119 and females 60] cases ranged from 11-65 years with a mean +/- SDof 35.8 +/- 12.7 years. 30.3% of the male cases were farmers. 167 [93.3%] cases initially started a good short course regimen, but discontinued later on. 110 [61.5%] cases discontinued after one month and further 42 [23.5%] cases within another one month. Maximum 72 [40.2%] number of cases discontinued therapy due to financial constraints. Other reasons for defaulting were, poor briefing in 41 [22.9%], ignorance 31 [17.3%], adverse effects of drugs 18 [10.1%], apparent subjective improvement 11 [6.1%] and scarcity of drugs in 6 [3.4%]. Since drug defaulters may play a vital role in the emergence of multi-drug resistant tuberculosis, the reasons behind premature discontinuation of drugs need to be identified and appropriately dealt with. Since cost is the major factor, anti-tuberculous drugs should be made available free of cost under direct supervision, if possible and the cases should also be reviewed periodically