Complicaciones severas por el uso parenteral del Kerosene en intento de autólisis: a propósito de tres casos / Severe complications due to the parenteral use ofKerosene in autolysis intends: a propose of three cases

El suicidio o intento suicida es un proceder muy antiguo, realizado por el ser humano en contra de sí mismo. Se presentó un estudio descriptivo de tres pacientes, que en intento suicida se auto inocularon kerosene, combustible doméstico, lo que desencadenó severa necrosis tisular y lesión pulmonar aguda en uno de ellos. La falta de previsión desde su inicio en el personal facultativo sobre la envergadura de las complicaciones que posteriormente aparecieron, se puso de manifiesto en el estudio. Se realizaron sugerencias para futuros afectados por esta causa.

Suicide or suicidal intend is a very old procedure, carried out by the human being against himself. We presented the descriptive study of three patients who inoculated themselves kerosene, a domestic combustible, in a suicidal intend, unleashing severe tissue necrosis and acute pulmonary lesion in one of them. In the study it was clear the lack of prevision on the reach of the complications that lately appeared, from the part of the medical staff. We made suggestions for the persons injured for this cause in the future.

Epidemiology of acute poisoning in children due to household substances. Mortality and morbidity in Hazara division

Acute Poisoning in children due to house hold substances is a global problem, however mortality and morbidity is nowadays very less in developed countries due to precautionary measures and better treatment facilities while situation in developing countries like Pakistan is alarming one. The present study was conducted to know about the death and injuries due to household poisoning in children in Hazara Division. The purpose of study was also too seek measures to reduce the risk factor. This prospective study was carried out in the Paedriatic unit of Ayub Hospital Complex and Department of Forensic Medicine and Toxicology, Ayub Medical College, Abbottabad from July to 2008 to September 2009. A total number of 6 leases of acute poisoning of children were brought to emergency department of Ayub Hospital Complex. 45 cases were admitted in Paedriatic unit while 16 were treated in emergency department were sent back to home. There were 37 male children [60.65%] and 24 [39.34%] female. The maximum number of cases were between age group 1-5 years 43 [70.49%]. 99% percent cases in our this study were of accidental nature only one case was homicidal nature while suicidal was none. Insecticide / rodenticide were the commonist agent ingested, followed by pharmacutical products. Kerosene oil was the third commonist agent ingested in our studies. Mortality rate was 3.27%. Organo-phosphorus compound [insecticide], rodentcide and kerosene oil [petroleum products] and pharmaceutical products are common source of household accidental poison globally. In developed countries there frequencies is decreasing rapidly due to health education and precautionary measures adopted mandatorily by manufacturers but in developing countries like Pakistan the situation is same as 50 years back. The risk factor can be reduced by adopting preventive measures at national level through health education of masses and parents and making products safety measures mandatory for manufacturers, moreover parents must be educated about the harms of some Herbal agents containing Opiates and on safe storage of medicines and house hold poisonous agents

Accidental poisoning in children: frequency and outcome of the cases at a military hospital

To determine the frequency of accidental poisoning by various agents and their associated outcome in children. Descriptive Study. The study was carried out in emergency department at PNS Shifa hospital Karachi, from January 2007 to December 2008. A total of 200 patients reported with accidental poisoning during the study period. Detailed history and examination regarding the nature of poisoning was taken. Relevant investigations for purpose of diagnosis were carried out. Mortality and morbidity was noted on predesigned proforma. Total 200 patients were admitted with accidental poisoning during the study period. 155[77.5%] of patients belonged to less than 5 year age group. Most frequently ingested poison was kerosene oil [51%], followed by insecticides [17.5%], Oral route was involved in majority of cases 194[97%]. Complications were observed in 6% of cases, Pneumonia was the most frequently occurring complication in 8 [4%] cases of kerosene oil ingestion, followed by seizures in 2 [1%] cases of insecticide ingestion. No mortality was reported in this study. Acute childhood poisoning is a significant public health problem affecting mainly toddlers. Main substances responsible for acute poisoning are Kerosene oil, insecticides, bleach and drugs

Acute poisoning in children: etiological agents, risk factors and outcomes

A total of 70 patients were thus included. The patients were followed till discharge. A Proforma was filled and results were analyzed on SPSS version 10 of computer programme. All consecutive patients of poisoning who visited the Emergency Ward during the study period fulfilling inclusion criteria were enrolled. The mean age was 2.89 years with range of 6 months to 10 years. Male to female ratio was 1.5:1. Kerosene was the commonest agent accounting for 50% of all cases, followed by pharmaceutical products [14.3%] and chemicals [12.9%]. Storage of Kerosene in empty bottles of beverages and lack of proper storage of drugs were the commonest risk factors identified. Oral ingestion was the most common route of intoxication. Most of the patients [84.3%] were discharged without any sequelae. Overall mortality was 5.7%. Conclusion most of toxic substances to which children were exposed were those stored in eatable containers i.e. kerosene oil. Minority of children with accidental poisoning developed serious toxicity. Parents can prevent many of these accidents by identifying, adequately storing and locking away toxic material

Epidemiological aspects of acute childhood poisoning among patients attending a hospital at Kolkata.

A retrospective study from a tertiary care teaching hospital in Kolkata revealed 3.6% of total paediatric admissions were due to poisoning. Majority of the cases included oral/chemical poisoning followed by biological/envennomation. Kerosene was the commonest among all poisoning. Most of the cases were accidental.

Kerosene poisoning--varied systemic manifestations.

We report here unusual clinical manifestations in a case of kerosene poisoning. The patient presented with encephalopathy and in the course of stay in the hospital developed renal tubular acidosis, delayed first-degree burns and myocarditis. With supportivetherapy the patient recovered completely and was discharged without any sequelae.

Acute poisoning in children. Cases hospitalized during a three-year period in Trinidad

The aim of this study is to describe the epidemiological features of acute poisoning in children less than 16 years old who were admitted to a paediatric hospital in north Trinidad. The specific objectives included the determination of the age range most susceptible to poisoning, which agents are mainly responsible, an examination of the need for preventive strategies and educational programmes as well as to evaluate the need for a poison control centre in the country. Data were extracted from the medical records of 169 patients (83 males (49) and 86 females (51) with acute poisoning during the period of January 1998 to December 2000. The results revealed that the majority of cases of poisoning were accidental (84.6), suicide (11.2) and forced poisoning (4.1). The largest category of poisoning was a miscellaneous group (24.8) followed by the drug category (21.8), kerosene (19.5), pesticides (15.9) and bleach (9.4). Paraquat ingestion constituted 5.3 of cases. The highest prevalence of acute poisoning occurred within the age group of 0-4 years (69.2), followed by the age group of 10-13 years (13.6), 5-9 years (9.4) and the age group with the lowest incidence was 14-16 years (7.6). The only fatality was a female (10-13 year-group) and this was due to suicidal ingestion of paraquat. All other cases were treated and subsequently discharged. The frequency of accidental poisoning in Trinidad merits more widespread public education aimed at preventing exposure to toxic substances while increasing the use of deterrents such as child-resistant containers

The spectrum of accidental childhood poisoning in the Caribbean

Objective. To assess accidental poisoning in children in the Caribbean country of Antigua and Barbuda, including the incidence, the types of substances ingested, the age of the children involved, and the clinical outcomes. The results from Antigua and Barbuda were compared with the results of other reports from the English-speaking Caribbean and from the United States of America. Design and Methods. We performed a retrospective review of the charts of all patients less than 13 years old admitted to the Children's Ward at Holberton Hospital in Antigua for accidental poisoning between March 1989 and March 1999. Those data were compared with data from earlier reports from Barbados, Guyana, Jamaica, and the United States of America. Results. In Antigua and Barbuda there were 255 hospital admissions for accidental poisoning among children below 13 years old over that 10-year period. Of the 255 ingestions, 115 of them (45 percent) were in 1-year-old children, 69 (27 percent) were in 2-year-old children, and 26 (10 percent) were in 3-year-old children. These proportions in Antigua and Barbuda are similar to the age patterns seen in the other countries with which we made comparisons. In Antigua and Barbuda there was an annual average of 26 hospital admissions for poisoning for the roughly 20 000 children below 13 years of age, for a rate of 1.3 per 1 000. In comparing the patterns of childhood poisoning in all the countries we studied, we found that, as economic levels rose, there was a shift in the substances ingested, with hydrocarbon and plant ingestions decreasing and chemical and medication ingestions increasing. Conclusions. There is an increasing variety and complexity of poisonous substances ingested as economic conditions improve. This trend would make the establishment of a poison control center for the English-speaking Caribbean a logical step

Pacientes atendidos en el cuerpo de guardia por ingestión de queroseno / Patients seen in the emergency room due to kerosene ingestion

Se realizó un estudio descriptivo y transversal de 30 pacientes atendidos en el Cuerpo de Guardia del Hospital Infantil Norte de Santiago de Cuba, durante el segundo trimestre de 1997, por haber ingerido queroseno; de ellos, los más comúnmente accidentados por esa causa fueron los niños de 1 a 4 años, con predominio de los varones; la cocina fue el lugar de mayor ocurrencia y el horario matutino. Los signos que prevalecieron fueron la tos y falta de aire. Todos los integrantes de la serie evolucionaron satisfactoriamente, con el apoyo directo del personal de enfermería, tanto a los afectados como a sus familiares(AU)

A descriptive and cross-sectional study of 30 patients seen in the Emergency Room of the Infantile Northern Hospital of Santiago de Cuba province was conducted, during the second quarter of 1997, because of kerosene ingestion; the most commonmly injured were the children of 1-4 years old, with boys prevalence; the place and period of greater occurrence were the kitchen and the morning respectively. The signs that prevailed were the cough and lack of air. All the subjects of the series evolved satisfactorily, with the direct support of the nursing staff not only to the affected children but also to their relatives(AU)

Bronchiectasis after kerosene ingestion

Kerosene paraffin ingestion represent a serious source of childhood poisoning in Saudi Arabia. The incidence of pneumonia after kerosene ingestion is high and may be accompanied with pleural effusion, pneumatocele or lung abscess. In this report we describe a case of kerosene ingestion that was complicated with bilateral pneumonia, pleural effusion and later with bronchiectasis

Accidental poisoning in children in Karachi, Pakistan

188 children were admitted to the pediatric ward of the Aga Khan University Hospital during 1991 to 1996 with accidental poisoning. The Mean age was 31] ' 21 months [with range of one month to 14 years]. 52% children were under two years of age and another 42% were between two to five years of age. Males were 63%, and females were 37%. Kerosene was the commonest substance taken by 54[29%], corrosives by 20 [11%] and insecticides by 24[13%] of the children. The commonest drugs were sedatives and tranquilizers, taken by 25[13]% children. None of the drugs were sold in childproof containers. It is recommended that the drags should be sold in child proof containers

Kerosene oil poisoning in children: a hospital-based prospective study in Sri Lanka.

This is a prospective hospital based study of 526 cases of kerosene oil poisoning seen during a 10 year period. There were 5 cases of deliberate self poisoning and 1 case of attempted homicide. 520 cases were accidental. Pneumonitis occurred in 299 children of whom 253 had vomited after kerosene oil ingestion. There were 3 deaths.

Querosene: uma ameaça à saúde do trabalhador / Kerosene: a threat to the health of workers

O querosene é um derivado da destilação do petróleo amplamente utilizado como agente de limpeza em diversas ocupações e atividades de lazer. É, também, empregado como combustível de avião, de lamparina, de forno de cozinha e até como componente de formulações inseticidas. A substância está comprovadamente relacionada à enfermidades dermatológicas (incluindo infecções, ressecamento, queimadura e neoplasia), hematológicas (anemia aplástica, leucocitose , metahemoglobinemia) e respiratórias (é capaz de induzir asma e provocar crises agudas da doença além de desastrosa pneumonite química nos casos de ingesta acidental e/ou aspiração). São apresentadas considerações gerais sobre a fisiopatologia da intoxicação aguda e seu tratamento, destacando medidas relevantes para a prevenção dos danos causados por sua exposição ocupacional, tanto por parte do trabalhador quanto do empregador. É proposta uma rotina para o exame médico admissional, periódico e demissional dos trabalhadores que irão manipular o produto. O trabalho faz uma revisão da legislação vigente, que define o querosene como agente insalubre de grau médio. Por último, o autor apresenta uma reflexão sobre a postura do empregador e trabalhador sobre a questão da insalubridade.

Prognostic score for kerosene oil poisoning.

Ninety five consecutive children with kerosene oil poisoning were studied, the first 70 retrospectively (internal group) and the rest 25, prospectively (external group) over a period of 3 years and 8 months. Based on clinical features and severity of illness in initial 70 cases, a weighted scoring system to determine the outcome was evolved. This included: (i) fever--absent 0, present 1; (ii) severe malnutrition--absent 0, present 1; (iii) respiratory distress--absent 0, present 2, with cyanosis 4; and (iv) neurological symptoms--absent 0, present 2, with convulsions 4. The scores ranged from 0 to 10 in the internal group. Using discriminate function analysis, a score of 4 or more was found to be associated with prolonged hospital stay and complications. The risk of dying increased if the score was equal to or more than 8. The predictive value of the score was 85.7%. For validation, this scoring was applied to the external group as well and 84% of cases could be correctly predicted.

A study of accidental poisoning (in children) in a rural medical college hospital of West Bengal.

134 cases of accidental poisoning in children have been reported, children belonging to the age group of 1-3 years are the main victims. Kerosene has been noted as the single most important cause of poisoning. Mortality was fortunately low amounting to 5.2% of all cases.