Clinico-Epidemiological study of poisoning in a tertiary care hospital in Bangladesh

Objective: The scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool. Methods: This prospective study was done at two medicine units (Unit ۵ and ۱۰) of Dhaka Medical College Hospital from July to December ۲۰۱۰ where all poisoning cases were seen. A total of ۲۸۹۰ patients were admitted out of which ۶۰۰ were taken into the study. Results: Among the poisoning cases ۲۹% were pesticide, ۲۷% travel related poisoning, and ۲۰% benzodiazepine. ۷۰% of poisoning occurred below ۳۰ years of age and male: female ratio was ۳:۲. Incidence of poisoning was highest among students (۳۱%) and housewives (۲۵%). Majority of the patients were from urban area (۷۶%) and most common intention was suicidal (۶۶%). Familial disharmony was the prime cause (۶۳%) behind poisoning. ۴۲% cases got admitted between ۵-۸ hours of poisoning and more than ۸۰% patients were admitted in the hospital directly without getting any first aid anywhere. Sixty-eight percent had Glasgow coma scale (GCS) score above ۱۰ during admission. Cardinal clinical features of poisoning were nausea/vomiting (۶۳%), drowsiness (۵۶%), miosis (۳۱%). Seventy percent patients were treated with only general and supportive treatment and specific antidotes were used in ۳۰% cases. Case fatality for pesticide, benzodiazepine/anti-psychotic, rodenticide and snake bite was ۶.۹%, ۲.۲%, ۸.۳% and ۳.۳% respectively. Conclusion: To assess the magnitude of problem, awareness of the public for prevention, immediate first aid measures and quick hospital admission is crucial component of poisoning.

Keywords:

Clinical , Epidemiology , Poisoning , Tertiary care center