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Clinical pharmacy and clinical trials (including case series)
A prospective observational study on prevalence of poisoning cases – focus on vasmol poisoning (para-phenylenediamine(PPD) poisoning)
  1. G. Uday Kiran,
  2. N. Shilpa,
  3. K. Ravindra Reddy,
  4. S. Chandra babu,
  5. K.V. Yadavendra Reddy
  1. 1P.R.R.M college of Pharmacy, Pharm.D, Kadapa, India
  2. 2P.R.R.M College of Pharmacy, Pharmaceutics, Kadapa, India
  3. 3RIMS Medical College and Hospital, General Medicine, Kadapa, India

Abstract

Background The intentional and accidental poisoning by various modes are common in India. Nearly 1 million people die each year globally due to poisoning. Vasmol is an external preparation that contains para-phenylenediamine as major ingredient, used as hair dye. There were no much studies on Vasmol(PPD) poisoning. Our study mainly focused on Vasmol(PPD) poisoning, as its incidence is more in our region.

Purpose To detect and evaluate the prevalence of different poisoning cases and to analyse the clinical symptoms, causes, their outcome and finally to assess the effectiveness of supportive therapy for Vasmol(PPD) poisoning.

Materials and methods A prospective observational study was conducted on different poisoning cases over 5-months period(March-2011 to July-2011) in general medicine and ICU departments of a tertiary care teaching hospital. A specially designed patient data collection proforma was used to collect the information and various parameters were analysed.

Results Out of 680 poisoning cases, Vasmol(PPD)-419, Organophosphorous-90, Tablets-62, Others-109 were observed. In Vasmol(PPD) poisoning 126(30%)-male and 293(69%)-female with most cases between the age-group of 12-25. The clinical features were Cervicofacial oedema-163(40%), Stridor-102(24%), Myalgia-79(19%), Gastrointestinal disturbances-37(9%), Seizures-5(1%), Vertigo-56(13%) and Rhabdomyolysis-135(32%). Tracheostomy is the most commonly used supportive therapy which was done for 71(17%) cases where 52 recovered and 19 died. Deaths were mainly due to Cardiorespiratory failure-11(58%), Myocarditis-5(26%), Cardiac-arrest-2(11%) and Acute renal failure-1(5%). Rest of the results were categorised based on socio-demographic status, volume consumed, reasons for poisoning and laboratory findings.

Conclusions Vasmol(PPD) hair dye intoxication is a life threatening condition. Clinical outcomes rely on early recognition, prompt referral and supportive therapy. This study has shown that Vasmol(PPD) poisoning mortality was 5%, due to Cardiorespiratory failure, Cardiac-arrest, Myocarditis and Acute renal failure. Tracheostomy is the life-saving measure in reducing mortality. Community should be educated about handling of poisonous substances which endanger their life and there should also be a proper control over sale of Vasmol.

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