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Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital

Received: 19 September 2015     Accepted: 22 September 2015     Published: 23 October 2015
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Abstract

Cleistanthus collinus (Oduku) is a common suicidal poison used in rural southern India. There is paucity of information on human studies about this poisoning at global level. We conducted a cross-sectional observatory study to analyse clinical and laboratory profile of patients admitted with Oduku poisoning in Department of General Medicine, Government medical college, Thrissur over a period of one year from 1st January 2013 to 31st December 2013.Out of the 143 cases of plant poisoning, study population consisted of76 (53%)patients who consumed Oduku. Mean age of the population was 33.5 years (+/-SD 16.10). 43 patients (57.33%) were asymptomatic; among those with symptoms, 41 patients (54.67%). had nausea, 33 patients (44.00%) had vomiting, 7 patients (9.33%) had abdominal pain, 1 patient (1.33%) had palpitation and altered sensorium. Hypokalemia was found in 15 patients (19.74%) on admission, 7 patients (9.33%) after 24 hours and 8 patients (10.67%) after 48 hours. ECG changes observed were ST depression (23.68%), T inversion (23.68%) and u waves (17.11%). Mortality rate of Oduku poisoning found in this study was 2.63% (n=2) and expired patients showed persistent hypokalemia despite treatment. Oduku plant constitutes a major agent of DSH among the plant poisons in South India. Gastrointestinal, cardiovascular and neurological symptoms are common with oduku poisoning. Hypokalemia and ECG changes are seen, but mortality rate is low.

Published in American Journal of Internal Medicine (Volume 3, Issue 6-1)

This article belongs to the Special Issue Toxicology

DOI 10.11648/j.ajim.s.2015030601.14
Page(s) 14-17
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Cleistanthus Collinus, Oduku Poisoning, Deliberate Self Harm, Hypokalemia, U Waves

References
[1] Eddleston M, Sheriff MHR, Hawton K. Deliberate self-harm in Sri Lanka: an overlooked tragedy in the developing world. Br Med J 1998; 317:133–5
[2] Shankar, V., Jose, V. M., Bangdiwala, S. I., & Thomas, K. (2009). Epidemiology of Cleistanthus collinus (oduvan) poisoning: clinical features and risk factors for mortality. International Journal of Injury Control and Safety Promotion, 16, 223–230.
[3] Bammigatti, C., Surynarayana, B. S., Harichandra Kumar, K. T., & Ganesh Kumar, S. (2013). Pattern and outcome of Cleistanthus collinus (Oduvanthalai) poisoning in a tertiary care teaching hospital in South India. Journal of Forensic and Legal Medicine, 20, 959–961.
[4] SPE Benjamin, M Edwin Fernando, J Jerene Jayanth, B Preetha, Cleistanthus Collinus Poisoning.journal of association of physicians India vol 54
[5] Asolkar LV, Kakkar KK, Chakre OJ, eds. Second Supplement to Glossary of Indian Medicinal Plants with Active Principles Part-1(A-K) (1965-1981) : New Delhi,National Institute of Science Communication(CSIR), 2000:214
[6] Subrahmanyam DK, Mooney T, Raveendran R, Zachariah B. A clinical and laboratory profile of Cleistanthus collinus poisoning. J Assoc Physicians India. 2003;51:1052–4
[7] Satyanarayana P, Subrahmanyam P, Koteswara RP. Chemical constituents of Cleistanthus collinus roots. Indian J Pharm Sci 1984;46:95-96.
[8] Rajagopal Naidu S,Venkat Rao P, Subrahmanyam CA.The microscopy and chemistry of oduvin. J Proc Inst Chem India 1944;16:59-63.
[9] Thomas K, Dayal AK, Gijsbers A, Seshadri MS. Oduvanthalai leaf poisoning. J Assoc Physicians India. 1987;35:769–71
[10] Nagaraj S. Cardiac toxicity of Oduvanthalai (Cleistanthus collinus) common leaves poisoning in Tamil Nadu (Report of 25 cases) Antiseptic.1987;84:33–5
[11] Shankar V, Jose VM, Bangdiwala SI, Thomas K. Epidemiology of Cleistanthus collinus (oduvan) poisoning: Clinical features and risk factors for mortality. Int J Inj Contr Saf Promot. 2009;16:223–30
[12] Nagaraj S. Cardiac toxicity of Oduvanthalai (Cleistanthus collinus) common leaves poisoning in Tamil Nadu (Report of 25 cases) Antiseptic. 1987;84:33–5.
[13] Eswarappa S, Chakraborty AR, Palatty BU, Vasnaik M. Cleistanthus collinus poisoning: Case reports and review of literature. J Toxicol Clin Toxicol. 2003;41:369–72
[14] Shankar, V., Jose, V. M., Bangdiwala, S. I., & Thomas, K. (2009). Epidemiology of Cleistanthus collinus (oduvan) poisoning: clinical features and risk factors for mortality. International Journal of Injury Control and Safety Promotion, 16, 223–230.
[15] Nampoothiri K, Chrispal A, Begum A, Jasmine S, Gopinath KG, Zachariah A. A clinical study of renal tubular dysfunction in Cleistanthus collinus (Oduvanthalai) poisoning. Clin Toxicol (Phila) 2010;48:193–7
[16] Aleem MA, Paramasivam M. Spectrum of acute poisoning in villagers. J Assoc Physicians India. 1993;43:85
[17] Subrahmanyam DK, Mooney T, Raveendran R, Zachariah B. A clinical and laboratory profile of Cleistanthus collinus poisoning. J Assoc Physicians India. 2003;51:1052–4
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    Ramya Das N. K., Mary Grace N. C., Indira M., Jayachandran N. V. (2015). Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital. American Journal of Internal Medicine, 3(6-1), 14-17. https://doi.org/10.11648/j.ajim.s.2015030601.14

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    ACS Style

    Ramya Das N. K.; Mary Grace N. C.; Indira M.; Jayachandran N. V. Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital. Am. J. Intern. Med. 2015, 3(6-1), 14-17. doi: 10.11648/j.ajim.s.2015030601.14

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    AMA Style

    Ramya Das N. K., Mary Grace N. C., Indira M., Jayachandran N. V. Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital. Am J Intern Med. 2015;3(6-1):14-17. doi: 10.11648/j.ajim.s.2015030601.14

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  • @article{10.11648/j.ajim.s.2015030601.14,
      author = {Ramya Das N. K. and Mary Grace N. C. and Indira M. and Jayachandran N. V.},
      title = {Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital},
      journal = {American Journal of Internal Medicine},
      volume = {3},
      number = {6-1},
      pages = {14-17},
      doi = {10.11648/j.ajim.s.2015030601.14},
      url = {https://doi.org/10.11648/j.ajim.s.2015030601.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.s.2015030601.14},
      abstract = {Cleistanthus collinus (Oduku) is a common suicidal poison used in rural southern India. There is paucity of information on human studies about this poisoning at global level. We conducted a cross-sectional observatory study to analyse clinical and laboratory profile of patients admitted with Oduku poisoning in Department of General Medicine, Government medical college, Thrissur over a period of one year from 1st January 2013 to 31st December 2013.Out of the 143 cases of plant poisoning, study population consisted of76 (53%)patients who consumed Oduku. Mean age of the population was 33.5 years (+/-SD 16.10). 43 patients (57.33%) were asymptomatic; among those with symptoms, 41 patients (54.67%). had nausea, 33 patients (44.00%) had vomiting, 7 patients (9.33%) had abdominal pain, 1 patient (1.33%) had palpitation and altered sensorium. Hypokalemia was found in 15 patients (19.74%) on admission, 7 patients (9.33%) after 24 hours and 8 patients (10.67%) after 48 hours. ECG changes observed were ST depression (23.68%), T inversion (23.68%) and u waves (17.11%). Mortality rate of Oduku poisoning found in this study was 2.63% (n=2) and expired patients showed persistent hypokalemia despite treatment. Oduku plant constitutes a major agent of DSH among the plant poisons in South India. Gastrointestinal, cardiovascular and neurological symptoms are common with oduku poisoning. Hypokalemia and ECG changes are seen, but mortality rate is low.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital
    AU  - Ramya Das N. K.
    AU  - Mary Grace N. C.
    AU  - Indira M.
    AU  - Jayachandran N. V.
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    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    EP  - 17
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.s.2015030601.14
    AB  - Cleistanthus collinus (Oduku) is a common suicidal poison used in rural southern India. There is paucity of information on human studies about this poisoning at global level. We conducted a cross-sectional observatory study to analyse clinical and laboratory profile of patients admitted with Oduku poisoning in Department of General Medicine, Government medical college, Thrissur over a period of one year from 1st January 2013 to 31st December 2013.Out of the 143 cases of plant poisoning, study population consisted of76 (53%)patients who consumed Oduku. Mean age of the population was 33.5 years (+/-SD 16.10). 43 patients (57.33%) were asymptomatic; among those with symptoms, 41 patients (54.67%). had nausea, 33 patients (44.00%) had vomiting, 7 patients (9.33%) had abdominal pain, 1 patient (1.33%) had palpitation and altered sensorium. Hypokalemia was found in 15 patients (19.74%) on admission, 7 patients (9.33%) after 24 hours and 8 patients (10.67%) after 48 hours. ECG changes observed were ST depression (23.68%), T inversion (23.68%) and u waves (17.11%). Mortality rate of Oduku poisoning found in this study was 2.63% (n=2) and expired patients showed persistent hypokalemia despite treatment. Oduku plant constitutes a major agent of DSH among the plant poisons in South India. Gastrointestinal, cardiovascular and neurological symptoms are common with oduku poisoning. Hypokalemia and ECG changes are seen, but mortality rate is low.
    VL  - 3
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Author Information
  • Department of General Medicine, Government Medical College, Thrissur, India

  • Department of General Medicine, Government Medical College, Thrissur, India

  • Department of General Medicine, Government Medical College, Thrissur, India

  • Department of General Medicine, Government Medical College, Thrissur, India

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