Abstract | OBJECTIVE: To determine the clinical presentation, complications, and outcome of paraphenylene diamine ( PPD) poisoning in patients presenting to Nishtar Hospital, Multan. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Medical Unit II and III, Nishtar Hospital, Multan, from April 2015 to September 2016. METHODOLOGY: All adult patients admitted with history of paraphenylene diamine ingestion were evaluated for clinical features, complications, and outcomes on a pre-designed proforma. RESULTS: Out of 122 patients, 95 were females (77.9%) and 101/122 patients had ingested the poison with an intention of suicide or self harm (82.8%). The mean age of presentation was 23.21 ±8.2 years. Cervico-facial edema was the chief presenting complaint, seen in 116/122 (95%) of patients, with median of 2 (interquartile range=3) for time of onset after ingestion of poison. Tracheostomy was needed in 95/116 (82%) patients with cervico-facial edema. Other common complaints were dark urine in 95/122 (77.9%) and pain in limbs in 98/122 (80.3%) patients. Rhabdomyolysis was evident in 91/122 (74.5%) patients at admission. Acute kidney injury developed in 37/122 (30.3%) patients. Among these, 16 (43.2%) patients required haemodialysis. Myocarditis was diagnosed in 33/122 (27%) patients. The median for hospital stay was 9.50 days (interquartile range=6.25). The mortality was 34/122 (28%). Ventricular arrhythmias were the commonest cause of death in 25/34 (73.5%), followed by renal failure in 5/34 (14.7%), asphyxia in 2/34 (5.88%), and aspiration pneumonia in 2/34 (5.88%) patients. CONCLUSION: Paraphenylene diamine is an emerging domestic poison in Pakistan, with a high morbidity and mortality.
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Authors | Salma Tanweer, Mehwish Saeed, Saira Zaidi, Wasif Aslam |
Journal | Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
(J Coll Physicians Surg Pak)
Vol. 28
Issue 5
Pg. 374-377
(May 2018)
ISSN: 1681-7168 [Electronic] Pakistan |
PMID | 29690967
(Publication Type: Journal Article)
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Chemical References |
- Phenylenediamines
- 4-phenylenediamine
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Topics |
- Acute Kidney Injury
(chemically induced, diagnosis, therapy)
- Adolescent
- Adult
- Angioedema
(chemically induced, diagnosis, therapy)
- Female
- Humans
- Length of Stay
(statistics & numerical data)
- Male
- Myocarditis
(chemically induced, diagnosis, therapy)
- Pakistan
(epidemiology)
- Phenylenediamines
(administration & dosage, poisoning)
- Poisoning
(mortality)
- Rhabdomyolysis
(chemically induced, diagnosis, therapy)
- Suicide
(statistics & numerical data)
- Suicide, Attempted
(statistics & numerical data)
- Treatment Outcome
- Young Adult
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