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

Ramya Das N. K.; Mary Grace N. C.; Indira M.; Jayachandran N. V.

doi:doi:10.11648/j.ajim.s.2015030601.14

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

Ramya Das N. K., Mary Grace N. C., Indira M., Jayachandran N. V.

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

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

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[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
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[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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APA Style

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.
Y1  - 2015/10/23
PY  - 2015
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DO  - 10.11648/j.ajim.s.2015030601.14
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
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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
IS  - 6-1
ER  -

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Author Information

Ramya Das N. K.

Department of General Medicine, Government Medical College, Thrissur, India
Mary Grace N. C.

Department of General Medicine, Government Medical College, Thrissur, India
Indira M.

Department of General Medicine, Government Medical College, Thrissur, India
Jayachandran N. V.

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

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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

Copy | Download

@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.
Y1  - 2015/10/23
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.s.2015030601.14
DO  - 10.11648/j.ajim.s.2015030601.14
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 14
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
IS  - 6-1
ER  -

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