Abstract

Dr. Imran Ali, Dr. Aaima Bakhtawar and Dr. Muhammad Sharief*

ABSTRACT

Aim of study: The objective of this study was to explore the clinical course and outcome of patients with this poisoning. Methodology: It is a cross-sectional observational study conducted at Nishtar Hospital, Multan for 6 month of duration from March 2017 to August 2017. History, examination, investigation and treatment given all were recorded on a preformed proforma. Patients having age below 15 years or with pre-existing morbid conditions e.g. Cardiac, Renal and hepatic disorders were excluded from the study. Results: There were total 120 patients out of which 88 (73.4%) were females and 32 (26.6%) males. Mean age was 24.5±6.2 and mean duration of hospital stay was 13.8±4.5 days. 58 belongs to age group 15-25 years, 34 patients in age group 26-35 years. 99 patients were from rural areas and 21 were from urban areas. We observed that 55.8% cases were from middle class. 68 patients were illiterate, 27 had got primary education, and only 3 patients were graduates. 77 (64.1%) patients were married. Tracheostomy was performed on 112 patients. 13 patients needed mechanical ventilation and 18 patient needed few sessions of hemodialysis. Angioedema was present in 91.6%, muscle pain in 90%, vomiting in 87.5%, dyspnea in 91.6%, oro-facial edema in 95%, dark colored urine in 115%, oliguria in 34% and 8% patient presented with anuria. 84 patients were having raised TLC i.e. above 11 thousand, raised blood urea in 58 patients, raised serum creatinine in 76, raised CPK in 116 patients, raised CK-MB in 89, hyperkalemia was observed in 40 patients, deranged LFT’s in 39 patients, 27 patients were having pathological findings in X-ray chest and 73 patients were having changes in ECG. 113 (94.1%) patients survived and mortality rate in this study was 5.8%. Conclusion: Paraphenylene diamine (kala pathar) poisoning is emerging now a days due to easy availability and low cheap price. It is more common in poor, illiterate, married females of younger age group living in rural areas in our set-up. Aggressive treatment and tracheostomy can save life of patients.