Epidemiological and clinical profile of various plant poisons in a tertiary care center in South Tamilnadu, India
Keywords:Cardiotoxitity, Datura, Glory lily, Neem oil, Oleander seeds
Background: Plant poisoning is a common scenario in a toxicology unit . Some of the plants contain active components used as medicines. However, some of the plant constituents are poisonous with wide variety of clinical manifestations. Authors aimed to study the pattern of various types of plant poisons and clinical presentations and complications of various plant poisons admitted in our toxicological unit.
Methods: A total of 87 patients admitted with history of plant poison ingestion, in toxicological unit of Tirunelveli medical college were studied . It was a retrospective observational study and was done over a period of one year.
Results: Out of 87 cases studied, 92%were due to consumption with suicidal intention. Plant poisoning ranks second only to pesticide poisoning . among the plant poisons encountered 66.6% were due to Oleander poison, followed by Datura (8%) and Glory lily(5.7%). Common parts of plant consumed by patients include seeds and plant oils . Vomiting and abdominal pain were the commonest presentations. Encephalopathy, dyselectrolytemia and arrhythmias were the notable complications in our study.
Conclusions: Early admission and prompt first aid and monitoring at tertiary care center are key to the reduced mortality. The study throws light on various manifestations, toxic parts and complications of plant poisons.
Singh NP, Guleen kaur. Poisoning - Basic considerations and Epidemiology. In: YP Munjal ED.API Textbook of Medicine. 9th edition. Mumbai: Jaypee Brothers Publicaions;2012:1934.
Ballantyne B, Mars TC, Turner P. Fundamentals of toxicology. General and Applied Toxicology. New York: McMillan;1995:1309-1427.
Ghosh N, Ghosh R, Mandal V, Mandal SC. Recent advances in herbal medicine for treatment of liver diseases. Pharm Biol. 2011;49(9):970-88.
Ekor M. The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Front Phamacol. 2014;4:177.
Patel SS, Beer S, Kearney DL; Phillips G, Carter BA. Green tea extract: A potential cause of acute liver failure. World J Gastroenterol. 2013;19(31):5174-7.
Tiongson J, Salen P. Mass ingestion of jimson weed by eleven teenagers. Del Med J.1998;70(11):471-6.
Palatnick W, Tenenbein M. Hepatotoxicity from castor bean ingestion in a child. J Toxicol Clinical Toxicol. 2000:38(1):67-9.
Malangu N. Contribution of plants and traditional medicines to disparities and similarities in acute poisoning incidents in Botswana, South Africa and Uganda. Afr J tradit complement altern med. 2014;11(2):425-38.
Ghorani – Azam A, Sepahi S. Plants toxins and acute medicinal plants poisoning in children : A systematic literature Review. J Res Med Sci. 2018;23:26.
Prakash Babu S, Chandrika DG, Kulkarni MR .Plant poisoning –an observational study in a tristate region emergency department.International journal of medicine and public health. 2016;5(10):2158-62.
Gopalakrishnan SK, Kandasamy S. Oleander toxicity- The clinical spectrum and mortality prediction: an observational study. Intern J Medicine Update. 2017 Jan;12(1):4-8.
Dwivedi S, Rajpal S, Narang S. Cardiotoxic manifestations of yellow oleander poisoning and its treatment: A case report. Indian Heart J. 2006;58(6):450-1.
DKS Subrahmanyam, Muktha V. Plant poisoning. In :YP Munjal Ed. API textbook of medicine. 10th ed. Mumbai. Jaypee Publications. 2015:2644-45.
horani-Azam A, Sepahi S, Riahi-Zanjani B, Ghamsari AA, Mohajeri SA, Balali-Mood M. Plant toxins and acute medicinal plant poisoning in Children J Res Med Sci. 2018;March;23(1)26.
Aleem HM. Gloriosa superba poisoning. JAP1 1992;40:541-2.
Dunuwille R, Balasubramanian K Bibile SW. Analysis of alkaloids in Gloriosa superba. Ceylon J Med Sci. 1968;17(1):1.
Baud FJ, Sabouraud A, Vicaut E, Taboulet P, Lang J, Bismuth C, et al. Brief report:Treatment of severe colchicine overdose with colchicine specific Fab fragments. NEJM 1995;332(10):642-5.
Wink Michael : Ben - Erik Van Wyk: Coralie Wink (2008). Handbuch der giftigen und Psychogktiven Pflanzen . ISBN 978 - 3-8047-2425-9.
Pfab R. Poisoning by Citrullus colocynthis. Unknown to us, a frequent poisonous plant in foreign travel. MMV. Fortschr Mede. 1999;141 (31.32):41-2.
Kesri R, Joseph J, Henry RA, Thomas A, Rao GG. Cleistantus collinus poisoning ; Diagnostic dilemma and N- Acetyl cysteine as a possible treatment option. JAPI. 2016;64(1);142.
Mohan A, Naik Gs et al. 2016. Cleistanthus collinus poisoning experience at a medical intensive care unit in a tertiary care hospital in South India. Indian J medical Res .143(6);793-7.
Subrahmanyam DK, Mooney T, Reveendran R, Zachariah B. A clinical and laboratory profile of Cleistanthus collinius poisoning. JAPI. 2003:Nov 21;57:1052-4.
Tibballs J. Clinical effects and management of Eucalyptus oil ingestion in infants and young children. Med J Aust. 1995;163(4):177-80.
Karunakara B, Jyotirmanju C. Eucalyptus oil poisoning in children. J pediatr sci. 2012;60:1-6.
Alzohairy MA. Therapeutics Role of Azadirachta Indica. Evid Based complement Alternat Med. 2016;7382506.
Mishra A, Dave N. Neem oil poisoning : Case report of an adult with toxic encephalopathy. Indian J Critical Care Medicine. 2013;Sep-Oct;17(5):321-2.
Dhongade RK, Kavade SG, Damle RS. Neem oil poisoning. Indian Pediatr. 2008;56-7.