Fatal plant poisoning in Kasturba hospital, Manipal

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Fatal plant poisoning in Kasturba hospital,
Manipal

• Pinakini KS?, Mohan Kumar TS?,
• Vikram Palimar?, Pradeep Kumar G?
• ? Dept of Pharmacology, MMMC, Manipal
• ? Dept of Forensic Medicine, KMC,Manipal

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Introduction

• Plant poisoning may be accidental, self induced,
  or homicidal
• Diagnosis is difficult / impossible
• Clinical features mimic natural disease
• Lack of knowledge of plants
• Different nomenclatures

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Materials and Methods

• A 12 year retrospective study
• (1993-2004)
• Hospital records
• Autopsy reports
• FSL reports

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Profile of poisoning deaths
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Clinical profile
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Clinical profile
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Lab parameters
Sahu et al, Yellow oleander poisoning with
jaudice renal failure. JAPI 1989
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Treatment

• Gastric lavage
• Inj atropine bradyarrythmias
• Temporary pacemaker femoral vein
• Phenytoin / lignocaine tachyarrythmias

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Autopsy findings

• Congestion of GI tract
• Brain congested edematous
• Heart - Subendocardial haemorhages
• Kidneys bilaterally congested
• FSL-Cardiac glycosides in the viscera

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Discussion

• Cardiac glycosides Cerbera thevetia odollum
• Apocynaceae
• Active principles
• cerberin, odolin, thevetin thevotoxin
• Accidental in children
• Suicidal/homicidal adults
• Cardiac manifestations

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thank u