Examining Biological Samples of People Poisoned with Aluminum Phosphide Referred to Forensic Medicine in Mazandaran Province in Terms of the Presence of Aluminum Phosphide during 2019-2021
Article Sidebar
Main Article Content
Abstract
Introduction: Rice tablet (aluminum phosphide:ALP) are an inorganic substance that is used as an insecticide and rodenticide in grain storage and transportation. It liberates lethal phosphine gas when it comes in contact either with atmospheric moisture or with hydrochloric acid in the stomach. ALP poisoning may be associated with serious and sometimes incurable complications. Considering the large number of suicides and poisonings, especially the suicides of young people with aluminum phosphide, and the lack of sufficient information about the prevalence of aluminum phosphide poisoning in Mazandaran province, the aim of this study, is to assess of complications leading to deaths in patients with aluminum phosphide poisoning referred to the forensic medicine of the Mazandaran province and also to check the registration rate of the midbrain sample compared to other samples.
Materials and Methods: In this study, 27 deceased people were determined by a history of poisoning with certain rice tablets, and then a silver nitrate test was conducted on gastric content of all cases. Then the sample of gastric contents and the liver sample along with the midbrain sample were sent to the laboratory and the results are compared. After collecting the data, the data will be entered into SPSS18.
Results: The frequency distribution of the samples separately was based on the samples taken from the liver, stomach and midbrain sections. It was found that 68%, 47% and 32% of the samples was positive in the stomach, liver and midbrain respectively.
Conclusion: According to the findings, the midbrain is a helpful sample, and in cases where the midbrain sample is positive along with the positive liver and stomach samples, it can indicate the true positivity of the presence of phosphine in the midbrain.
Article Details
References
1. Marchi AG, Messi G, Renier S. Epidemiology of children poisoning: comparison between telephone inquiries and emergency room visits. Vet Hum Toxicol. 1992;34(5):402-404.
2. Costa G, Gołembiowska K. Neurotoxicity of MDMA: Main effects and mechanisms. Exp Neurol. 2022 Jan;347:113894. DOI: 10.1016/j.expneurol.2021
3. Caravati EM, Erdman AR, Scharman EJ, Woolf AD, Chyka PA, Cobaugh DJ, et al. Long-acting anticoagulant rodenticide poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(1):1-22. DOI: 10.1080/15563650600795487
4. Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol. 2003;32(6):902-909. DOI: 10.1093/ije/dyg30
5.. Hassanian-Moghaddam H. Phosphides and phosphine: Mechanisms for toxicity and range of the problem. InClinical Toxicology 2014;52(4):397-398.
6. Rahbar Taromsari M, Teymourpour P, Jahanbakhsh R. Survey the histopathological findings in autopsy of poisoned patients with rice tablet (Aluminium Phosphide). Journal of Guilan University of Medical Sciences. 2011;19(76):56-63.
7. Van den Berg M, Birnbaum LS, Denison M, De Vito M, Farland W, Feeley M, et al. The 2005 World Health Organization reevaluation of human and mammalian toxic equivalency factors for dioxins and dioxin-like compounds. Toxicol Sci. 2006;93(2):223-41. DOI: 10.1093/toxsci/kfl05
8. Shokrzadeh M, Poorhossein M, Nasri Nasr Abadi N, Veisi F. Epidemiologic study of mortality rate from carbon monoxide poisoning recorded in Mazandaran department of forensic medicine, 2009-2011. Journal of Mazandaran University of Medical Sciences. 2013;23(99):86-95.
9. Singh S, Dilawari JB, Vashist R, Malhotra HS, Sharma BK. Aluminium phosphide ingestion. Br Med J (Clin Res Ed). 1985;290(6475):1110-1. DOI: 10.1136/bmj.290.6475.1110
10. Hassanian-Moghaddam H, Zamani N. Therapeutic role of hyperinsulinemia/euglycemia in aluminum phosphide poisoning. Medicine (Baltimore). 2016;95(31):e4349. DOI: 10.1097/MD.0000000000004349
11. Chugh SN, Jaggal KL, Sharma A, Arora B, Malhotra KC. Magnesium levels in acute cardiotoxicity due to aluminium phosphide poisoning. Indian J Med Res. 1991;94:437-439.
12. Chugh S. Aluminium phosphide poisoning: present status and management. J Assoc Physicians India. 1992;40(6):401-405.
13. Christophers AJ, Singh S, Goddard DG. Dangerous bodies: a case of fatal aluminium phosphide poisoning. Med J Aust. 2002;176(8):403; author reply 403. DOI: 10.5694/j.1326-5377.2002.tb04471
14. Moghadamnia AA, Abdollahi M. An epidemiological study of poisoning in northern Islamic Republic of Iran. East Mediterr Health J. 2002;8(1):88-94.
15. Chan L, Crowley R, Delliou D, Geyer R. Phosphine analysis in post mortem specimens following ingestion of aluminium phosphide. J Anal Toxicol. 1983;7(4):165-167.
16.. Lall SB, Peshin SS, Mitra S. Methemoglobinemia in aluminium phosphide poisoning in rats. Indian J Exp Biol. 2000;38(1):95-97.
17.. Chugh SN, Aggarwal HK, Mahajan SK. Zinc phosphide intoxication symptoms: Analysis of 20 cases. Int J Clin Pharmacol Ther. 1998;36(7):406-407.
18.. Jain SM, Bharani A, Sepaha GC, Sanghvi VC, Raman PG. Electrocardiographic changes in aluminium phosphide (ALP) poisoning. J Assoc Physicians India. 1985;33(6):406-409.
19. Sharda M, Goyal B, Bauddh NK, Ajmera D, Kumar P. Aluminium Phosphide poisoning causing intravascular haemolysis in G6PD deficient individual. J Assoc Physicians India. 2021;69(1):89-90.
20. Sahoo D, Kujur ST, Das DS, Dey A, Devi S. Aluminium Phosphide poisoning: early suspicion of cardiotoxicity is necessary for improved outcomes. Cureus. 2020;12(9):e10237. DOI: 10.7759/cureus.1023
21. Sadeghi M, Zakariaei Z, Rashidian H, Soleymani M. Fatal outcome due to aluminum phosphide poisoning in an old man with a psychiatric disorder as a latent post-COVID-19 challenge: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231177759. DOI: 10.1177/2050313X23117775 https://doi.org/10.1080/1556365070188580
22. Murali R, Bhalla A, Singh D, Singh S. Acute pesticide poisoning: 15 years experience of a large North-West Indian hospital. Clin Toxicol (Phila). 2009;47(1):35-8. DOI: 10.1080/1556365070188580
23. Shadnia S, Sasanian G, Allami P, Hosseini A, Ranjbar A, Amini-Shirazi N, et al. A retrospective 7-years study of aluminum phosphide poisoning in Tehran: opportunities for prevention. Hum Exp Toxicol. 2009;28(4):209-13. DOI: 10.1177/096032710809719
24. Basnet A, Thapa AJ, Khadka M, Regmi B, Khadka M, Adhikari K, Thapa AJ, Shrestha DB. Aluminum phosphide poisoning, an institutional experience: Case series. J Nepal Health Res Counc. 2022;20(1):251-256. DOI: 10.33314/jnhrc.v20i01.3607
25. Popp W, Mentfewitz J, Götz R, Voshaar T. Phosphine poisoning in a German office. Lancet. 2002;359(9317):1574. DOI: 10.1016/S0140-6736(02)08518
26. Lauterbach M, Solak E, Kaes J, Wiechelt J, Von Mach MA, Weilemann LS. Epidemiology of hydrogen phosphide exposures in humans reported to the poison center in Mainz, Germany, 1983-2003. Clin Toxicol (Phila). 2005;43(6):575-81. DOI: 10.1081/clt-20006884
27. Anand R BB, Gill KD. Aluminum phosphide poisoning: an unsolved riddle. J Appl Toxicol. 2011;31(6):499-505.
28. Jain RK, Gouda NB, Sharma VK, Dubey TN, Shende A, Malik R, et al. Esophageal complications following aluminium phosphide ingestion: an emerging issue among survivors of poisoning. Dysphagia. 2010;25(4):271-6. DOI: 10.1007/s00455-009-9251-y
29. Sood AK, Mahajan A, Dua A. Intravascular haemolysis after aluminium phosphide ingestion. J R Soc Med. 1997;90(1):47-8. DOI: 10.1177/01410768970900011
30. Alter P, Grimm W, Maisch B. Lethal heart failure caused by aluminium phosphide poisoning. Intensive Care Med. 2001;27(1):327. DOI: 10.1007/s0013400007