CLINICAL CHARACTERISTICS AND PREDICTORS OF OUTCOME IN WHEAT PILL POISONING: AN EXPERIENCE IN TERTIARY CARE HOSPITAL

ABSTRACT
Objective: To determine clinical characteristics and predictors of outcome in wheat pill poisioning (Aluminium Phosphide
poisioning)
Study design: Descriptive retrospective
Patients and methods:This study was carried out in Lady Reading Hospital, MTI, Peshawar from January 2017 to
December 2017. A total of 31 patients were included in the study. Diagnosis was based on history of ingestion of wheat
pills (Aluminium Phosphide ALP). Gastric lavage was done with vegetable oil and diluted potassium permanganate.
ECG and arterial blood gases were performed in all patients.
Results: Out of 31 patients, 18 (58%) were female and 13 (42%) were male. Female to male ratio was 1.4:1. Mean
age of the patients was 25 ± 2.31 years. In almost all cases, poisoning was taken for suicidal purpose (96.77%). Most
common presenting symptoms were vomiting and abdominal pain followed by hypotension, tachypnoea, cyanosis
and GI bleeding. ECG abnormalities in the form of SVT, VT and VF were found in 64.5 % cases. Mechanical ventilation
was required in 51.6% of cases. Overall mortality was 33.2%.
Conclusion: ALP is a very lethal poison because no specific antidote is available till now. Public awareness and policy
making is required to discourage over the counter sale of wheal pills .
Key Words: Aluminum Phosphide poisoning, Metabolic Acidosis, Cardiac Arrhythmias