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Abstract
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How to cite this article: Singh O, Juneja D, Nasa P. Toxicoepidemiology of Acute Poisoning: A Classic Tale of Two Indias. Indian J Crit Care Med 2024;28(4):315-316.
Acute poisoning remains a common problem, with many patients requiring hospitalization and even intensive care unit (ICU) admission. The reported mortality associated with acute poisoning is as high as 75%.1 Early diagnosis and identification of the offending agent, to initiate appropriate therapy, is imperative to improve outcomes. Identification of the offending agent largely depends on reliable clinical history and the presenting toxidrome. However, history may not be forthcoming in many of these cases as suicidal ideation is the most common cause for acute poisoning.2 Further, interpretation of toxidrome may be challenging because of overlapping symptoms and frequent coingestions.3 Hence, understanding the regional toxico-epidemiological profile becomes crucial to make the diagnosis and to decide initial empirically appropriate therapy.
The choice of poisoning agent largely depends on the ease of availability. Traditionally, it was reported that the studies originating from the Western developed countries reported over-the-counter and prescription drugs as the most common cause of poisoning.4 However, the Asian and African countries, being primarily agrarian economies, reported pesticides as the commonest poisons.2 But with increasing urbanization and changing economic and social milieu, this divide is no longer that apparent. Further, in a country as large and as diverse as India, the prevailing geographical, cultural, economic, and social differences across the country may have a profound impact on the toxico-epidemiological profile of the patients. These factors have further divided the studies originating from different regions by virtue of rural and urban populations, metro vs non-metro cities, southern and northern India, government and private hospitals, and ICU and non-ICU patient populations. Because of wide variations in the availability and choice of poisoning agent, clinical course, and patient outcomes, it becomes imperative to consider all these factors while translating the data from these epidemiological studies to your toxicology practice
Language: en |