TY  - JOUR
PY  - 2009//
TI  - Emerging epidemic of fatal human self-poisoning with a washing powder in Southern Sri Lanka: a prospective observational study
JO  - Clinical toxicology (Philadelphia, Pa.)
A1  - Gawarammana, I. B.
A1  - Ariyananda, P. L.
A1  - Palangasinghe, Chathura
A1  - De Silva, N. G. L.
A1  - Fernando, K.
A1  - Vidanapathirana, M.
A1  - Kuruppuarachchi, M. A.
A1  - Munasinghe, M. A. A. K.
A1  - Dawson, A. H.
SP  - 407
EP  - 411
VL  - 47
IS  - 5
N2  - INTRODUCTION: Self-poisoning is a public health problem in Sri Lanka. A new laundry detergent consisting of a sachet each of 1.2 g of potassium permanganate and 12.5 g of oxalic acid has become a popular agent among the youth for self-poisoning. METHOD: Prospective clinical data and major outcomes were recorded in all patients admitted to a referring and a referral hospital. Serial biochemistry was performed in 20 patients. Postmortem examinations were performed in some patients. RESULTS: There were 115 patients. The majority developed symptoms of the gastrointestinal tract within the first 24 h. There were 18 deaths. Ingestion of oxalic acid was associated with a case fatality ratio of 25.4% (95% CI = 14-39), while ingestion of both potassium permanganate and oxalic acid was associated with a case fatality ratio of 9.8% (95% CI = 3.2-21). Ingestion of more than one sachet was associated with a significantly higher risk of death (risk ratio = 13.26, 95% CI = 3.2-54, p < 0.05). Majority of the deaths occurred within an hour since ingestion. Postmortem examinations revealed mucosal ulceration in the majority of deaths. DISCUSSION: This case series brings to light an emerging epidemic of fatal self-poisoning in Sri Lanka from a compound that is not regulated. As deaths occur soon after ingestion, medical management of these patients is bound to be difficult. CONCLUSION: This case series highlights a fatal mode of self-poisoning that could be controlled through regulation of the manufacture and sale of the product.<p />  <p>Language: en</p>
LA  - en
SN  - 1556-3650
UR  - http://dx.doi.org/10.1080/15563650902915320
ID  - ref1
ER  -