Tanweer Salma, Saeed Mehwish, Zaidi Saira, Aslam Wasif
Department of Medical Unit, Nishtar Hospital, Multan.
J Coll Physicians Surg Pak. 2018 May;28(5):374-377. doi: 10.29271/jcpsp.2018.05.374.
To determine the clinical presentation, complications, and outcome of paraphenylene diamine (PPD) poisoning in patients presenting to Nishtar Hospital, Multan.
Descriptive study.
Medical Unit II and III, Nishtar Hospital, Multan, from April 2015 to September 2016.
All adult patients admitted with history of paraphenylene diamine ingestion were evaluated for clinical features, complications, and outcomes on a pre-designed proforma.
Out of 122 patients, 95 were females (77.9%) and 101/122 patients had ingested the poison with an intention of suicide or self harm (82.8%). The mean age of presentation was 23.21 ±8.2 years. Cervico-facial edema was the chief presenting complaint, seen in 116/122 (95%) of patients, with median of 2 (interquartile range=3) for time of onset after ingestion of poison. Tracheostomy was needed in 95/116 (82%) patients with cervico-facial edema. Other common complaints were dark urine in 95/122 (77.9%) and pain in limbs in 98/122 (80.3%) patients. Rhabdomyolysis was evident in 91/122 (74.5%) patients at admission. Acute kidney injury developed in 37/122 (30.3%) patients. Among these, 16 (43.2%) patients required haemodialysis. Myocarditis was diagnosed in 33/122 (27%) patients. The median for hospital stay was 9.50 days (interquartile range=6.25). The mortality was 34/122 (28%). Ventricular arrhythmias were the commonest cause of death in 25/34 (73.5%), followed by renal failure in 5/34 (14.7%), asphyxia in 2/34 (5.88%), and aspiration pneumonia in 2/34 (5.88%) patients.
Paraphenylene diamine is an emerging domestic poison in Pakistan, with a high morbidity and mortality.
确定就诊于木尔坦尼什塔尔医院的对苯二胺（PPD）中毒患者的临床表现、并发症及预后情况。
描述性研究。
2015年4月至2016年9月，木尔坦尼什塔尔医院第二和第三内科病房。
所有因有对苯二胺摄入史而入院的成年患者均依据预先设计的表格对临床特征、并发症及预后情况进行评估。
122例患者中，95例为女性（77.9%），101/122例患者摄入毒物是出于自杀或自我伤害目的（82.8%）。就诊时的平均年龄为23.21±8.2岁。颈面部水肿是主要就诊主诉，见于116/122例（95%）患者，摄入毒物后发病时间中位数为2天（四分位间距=3）。116例有颈面部水肿的患者中95例（82%）需要气管切开。其他常见主诉包括95/122例（77.9%）患者出现深色尿，98/122例（80.3%）患者出现肢体疼痛。91/122例（74.5%）患者入院时即有明显的横纹肌溶解。37/122例（30.3%）患者发生急性肾损伤。其中，16例（43.2%）患者需要血液透析。33/122例（27%）患者被诊断为心肌炎。住院时间中位数为9.50天（四分位间距=6.25）。死亡率为34/122例（28%）。室性心律失常是25/34例（73.5%）患者最常见的死亡原因，其次是肾衰竭5/34例（14.7%）、窒息2/34例（5.88%）和吸入性肺炎2/34例（5.8%）。
对苯二胺在巴基斯坦是一种新出现的家庭用毒物，发病率和死亡率都很高。
