Pattern of Acute Pediatric Poisonings in Birjand City, East of Iran

O Mehrpour, MD Sharifi, M Ebrahimi

402

Abstract

Background: Acute pediatric poisoning represents a frequent cause of admission to the emergency departments. This descriptive and retrospective study was conducted in Birjand, eastern Iran, with the aim of evaluating the pattern of pediatric poisoning in this region.

Methods: During the 6-year period from 21st March 2006 to 20th March 2012, all files of pediatrics poisoned patients admitted to the emergency department of Vali Asr teaching hospital was reviewed and the data were recorded in a pre-designed form. The results were analyzed by relevant statistical tests.

Results: During this period, 246 cases (41.1% female and 58.9% male) were admitted with a diagnosis of acute poisoning. The mean age was 37.6 +/-32.64 (range: 0.06-156) months. The majority of poisonings occurred in the children aged about 2 to 5 years. The most common agents involved were opioids (39.43%), pharmaceuticals (22.76%) and envenomations (15.9%). Most of the patients were living in urban areas (56.91%).  There was a significant correlation between older age and intentional poisoning (P<0.01). There were also significant correlations between the toxic agent and either the season (P<0.0001), or patients’ age (P<0.0001), residential status (P=0.008) and or consciousness (P<0.0001). Moreover, we introduced Majoon Birjandi as a new cause of poisoning in the literature.

Conclusion: Acute opium poisoning was the most common in terms of morbidity and mortality in this region. Health authorities should consider preventive programs in this regard. Moreover, Majoon-e-Birjandi as a new cause of poisoning should be considered in this region, which is not previously reported in the literature.

Keywords

Iran, Birjand, Pediatrics, Poisoning, Epidemiological research, Opium

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References

Budhathoki S, Poudel P, Shah D, Bhatta NK, Dutta AK, Shah GS et al. Clinical profile and outcome of children presenting with poisoning or intoxication: a hospital based study. Nepal Med Coll. 2009;11(3):170-5.

Tsalkidis A, Vaos G, Gardikis S, Kambouri K, Tripsianis G, Mantadakis E, et al. Acute poisoning among children admitted to a regional university hospital in Northern Greece. Cent Eur J Public Health. 2010;18(4):219-23.

Ozdogan H, Davutoglu M, Bosnak M, Tutanc M, Haspolat K. Ozdogan H, et al. Pediatric poisonings in southeast of Turkey: epidemiological and clinical aspects. Human & Experimental Toxicology. 2008;27:45–8.

Abahussain EA, Ball DE. Pharmaceutical and chemical pediatric poisoning in Kuwait: a retrospective survey. Pharmacy Practice (Internet). 2010;8(1):43-9.

Lito vitz IL, Flager SL, Manoguera AS, Veltiv JC, Wright L. Recurrent poisoning among pediatric poisoning victim. Med Toxicol Adverse Drug Exp. 1989 Sep-Oct;4(5):381-6.

Manzar N, Saad SM, Manzar B, Fatima SS. The study of etiological and demographic characteristics of acute household accidental poisoning in children - a consecutive case series study from Pakistan. BMC Pediatrics. 2010;10:28.

Camidge DR, Wood RJ, Bateman DN. The epidemiology of self-poisoning in the UK. J Clin Pharmacol. 2003;56:613–9.

Sahin S, Bora Carman K and Dinleyici E. Acute Poisoning in Children; Data of a Pediatric Emergency Unit. Iran J Pediatr. 2011;21(4):479-84.

Taghaddosinejad F, Mehrpour O, Afshari R, Seghatoleslami A,Abdollahi M, Dart RC. Factors related to seizure in tramadol poisoning and its blood concentration. J Med Toxicol. 2011;7:183-8.

Karrari P, Mehrpour O, Balali-Mood M. Iranian crystal:A misunderstanding of the crystal-meth. J Res Med Sci. 2012;17(2):203-4.

Mehrpour O, Keyler D, Shadnia S. Comment on aluminum and zinc phosphide poisoning. Clin Toxicol (Phila). 2009;47(8):838-9.

Hosseinian A, Pakravan N, Rafiei A, Feyzbakhsh SM. Aluminum phosphide poisoning known as rice tablet: A common toxicity in North Iran. Indian J Med Sci. 2011;65(4):143-50.

Ahmadi A, Pakravan N, Ghazizadeh Z. Pattern of acute food, drug, and chemical poisoning in Sari City, Northern Iran. Hum Exp Toxicol. 2010;29(9):731-8.

Mehrpour O, Abdollahi M. Poison treatment centers in Iran. Hum Exp Toxicol. 2012;31(3):303-4.

Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia: Mosby/Elsevier; 2013.

Gupta SK, Peshin SS, Srivastava A, Kaleekal T.A study of childhood poisoning at National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi. J Occup Health. 2003;45(3):191-6.

Memon Y, Majeed R, Kolachi H, Querashi K, Sheikh S.Clinical spectrum and outcome of accidental poisoning in children. Biomedica. 2010;26:92–5.

Olguin HJ, Garduño LB, Pérez JF, Pérez CF. Unintentional poisoning with drugs in a Mexican pediatric population. J Popul Ther Clin Pharmacol. 2011;18:156-60.

Moghadamnia AA, Esmaeilnia-Shirvani T, Esmaeili MR, Bayati Z, Gholitabar ZA. A report of childhood poisoning in babol. Archives of Iranian medicine. 2004;7(4):297-9.

Izuora GI, Adeoye A. A seven-year review of accidental poisoning in children at a military hospital in Hafr Al Batin, Saudi Arabia. Ann Saudi Med. 2001;21(1-2):13-15.

Seghatoleslam T, Farzaneh E, Rezaee O, Sajadfar F, Mehrpour O. Factors Related to Suicide Attempts by Poisoning in Iranian Children. Indian Journal of Forensic Medicine & Toxicology. 2013;7:254-87

Farzaneh E, Mehrpour O, Alfred S, Moghaddam HH, Behnoush B ,Seghatoleslam T. Self- poisoning suicide attempts among students in Tehran, Iran. Psychiatria Danubina. 2010;22(1):34–8.

Lin YR, Wu TK, Liu TA, Chou CC, Wu HP. Poison exposure and outcome of children admitted to a pediatric emergency department. World J Pediatr. 2011;7(2):143-9.

Joghataee H, Mirakbari SM, Moosavi SS, Farnaghi F, Poisoning In Children: A Study Of 1120 Poisoned Patients Younger Than 12 Years At Loghman Hakeem Poison Control Center, Tehran, Iran, 2000-2001. The Internet Journal of Pediatrics and Neonatology. 2002;2(2).

Khajeh A, Narouie B, Noori NM, Emamdadi A, Ghasemi Rad M, Kaykha M, et al. Patterns of Acute Poisoning in Childhood and Relative Factors in Zahedan, Southeast Iran. Shiraz E-Medical Journal. 2012;13(1).

Assar S, Hatami S, Lak E, Pipelzadeh M, Joorabian M. Acute poisoning in children. Pak J Med Sci 2009;25(1):51-54.

Zarezadeh M, Bahrampour A. Poisoning Survey of Referred Children to Afzalipour Hospital in Kerman in 2009-2010. IJT. 2011;4(4):397-401.

Cheraghali F, Taymori M. Epidmiological study of drug intoxication in children. Acta Medica Iranica. 2006;44(1):37-40.

Ahmadi J, Ghanizadeh A. Motivations for use of opiates among addicts seeking treatment in Shiraz. Psychol Rep. 2000;87(3 Pt 2):1158-64.

Zamani N, Mehrpour O: Outpatient treatment of the poisoned patients in Iran; may it be a feasible plan? DARU J Pharm Sci. 2013;21(1):45.

Mehrpour O, Sezavar SV. Diagnostic imaging in body packers. Mayo Clin Proc. 2012;87(7):53-4.

Besharat S, Jabbari A, Besharat M. Opium as a Fatal Substance. Indian Journal of Pediatrics. 2008;75:1125-8.

Afshari R, Majdzadeh R, Balali-Mood M. Pattern of acute poisonings in Mashhad, Iran 1993-2000. J Toxicol Clin Toxicol. 2004;42(7):965-75.

Zamani N, Sanaei-Zadeh H, Mostafazadeh B. Hallmarks of opium poisoning in infants and toddlers. Trop Doct. 2010;40(4):220-2.

Karrari P, Mehrpour O, Afshari R, Keyler D. Pattern of illicit drug use in patients referred to addiction treatment centres in Birjand, Eastern Iran. J Pak Med Assoc. 2013;63(6):711-6.

Mehrpour O, Karrari P, Afshari R. Recreational Use and overdose of ingested processed cannabis (Majoon Birjandi) in the Eastern Iran. Hum Exp Toxicol. 2012;31(11):1188-9

Hassanian-Moghaddam H, Zamani N, Rahimi M, Shadnia S, Pajoumand A, Sarjami S. Acute adult and adolescent poisoning in Tehran, Iran; the epidemiologic trend between 2006 and 2011. Arch Iran Med. 2014;17(8):534-8.

Akin Y, Ağzikuru T, Cömert S, Atilkan P, Erdağ GC, Telatar B. Hospitalizations for pediatric intoxication: a study from Istanbul. Turk J Pediatr. 2011;53(4):369-74.

Mehrpour O, Shadnia S, Sanaei-Zadeh H. Late extensive intravenous administration of N-acetyl cysteine can reverse hepatic failure in acetaminophen overdose. Hum Exp Toxicol. 2011;30(1):51-4.

Oprescu F, Peek-Asa C, Wallis A, Young T, Nour D, Cherecheş RM. Pediatric Poisonings and Risk Markers for Hospital Admission in a Major Emergency Department in Romania. Matern Child Health J. Matern Child Health J. 2012;16(2):495-500.

Graber JM, Smith AE.. Results from a state-based surveillance system for carbon monoxide poisoning. Public Health Reports. 2007;122(2):145–54.

Barry J. Diagnosis and management of the poisoned child. Pediatric Annals. 2005;34(12):937–46.