A Clinico-Epidemiological Study on Poisoning among Commuters: Is There any Substance Abuse?

Poisoning among commuters is becoming a major health hazards day by day in Bangladesh. Few studies were done in Bangladesh regarding this problem. To describe the clinico-epidemiological features of patients with suspected intentional poisoning during travel for robbery. This was a prospective observational study, conducted in medicine department of Chittagong Medical College Hospital, Bangladesh during March 2010 to September 2010. 40 patients were selected. Out of whom, 15 who had GCS < 8 at presentation were selected for urine analysis by detection kits for a few substances in the urine. Detailed demographic data were collected from the informant in a structured case report form. Clinical examination of the patient was done at presentation and urine was collected in selected patients. Routine patient follow-ups were carried out and the outcome was recorded. Victims being males of 31.23 ± 7.6 years of age, most of whom were married (80%), and businessmen (40%). Most of them were brought to hospital by their relatives (80%). Their financial loss by the incidence did not exceed 50,000 tk (i.e., 18937 Tk). They were mainly from middle class family, usually poisoned by beverage (55%), food (30%), and inhalation (5%). Most of them presented with unconsciousness (75%), having GCS 10 on average. Their pupils usually remained constricted bilaterally (75%) with intact light reflex in 35% of the cases. There was no papilledema, and cranial nerves were usually intact in those who could be examined (25%). Patients were usually depressed with absent planter reflex (70%) or flexor (30%). Within 2.5 days, most of them could walk without support and could be discharged. There was neither any case fatality reported or any long term disability recorded. Only 7.5% of the patients had substance examined by kit in their urine. We can come to the conclusion that money bearing people were victimized by the miscreant and they usually used a substance which has short onset of action and which can sedate people for a short time with depressive neurological findings.