Changing trends in poisoning.

739 P oison refers to any agent that can kill, injure or impair normal physiologic function in humans. 1 Use of poisons has been described since ancient times. Schools of toxicology have been described in venice and rome in as early as 17 th century. 2 Development of new principles of pharmacology (drug interactions) and pharmacogenomics have facilitated better understanding of medical toxicology. over last 50 years poison control training and research centers have been created globally to aid management of poisonings. These centers also focus on prevention of poisonings. Poisoning is a major problem throughout the world. The exact incidence of poisoning is not known in India due to lack of central registry but approximately it accounts for 10% of admissions in medical emergency. Suicide is ranked as third leading cause of death in age group 15-44 years. It was responsible for around 600,000 deaths in 1990s. 3 Toxicity of available poisons and paucity of medical services ensure that the mortality is greater in developing countries than in industrialized world. The most common poisoning encountered is ingestion or exposure to insec ticides and pesticides containing organophosphorus compounds. Several studies have focused on clinical features, treatment and prognostic factors in organophosphorus compound poisonings including late manifestations like intermediate syndrome. 4 recent studies have focused on dosage of pralidoxime in the treatment. 5 north, northwest and Central India commonly report poisoning due to aluminium phosphide which is a grain preservative. In 1990s, it was the leading cause of suicidal poisoning in north India. 6 Hooch tragedies, hypnotic and sedative over dosage are increasingly reported from various areas. Hair dye consumption is not an uncommon means of deliberate self harm. It is being increasingly reported from the developing countries probably due to easy availability and low cost. 7 An 11 year (1992-2002) retrospective study of 374 cases has been published from Poison Control Center of morocco. 8 A study of 150 cases over 10 years has been reported from Khartoum, Sudan. 9 numerous case reports have been published from India, many of which are from Andhra Pradesh. Hair dye is commonly available as Super vasmol 33. Paraphenylene diamine (PPD) is a major component of the hair dye. Angioneurotic edema with stridor, rhabdomyolysis with dark urine and acute renal failure are common features of hair dye poisoning. In this issue of the journal Sahay et al have studied 30 patients with acute kidney …