Abstract

Background: Cerebera Odollam is a small plant/shrub which grows wild over many parts of Kerala.  It is the most common plant suicidal agent in the coastal areas of southern Kerala. This is an attempt to study the clinical profile and outcome of C.odollam poisoning in my institution.

Objectives: To study the clinical profile with respect to age, sex, methods of self-administration, circumstances of poisoning, dosage, clinical features, ECG changes, treatment and various determinants of outcome of Cerebera Odollam poisoning in a tertiary care centre in Kerala.

Methods: This is an observational study conducted on 72 patients admitted with history of C.odollam poisoning, during the study period of one and a half years. Samples were selected by convenience sampling method.  The study subjects were evaluated by history and clinical examination. Blood samples were drawn for assessment of complete hemogram, RBS, RFT, LFT, and serum electrolytes. A standard 12 lead ECG including lead II was taken at the time of admission. Serial ECGs were taken to assess the progression of symptoms.  The treatment given as well as the outcome were observed.  The patients were in the study till they get discharged or expired.  Data analysis was done using SPSS software. 

Results: All the cases consumed C.odollam with suicidal intent. The highest number of patients belonged to the age group of 30 – 40 years.  70% of the study subjects were males.  The most common method of self-administration was by mixing with food/drink (81.9%).The majority of the study population consumed half kernel (37.5%), followed by one kernel (25%). The commonest symptom was vomiting seen in 65.3% of the study population. Thrombocytopenia was seen in 13.9% of the study population. Rest of the patients had normal hemogram. Hyperkalemia was seen in 27.8% of the study population. The majority of the study population had no ECG changes (31.9%) followed by sinus bradycardia (29.2%). The duration of hospital stay for the majority of the study subjects were less than 7 days (81.9%).

Conclusion: The association between ECG changes and method of self-administration is statistically significant. There is no statistically significant association between method of self-administration with clinical symptoms, hyperkalemia, and thrombocytopenia. There was statistically significant association between dosage with symptoms, thrombocytopenia, and ECG changes. There was no statistically significant association between dosage and hyperkalemia. There was statistically significant association between dosage with the need for cardiac pacing, ICU care, duration of hospital stay, and overall mortality.