A Study on Profile of Ingestional Hair Dye Poisoning

INTRODUCTION: Poisoning comprises an important proportion of cases admitted in the medical wards of our hospital. Poisoning is one of the preferred means of suicide / self harm. Poisoning either due to intentional, deliberate self harm or by accident may cause significant morbidity and mortality, and also significant social consequences. Insecticides, especially organophosphorus compounds comprise the major chunk of self harm or suicidal cases admitted in the hospitals. Of late, people resort to novel modes of attempt to self harm in the changes sociocultural scenario. AIM OF THE STUDY: To study the following in patients admitted with ingestional hair dye poisoning in medical wards of Government Rajaji Hospital, Madurai. 1. Demographic Profile, 2. Clinical Profile, 3. Laboratory Profile, 4. Treatment details, 5. Morbidity and mortality data. MATERIALS AND METHODS: Study Design: Prospective cross sectional observational study. Study Subjects: patients admitted in medical wards of Government Rajaji Hospital, Madurai with hair dye ingestion. Study Duration: June 2012 to November 2012. Study Setting: Government Rajaji Hospital, Madurai. materials: Of a total 52 patients admitted with hair dye ingestional poisoning in the study period, 46 patients were included in the study. Inclusion Criteria: Patients admitted with a history of hair dye ingestion with classical symptoms of neck swelling, muscle pain and dark colored urine. Exclusion Criteria: 1. Patients and attenders doesn't opt for inclusion in the study, 2. Death within 6 hours of admission, 3. Absconded within 24 hours, 4. Known cardiac disease patient 5. Known renal disease patient 6. Known hepatic disease 7. Patients with history of consumption of other substances/poisons in addition to hair dye. CONCLUSION: Hair dye Poisoning, an emerging cause of self harm among people in our region, is well poised to overtake the traditional modes of self harm and become the leading cause of suicides in our part of the world in the years to come. Since it was first published in 1996 in the Journal of Association of Physicians of India, the incidence is steadily increasing, with significant mortality and morbidity. A unique feature of this Poisoning is the absence of antidote when compared to other "traditional" modes of Poisoning like insecticides etc. Therefore, the hey is to recognize this condition earlier, start supportive therapy to ensure good outcome. The short term prognosis was determined by respiratory failure due to airway edema. The long term prognosis is related to muscular and renal damage. In the primary care set up itself, attempts can be made to mitigate the future damage, it measures like steroids and parenteral liberal fluid therapy was started before referring the patient to higher centres. Thus the knowledge about this condition should be imparted to all primary care physicians of our country. the higher centres, apart from maintaining the airway, efforts should be taken to prevent renal failure by fluid therapy, alkaline diuresis etc. since it was found in our study and many other studies that renal failure once established, is associated with higher mortality. There is strong case for the ban of the sale of hair dye and other cosmetic products containing paraphenylene diamine and regulation of products containing paraphenylene diamine for industrial use, since it is inexpensive, easily accessible, omnipresent, has the potential to cause significant mortality and morbidity among all sections of people, especially children who may consume it accidentally, leading to social problems. Instead, dyes containg products other than paraphenylenediammine should be promoted