MyMedR

Treatment of malathion poisoning. Experience of two cases in Sarawak

Mathewson I, Hardy EA

Anaesthesia, 1970 Apr;25(2):265-71.

PMID: 4909432

Matched MeSH terms: Insecticides/poisoning*; Phosphates/poisoning; Poisoning/therapy

Analysis of lead content in herbal preparations in Malaysia

Ang HH, Lee EL, Matsumoto K

Hum Exp Toxicol, 2003 Aug;22(8):445-51.

PMID: 12948085 DOI: 10.1191/0960327103ht382oa

In Malaysia, the phase 3 registration for traditional medicines was implemented on 1 January 1992 under the Control of Drugs and Cosmetics Regulation 1984, emphasizing quality, efficacy and safety (including the detection of the presence of heavy metals) in all pharmaceutical dosage forms of traditional medicine preparations. Therefore, a total of 100 products in various pharmaceutical dosage forms of a herbal preparation, were analysed for lead content using atomic absorption spectrophotometer. Results showed that 8% (eight products) possessed 10.64-20.72 ppm of lead, and therefore, do not comply with the quality requirement for traditional medicines in Malaysia. One of these products, M-Tongkat Ali (exhibited 10.64 +/-0.37 ppm of lead), was in fact already registered with the DCA Malaysia. The rest, Sukarno Tongkat Ali, Eurycoma Madu, Super Pill Tongkat Ali, Force Pill Tongkat Ali, Tender Pill Tongkat Ali, Super Pill Tongkat Ali Plus and Great Pill Tongkat Ali Plus have not registered with the DCA Malaysia and exhibited 12.24-20.72 ppm of lead. Although this study showed that only 92% of the products complied with the quality requirement for traditional medicines in Malaysia, however, they cannot be assumed safe from lead contamination because of batch-to-batch inconsistency.

Matched MeSH terms: Lead Poisoning/etiology; Lead Poisoning/epidemiology; Plant Preparations/poisoning

Profile of poisoning admissions in Malaysia

Rajasuriar R, Awang R, Hashim SB, Rahmat HR

Hum Exp Toxicol, 2007 Feb;26(2):73-81.

PMID: 17370864

We retrospectively reviewed poisoning admissions to all government health facilities from 1999 to 2001, in an effort to expand our current knowledge on poisoning in Malaysia to a level that better reflects a nationwide burden. There were 21 714 admissions reported with 779 deaths. The case-fatality rate was 35.88/1000 admissions. The majority of admissions (89.7%) and deaths (98.9%) occurred in adults. Some 55.1% of all admissions were female, mostly involving pharmaceutical agents. Male poisoning admissions were more often due to chemical substances. The prevalence of poisoning and death was highest among Indians compared to all other races in Malaysia. Overall, the majority of poisoning admissions were due to pharmaceutical agents, with agents classified as non-opioid analgesics, anti-pyretics and anti-rheumatics the most common. Pesticides accounted for the largest number of fatalities. It was also the commonest substance reported in cases of intentional self-harm. Most cases of poisoning admissions occurred due to accidental exposure (47%), followed by cases of intentional self-harm (20.7%). Overall, this study has managed to contribute substantial additional information regarding the epidemiology of poisoning in Malaysia, highlighting important issues, such as the rampant poisonings involving pesticides and analgesics, as well as the high prevalence of poisoning among Indians in Malaysia.

Matched MeSH terms: Pesticides/poisoning; Poisoning/epidemiology*; Solvents/poisoning

Blowfly Larval Tissues as a Secondary Detector for Determining Paraquat-Related Death in Rabbit Carcass

Lawai V, Abdul Rahim NA, Ngaini Z

J Forensic Sci, 2015 11;60(6):1620-4.

PMID: 26382214 DOI: 10.1111/1556-4029.12852

Paraquat poisoning is commonly associated with suicide or homicide in Malaysia. In a case involving advanced body decomposition, pathological analysis regarding the cause of death may become difficult or almost impossible. Insects serve as common alternative matrix for poison detection in forensic analysis. Paraquat detection via secondary bioaccumulation in fly larvae tissue has never been reported. In this study, tissues from blowfly larvae collected from a rabbit carcass with paraquat poisoning were analyzed for secondary bioaccumulation. Larvae samples were collected and analyzed using liquid-liquid extraction. The detection was performed via reduction of quaternary ammonium presence in paraquat and analyzed using gas chromatography-mass spectrometry (GC-MS) with selected ion monitoring mode (SIM mode). GC-MS showed the elution of reduced paraquat was at retention time 12.8 min. Blowfly larvae tissue has proven useful as a secondary detector in paraquat-related deaths.

Matched MeSH terms: Herbicides/poisoning*; Paraquat/poisoning*; Poisoning/diagnosis

Fulltext Outbreak of mushroom poisoning among Malaysian soldiers in Perak, March 1980

Supramaniam V, Mohanadas R

Med J Malaysia, 1980 Sep;35(1):28-30.

PMID: 7253994

Two outbreaks of mushrooms poisoning involving 3 and 9 soldiers respectively with one death on 9 March 1980 in Perak are described. The symptoms were compatible with muscarine [a neurotoxin] poisoning which was detected in the stomach contents of the dead soldier and the mushrooms consumed by one group.

Matched MeSH terms: Mushroom Poisoning/etiology; Mushroom Poisoning/physiopathology*

Fulltext Acute respiratory distress syndrome due to overdose desferrioxamine: report of a child

Atas B, Caksen H, Tuncer O, Oner AF, Kirimi E, Akbayram S

Med J Malaysia, 2005 Mar;60(1):91-3.

PMID: 16250288

In this article, we present an 18-month-old girl with acute iron poisoning who died from acute respiratory distress syndrome due to overdose of desferrioxamine. Our purpose is to emphasize the importance of close follow-up children with acute iron poisoning for desferrioxamine toxicity.

Matched MeSH terms: Deferoxamine/poisoning*; Siderophores/poisoning*

The potential risk from 222radon posed to archaeologists and earth scientists: reconnaissance study of radon concentrations, excavations, and archaeological shelters in the Great Cave of Niah, Sarawak, Malaysia

Gillmore G, Gilbertson D, Grattan J, Hunt C, McLaren S, Pyatt B, et al.

Ecotoxicol Environ Saf, 2005 Feb;60(2):213-27.

PMID: 15546638

This reconnaissance study of radon concentrations in the Great Cave of Niah in Sarawak shows that in relatively deep pits and trenches in surficial deposits largely covered by protective shelters with poor ventilation, excavators are working in a micro-environment in which radon concentrations at the ground surface can exceed those of the surrounding area by a factor of > x 2. Although radon concentrations in this famous cave are low by world standards (alpha track-etch results ranging from 100 to 3075 Bq m(-3)), they still may pose a health risk to both excavators (personal dosemeter readings varied from 0.368 to 0.857 mSv for 60 days of work) and cave occupants (1 yr exposure at 15 h per day with an average radon level of 608 Bq m(-3) giving a dose of 26.42 mSv). The data here presented also demonstrate that there is considerable local variation in radon levels in such environments as these.

Matched MeSH terms: Radon/poisoning*; Soil Pollutants, Radioactive/poisoning*

Filling the gap of Brachiaria decumbens (signal grass) research on clinico-pathology and haemato-biochemistry in small ruminants: A review

Muniandy KV, Chung ELT, Jaapar MS, Hamdan MHM, Salleh A, Jesse FFA

Toxicon, 2020 Jan 30;174:26-31.

PMID: 31989927 DOI: 10.1016/j.toxicon.2019.12.158

Brachiaria decumbens (signal grass) is a highly productive tropical grass that is widespread in some tropical countries due to its adaptation to a wide range of environments and soil types. However, a limiting factor for the use of this grass is its toxicity from steroidal saponins. Sporadic outbreaks of hepatogenous photosensitization in ruminants grazing on this grass have been reported. Sheep are more susceptible than other animal species and the young are more susceptible than adults. This review article will critically shed light on the B. decumbens profile, its toxic compounds, mechanisms, clinical responses, blood profile alterations, pathological changes, and acute phase responses related to signal grass intoxication. Further research is needed to integrate new findings on B. decumbens intoxication with previous preventive and therapeutic trials to minimize or remove its deleterious toxic effect.

Matched MeSH terms: Plant Poisoning*

Fulltext Puffer fish poisoning: four case reports

Lyn PCW

Med J Malaysia, 1985 Mar;40(1):31-4.

PMID: 3831731

Four cases of puffer fish poisoning with one death in a family are described. Acute respiratory cessation probably resulted from both depression of the medullary centres and muscular paralysis by the neurotoxin. Artificial ventilation is the single most effective therapeutic measure and should be considered in all severe cases. Delay in treatment may result in death. Anticholinesterases are not known to confer any benefit. Medical staff in coastal hospitals should familiarise themselves with the management of puffer fish poisoning.

Matched MeSH terms: Tetrodotoxin/poisoning*

Curing, poisoning, and sorcery: earlier and later European interpretations of Malay belief and ritual

Winzeler RL

Halcyon, 1985;7:77-91.

PMID: 11617027

Matched MeSH terms: Poisoning/history*

Fulltext A food poisoning outbreak due to Staphylococcus aureus, Kapar, Malaysia, 1983

Rampal L

Med J Malaysia, 1983 Dec;38(4):294-8.

PMID: 6599985

An epidemiological investigation was carried out on a food borne outbreak in a National Type Primary School (Chinese). The findings of the outbreak are reported. Of the 495 Chinese students (ages between 7-12 years) interviewed, 321 were exposed to one or more of the food items sold at the school canteen. The median incubation period was one hour for the outbreak. The main symptoms were related to the upper gastro-intestinal tract (nausea and vomiting). Fried meehoon (rice vermicelli) was suspected as being the responsible vehicle. The causative organism was Staphylococcus aureus. 48 cases were treated in the Main Health Centre, Kapar.

Matched MeSH terms: Staphylococcal Food Poisoning/epidemiology*

Paraquat poisoning: per vagina

Ong ML, Glew S

Postgrad Med J, 1989 Nov;65(769):835-6.

PMID: 2616419

We describe a fatal case of paraquat poisoning as a result of per vaginal contact with the herbicide. Death occurred 18 days later from hepatic, renal and respiratory failure.

Matched MeSH terms: Paraquat/poisoning*

Relationship Between Alcohol Co-Ingestion and Clinical Outcome in Pesticide Self-Poisoning: A Systematic Review and Meta-Analysis

Dhanarisi J, Perera S, Wijerathna T, Gawarammana I, Shihana F, Pathiraja V, et al.

Alcohol Alcohol, 2023 Jan 09;58(1):4-12.

PMID: 36172715 DOI: 10.1093/alcalc/agac045

AIM: Alcohol is a commonly co-ingested compound during self-poisoning with pesticides. Clinical experiences suggest alcohol co-ingestion (or withdrawal) makes patient management more difficult after self-poisoning and may contribute to poor clinical outcomes. We aimed to systematically review the world literature to explore the relationship between alcohol co-ingestion and outcome in pesticide self-poisoning.

METHODS: We searched 13 electronic databases and Google scholar, conducted citation searching and a review of reference lists to find studies which investigated the relationship of alcohol with clinical outcome of pesticide self-poisoning in different countries. Thirteen studies, including 11 case series/reports and two cohort studies were considered for inclusion.

RESULTS: Meta-analysis showed that alcohol co-ingestion in pesticide self-poisoning was associated with increased risk of death [odds ratio (OR) 4.9, 95% confidence interval (CI) 2.9-8.2 P<0.0001] and that alcohol co-ingested group required intubation eight times more often than non-co-ingested group in organophosphorus insecticide self-poisoning (OR 8.0, 95% CI 4.9-13.0 P<0.0001). Cases who co-ingested alcohol were older than non-alcohol group in two studies. One cohort study demonstrated that alcohol co-ingestion was associated with larger pesticide ingestions but did not itself affect the outcome.

CONCLUSIONS: This systematic review indicates that alcohol co-ingestion may worsen clinical outcome in pesticide self-poisoning.

Matched MeSH terms: Organophosphate Poisoning*

Case Report: Paralytic Shellfish Poisoning in Sabah, Malaysia

Suleiman M, Jelip J, Rundi C, Chua TH

Am J Trop Med Hyg, 2017 Dec;97(6):1731-1736.

PMID: 29016314 DOI: 10.4269/ajtmh.17-0589

During the months of January-February and May-June 2013 coinciding with the red tide occurrence in Kota Kinabalu, Sabah, Malaysia, six episodes involving 58 cases of paralytic shellfish poisoning (PSP) or saxitoxin (STX) poisoning and resulting in four deaths were reported. Many of them were intoxicated from consuming shellfish purchased from the markets, whereas others were intoxicated from eating shellfish collected from the beach. Levels of STX in shellfish collected from the affected areas were high (mean 2,920 ± 780 and 360 ± 140 µg STX equivalents/100 g shellfish meat respectively for the two periods). The count of toxic dinoflagellates (Pyrodinium bahamense var compressum) of the sea water sampled around the coast was also high (mean 34,200 ± 10,300 cells/L). Species of shellfish containing high levels of STX were Atrina fragilis, Perna viridis, and Crassostrea belcheri. The age of victims varied from 9 to 67 years. Symptoms presented were typical of PSP, such as dizziness, numbness, vomiting, and difficulty in breathing. Recommended steps to prevent or reduce PSP in future red tide season include better monitoring of red tide occurrence, regular sampling of shellfish for determination of STX level, wider dissemination of information on the danger of eating contaminated shellfish among the communities, fishermen, and fishmongers.

Matched MeSH terms: Saxitoxin/poisoning*; Shellfish Poisoning/diagnosis*

Fatal results following the administration of magnesium sulphate

Byron FE

Journal of the Malaya Branch of the British Medical Association, 1939;3:100-101.