Clinical spectrum and outcomes of acute pyrethroid poisoning: a hospital-based prospective observational study.

Anand  Acharya; Nageswar  Rao Tokala; K. Muni Kumar

doi:10.51168/sjhrafrica.v6i9.2155

Authors

Dr. Anand Acharya Dean and Professor , Department of Pharmacology, Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India
Dr. Nageswar Rao Tokala Associate professor, Department of Pharmacology, Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India
K. Muni Kumar Assistant professor, Department of Pharmacology, Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2155

Keywords:

Pyrethroid poisoning, Clinical profile, Neurotoxicity, Poison Severity Score, Acute pesticide exposure

Abstract

Background

Pyrethroids are widely used synthetic insecticides considered relatively safe. However, acute poisoning can lead to significant neurotoxic and systemic complications, particularly in cases of oral ingestion. Understanding the clinical profile and outcomes is essential for early recognition and management. To assess the clinical profile, severity, and outcomes of patients presenting with acute pyrethroid poisoning.

Materials and Methods

A prospective observational study was conducted over 12 months at a tertiary care hospital. Sixty patients with confirmed acute pyrethroid poisoning were included. Data collected included demographics, mode and route of exposure, clinical manifestations, laboratory parameters, severity (assessed by Poison Severity Score), treatment, and outcomes. Continuous variables were expressed as mean ± standard deviation, and categorical variables as frequencies and percentages. Statistical analysis was performed using appropriate tests with significance set at p < 0.05.

Results

The mean age of patients was 32.5 ± 12.4 years, with a male predominance (63.3%). Oral ingestion was the most common route of exposure (83.3%), with suicidal intent in 63.3% of cases. Neurological manifestations were predominant, including tremors (75%), altered sensorium (30%), and seizures (20%). Gastrointestinal symptoms occurred in 60% of patients. According to Poison Severity Score, 53.3% had mild poisoning, 33.3% moderate, and 13.3% severe. ICU admission was required in 13.3% of cases. The mean hospital stay was 4.2 ± 1.8 days, and overall mortality was 3.3%.

Conclusion

Acute pyrethroid poisoning primarily affects young adults and presents predominantly with neurological symptoms. Most cases are mild to moderate and respond well to supportive care. Severe cases, though less common, require intensive monitoring. Early recognition and appropriate supportive management are crucial to reduce morbidity and mortality.

Recommendation

Early identification, prompt supportive management, and community education on safe pesticide handling can effectively reduce morbidity and prevent fatalities.

Author Biographies

Dr. Anand Acharya, Dean and Professor , Department of Pharmacology, Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India

MBBS, MD (Pharmacology), currently serves as Dean and Professor, Department of Pharmacology, at Konaseema Institute of Medical Sciences & Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India. A distinguished academician and medical education leader, he has been instrumental in developing KIMS&RF from its formative years into a premier medical institution with over 200 undergraduate and 100 postgraduate seats.

With more than 18 years of teaching and administrative experience, Dr. Acharya has held multiple key positions including Vice Principal, Principal, Chief Warden, Member Secretary of Institutional Ethics and Animal Ethics Committees, and is an approved PhD Guide under Dr. YSR University of Health Sciences, Vijayawada. His notable contributions to institutional growth include enhancing academic standards, clinical material utilization, research infrastructure, and postgraduate training quality.

Dr. Acharya has completed several prestigious national faculty development programs such as the Revised Basic Course Workshop (rBCW), Advance Course in Medical Education (ACME), and National Teacher Training Course (NTTC, JIPMER). He also serves as a Coordinator for Pharmacovigilance and Materiovigilance Programs under IPC–PvPI and MoHFW, Government of India.

A prolific researcher, he has authored and co-authored over 80 scientific publications in national and international indexed journals covering a broad spectrum of topics including toxicology, pharmacovigilance, antimicrobial resistance, endocrinology, and clinical pharmacology. His recent research includes landmark long-term studies on pyrethroid, paraquat, and chlorpyrifos poisoning, antimicrobial resistance trends, and predictors of treatment outcomes in dermatological emergencies.

Dr. Acharya’s professional interests encompass clinical pharmacology, toxicology, rational drug use, pharmacovigilance, and medical education technologies. He continues to mentor postgraduate and undergraduate research scholars while actively contributing to curriculum development, ethics governance, and institutional academic advancement.ORCID iD: https://orcid.org/0009-0000-7967-9092

Dr. Nageswar Rao Tokala, Associate professor, Department of Pharmacology, Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India

is currently serving as an Associate Professor of Pharmacology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, East Godavari District, Andhra Pradesh, India. He holds a doctoral degree in Medical Pharmacology from the prestigious Index Medical College and Research Institute, Madhya Pradesh. With over 16 years of teaching experience in various medical institutions, Dr. Nageswararao has made significant contributions to the field of pharmacology. His academic work includes nine research publications in reputed national and international journals, including one article indexed in PubMed. His dedication to research and education continues to enrich the academic and clinical landscape of medical pharmacology. ORCID iD:https://orcid.org/0009-0005-1638-6897

K. Muni Kumar , Assistant professor, Department of Pharmacology, Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India

is an Assistant Professor of Pharmacology at the Konaseema Institute of Medical Sciences & Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India. He has 12 years of teaching experience in medical institutions and is currently pursuing a PhD in Pharmacology at Chettinad Hospital & Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu (603103).
His scholarly work focuses on rational pharmacotherapy, toxicology, and pharmacovigilance, with nine peer-reviewed publications in national and international journals, including one PubMed-indexed article. His academic interests include experimental pharmacology, drug safety, and evidence-based therapeutics. ORCID iD: https://orcid.org/0009-0000-1536-8711

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