Citation

Mohan A, Harikrishna J. Indian J. Crit. Care Med. 2019; 23(Suppl 4): S256-S259.

Copyright

(Copyright © 2019, Indian Society of Critical Care Medicine, Publisher Medknow Publications)

DOI

10.5005/jp-journals-10071-23317

PMID

32020999 PMCID

Abstract

Poisoning is a major public health problem world over. Acute deliberate self-poisoning is an important cause of admission to intensive care units (ICUs) in India. In a study published from Delhi 9.3% of total ICU admissions were due to acute poisoning.1 According to the World Health Organization, the global crude suicide rate in 2016 was 10.6/100,000 population.2 In India, it was 16.3/100,000 population. Suicide is the second leading cause of death among 15-29-year-old population globally.3 Suicide accounted for 1.4% of all deaths worldwide, making it the 18th leading cause of death in 2016; 79% of all suicides occurred in low- and middle-income countries.3 According to the National Crime Record Bureau, poisoning is the second most common mode of suicide in India.4 Consumption of toxic plants is one of the modes of deliberate self-poisoning, especially in the rural population. In a study5 published from the National Poisoning Information Centre, All India Institute of Medical Sciences, New Delhi, consumption of plant material constituted 1.7% of all poisonings. In another study6 from Vellore, plant poisoning constituted 8% of total poisoning of which Cleistanthus collinus constituted 77%, and yellow oleander 23%. At the Sri Venkateswara Institute of Medical Sciences, Tirupati, plant poisoning constituted 5.3% of all cases of poisoning and C. collinus was the most common plant poison.7 These observations suggest that C. collinus is the most common plant poisoning encountered in South India. In this article, we review the mechanism of toxicity, clinical manifestations, and management of C. collinus poisoning.

Cleistanthus collinus, belonging to the family Euphorbiaceae, is a small tree with elliptical leaves and silky villous inflorescence. It is commonly found in deciduous dry hilly forests of South India, Sri Lanka and Malaysia.8 It is known by various names in different languages in India, Garari (Hindi), Vadisaaku (Telugu), Oduvanthalai (Tamil), and Odaku (Malayalam).9 All parts of the plant are highly poisonous. The leaves are frequently used as a cattle poison and abortifacient in South India.10 Cleistanthus collinus is the most common plant poison encountered in rural South India, especially in women; probably due to the easy availability and knowledge of the toxic nature of the plant. The leaves are consumed either by chewing or by making a decoction of the leaves...

Language: en