Literature DB >> 25722560

Should ratol paste be banned?

S Khaja Mohideen1, K Senthil Kumar1.   

Abstract

Entities:  

Year:  2015        PMID: 25722560      PMCID: PMC4339902          DOI: 10.4103/0972-5229.151026

Source DB:  PubMed          Journal:  Indian J Crit Care Med        ISSN: 0972-5229


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Sir, Ratol paste, a commonly used rodenticide in Indian houses contain 3% yellow phosphorus. Yellow phosphorus is a general protoplasmic poison causing multiorgan failure.[1] Doses >1 mg/kg are almost invariably fatal. Ratol paste poisoning is either suicidal or accidental. The clinical course of ratol paste poisoning is different from that of most other poisons. The patients are usually asymptomatic during the initial 72 h of ingestion, or they may have signs and symptoms of gastrointestinal irritation. After 72 h they develop deranged liver function, acute hepatic failure, coagulopathy. Central nervous system effects include changes in mental status like confusion, psychosis, hallucinations, and coma. Cardiac toxicity includes hypotension, tachycardia, arrhythmias, and cardiogenic shock. Some patients may develop acute tubular necrosis and acute renal failure.[123] Because of the initial asymptomatic phase few patients do not reveal about ratol paste ingestion and present late to the hospital. Patients who present late after consumption of the lethal dose develops fulminant hepatic failure with mortality of 100%.[2] In severe ingestions of ratol paste, patients do not have the initial asymptomatic stage, and they die due to shock and cardiopulmonary arrest in early stages itself.[4] There is no specific antidote for yellow phosphorus poisoning. Treatment is directed at removal of the poison and supportive therapy.[123] Aluminum phosphide, zinc phosphide are the other rodenticides available. They are mainly used in agricultural fields[5] in contrast to ratol paste, which is used in houses. Also, ratol paste is commonly mistaken for toothpaste and consumed by children. And the product directions suggest that the paste be applied to bread to enable ingestion by rodents, thus making it appealing to children as well.[1] Hence, accidental poisoning is more common with ratol paste. This fatal poison is freely available over the counter in toxic doses at very cheaper prices.[3] Similar to any other poisoning, prevention strategies by restricting access to this poison, creating public awareness regarding the lethality of ratol paste and regulating the market sale of this compound should be helpful. However, this lethal ratol paste is easily available at cheaper costs and accidental poisoning is more common, especially among children. Hence, we call for a ban on market sales of ratol paste.
  3 in total

1.  Acute yellow phosphorus poisoning. "Smoking stool syndrome".

Authors:  F A Simon; L K Pickering
Journal:  JAMA       Date:  1976-03-29       Impact factor: 56.272

Review 2.  Phosphide poisoning: a review of literature.

Authors:  Gurvinder Singh Bumbrah; Kewal Krishan; Tanuj Kanchan; Madhulika Sharma; Gurvinder Singh Sodhi
Journal:  Forensic Sci Int       Date:  2011-07-16       Impact factor: 2.395

3.  Acute hepatic failure due to yellow phosphorus ingestion.

Authors:  Anupama Mauskar; Kunal Mehta; Leena Nagotkar; Preeti Shanbag
Journal:  Indian J Pharmacol       Date:  2011-05       Impact factor: 1.200

  3 in total
  3 in total

1.  Acute liver failure secondary to yellow phosphorus rodenticide poisoning: Outcomes at a center with dedicated liver intensive care and transplant unit.

Authors:  Ravi Mohanka; Prashantha Rao; Mitul Shah; Amit Gupte; Vinayak Nikam; Mihir Vohra; Ruhi Kohli; Anurag Shrimal; Ankush Golhar; Ameya Panchwagh; Saurabh Kamath; Akash Shukla; Priyesh Patel; Somnath Chattopadhyay; Gaurav Chaubal; Yasmin Shaikh; Vidhi Dedhia; Shivali S Sarmalkar; Ravikiran Maghade; Kavita Shinde; Priyanka Bhilare; Rohini Nalawade; Jacob As; Samir Shah
Journal:  J Clin Exp Hepatol       Date:  2020-10-08

2.  A fatal case of multi-organ failure in acute yellow phosphorus poisoning.

Authors:  Jai Prakash Soni; Pankaj Suresh Ghormade; Swapnil Akhade; Krishnadutt Chavali; Bedanta Sarma
Journal:  Autops Case Rep       Date:  2020-01-30

3.  Rodenticide Poisoning.

Authors:  Carol D'Silva; Bhuvana Krishna
Journal:  Indian J Crit Care Med       Date:  2019-12
  3 in total

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