Overview
The incidence of poisoning in India is among the highest in the world and more than 50,000 people die every year from toxic exposure. To add to this, there is rampant use of substance of abuse amongst the younger generation. As Kasturba Medical College hospital is a main tertiary care referral hospital catering to a population of 130,000,000 across states of Karnataka, Kerala and Andhra Pradesh in southern part of India, we frequently get poisoning/drug abuse cases. In order to support diagnosis, early intervention and comprehensive care, Analytical toxicology wing was started on 20 March 2015. This wing was established in collaboration with department of Biochemistry, Forensic Medicine and toxicology and Pharmacy Practice. This centre offers different panel of tests including- drug abuse panel; pesticide panel; alcohol panel; narcotic panel and heavy metal panel. This is helping in early detection and proper treatment of such cases.
The Poison Information centre established in 2001 under the Department of Pharmacy Practice which assists the physicians in providing the information for the management of acute poisoning and adverse drug events. The poison Information centre is equipped with a computer, internet software such as Micromedex, Poisindex, and access to authenticated databases which help in providing the information to clinicians. Poison Information centre has assisted in providing more than 200 poison and adverse event-related information for physicians each year. It is also actively involved in educating the community regarding pesticide poisoning and first aid management. The department also initiated community training programmes for farmers on safe handling of pesticides. Poison information centre is one of the integral parts of toxicovigilance and drug safety centre which is actively involved in many research projects in the area of clinical toxicology.
Moreover, two doctoral research programs and 8 postgraduate projects have been completed in this area. We have also published several research papers related to poisoning management and new interventions, which have been recorded as part of the information management system.
Services Offered
1. Providing round the clock poison information to all doctors/public regarding any poisoning and management using Micromedex and Poisindex software's.
2. Rapid analysis of suspected samples to help in timely intervention.
3. Organize awareness programs regarding safe handling and health effects of chemicals to farmers who are actively involved in farming.
4. To offer health check and screening for poisons including genetic studies to understand epigenetic changes on chronic exposure with public – private partnership with government of Karnataka.
5. Give medico legal assistance to police and public in cases of suicidal/ accidental and homicidal poisonings.
Analytical Services
Toxicology Statistics of various years :
Publications
1. Puppala GK, Thunga G, Chekka M, Vidyasagar S, Vijayanaryana K, Sreedharan N, Shetty PK. Demographics, clinical characteristics, treatment and outcomes of acute organo-phosphorous pesticide poisoning from South India. Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2015;6(6):826-34.
2. Priyadarshini M, Thunga G, Pariti B. occupational hazards of pesticides: plight of farmers. Journal of Pharmacy Practice & Research. 2014 Mar 1;44(1):61-2.
3. Thunga G, Pandey S. Effectiveness of Different Dosage Regimen of Pralidoxime in Organophosphorus Poisoning in Tertiary Care Hospital. Value in Health. 2013 Nov 1; 16(7): A678.
4. Pariti B, Thunga G, MK U, Nikhil B. Analysis of Total Treatment Costs of Organophosphorous Poisoning in a Tertiary Care Hospital. Value in Health. 2013 Nov 1;16(7): A466.
5. Devabhaktuni R, Cherukuri H, Kuluru P, Thunga G. Mixed organophosphate and rodenticide poisoning accelerates fulminant hepatic failure. Journal of Pharmacy Practice and Research. 2013;43(4):333-4.
https://eprints.manipal.edu/view/creators/Thunga=3AGirish=3A=3A.html
Achievements
As a part of social responsibility, our centre took an initiative and conducted a camp in our district for creating awareness about pesticide hazards and screening pesticide levels in farmers with the help of agricultural department of government of Karnataka. Based on the response seen Government of Karnataka (agricultural pay commission) came forward and offered Rs 15,00,000/- (15 lakhs) to conduct camps for farmers selected from 8 villages across Karnataka.
Manipal poison infermation center has been listed on the world map.
Antidotes available in the Hospital
1. Activated Charcoal -PDW PRODUCT- Activated Charcoal 25GSM- Available
2. Dimercaprol -BAL INJ(BAL001)- BAL 2ML Injection – Available
3. Methylene blue -PDW PRODUCT – Methylene Blue 2% 10ml- Available
4. Penicillamine -PENCITIN 250MG CAPSULES – Available
5. Sodium nitrite – PDW PRODUCT – Available
6. Sodium thiosulfate -PDW PRODUCT – Available
Conference/CME
1. We have conducted a CME on Analytical toxicology on 14th August 2015.
2. We have conducted a Toxicology workshop in DIAGNOCON 2018 conference from 23rd to 25th February 2018.
Conference Presentations:
1. Ms. Tejal (MSC PG) presented Poster on “ STRYCHNINE POISONING- CASE DETECTED AT MANIPAL POISON DETECTION CENTRE”v at the DIAGNOCON Conference held at Manipal from 23rd to 25th Feb 2018 under the moderation of Dr. Vinutha R Bhat & Dr. Kavitha Saravu.
2. Ms. Deeksha (MSC PG) presented Poster on “Incidence of Tetrahydro Cannabinol toxicity detected at Manipal Poison Detection Centre” at ACBI Conference held at Lucknow from December 3rd to 6th 2017 under the moderation of Dr. Vinutha R Bhat & Dr. Padmanabha Udupa.
3. Mr. Thejesh (MSC PG) presented Poster on – “Incidence of paraquat poisoning detected at Manipal Poison Detection Centre, Manipal” at ACBI Conference held at Lucknow from December 3rd to 6th 2017 under the moderation of Dr. Vinutha R Bhat & Dr. Shankar M Bakkannavar
4. Ms. Gagana (MSC PG) presented Poster on “ Prevalence of phosphides and phosphorous poisoning detected at Manipal Poison Detection Centre, Manipal” at ACBI Conference held at Lucknow from December 3rd to 6th 2017 under the moderation of Dr. Vinutha R Bhat.
5. Ms. Priyanka (MSC PG) presented Poster on “ Evaluation of Liver enzyme in organic phosphorous poisoning cases” at ACBI Conference held at Lucknow from December 3rd to 6th 2017 under the moderation of Dr. Vinutha R Bhat.
6. Brijesh (MSC PG) presented Poster on “ Assessment of Kidney function test in organic phosphorous poisoning cases” at ACBI Conference held at Lucknow from December 3rd to 6th 2017 under the moderation of Dr. Vinutha R Bhat.
7. Dr. Shankar M Bakkannavar presented a paper on “Intentional Self-harm due to Paraquat Poisoning” at the 2nd Asian Symposium on Healthcare Without Borders - 2015 held at Mitsui Garden Hotel, Hiroshima, Japan on 6th to 8th August 2015.
8. Dr. Shankar M Bakkannavar presented a paper titled “Anisocoria in Devil’s Trumpet Poisoning” at the 10th Annual National Conference ‘TOXOCON – 10’at Amrita Institute of Medical Sciences, Cochin from 28th and 29th December 2016. Won Best Paper award under Faculty Oral Presentation.
9. Dr. Shankar M Bakkannavar presented a paper titled “Paraquat Poisoning: Analysis of an Uncommon Cause of Fatal Poisoning from Manipal, South India” at the 21st International Forensic Symposium ANZFSS held at Auckland, New Zealand on 18th to 22nd September 2016.
10. Dr. Shankar M Bakkannavar presented a poster on “Death came as a Sting” in “Simla-2016”, 16th Annual Conference of South Indian Medico-legal Association, organized by the Department of Forensic Medicine, KS Hedge Medical Academy, Mangalore, on 8th to 9th October 2016.
11. Dr. Shankar M Bakkannavar presented a poster titled “Clinical Profile of Mixture of Organophosphorus and Pyrethroids Intoxication – Diagnostic Dilemma and Therapeutic Approach” at the 38th Annual National Conference of Indian Academy of Forensic Medicine ‘Forensic Medicon 2017’ at Seth GS Medical College and KEM Hospital, Mumbai from 23rd to 25th February 2017.
12. Dr. Shankar M Bakkannavar presented a poster titled “Clinico-epidemiological Profile of Snakebite Patients in a Tertiary Care Centre in South India” at the 12th Annual National Conference of Indian Society of Toxicology TOXOCON – 12, at SMIMS, Gangtok from 6th to 7th April 2018. Won Best Poster award under Faculty Poster Presentations.
Camps conducted –
1. Awareness program conducted at Manipal on 28th & 29th Jan 2018.
GRANT DETAILS (2017 ONWARDS):
Name of the agency |
Title of the project |
Status and year |
Amount |
ICMR Extramural Ad- hoc |
Prevalence of Chronic Kidney Disease of Unknown Etiology in Udupi District: An Observational Study. |
Status: Technically Approved
Year: 2020 |
16,04,156 Rs/- |
NCP 2022 Mobility Grant |
Training in Toxicovigilance |
Approved
Year: 2021 |
10,00,000 Rs/- |
ICMR Extramural Ad- hoc |
Capacity building program on Integrated Nursing Care (PINC) of Organophosphate Poisoning patients in a tertiary care hospital: A non-randomized controlled trial |
Status: Technically Approved
Year: 2021 |
18,20,733 Rs/- |
Ph.D PROJECTS
1. Title: Development of Optimal Management Strategy in Acute Paraquat Poisoning: A Toxicokinetic Approach
Candidate Name: Dr. Harsimran Kaur, Reg No: 200600116
Reg Date: 02 July 2021, Role: Guide
2. Title: Capacity building program on Integrated Nursing Care (PINC) of Organophosphate Poisoning patients in a tertiary care hospital: A non-randomized controlled trial
Candidate Name: Mrs. Janet Alva, Reg No: 200500001
Reg Date: 13 March 2020, Role: Co-Guide