A Cross-Sectional Study on Investigations and Outcome of Cleistanthus Collinus (Vadisaku) Poisoning in A Tertiary Care Center

Authors

  • Kavya J
  • Molakala Pavan Kumar Reddy
  • Addapu Dharaneedhar
  • Goutham G
  • M Mythreyee
  • Hemanth Kumar VM

DOI:

https://doi.org/10.63682/jns.v14i29S.6782

Keywords:

Cleistanthus collinus, Vadisaku poisoning, Toxicology, suicide, Acute kidney injury, Mortality rate

Abstract

Introduction:

Typically found in South India, Cleistanthus collinus (vadisaku) is a poisonous plant belonging to the Euphorbiaceae family. Intentional poisoning during suicide attempts and homicidal intent are frequent uses. Multiple organ systems are affected by the strong toxicological effects of cleistanthin A and B, the plant's poisonous chemicals. Despite its well-established toxicity, little is known about its clinical management and treatment outcome.

Objective:

To evaluate C. collinus poisoning cases' clinical presentation, test results, and treatment in order to enhance patient outcomes and diagnostic precision.

Materials and methods:

The case files of 60 patients who received treatment for C. collinus poisoning at a tertiary care facility in Andhra Pradesh between June 2022 and June 2024 were examined in this observational retrospective cross-sectional study. Demographics, presenting symptoms, and examination results were among the clinical data gathered. Treatment information (gastric lavage, usage of pantoprazole, supportive care) and laboratory tests (CBC, LFT, RFT, electrolytes, ABG) were documented. Good recovery and poor recovery (death or problems) were the two categories used to describe patient outcomes. Data were examined using means, percentages and frequencies.

Results:

Two occurrences (3.5%) were unintentional, while 58 (96.5%) of the 60 patients were suicide attempts. The majority (47%), who were young adults between the ages of 16 and 30, were slightly more likely to be female (53.3%). Abdominal disturbances (30%), acute kidney injury (18.3%), chest discomfort (13.3%), and altered sensorium (16.7%) were among the most common symptoms. Results from the lab indicated increased creatinine (28.8%), hyponatremia (45%), and hypokalemia (51.6%). Patients with ECG abnormalities made up 18.3% of the total. While receiving supportive care in the emergency room, all patients got pantoprazole and gastric lavage. Within seven days of hospitalization, nine patients passed away, resulting in a 15% mortality rate.

Conclusion:

Poisoning by C. collinus poses serious clinical problems due to its high 15% fatality rate. To improve patient outcomes, early

 

diagnosis, timely supportive care, and focused therapies are essential. Reducing the prevalence of intentional poisoning requires public health initiatives, such as programs for poison prevention and mental health care. It is advised that more study be done on particular antidotes to improve treatment modalities and outcome.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Priyadharsini, R.P., Parasuraman, S., Puli, S., & Raveendran, R. (2024). A Review on the poisonous plant Cleisanthus Collins. Journal of Pharmacology and Pharmacotherapeutics. https://doi.org/10.1177/0976500x241257741

Rao, R. B., Ramalingam, S., & Narayanan, S. (2024). A case of oduvanthalai poisoning. IP International Journal of Forensic Medicine and Toxicological Sciences, 9(3), 117–121. https://doi.org/10.18231/j.ijfmts.2024.024

Das, S., Hamide, A., Mohanty, M. K., & Muthusamy, R. (2014). Fatal Cleistanthus collinus toxicity: a case report and review of literature. Journal of Forensic Sciences, 59(5), 1441–1447. https://doi.org/10.1111/1556-4029.12519

Das, N. K. R., Grace, N. C. M., Indira, M., & Jayachandran, N. V. (2015). Clinical and Laboratory Profile of Patients Admitted with Cleistanthus Collinus Poisoning in a Tertiary Care Hospital. American Journal of Internal Medicine, 3(6), 14. https://doi.org/10.11648/J.AJIM.S.2015030601.14

Bompelli, N., Reddy, R. C., Modani, S., & Deshpande, A. (2019). Cleistanthus collinus poisoning: a case report of intentional poisoning. Case Reports, 12(2). https://doi.org/10.1136/BCR-2018-228197

Singh O, Javeri Y, Juneja D, Gupta M, Singh G, Dang R. Profile and outcome of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J Anaesth 2011;55(4):370–374. DOI: 10.4103/0019-5049.84860.

Pradheepkumar CP, Panneerselvam N, Shanmugam G. Cleistanthin A causes DNA strand breaks and induces apoptosis in cultured cells. Mutat Res 2000;464:185–193. DOI: 10.1016/S1383-5718(99)00179-5.

Sarathchandra G, Balakrishnamurthy P. Perturbations in glutathione and adenosine triphosphatase in acute oral toxicosis of Cleistanthus collinus: an indigenous toxic plant. Indian J Pharmacol 1997;29:82–85

Venkatesh, C., & Adhisivam, B. (2011). Hypocalcemia in Cleistanthus collinus Poisoning. Indian Pediatrics, 48(9), 741. https://www.ncbi.nlm.nih.gov/pubmed/21992915

Mohan, A., Naik, Gs., Harikrishna, J., Kumar, Dp., Rao, M., Sarma, K. V. S., & Guntupalli, K. K. (2016). Cleistanthus collinus poisoning: experience at a medical intensive care unit in a tertiary care hospital in south India. Indian Journal of Medical Research, 143(6), 793–797. https://doi.org/10.4103/0971-5916.192068

Benjamin, S. P. E., Fernando, M. E., Jayanth, J. J., & Preetha, B. (2006). Cleistanthus collinus poisoning. Journal of Association of Physicians of India, 54, 742–744. https://europepmc.org/article/MED/17212028

Kettimuthu, K. P., Kini, A., Manickam, A. S., Lourthuraj, A. A., Venkatraman, A., Subramani, S., & Ramachandran, A. (2019). Cleistanthus collinus poisoning affects mitochondrial respiration and induces oxidative stress in the rat kidney. Toxicology Mechanisms and Methods, 29(8), 561–568. https://doi.org/10.1080/15376516.2019.1624905

Subrahmanyam DK, Mooney T, Raveendran R, Zachariah B. A clinical and laboratory profile of Cleistanthus collinus poisoning. J Assoc Physicians India 2003;51:1052–1054.

Bammigatti C, Surynarayana BS, Harichandra Kumar KT, Ganesh Kumar S. Pattern and outcome of Cleistanthus collinus (Oduvanthalai) poisoning in a tertiary care teaching hospital in South India. J Forensic Leg Med 2013;20:959–961. DOI: 10.1016/j.jflm. 2013.08.011...

Downloads

Published

2025-05-30

How to Cite

1.
J K, Kumar Reddy MP, Dharaneedhar A, G G, Mythreyee M, Kumar VM H. A Cross-Sectional Study on Investigations and Outcome of Cleistanthus Collinus (Vadisaku) Poisoning in A Tertiary Care Center. J Neonatal Surg [Internet]. 2025May30 [cited 2025Sep.29];14(29S):308-13. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6782

Most read articles by the same author(s)