Poisoning in Jamaican children - abstract

All admissions to the Paediatric wards of the University Hospital of the West Indies for the 12-year period, February 25, 1961 to February 28, 1973, have been examined. 130 cases of poisoning or drug overdosage were admitted during this period. 101 children (78 percent) were between the ages 1 and 4 years. The yearly incidence of admissions varied from only one case in 1962 to 18 in 1971, and 60 percent of them were admitted in the latter half of the study period. Kerosene ingestion resulting in aspiration pneumonitis was the commonest cause of poisoning. Only 2 cases of salicylate poisoning were admitted - one was mildly affected while the other due to ingestion of 'oil of winter-green' was of modern severity. Phenothiazines (13 cases), acid or caustic substances (11 cases), ferrous sulphate (10 cases), barbiturates (7 cases), ackee with toxic hypoglycaemia (6 cases), digoxin (5 cases) and organic phosphate insecticides (5 cases) accounted for most of the other admissions. 2 cases of lead poisoning and 2 children with severe vomiting and diarrhoea due to ingestion of 'Physic nut' (Jatropha curcas) were admitted and there were single cases of poisoning from a variety of toxic substances including napthalene (camphor balls), oil of chenopodium and nitrobenzene. One child was admitted following an overdose of lignocaine administered in Casualty for local anaesthesia and another from linctus codeine given for diarrhoea. 5 patients died, one from severe pneumonitis. 3 from toxic hypoglycaemia and the 5th from an unknown poison. Examination of the admission records of all children admitted to the Casualty Observation ward during a 20-month period, 1971-1972, revealed 54 cases of poisoning. 37 of these were due to kerosene ingestion and only 2 of these were admitted to the ward, the others being discharged after 1 to 3 days of observation. Many milder cases of poisoning are seen in Casualty and treated and sent home without further observation (AU)

Studies on acid excretion in adults with sickle-cell anaemia

The acid excretion of patients with sickle-cell anaemia has been studied. There is a mild defect in urinary acidification and a decreased H+ excretion in response to ammonium chloride loading. The acidification defect was not corrected by oral administration of a phosphate solution. Infusion of sodium sulphate solution in subjects who were avidly reabsorbing sodium produced equal degrees of urine acidification in patients and controls. Studies on bicarbonate reabsorption were inconclusive. We conclude that patients with sickle-cell anaemia have a mild form of incomplete distal renal tubular acidosis (AU)