Drug ingestions associated with miosis in comatose children.

The occurrence of pupillary constriction in children comatose as a result of the acute ingestion of common drugs has been studied in a large pediatric hospital by reviewing records of patients admitted between 1965 and 1974. Among 94 patients with an acute drug ingestion, the frequency of miosis in relation to the cause of coma was 88% for narcotics, 72% for phenothiazines, 35% for ethanol, and 31% for barbiturates. In contrast, miosis was noted in only 3% of 105 patients with coma from head injuries or infection of the central nervous system. Miosis was associated with all four drug ingestions among patients in deep coma and with narcotic and phenothiazine ingestions among patients in light coma. The frequency of miosis was found to increase with increasing depth of coma in patients with all four drug overdoses, particularly among patients with phenothiazine and barbiturate ingestions.

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)