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DC Field | Value | Language |
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dc.contributor.author | de Silva, H.A. | en_US |
dc.contributor.author | Fonseka, M.M.D. | en_US |
dc.contributor.author | Pathmeswaran, A. | en_US |
dc.contributor.author | Alahakoon, D.G.S. | en_US |
dc.contributor.author | Ratnatilaka, G.A. | en_US |
dc.contributor.author | Gunatilake, S.B. | en_US |
dc.contributor.author | Ranasinha, C.D. | en_US |
dc.contributor.author | Lalloo, D.G. | en_US |
dc.contributor.author | Aronson, J.K. | en_US |
dc.contributor.author | de Silva, H.J. | en_US |
dc.date.accessioned | 2014-10-29T09:21:35Z | - |
dc.date.available | 2014-10-29T09:21:35Z | - |
dc.date.issued | 2003 | en_US |
dc.identifier.citation | Lancet. 2003; 361(9373): pp.1935-38 | en_US |
dc.identifier.issn | 0140-6736 (Print) | en_US |
dc.identifier.issn | 1474-547X (Electronic) | en_US |
dc.identifier.uri | http://repository.kln.ac.lk/handle/123456789/1557 | - |
dc.description | Indexed in MEDLINE | - |
dc.description.abstract | BACKGROUND: Deliberate self-poisoning with yellow oleander seeds is common in Sri Lanka and is associated with severe cardiac toxicity and a mortality rate of about 10%. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. Multiple-dose activated charcoal binds cardiac glycosides in the gut lumen and promotes their elimination. We aimed to assess the efficacy of multiple-dose activated charcoal in the treatment of patients with yellow-oleander poisoning. METHODS: On admission, participants received one dose of activated charcoal and were then randomly assigned either 50 g of activated charcoal every 6 h for 3 days or sterile water as placebo. A standard treatment protocol was used in all patients. We monitored cardiac rhythm and did 12-lead electocardiographs as needed. Death was the primary endpoint, and secondary endpoints were life-threatening cardiac arrhythmias, dose of atropine used, need for cardiac pacing, admission to intensive care, and number of days in hospital. Analysis was by intention to treat. FINDINGS: 201 patients received multiple-dose activated charcoal and 200 placebo. There were fewer deaths in the treatment group (five [2.5%] vs 16 [8%]; percentage difference 5.5%; 95% CI 0.6-10.3; p=0.025), and we noted difference in favour of the treatment group for all secondary endpoints, apart from number of days in hospital. The drug was safe and well tolerated. INTERPRETATION: Multiple-dose activated charcoal is effective in reducing deaths and life-threatening cardiac arrhythmias after yellow oleander poisoning and should be considered in all patients. Use of activated charcoal could reduce the cost of treatment. | en_US |
dc.publisher | Lancet Publishing Group | en_US |
dc.subject | Poisoning | en_US |
dc.subject | Randomized Controlled Trial | en_US |
dc.subject | Charcoal-administration and dosage | en_US |
dc.subject | Thevetia-poisoning | en_US |
dc.subject | Self-Injurious Behavior | en_US |
dc.title | Multiple-dose activated charcoal for treatment of yellow oleander poisoning : a single-blind randomized placebo controlled trial | en_US |
dc.type | Article | en_US |
dc.identifier.department | Pharmacology | en_US |
dc.identifier.department | Medicine | en_US |
dc.identifier.department | Public Health | en_US |
dc.description.note | Lancet. 2003 Aug 16;362(9383):581; author reply 581; Lancet. 2008 Feb 16;371(9612):538-9 | en_US |
Appears in Collections: | Journal/Magazine Articles |
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