Aruna Dewan

Publications of Aruna Dewan

• Medical toxicology: Need for recognition as a subspecialty.

  Authors: Aruna Dewan

  Indian journal of pharmacology. 02/2011; 43(1):1-2.

• Mass ethion poisoning with high mortality.

  Authors: Aruna Dewan, Ashwin B Patel, Ramavati R Pal, Umesh J Jani, Vinu C Singel, Maulik D Panchal

  Clinical toxicology (Philadelphia, Pa.). 02/2008; 46(1):85-8.

  INTRODUCTION. Fifteen people who consumed a meal during a social ceremony at a remote farm developed symptoms and signs of organophosphate poisoning. METHODS. Information was gathered from villagersINTRODUCTION. Fifteen people who consumed a meal during a social ceremony at a remote farm developed symptoms and signs of organophosphate poisoning. METHODS. Information was gathered from villagers and doctors at the primary health center and district hospital. Serial measurements of plasma and red blood cell cholinesterase activity levels were carried out and the organophosphate compound was identified in blood samples. RESULTS. Clinical toxicity included abdominal pain, vomiting, diarrhea, excessive secretions, and respiratory distress. The victims were taken to a community health center about 30 km away where three people died. The others were taken to the district level hospital at Palanpur where five died. Of the seven remaining victims who were transferred to a tertiary care hospital at Ahmedabad, one died during transport and another succumbed within a few hours. The remaining five people were hospitalized. Three recovered within a week but two developed complications: one had a lung infection and the other had cerebral anoxia following cardiorespiratory arrest. The person with cerebral anoxia died after eight and a half months. Red blood cell cholinesterase levels on the day of admission correlated well with clinical severity and outcome of the patients. The pesticide was identified as ethion. CONCLUSIONS. Pesticide poisonings in developing countries have high morbidity and mortality rates, as facilities for immediate treatment are not readily available. Such incidents should sensitize clinical toxicologists, health authorities, and policy makers to the problems of pesticide poisoning in third world countries.

• Repeated episodes of endosulfan poisoning.

  Authors: Aruna Dewan, Vijay K Bhatnagar, Murli L Mathur, Tapas Chakma, Rekha Kashyap, Harsiddha G Sadhu, Sukesh N Sinha, Habibullah N Saiyed

  Journal of toxicology. Clinical toxicology. 02/2004; 42(4):363-9.

  INTRODUCTION: A number of families in a rural area of Jabalpur District (Madhya Pradesh), India, were affected by repeated episodes of convulsive illness over a period of three weeks. The aim of thisINTRODUCTION: A number of families in a rural area of Jabalpur District (Madhya Pradesh), India, were affected by repeated episodes of convulsive illness over a period of three weeks. The aim of this investigation was to determine the cause of the illness. METHODS: The investigation included a house-to-house survey, interviews of affected families, discussions with treating physicians, and examination of hospital records. Endosulfan poisoning was suspected as many villagers were using empty pesticide containers for food storage. To confirm this, our team collected blood and food samples, which were transported to the laboratory and analyzed with GC-ECD. RESULTS: Thirty-six persons of all age groups had illness of varying severity over a period of three weeks. In the first week, due to superstitions and lack of treatment, three children died. In the second week, symptomatic treatment of affected persons in a district hospital led to recovery but recurrence of convulsive episodes occurred after the return home. In the third week, 10 people were again hospitalized in a teaching hospital. Investigations carried out in this hospital ruled out infective etiology but no facilities were available for chemical analysis. All persons responded to symptomatic treatment. The blood and food samples analyzed by our team showed presence of endosulfan, which was confirmed by GCMS. One of the food items (Laddu) prepared from wheat flour was found to contain 676 ppm of alpha-endosulfan. CONCLUSIONS: Contamination of wheat grains or flour with endosulfan and its consumption over a period of time was the most likely cause of repeated episodes of convulsions, but the exact reason for this contamination could not be determined. This report highlights the unsafe disposal of pesticide containers by illiterate farm workers, superstitions leading to delay in treatment, and susceptibility of children to endosulfan.

• Effect of endosulfan on male reproductive development.

  Authors: Habibullah Saiyed, Aruna Dewan, Vijay Bhatnagar, Udyavar Shenoy, Rathika Shenoy, Hirehall Rajmohan, Kumud Patel, Rekha Kashyap, Pradip Kulkarni, Bagalur Rajan, Bhadabhai Lakkad

  Environmental health perspectives. 01/2004; 111(16):1958-62.

  There is experimental evidence of adverse effects of endosulfan on the male reproductive system, but there are no human data. Therefore, we undertook a study to examine the relationship betweenThere is experimental evidence of adverse effects of endosulfan on the male reproductive system, but there are no human data. Therefore, we undertook a study to examine the relationship between environmental endosulfan exposure and reproductive development in male children and adolescents. The study population was composed of 117 male schoolchildren (10-19 years of age) of a village situated at the foothills of cashew plantations, where endosulfan had been aerially sprayed for more than 20 years, and 90 comparable controls with no such exposure history. The study parameters included recording of clinical history, physical examination, sexual maturity rating (SMR) according to Tanner stages, and estimation of serum levels of testosterone, luteinizing hormone (LH), follicle-stimulating hormone, and endosulfan residues (70 study and 47 control subjects). Mean +/- SE serum endosulfan levels in the study group (7.47 +/- 1.19 ppb) were significantly higher (p < 0.001) than in controls (1.37 +/- 0.40 ppb). Multiple regression analysis showed that SMR scoring for development of pubic hair, testes, penis, and serum testosterone level was positively related to age and negatively related to aerial exposure to endosulfan (AEE; p < 0.01). Serum LH levels were significantly positively related to AEE after controlling for age (p < 0.01). The prevalence of congenital abnormalities related to testicular descent (congenital hydrocele, undescended testis, and congenital inguinal hernia) among study and controls subjects was 5.1% and 1.1%, respectively, but the differences were statistically nonsignificant. Our study results suggest that endosulfan exposure in male children may delay sexual maturity and interfere with sex hormone synthesis. Our study is limited by small sample size and nonparticipation.