Comparison of the prognosis of the new and old therapeutic protocols in poisoning by phosphide compounds

Introduction: Rice tablets (aluminum phosphide) are used to fight insects and pests in the grain storage spaces. This tablet produces phosphine gas which is a toxic substance for mitochondria. New measures have merely been recommended to save the lives of poisoned patients at referral clinical toxicology centers. The purpose of this study is to compare the prognosis of the new and old protocols in rice tablet poisoning.

Methods: This clinical trial recruited 126 eligible patients poisoned with rice tablets presenting to the Imam Khomeini Hospital in Kermanshah in 2013, who were assigned into two groups of the new (magnesium sulfate) and old protocols. Data were analyzed using statistical tests in SPSS software version 21.

Results: The age of the patients was between 12 and 76 years, with a mean of 30.78 years and a standard deviation of 12.88 years. Among the patients, 77 (58.3%) were male and 55 (41.7%) were female. 43.9%/59.1%, 16.7%/31.8%, 9.1%/25.8%, and 40.9%/42.4% subjects suffered from cardiac, renal, hepatic and pulmonary complications, in new and old treatment groups respectively. Renal (P=0.046) and hepatic (P=0.12%) complications were significantly lower in patients under the new treatment. Furthermore, the mortality rate in the new protocol was significantly lower (P=0.036).

Conclusion: In this study, the new protocol was better able than the old one to reduce morbidity and mortality rates. Therefore, the use of this new treatment protocol can be beneficial in the treatment of patients poisoned with rice tablets.