A Cross-Sectional Study on Investigations and Outcome of Cleistanthus Collinus (Vadisaku) Poisoning in A Tertiary Care Center

Introduction: Typically found in South India, Cleistanthus collinus (vadisaku) is a poisonous plant belonging to the Euphorbiaceae family. Intentional poisoning during suicide attempts and homicidal intent are frequent uses. Multiple organ systems are affected by the strong toxicological effects of cleistanthin A and B, the plant's poisonous chemicals. Despite its well-established toxicity, little is known about its clinical management and treatment outcome. Objective: To evaluate C. collinus poisoning cases' clinical presentation, test results, and treatment in order to enhance patient outcomes and diagnostic precision. Materials and methods: The case files of 60 patients who received treatment for C. collinus poisoning at a tertiary care facility in Andhra Pradesh between June 2022 and June 2024 were examined in this observational retrospective cross-sectional study. Demographics, presenting symptoms, and examination results were among the clinical data gathered. Treatment information (gastric lavage, usage of pantoprazole, supportive care) and laboratory tests (CBC, LFT, RFT, electrolytes, ABG) were documented. Good recovery and poor recovery (death or problems) were the two categories used to describe patient outcomes. Data were examined using means, percentages and frequencies. Results: Two occurrences (3.5%) were unintentional, while 58 (96.5%) of the 60 patients were suicide attempts. The majority (47%), who were young adults between the ages of 16 and 30, were slightly more likely to be female (53.3%). Abdominal disturbances (30%), acute kidney injury (18.3%), chest discomfort (13.3%), and altered sensorium (16.7%) were among the most common symptoms. Results from the lab indicated increased creatinine (28.8%), hyponatremia (45%), and hypokalemia (51.6%). Patients with ECG abnormalities made up 18.3% of the total. While receiving supportive care in the emergency room, all patients got pantoprazole and gastric lavage. Within seven days of hospitalization, nine patients passed away, resulting in a 15% mortality rate. Conclusion: Poisoning by C. collinus poses serious clinical problems due to its high 15% fatality rate. To improve patient outcomes, early diagnosis, timely supportive care, and focused therapies are essential. Reducing the prevalence of intentional poisoning requires public health initiatives, such as programs for poison prevention and mental health care. It is advised that more study be done on particular antidotes to improve treatment modalities and outcome.