Habibullah Khan, Nisar Khan, Nowshad Khan, Iftikhar Ahmad, Faizan Shah, Atif Ur Rahman, Irfanullah Mahsud


Background: Paraphenylenediamine (kala pathar) poisoning is an emerging way of self-harm in developing countries. The objective of this study was to explore the clinical course and outcome of patients with this poisoning.
Material & Methods: This case series was observed at Medical Unit B, DHQ Teaching Hospital, D.I.Khan, Pakistan over a period of two years from September 2013 to August 2015. Demographic details, clinical manifestations, complications, and outcome of patients with paraphenylenediamine poisoning were noted.
Results: Thirty-eight patients were observed during the study period with male to female ratio of 1:18 and mean age of 22.08±6.42 years. Among 38 patients 27(71.1%) were unmarried, 27(71.1%) of low socioeconomic class, 28(73.7%) illiterate, and 23(60.5%) rural dwellers. Suicidal intention was identified in 36(94.74%) cases. Dysphagia was noted in 38(100%), cervicofacial oedema in 36(94.7%), dysponea in 36(94.7%), haematuria in 8(21.1%) and stridor in 7(18.4%) cases. Rhabdomyolysis was observed in 22(57.9%), acute renal failure in 15(39.5%), and shock in 10(26.3%) cases. The mortality rate was 47.4%.
Conclusion: Paraphenylenediamine (kala pathar) poisoning is more common in poor, illiterate, unmarried females of younger age group living in rural areas in our set-up and is associated with very high mortality.


Paraphenylenediamine; Poisoning; Hair dyes; Deliberate self-harm; Suicide

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