Methyl alcohol poisoning common in India, deaths can be reduced with timely intervention: JAPI
Lucknow, UP: In developing countries like India, methanol intoxication or methyl alcohol poisoning is a serious problem. Mortality among these patients can be reduced with timely intervention.
The study, published in the Journal of the Association of Physicians of India, highlights that if intervened and recognized in time, methanol intoxication can be managed at the very ground level with minimal resources (as available).
Consumption of alcohol is responsible for about 3 million deaths each year, according to WHO. Outbreaks of methanol poisoning have occurred when methanol is used to adulterate moonshine (bootleg liquor).
Methyl alcohol poisoning or deaths from intake of illegally brewed cheap alcohol which is often spiked with chemicals to increase its potency are common in India. From time to time, many outbreaks from different parts of the country have been reported. Due to the spurious liquor in the country, a total of 11,830 people lost their lives between 2006 and 2015. The symptoms can range from mild to severe depending upon factors like the amount of exposure and time of presentation.
Medhavi Gautam, Associate Professor, King George's Medical University, Lucknow, Uttar Pradesh, India, and colleagues discussed clinical features of patients with methanol intoxication, their outcome, and the clinical correlation with autopsy findings of patients who succumbed to death in a retrospective, descriptive study.
The study was performed at King George's Medical University, Lucknow. Enrollment of patients was done from a methanol intoxication outbreak in Barabanki district on 28th May 2019 followed by a similar outbreak in Sitapur district two days later.
The study included a total of 33 patients based on predefined clinical characteristics. The average amount of alcohol consumed was about 223 mL (range: 100–300 mL).
Based on the study, the researchers reported the following findings:
- The majority of patients had onset of symptoms between 12 and 24 hours.
- All patients had gastrointestinal symptoms, 97% of patients had visual disturbances, 91% of patients had central nervous system manifestation while frank coma was observed in 15% of patients.
- Decreased urine output was reported in 6% of patients.
- About 90% of patients had metabolic acidosis.
- Out of 33 patients included in this study, 30 patients were discharged in stable condition while two died and one absconded.
- Autopsy findings revealed marked cerebral edema and hyperemia, hyperemic heart, and congested lungs in all the patients.
- One patient showed putaminal necrosis which is characteristic of methanol poisoning.
- Kidneys in two cases were hyperemic and show parenchymal degeneration which co-relates with both patients being anuric.
The researchers stated in their study that, "to our knowledge, this is one of the very few studies which have tried to correlate the clinical profile of the patients with the autopsy findings." "A planned prospective study seems difficult given the nature of the problem.'
Reference:
Gautam M, Dandu H, Siddiqui SS, et al. Acute Methanol Toxicity: Clinical Correlation With Autopsy Findings, a Descriptive Study. J Assoc Physicians India 2022;70(6):42–45.
