{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:08:40Z","timestamp":1783728520175,"version":"3.55.0"},"reference-count":15,"publisher":"Scientific Scholar","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,6]]},"abstract":"\n Background & objectives:<\/jats:title>\n Ingestion of Cleistanthus collinus<\/jats:italic> causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus<\/jats:italic> poisoning.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C. collinus<\/jats:italic> poisoning were retrospectively analysed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The mean age of patients was 36.7\u00b113.3 yr; there were 30 males. Salient clinical manifestations included hypokalemia (58%), neutrophilic leucocytosis (48.2%), acute kidney injury (AKI) (42.9%), acute respiratory failure requiring mechanical ventilation (AcRFMv) (32.1%), shock (21.4%); cardiac arrhythmias and neuromuscular weakness (19.6% each); 21 patients (37.5%) had adverse outcome. Longer time-lapsed from consumption to reaching emergency room [median (interquartile range)] (hours) [49 (22-97) vs. 28 (7-56), P<\/jats:italic>=0.038]; higher acute physiology and chronic health evaluation II (APACHE II) score at presentation [14 (8.25-14.75) vs. 2 (0-6) P<\/jats:italic><0.001]; and presence of the following [odds ratio (95% confidence intervals)] at initial presentation: shock [37.40 (4.29-325.98), P<\/jats:italic>=0.001]; AcRFMv [26.67 (5.86-121.39), P<\/jats:italic><0.001]; elevated alanine aminotransferase [5.71 (1.30-25.03), P<\/jats:italic>=0.021]; metabolic acidosis [5.48 (1.68-17.89), P<\/jats:italic>=0.005]; acute kidney injury (AKI) [5 (1.55-16.06), P<\/jats:italic>=0.007]; hyponatremia [4.67 (1.25-17.44), P<\/jats:italic>=0.022]; and neutrophilic leucocytosis [3.80 (1.02-14.21), P<\/jats:italic>=0.047] predicted death. A significant (P<\/jats:italic><0.001) increasing trend in mortality was observed with increasing International Program on Chemical Safety Poisoning Severity Score (IPCS-CSS) grade.<\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusions:<\/jats:title>\n \n C. collinus<\/jats:italic> is a lethal poison associated with high mortality for which there is no specific antidote. Careful search and meticulous monitoring of the predictors of death and initiating appropriate corrective measures can be life saving.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0971-5916.192068","type":"journal-article","created":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T12:22:48Z","timestamp":1476879768000},"page":"793-797","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Cleistanthus collinus poisoning"],"prefix":"10.25259","volume":"143","author":[{"given":"Alladi","family":"Mohan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Sivaram","family":"Naik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Harikrishna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Prabath","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.H.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.V.S.","family":"Sarma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.K.","family":"Guntupalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","reference":[{"key":"R1-16-20241212","first-page":"1052","article-title":"A clinical and laboratory profile of Cleistanthus collinus poisoning","volume":"51","author":"Subrahmanyam","year":"2003","journal-title":"J Assoc Physicians India"},{"key":"R2-16-20241212","first-page":"742","article-title":"Cleistanthus collinus poisoning","volume":"54","author":"Benjamin","year":"2006","journal-title":"J Assoc Physicians India"},{"key":"R3-16-20241212","doi-asserted-by":"crossref","first-page":"2815","DOI":"10.1016\/0040-4020(69)80025-6","article-title":"Chemical constituents of Cleistanthus collinus (Roxb)","volume":"25","author":"Govindachari","year":"1969","journal-title":"Tetrahedron"},{"key":"R4-16-20241212","first-page":"642","article-title":"Toxico-epidemiology and prognostic profile of patients with Cleistanthus collinus poisoning","volume":"8","author":"Devaprabhu","year":"2007","journal-title":"Indian J Trauma Anaesth Crit Care"},{"key":"R5-16-20241212","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/00003246-198510000-00009","article-title":"APACHE II: a severity of disease classification system","volume":"13","author":"Knaus","year":"1985","journal-title":"Crit Care Med"},{"key":"R6-16-20241212","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3109\/15563659809028940","article-title":"Poisoning severity score. Grading of acute poisoning","volume":"36","author":"Persson","year":"1998","journal-title":"J Toxicol Clin Toxicol"},{"key":"R7-16-20241212","doi-asserted-by":"crossref","first-page":"62","DOI":"10.4103\/0019-5359.39368","article-title":"Myasthenic crisis-like syndrome due to Cleistanthus collinus poisoning","volume":"62","author":"Damodaram","year":"2008","journal-title":"Indian J Med Sci"},{"key":"R8-16-20241212","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1080\/17457300903307094","article-title":"Epidemiology of Cleistanthus collinus (oduvan) poisoning: clinical features and risk factors for mortality","volume":"16","author":"Shankar","year":"2009","journal-title":"Int J Inj Contr Saf Promot"},{"key":"R9-16-20241212","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3109\/15563651003641786","article-title":"A clinical study of renal tubular dysfunction in Cleistanthus collinus (Oduvanthalai) poisoning","volume":"48","author":"Nampoothiri","year":"2010","journal-title":"Clin Toxicol (Phila"},{"key":"R10-16-20241212","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.jflm.2013.08.011","article-title":"Pattern and outcome of Cleistanthus collinus (Oduvanthalai) poisoning in a tertiary care teaching hospital in South India","volume":"20","author":"Bammigatti","year":"2013","journal-title":"J Forensic Leg Med"},{"key":"R11-16-20241212","first-page":"81","article-title":"Effect of potassium channel modulators on toxicity of Cleistanthus collinus","volume":"42","author":"Jose","year":"2004","journal-title":"Indian J Exp Biol"},{"key":"R12-16-20241212","first-page":"121","article-title":"Experimental myasthenic crisis like neuromuscular impairement with Cleistanthus collinus leaf extract administration in rat","volume":"10","author":"Nandakumar","year":"1996","journal-title":"Physiother Res"},{"key":"R13-16-20241212","first-page":"215","article-title":"Confirmatory in vivo electrodiagnositic and electromyographic studies for neuromuscular junctional blocking action of Cleistanthus collinus leaf extract administration in rat","volume":"10","author":"Vijayalakshmi","year":"1996","journal-title":"Physiother Res"},{"key":"R14-16-20241212","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/0041-0101(89)90030-5","article-title":"Effect of Cleistanthus collinus leaf extract on neuromuscular junction of the isolated mouse phrenic nerve-diaphram","volume":"27","author":"Nandakumar","year":"1989","journal-title":"Toxicon"},{"key":"R15-16-20241212","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1159\/000136164","article-title":"Investigations on induction of neutrophilic granulocystosis and toxicity of Cleistanthin-CIBA Go.4350-a new glycoside from Cleistanthus collinus (Roxb)","volume":"4","author":"Rao","year":"1970","journal-title":"Pharmacology"}],"container-title":["Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/02223309-201643060-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T22:57:48Z","timestamp":1751497068000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijmr.org.in\/cleistanthus-collinus-poisoning-experience-at-a-medical-intensive-care-unit-in-a-tertiary-care-hospital-in-south-india\/"}},"subtitle":["experience at a medical intensive care unit in a tertiary care hospital in south India"],"short-title":[],"issued":{"date-parts":[[2016,6]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.4103\/0971-5916.192068","relation":{},"ISSN":["0971-5916"],"issn-type":[{"value":"0971-5916","type":"print"}],"subject":[],"published":{"date-parts":[[2016,6]]}}}