• Rizwan Zafar Ansari NWSM
  • Abrar Hussain Khosa 03457136531 Assistant Professor, Anesthesia & ICU Department, DG Khan Medical College, DG Khan.
  • Syed Muhammad Yadain Assistant Professor abbottabad Intel Med College
  • Shagufta Shafi Assoc Prof Abbot Intel Medical College
  • Anwar ul Haq Assoc Prof KGMC, Peshawar
  • Zahid Hussain Khalil Professor Kabir Medical College, Peshawar


Background: Paraphenylene-diamine (PPD) poisoning is an emerging problem of developing African and South Asian countries. This study was done with the objective to determine the clinical lab diagnostic accuracy of serum creatinine phosphokinase in cases initially reporting facial oedema followed by renal failure and rhabdomyolysis due to paraphenylene-diamine (PPD) poisoning. Methods: It was a cross-sectional study in which data was retrospectively collected at District Head Quarter (DHQ) Hospitals. Data was collected over a period of one year from Jan-Dec 2018. Data was collected from the patient file records. Data was analysed on SPSS version 20. Results: In the present study, 658 cases of Kala Pathar poisoning presented and treated. M: F ratio was 5:20. There were 518 (78.8%) females. Majority of the female patients were married 488 (94%). Most common clinical manifestations included marked facial oedema; dysphagia and stridor. Post complications include rhabdomyolysis and acute renal failure which developed after two to five days. Initial lab investigations within 6–8 hours after ingestion showed marked increase in TLC count, ALT and Na+ ions. There were marked elevation of serum CPK (1400 ±200 U/L) levels after 24 hours. Conclusion: PPD poisoning is more common in females of younger age group belonging to rural areas. Early diagnosis and prompt supportive treatment within 2–12 hours of ingestion can save many lives. There is no specific antidote available for this poison.Keywords: Rhabdomyolysis; Para Phenylene Diamine; Acute renal failure; Creatinine kinese, CK

Author Biographies

Rizwan Zafar Ansari, NWSM

Dept of Forensic Medicine, HOD & Associate Professor

Abrar Hussain Khosa, 03457136531 Assistant Professor, Anesthesia & ICU Department, DG Khan Medical College, DG Khan.

emergency, anaesthesia, casulty dept

Syed Muhammad Yadain, Assistant Professor abbottabad Intel Med College

Forensic Medicine

Shagufta Shafi, Assoc Prof Abbot Intel Medical College

Forensic Medicine

Anwar ul Haq, Assoc Prof KGMC, Peshawar

Forensic  Medicine

Zahid Hussain Khalil, Professor Kabir Medical College, Peshawar

Forensic Medicine, Professor


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