Metallic poison - As & Ba

How metallic poison affect human body.

1. Government Holkar ( Model autonomous) science College Department of forensic science Topic:- Metallic Poisons- Arsenic & Barium Presented to:- prof.Ruchi Sonwane mam Presented By :- Purvi Bhalave M.S.c II SEM Forensic Science

2. Content Metallic poison Metalloid Arsenic Barium Arsenic As form As action Absorption Excreation Sings and symptoms of acute poisoning. Type of acute poison. Fatal dose & Fatal period. Laboratory investigation. Treatment. PM–finding. Chronic poisoning. Sings & symptoms. Treatment. PM-Finding. Medico-legal Importance. Barium Toxic compounds Action I Sings & symptoms Fatal dose & Fata period Treatment PM-FINDING Medico-legal Importance.

3. Metallic poison Metallic poison is caused by the accumulation of certain metals in the body due to exposure through food, water, industrial chemicals, or other sources .

4. Metalloid A metalloid is a type of chemical element Those of metals and nonmetals . The six commonly recognised metalloids are boron, silicon, germanium, arsenic, antimony, and tellurium

5. Arsenic Allotropes Grey (most common), yellow, black (see Allotropes of arsenic) Appearance metallic grey Period 4 Block P-Block Arsenic is typically considered a heavy metal . It is ubiquitous in the environment Arsenic is a natural component of the earth’s crust and is widely distributed throughout the environment in the air, water and land. It is highly toxic in its inorganic form Metallic As is nonpoisonous because it is water insoluble and is not absorbed from GIT. But when is is heated,it volatilise & readily oxidises on exposure to air to form (As2O3) which is poisonous.

6. Arsenic poisoning forms Arsenic oxide or arsenic trioxide SANKHYA , SOMALKHAR , WHITE ARSENIC Arsenite (SCHEELE’S GREEN) & arsenic Copper Acetoarsenic (PARIS GREEN) Arsenic sulphide (As2s2) (Red ArseniC Arsenic trisulphide (As2S3) (Hartal) Natural source Others Yellow colour Nonpoisonous Always changes to White form which is poisonous Useed as fly paper White crystalline or amorphous powder Tasteless ,odourless
Soluble in water
Uses :- Fruit spray, sheep dips weed, killer rat poison Soli, Water sea fish (mussels,prawns). Tobacco,smoke,cigar Lead Arsenate,sodium or potassium Arsenate etc. Uses:-Colouring agent

7. MECHANISM OF ACTION Combine with SH gr. Of mitochondrial enzyme, especially pyruvate dehydrogenase & certain Hydrogen. Conversion of Pyruvate Acetyl CoA is decreased production of cellular ATP is decreased. Target is vascular endothelium – increased permeability, tissue oedema, haemorrhage. It inhibit cellular glucose uptake gluconeogenesis,fatty acid oxidation. Local action- mucous membrane irritation. Remote – depression of CNS.

8. Absorption Orally:- GIT,Lungs,skin, present in all tissue, Liver(large amount) then kidney at last spleen In case of patient survive,then As found in muscles (month),bone,hair,nails,skin(years) ExcreAtion Hair,nails (with in Few hours) In chronic:- Deposition if As in Hair & nails

9. Arsenic poisoning Acute poisoning Chronic poisoning Is caused by an excessive single dose or several dose of a poison taken over a short interval of time which produce immediate symptoms Is caused by smaller doses over a period of time , resulting in Slight symptoms .

10. Sing and symptoms Of acUte poisoning GIT :- Sweetish Metallic Taste,nausea, burning mouth , throat & oesophagus,stomach.Garlicky odour to breath Intense thirst Vomiting – projectile may save life Of pt. Pain in Abdomen,tenesmus(the feeling that you need to pass stools, even though your bowels are already empty) Diarrhea – watery, colourless & odourless stools.resemble rice water stools of chloera . Blood tinged. Kidney- oliguria(small amount of urine),albuminuria(kidney disease),renal failure(one or both kidneys can no longer function well on their own). CVS- headache,vertigo(loss balance),tremors(disorder that causes involuntary and rhythmic shaking), convulsions ( uncontrollable shaking that is rapid and rhythmic, with the muscles contracting and relaxing repeatedly ),coma. Skin- eruption,loss of hair

11. Large dose (3-5gm) – rapid death in 1to3 Hrs due to shock & peripheral vascular failure. Direct action on heart as well as dilation of blood vessel in splanchnic area – reduced BP All GIT symptoms absent Narcotics type is seen when there is quick absorption Of poison.GIT symptoms less. Giddiness,delirium,coma & death. Inhalation of fumes- cough,sputum,dyspnea, pulmonary oedema.As has exposure cause hemolysis.urine appears black due to haemoglobinuria Vomiting,loose motions,foul breath,pain in Abdomen tenesmus.Vomitingain in abd.Vomiting Dyspnea, cough,pain in throat. Cramps in muscles, depression, Giddiness, neuritis Circulatory collapse Sing and symptoms
Of acute poisoning Fulminant type Narcotic type subacute poisoning

12. Fatal dose & Fatal period Fatal Dose- Acute poisoning :- 100-200mg in adults 2mg/kg in children. Fluminant :- 3-5gm Narcotic :- 1-2gm Fatal period :- Acute form :- 1-2days Fulminant :- 1-3 hrs Subacute :- 7-10days Narcotics :- 6-12hrs

13. Laboratory investigation Urine :- Excretion of more than 50ug/L in 24 hrs is indicative of poisoning.Metabolites of As methylarsenic acid & dimethyl arsenic acid are found in urine. Blood :- serum As level 0.9ug/d1 Hair :- As more than 75 ug% Nails :- presence of > 100 ug% X-ray abdomen – radio – opacity ECG :- QRS- bordening QT – prolongation ( tissue damage) ST :- depression (Less 02 to heart). Twave- flatten(The T wave flattening is widespread, and may reflect low K+, widespread coronary artery disease or left ventricular dysfunction from any other cause.). Neutron activation analysis

14. Treatment Stomach wash :- warm water or milk. Butter/greasy substance prevent absorption Antidote-BAL(British anti-Lewisite):- 3-4 mg/kg Intramuscular 4 hrly for 2 days, 6hrly for 1 day & 12 hrly for 10 days. Oral succimer (DMSA)(dimercapto succinic acid) i :- 10mg per kg every 8 hrly for 10days.OR Dimerval (DMPA) :- 200mg IV 4 hrly till oral dose given.

15. PM-finding External funding:- Sunken eyeballs Dehydrated body Cyanosis Rigor mortis – appears early & lasts longer Blood tinged vomitus May be seen on body & clothes. Internal findings :- Stomach – Red velvet appearance- Mucosa swollen, reddish,oedematous.Sticky mucus covers the mucosa,particles of As embedded in mucosa.greater curveture & posterior part of the cardic end inflammed

16. Pm findings Small Intestine- mucosa membrane inflamed with submucous haemorrhage may contain rice water stools. Large intestine- empty,contracted.Rectum & caecum inflammed.Peritonium congested. Liver,Spleen, Kidney :- congested, enlarged,fatty infiltration, nephritis is seen. Lungs :- congested,subpleural haemorrhage. Heart :- ecchymoses, sun endocardial haemorrhage. Brain :- congested,oedema seen. X-ray :- shows presence of As in GIT .

17. Chronic poisoning of As It may occur due To:- Recovery From an Acute poisoning. Accidental ingestion of small doses repeatedly by those working with metal. Patients of renal failure Inhalation of As dust Intake of food/drink in which there are traces of As (may be homicidal in nature). SYMPTOMS OCCURS IN 4 STAGES Nutritional/GLT disturbance Catarhhal/skin lesions CNS/sensory symptoms Peripheral neuritis & muscular dystrophy

18. Signs & symptoms of chronic poisoning Stage1-(GIT symptoms) -Anorexia,nausea, vomiting,pain,in abdomen,diarrhea. Gums – red,soft,coated tongue (silvery fur) Oedema over feet & of lower eyelid Stage 2:- (dermatological) Rain drop pigmentation :- on flexors,nipples,lower abdomen,temples and eyelids. Hyperkeratosis due to epithelial hyperplasia-multiple wart-like growths on the plam,soles,head and trunk.It may lead to basal cell carcinoma. Aldrich-Mee’s line:- white transverse lines in the nails plate up to a year after As intoxication. Hair become dry and fall off- Alopecia Other :- Painless perforation of nasal septum. Liver is enlarged and cirrhotic Kidney are damaged Voice is hoarse and husky

19. Third stage (neurological):- CNS: polyneuritis (peripheral nerves are damaged) – Headache , tingling and numbness., Hyperesthesia (increased pain sensations) of skin., Muscle tenderness and cramps, Arthralgia Bone marrow suppression with karyorrhexis . Fourth stage (neuromuscular) Peripheral neuritis & muscular dystrophy Muscle Weakness,ataxia, wrist drop,foot drop Tremors, delusion. Polyneuritis, encephalopathy

20. TREATMENT- remove the patient from sources of exposure & BAL(British anti-Lewisite)4mg/kg long duration,vitamin B complex is given PM FINDINGS- f Fatty degeneration (the abnormal formation of tiny globules of Fat with in the cytoplasm of the cell )liver, kidney & heart. Hemorrhages spot in brain Microscopy- nerves show fragmentation & resorption of myelin.

21. Medico-legal Importance Homicidal poison. Reason— Symptoms stimulate natural disease Cholera Small amount is required to cause death Can be administered easily with food,drinks,betel leaves Cheap , easily obtained Tasteless & odourless Chronic cases result in generalized bebility which resemble certain disease . 2. suicide:- Is rare , because it causes too much of pain. 3. Accidental:- Death may be due to admixture with the article of food or from it’s improper medicinal use. Chronic poisoning results from drinking well water containing As . As exposure can be occupational in those working in metal foundry,mining,glass production or un the semiconductor industry. Paste ointment Cattle poison

22. Barium Barium   is a   chemical element   with the   symbol   Ba  and   atomic number   56. It is the fifth element in group 2 and is a soft, silvery   alkaline earth metal . Because of its high chemica l  reactivity , barium is never found in nature as a free element. Barium poisoning Physical properties It is heavy, White, tasteless, odourless powder and insoluble in water Ba sulfate is used for the X-ray examination of the GIT

23. Toxic compounds Barium cholride Barium nitrate Barium carbonate Barium sulphide Uses:- The industrial application in the purification of the brine solutions that are used in caustic chlorine plants. Hardening of steel Uses:- green signal lights.
ceramic glazes.
primers and tracer bullets. Uses:- BaCO3 is a rat poison. It also is used in paints,enamels, rubber, and certain plastics Uses:- luminous paints , Used in hair removing formulations and also in the manufacture of Lithopone

24. Action It acts locally as an irritant posion After absorption it acts both on voluntary and involuntary muscles. Ba seems to acts as postassium antagonist and calcium agonist. ( blocking of the K+-channels of the Na–K pump in cell membranes, increasing the active inward transport and inhibiting the passive outward transport of potassium). ABSORPTION Toxicity of Ba compounds depends on their solubility. The free ion is absorbed from the lungs and GIT ,but Ba sulfate remain Unabsorbed. After absorption,it accumulates in the skeleton and in pigmented parts of the eye

25. Sings and symptoms On ingestion:- the most characteristic features are flexia(softness) and paralysis (Ba+ ion muscle poison). Inhalation :- barium sulfate dust causes a benign l pneumoconiosis ('baritosis’) with conspicuous radiographic manifestation ,but no impairment of pulmonary function. System Sings and symptoms GIT Nausea, vomiting, abdominal pain, diarrhea. CVS Hypertension, arrhythmia,ectopic,beats, ventricular fibrillation, irregular pulse, cardiac arrest. CNS Dilatation of pupils,vertigo.

26. Fatal Dose & Fatal period Fatal dose :- Aboht 1g of barium cholride/sulphide/nitrate Fatal period:- Usually within 12 hrs.

27. Treatment Administration of larger amounts of potassium parentally ( KCL 20-40 mEq/l is indicated causes severe hypokalemia, potassium infusion is an effective antidote). 10ml of 10% sodium sulphate IV every 15min to convert Ba into insoluble sulphate (acute renal failure may develop due to intrarenal precipitation of barium sulfate).

28. Pm findings Non-specific Submucosal haemorrhage may be seen in the GLT. MEDICO-LEGAL ASPECTS Suicidal cases may be seen . Homicidal cases are rare Accidental poisoning with Barium sulphide may occur ,if taken by mistake as Barium sulphate For X-ray examination.

29. Difference Between Acute As poisoning & Cholera Features Acute Arsenic poisoning Cholera 1. Pain in throat Before vomiting After vomiting 2. Voice Normal Whistling, rough 3. Stool Rice water but blood tinged Rice water not bloody 4. Tenesmus Present Absent 5. Vomitus Mucus, blood,bile Watery 6. Laboratory investigation As particles present Microorganisms, vibro cholera present 7. Circumtantial Evidence Poisoning may be present in an individual or a family or a group May occur is sporadic or epidemic form in the locality 8. Motive Homicidal, rarely accidental No such thing

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