Histomorphological Study of Rodenticide Poisoning: An Autopsy-based Crosssectional Study from a Tertiary Care Centre, Krishnagiri, Tamil Nadu, India

Introduction: In the rise of the modern era, which intensifies mental health issues, some individuals consider suicide using methods such as poison ingestion. Rodenticides, commonly used for pest control, including brodifacoum, bromadiolone and bromethalin, are often involved in these cases. In a retrospective study conducted by the National Poison Information Centre, it was found that death due to rodenticide poisoning accounted for about 17.06% when compared to other pesticides, indicating a rise in the global burden of rodenticide poisoning. Prompt medical intervention and hospitalisation are vital in cases of rodenticide poisoning. Hence, histomorphological examination of affected organs is essential to determine the damage to vital organs, thereby guiding clinicians in future perspectives to facilitate patient recovery. Aim: To study the histomorphological findings of various organs affected by rodenticide poisoning and to assess which organ is most commonly involved. Materials and Methods: This cross-sectional study investigated the effects of rodenticide poisoning through medicolegal autopsy specimens at Government Medical College and Hospital, Krishnagiri, Tamil Nadu, India from June 2023 to June 2024 over a duration of 12 months. The study utilised retrospective data from autopsies, focusing on cases where death resulted from rodenticide poisoning. Autopsy specimens, including the heart, lungs, kidneys, liver, spleen and brain, were preserved in formalin and subjected to gross and microscopic examination by a pathologist. Histopathological sections were stained with Haematoxylin and Eosin (H&E). The study employed a convenience sampling technique with a sample size of 30, determined using Solvin's formula. Data from crime history, clinical history and autopsy findings were recorded and analysed using Statistical Package for the Social Sciences (SPSS) version 25.0, and compiled to draw conclusions regarding the impact of rodenticide poisoning on organ damage. Results: During the one-year period of the study, 450 medicolegal autopsies were processed, of which 180 (40%) cases were due to poison consumption. Of these, 32 cases (17.78%) were from rodenticide intake. Male predominance was observed in this study, comprising 20 males (62.50%) and 12 females (37.50%), with a ratio of 5:3. Histopathology revealed congestion in most of the organs, with the liver showing steatosis and necrosis, kidneys exhibiting acute tubular necrosis, and lungs displaying haemorrhage and oedema. The heart showed features of atherosclerotic changes in seven cases, whereas the brain showed congestion in 11 cases and cerebral haemorrhage in one case out of the 32 cases, respectively. Conclusion: This study found a higher prevalence of poisoning among males and increased susceptibility in teenagers and elderly individuals. The study emphasises the histomorphological findings of various organs in rodenticide poisoning and concludes that the liver, kidneys and lungs appear to be the most affected organs. It also highlights the importance of yoga in preventing suicides.