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High-dose Immunosuppression to Prevent Death After Paraquat Self-poisoning – a Randomised Controlled Trial by Indika Gawarammana; Nicholas A. Buckley; Fahim Mohamed; Kamal Naser; K. Jeganathan; P. L. Ariyananada; Klintean Wunnapuk; Timothy A. Dobbins; John A. Tomenson; Martin F. Wilks; Michael Eddleston; Andrew H. Dawson is a Medicine article available to read on EtoBox.

What is High-dose Immunosuppression to Prevent Death After Paraquat Self-poisoning – a Randomised Controlled Trial about?

## Context: Intentional self-poisoning with the herbicide paraquat has a very high case-fatality and is a major problem in rural asia and pacific. ## Objectives: We aimed to determine whether the addition of immunosuppression to supportive care offers benefit in resource poor asian district hospitals. ## Materials and methods: We performed a randomised placebo-controlled trial comparing immunosuppression (intravenous cyclophosphamide up to 1 g/day for two days and methylprednisolone 1 g/day for three days, and then oral dexamethasone 8 mg three-times-a-day for 14 days) with saline and placebo tablets, in addition to standard care, in patients with acute paraquat self-poisoning admitted to six sri lankan hospitals between 1st march 2007 and 15th november 2010. the primary outcome was in-hospital mortality. ## Results: 299 patients were randomised to receive immunosuppression (147) or saline/placebo (152). there was no significant difference in in-hospital mortality rates between the groups (immunosuppression 78 [53%] vs. placebo 94 [62%] (chi squared test 2.4, p = .12). there was no difference in mortality at three months between the immunosuppression (101/147 [69%]) and placebo gro

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Author

Indika Gawarammana; Nicholas A. Buckley; Fahim Mohamed; Kamal Naser; K. Jeganathan; P. L. Ariyananada; Klintean Wunnapuk; Timothy A. Dobbins; John A. Tomenson; Martin F. Wilks; Michael Eddleston; Andrew H. Dawson

Publisher

Informa UK Limited

Published

2017

Language

EN

Field

Medicine (Health Sciences)