Table 1.
Description of paraphenylenediamine-containing hair dye poisoning studies which are included in this systematic review and meta-analysis
| The study, author, year | Journal | Study location | Type of study | Period of study | Sample size | Study settings | Male: female | Mean or median age (years) | Conclusion |
|---|---|---|---|---|---|---|---|---|---|
| Venkatasubbaiah et al., 2016[15] | Otolaryngol Online J | Kadapa, India | Prospective | 2014-2015 | 386 | Causality | 97:289 | - | Awareness in the rural areas regarding the complications caused by PPD poisoning |
| Tiwari et al., 2015[16] | Int J Med Sci Public Health | Gwalior, India | Prospective | 2008-2009 | 50 | Medical wards | 20:30 | - | Tracheostomy, endotracheal intubation with or without ventilation, and dialysis can decrease the mortality |
| Mohammed et al., 2015[32] | Eur J Pharm Med Res | Khartoum, Sudan | Prospective | 2013-2014 | 40 | ENT department | 2:38 | 27.2 | Identified cardiac rhabdomyolysis in PPD poisoning |
| Amarnath et al., 2015[17] | J Evolution Med Dent Sci | Tirupati, India | Prospective(2,931 of 4,342 patients) | 2009-2011 | 27 | Causality and ENT department | 18:9 | 50.5 | Emergency tracheostomy is a reliable method of restoring the airway in hair dye poisoning |
| Mahsud, 2015[38] | Gomal J Med Sci | Dera Ismail Khan, Pakistan | Prospective | 2013-2015 | 38 | Emergency ward | 2:36 | 22.08±6.4 | PPD poisoning causing asphyxia and respiratory failure leading to death |
| Naqvi et al., 2015[39] | Open J Nephrol | Karachi, Pakistan | Prospective | 2010-2014 | 75 | Nephrology ward | - | 28.2±11.2 | PPD poisoning is a contributing factor for toxic rhabdomyolysis |
| Balasubramanian et al., 2014[18] | Ann Nigerian Med | Thoothukudi, India | Prospective | April-December 2010 | 125 | Intensive care unit | 39:86 | 24 | Time of hospital presentation is an important risk factor for oropharyngeal edema in hair dye poisoning |
| Shigidi et al., 2014[33] | Pan Afr Med J | Khartoum, Sudan | Prospective | 2012-2013 | 30 | Emergency | 2:28 | 25.6±4.2 | Hair dye poisoning patients with Acute 9kidney injury re10quired dialysis |
| Sugunakar et al., 2013[19] | J Evolution Med Dent Sci | Amalapuram, India | Retrospective | 2005-2006 | 18 | Hospital admission | 4:14 | - | PPD intoxication needed aggressive treatment support |
| Gella et al., 2013[20] | Int J Pharm PharmSci | Kadapa, India | Prospective | March-September 2011 | 419 | Intensive care unit and medical wards | 126:293 | - | Cardiorespiratory failure, myocarditis, and acute renal failure leading to death |
| Rebgui et al., 2013[41] | IOSR J Environment SciToxicol Food Tech | Rabat, Morocco | Retrospective | 1996-2007 | 102 | Poison control and drug monitoring center | 18:84 | 17.3±15.6 | PPD import and sales should be banned in Morocco |
| Gupta and Singh, 2013[21] | J Indian SocToxicol | Gwalior, India | Prospective | - | 36 | Hospital admissions | - | - | Emergency tracheostomy tends to decrease the mortality in PPD poisoning |
| Elgamel and Ahmed, 2013[34] | Sudan Med Monit | Khartoum, Sudan | Retrospective | June-December 2008 | 200 | ENT department | 39:161 | - | Emergency tracheostomy tends to decrease the mortality in PPD poisoning |
| Khuhro et al., 2012[40] | Anaesth Pain Intensive Care | Nawabshah, Pakistan | Prospective | 2009-2012 | 16 | Intensive care unit | 2:14 | 25.8±5.6 | PPD poisoning associated with high mortality |
| Nirmala and Ganesh, 2012[22] | Otolaryngol Online J | Thoothukudi, India | Retrospective | 2009-2010 | 108 | ENT department | 38:70 | 24.7±6.5 | Needed public awareness of hair dye |
| Osman et al., 2012[35] | Gazira J Health Sci | Gezira, Sudan | Retrospective | 2006-2007 | 55 | Renal diseases and surgery | 2:53 | - | Hair dye poisoning containing PPD is the main causative factor of ARF |
| Kindle et al., 2012[23] | ISRN Emergency Med | Nellore, India | Retrospective | 2008-2011 | 50 | Emergency ward | 9:41 | 23±7.8 | Supervasmol-33 is an emerging alternative to organophosphorus poisoning. |
| Radhika et al., 2012[24] | J Biosci Tech | Kadapa, India | Prospective | January-April 2010 | 264 | Causality ward | 93:171 | - | Banning hair dyes in some parts of India |
| Jain et al., 2012[25] | J Toxicol Environ Health Sci | Jhansi, India | Prospective | 2000-2011 | 1595 | Medicine department | 381:1214 | - | Myocarditis is a fatal complication due to ingestion of PPD-20-containing hair dye with >10 grams of dose |
| Sandeep Reddy et al., 2012[26] | Renal Fail | Tirupati, India | Prospective | 2007-2011 | 81 | Hospital admissions | 43:38 | - | Acute kidney injury testifies the severity of intoxication and poor prognosis |
| Prasad et al., 2011[27]* | J ClinDiagnos Res | Tirupati, India | Retrospective | 2008-2010 | 81 | Emergency | - | - | Biochemical changes are the cornerstone for early diagnosis of hair dye poisoning complications |
| Jain et al., 2011[28] | J Assoc Physicians India | Jhansi, India | Prospective | 2004-2009 | 1020 | Medicine department | 286:734 | - | Early therapeutic intervention is essential for PPD hair dye poisoning |
| Charra et al., 2011[42]* | Int J Clin Med | Casablanca, Morocco | Prospective | 2010 | 21 | Intensive care unit | 4:17 | 20 | Inflammatory stress, pro-inflammatory power, and immunomodulative actions were causing cytotoxicity in hair dye poisoning patients |
| Chrispal et al., 2010[29] | Trop Doctor | Vellore, India | Retrospective | 2006-2009 | 13 | Hospital admissions | 2:11 | 27.2±8.7 | Early referral and aggressive management could reduce the mortality |
| Shalaby et al., 2010[10] | Toxicol Ind Health | Cairo, Egypt | Retrospective | 2001-2008 | 25 | Poison control center | 7:18 | 35±10.5 | Early recognition of complications and prompt treatment are necessary for successful outcome |
| Murugan and Bairagi, 2010[30]* | J Indian SocToxicol | Karaikal, India | Retrospective | 2008-2009 | 9 | Hospital deaths | 0:9 | Female gender aged between 20 and 30 years was risk for suicidal exposure | |
| Sahay et al., 2009[31] | J Assoc Physician India | Hyderabad, India | Prospective | - | 30 | Nephrology | 24:6 | 26.9±4.9 | Hair dye poisoning is an important cause of acute renal failure and required respiratory and hemodynamic support for recovery |
| Kaballo et al., 2007[36] | Saudi J Kidney Dis Transplant | Khartoum, Sudan | Retrospective | 2003-2004 | 89 | Nephrology | 57:32 | 39±19.4 | Acute tubular necrosis was associated with PPD poisoning |
| Filali et al., 2006[43] | Afr J Trad CAM | Rabat, Morocco | Retrospective | 1992-2002 | 374 | Poison control center | 86:288 | - | PPD poisoning has serious consequences which may eventually lead to death. |
| Kallel et al., 2005[11] | J Nephrol | Sfax, Tunisia | Retrospective | 1994-2000 | 19 | Intensive care unit | - | 27.9±16.8 | PPD intoxication was associated with respiratory, muscular, renal moreover, hemodynamic syndromes |
| Fatihi el et al., 1997[44] | Saudi J Kidney Dis Transplant | Casablanca, Morocco | Prospective | 1984-1994 | 13 | Nephrology | - | - | PPD can cause rhabdomyolysis |
| Suliman et al., 1995[37] | Saudi J Kidney Dis Transplant | Khartoum, Sudan | Retrospective | 1983-1993 | 150 | Hospital admissions | 30:120 | 40 | PPD poisoning causes severe side effect on oral ingestion |
The systematic review includes 32 studies, n=5559; meta-analysis - 29 studies, n=5448; *Studies excluded from the meta-analysis. PPD=Paraphenylenediamine, ENT=Ear, nose, and throat, ARF=Acute renal failure