Please refer to article "Cassia occidentalis poisoning causes fatal….." published in July 2007(1). I also came across two more patients from Faridpur village of Chandausi (Moradabad) western UP in the month of October 2007. Three children while playing together consumed good amount of "Usaya ki Fali" (local popular name of Cassia occidentalis). One was five years old male child with symptoms and signs of acute encephalopathy with history of consumption of toxic beans 4 days before. Markedly low levels of blood glucose and raised liver enzyme SGPT were the only positive finding. The child collapsed within six hours with hematemesis and sudden cardiorespiratory arrest.

Second female child of four years of the same group was admitted one day before with symptoms of moderate fever and irritability and signs of mild encephalopathy as she was able to sit and take food by mouth but not responding to vocal commands and unable to recognize her parents. SGPT was raised and blood glucose was low. Child recovered on 7th day except persistent irregular fever and discharged on paracetamol. Attendant of the patient also informed that third child of the group died on 4th day after ingestion of beans during treatment elsewhere.

While treating children from rural areas with acute encephalopathy, one should also take the history of ingestion of toxic beans.

Atulya Kumar Gupta,
Pediatrician,
Mother & Child Health Care Center,
Braham Bazar, Chandausi,
Moradabad 202 412, UP, India.