Suicidal Poisoning Research Articles

Epidemiological Study of Pediatric and Adolescent Poisoning Cases in a Rural Tertiary Care Centre in South India

Pediatric poisoning covers the entire spectrum of cases from accidental ingestion in toddlers to intentional abuse in teenagers. Epidemiological surveillance of oral ingestion of poisonous substances in children and adolescents in a particular area is necessary to determine the extent and characteristics of the problem, according to which related preventive measures can be taken. This was a retrospective, observational study including all pediatric poisoning patients (between the age of 0 to 19 years) received at the Trichy SRM Medical college & Research Centre, Irungalur, Trichy during the 2 year period from May 2021 to April 2023. A total of 52 cases were received in the casualty department of our hospital during the study period. Out of this, Male patients were predominant (53.85%). Most of the cases belonged to the age group between 16- 19 Years . Most of the cases were from the Rural areas (82.69%).Accidental Poisoning (61.54%) is more common followed by suicidal poisoning (38.46%). The substances involved in Poisoning are Kerosene(19%),Rat Killer (10%), Paracetamol(10%), Oleander(8%), ant-killer (8%), Organo-phosphorus Poisoning(6%) among many others. Most of the time the poisoning happened inside Home(65%) followed by area surrounding home(17%). Oral route (88%) was the most common way of taking poison. Most cases took less than 4 hours (71%) to reach the hospital. Vomiting was the most common symptom in most of the cases. 23 cases (44%) were requiring intensive care of which only 8 cases (15%) needed more than 3 days of ICU care.

Clinical course and demographic insights into suicide by self-poisoning: patterns of substance use and socio-economic factors.

To analyze whether sociodemographic characteristics influence the substance choice and preclinical and clinical course of suicidal poisoning. This was a retrospective single-center study in patients hospitalized due to suicidal poisoning and who received at least one psychiatric exploration during their inpatient stay. Patients' sociodemographic, anamnestic, preclinical, and clinical parameters were analyzed with respect to sex and age. 1090 patients were included, 727 (67%) were females, median age was 39 years (min-max: 13-91) with 603 (55%) aged 18-44 years. 595 patients (54.8%) ingested a single substance for self-poisoning, 609 (59.5%) used their own long-term medication. Comparing to males, females preferred antidepressants (n = 223, 30.7%, vsn = 85, 23.4%; p = 0.013) and benzodiazepines (n = 202, 27.8%, vsn = 65, 17.9%; p < 0.001); males more often used cardiovascular drugs (n = 33, 9.1%, vsn = 34, 4.7%; p = 0.005) and carbon monoxide (n = 18, 5.0%, vsn = 2, 0.3%; p < 0.001). Use of Z-drugs (n = 1, 1.7%, to n = 37, 33.3%; p < 0.001) and benzodiazepines (n = 4, 6.9%, to n = 33, 29.7%; p = 0.003) increased with age (< 18 to > 64 years), while use of non-opioid analgesics (n = 23, 39.7%, to n = 20, 18.0%; p < 0.001) decreased. Average dose of substance in patients > 64 years was 12.9 ± 18.4 times higher than recommended maximum daily dose (compared to 8.7 ± 15.2 higher in those aged < 18 years; p < 0.001). Males more often required intensive care (n = 150, 41.3%, vsn = 205 females, 28.2%; p < 0.001). These results underline the complexity of (para-)suicidal poisonings and identify potential measures for their prevention, such as restricting access and better oversight over the use of certain substances.

Serum Potassium Level in Acute Organophosphorus Poisoning and its Correlation with Severity in Patients Presenting to Emergency Room in a Tertiary Hospital

Background: Organophosphorus compounds (OPCs) are common causes of accidental and suicidal poisoning in agricultural countries like Nepal. Serum cholinesterase, used to diagnose organophosphorus poisoning (OP), is not reliable for predicting its severity. This study aimed to assess serum potassium as an alternative prognostic indicator for OP poisoning severity. Methodology: This single-centric cross-sectional study included patients presenting with OP poisoning at a tertiary care center over six months. Total 86 cases met the inclusion criteria. The Peradeniya organophosphorus poisoning (POP) scale categorized patients by severity. The association between OP poisoning severity and serum potassium level at presentation was studied. Results: Of the 86 cases, 47 (55%) were females. The mean age was 26.96 years (SD: 8.73), ranging from 18 to 65 years. Most cases, 53% (n=46), were aged 20-29 years. Chlorpyriphos (50%) + cypermethrin (5%) was the most common OP compound, used in 29% cases. Malathion (50%) was the least used, in 7% (n=6) of cases. At presentation, 36% (n=31) had hypokalemia, among which 6 had mild poisoning (POP score: 0-3), while 25 had moderate to severe case of poisoning (POP score: 4-11). The association between OP poisoning severity and hypokalemia was statistically significant (p-value &lt;0.001, OR: 23.958, 95% CI). Conclusion: Serum potassium levels in patients presenting within 12 hours of OP poisoning significantly correlate with severity, as determined by the POP scale. Hypokalemia is prevalent in moderate to severe OP poisoning cases, with higher POP scores linked to lower serum potassium levels.

Novel Technique for Simultaneous Ethylene Glycol and Its Metabolites Determination in Human Whole Blood and Urine Samples Using GC-QqQ-MS/MS.

Toxicological analyses often necessitate the identification of compounds belonging to diverse functional groups. For GC-MS analyses, derivatization of compounds belonging to different functional groups can pose a challenge and requires the development of comprehensive methods of analysis. One example could be ethylene glycol, whose widespread use is related to possible unintentional or suicidal intoxications. This fact clearly indicates the need to develop sensitive methods for the determination of ethylene glycol and its metabolites in biological material, as only such complex analysis allows for proper toxicological expertise. A simultaneous GC-QqQ-MS/MS method for the determination of ethylene glycol together with its metabolites, glyoxal and glycolic acid, as well as the detection of glyoxylic acid and oxalic acid, was developed and fully validated. A novel approach for simultaneous derivatization of substances from different groups (alcohols, aldehydes, and carboxylic acids) was established. Sample preparation included the addition of three internal standards (BHB-d4, ethylene glycol-d4 and methylglyoxal), precipitation with acetonitrile and subsequent derivatization with N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide (MTBSTFA), as well as pentafluorophenylhydrazine (PFPH). Detection was carried out with the use of triple quadrupole mass spectrometer. The ionization method was electron impact, and quantitative analysis was carried out in multiple reaction monitoring mode. The lower limit of quantification was 1 μg/mL, 0.1 μg/mL, and 500 μg/mL for ethylene glycol, glyoxal, and glycolic acid, respectively. The presented method was applied in three authentic postmortem cases of ethylene glycol intoxication.

Situs inversus partialis (levocardia): an incidental discovery of an extremely rare case during the autopsy of a female with suicidal poisoning

BackgroundSitus inversus is a rare congenital anomaly. In this condition, the abdominal and chest organs are positioned in reverse, a mirror image of the normal anatomical position. It is divided into two categories. 1. Situs inversus totalis, in which the apex of the heart points toward the right side. 2. Situs inversus partialis or incompletus, in which the apex of the heart points toward the left side. Situs inversus totalis is present in 1 per 10,000 to 50,000 individuals of the general population, whereas situs inversus partialis is a much rarer condition and is present in 1 per 2,000,000 individuals of the general population. The term situs ambiguous is also used for the arrangement of organs and vessels in an unordered manner.Case presentationIn this paper, we present an extraordinary case of situs inversus partialis discovered incidentally during the autopsy of a female body with a documented history of suicidal poisoning. This unique finding sheds light on the diagnostic challenges and implications of situs inversus partialis, especially in patients with underlying medical conditions.ConclusionsThis report underscores the importance of thorough and systematic investigations during autopsy examinations to identify and comprehend rare anatomical anomalies that may otherwise remain unnoticed. Increased awareness of such rare congenital anomalies may contribute to a better understanding of their prevalence and potential clinical implications for healthcare professionals and researchers.

Paraquat Poisoning: A Growing Homicidal Threat: Insights and Strategies

Abstract Paraquat is a widely used non-selective herbicide in Indian agriculture. It has gained popularity for its misuse in suicidal poisoning, primarily because it lacks an antidote, and ingestion often leads to death. When examining the historical trends of pesticide-related suicidal poisonings in India, there is a noticeable transition from endrin, organophosphates and rodenticides to the current prevalent use of paraquat. This review delves into globally reported cases of homicidal paraquat poisonings, which are sporadically reported in India as well, although not published in mainstream academia. Clinicians must remain vigilant in homicidal paraquat poisoning situations as there is often improper history at the time of presentation. Such cases typically present with some non-specific symptoms such as oral and pharyngeal burns and appear like any other typical acute gastroenteritis or a flu-like illness which ultimately leads to death as a result of pulmonary complications. At the same time, forensic pathologists need to be well versed in the characteristic autopsy findings and analytical toxicology considerations of paraquat-induced criminal poisoning, given the occasional incidents in India. The use of paraquat as a weapon in poisoning cases is a significant public health concern that underscores the need for a ban on paraquat in India.

A Review on the Poisonous Plant Cleistanthus collinus

Cleistanthus collinus is a toxic plant belonging to the Euphorbiaceae family, and all parts of the plant are poisonous. It is used as suicidal, homicidal, cattle and fish poison and for inducing criminal abortion. The leaves and plant parts are consumed in various forms for homicidal and suicidal and it results in symptoms such as chest pain, dyspnea, central nervous system symptoms, and vision disturbances. There is no specific antidote for the C. collinus poisoning. The percentage of mortality with C. collinus poisoning varies from 20% to 50%, and the mortality depends on the amount and mode of consumption of the leaves. The major phytoconstituents of the plant include ellagic acid, diphyllin, collinusin, cleistanthin A, and cleistanthin B. The two major compounds cleistanthin A and cleistanthin B were evaluated for pharmacological activities such as antineoplastic activity, antiviral activity, diuretic activity, neuromuscular blocking property, alpha receptor blocking property, and antioxidant effect. The current review focuses on the toxicological and pharmacological properties of this plant and its phytoconstituents.

A Retrospective Study to Assess the Clinico-Epidemiological Profile of Acute Poisoning Patients Admitted in a Tertiary Care Hospital, Karnataka, India

ABSTRACT Background and Objectives: Acute poisoning is one of the most common medical conditions which requires emergency management. This study was aimed to generate the clinico-epidemiological profile of acute poisoned patients admitted to the emergency department in a tertiary care hospital. Methods: A retrospective research study was conducted in between June 2018 and September 2019. All acute poisoned patients admitted in KH hospital Manipal were included in the study. Collected data were analyzed using descriptive and inferential statistics. The obtained results were stated as frequency, percentage, and Chi-square analysis. Results: Among 324 poisoned patients, 47.5% were organophosphate poisoning, with 48.9% belonging to the age group of 19–35 years. Apparently, 59.2% were male patients. The most common route of poisoning seen is 96.60% ingestion. Suicidal poisoning was noted in majority of the patients 92.90%. A large number of poisoned patients, 61.11%, were conscious while reporting to emergency department. The main reason for poisoning was marital disharmony 54.32%, and 14.5% patients were put on ventilator life support during treatment. Recovered and discharged from the hospital was seen in 76.54% of patients and death witnessed in 12.34% of poisoned patients. The patient outcome was found to be significantly associated with type of poisoning (P &lt; 0.001) and motive of poison consumption (P &lt; 0.001). Conclusion: This study has succeeded to contribute added evidence concerning the clinico-epidemiological profile and consequence of acute poisoning patients admitted in a tertiary care hospital. Increased treatment expenses and admission in intensive care make burden to the family.

Clinico-demographic characteristic and outcome of adult acute organophosphorus (OP) poisoning in Teaching Hospital of Madhesh Province, Nepal

Background &amp; Objectives: Organophosphorus (OP) poisoning is a major health problem worldwide, especially in developing countries. This study aimed to find out the demographic, clinical presentation and outcome of OP poisoning patients. Materials and Methods: A cross-sectional study of two years duration was conducted on patients presenting to Emergency Department (ER) with clinical features of OP poisoning at Janaki Medical College Teaching Hospital (JMCTH), a tertiary care hospital. Results: A total of 84 cases of acute poisoning were reported in ER-JMCTH. Patient ages ranged from 15 to 60 years. The highest number of poisoning cases was observed in the 15-25 years age group (44 cases 52.4%) male = 33 (39.3%) and female = 51(60.7%), ratio M: F = (1:1.5). Most cases of poisoning were due to suicidal intention (n = 63, 75%), most common toxic substances used for suicidal purposes of OP were chlorpyriphos (n = 56, 66.7%) and dichlorvos (n = 17, 20.2%). Most of the cases belonged to illiterate (n = 26, 31%) and primary education (n=19, 22.6%). About 79.8% of the patient’s symptoms were cholinergic effect (muscarinic), 9.5% nicotinic and 10.7% central nervous system (CNS) effect. Nearly 93% (n = 78) patients survived and 7% resulted in death. Conclusion: The majority of OP poisoning patients were of young age and OP poisoning was more common in women compared to men. Suicidal poisonings were more frequent than accidental ones. The research team's a treating physicians noted miosis as the most common symptom, whereas patients most frequently complained of nausea and vomiting.

Trends of Suicidal Poisoning in Southern part of Assam

Suicide is a leading cause of mortality among young people in many countries, making it a serious global public health problem. It is estimated that around 20% of global suicides are due to pesticide poisoning. This study was conducted with an objective to find out the commonest suicidal poison and its demographic distribution. This study was designed on victims of suicidal poisoning brought for medicolegal autopsy at Silchar Medical College and Hospital, Silchar, Assam between 15th October 2017 and 14th October 2022. Required information for the study was gathered from inquest reports, autopsy reports, chemical examiner’s analysis report of viscera and available documents in the departmental records. The collected information was statistically analysed using Microsoft excel version 2019. Out of 64 cases, poison was detected in 33 Cases. Male victims surpassed females with highest number of victims from age group 21-30 years. Most common poisoning agent was organophosphorus compounds. Educational and awareness programs regarding usage and storage of pesticides can become an important step for the prevention of deaths due to poisoning. However more research is needed to better understand suicides involving pesticides in their cultural contexts

Carbon Monoxide Poisoning: From Occupational Health to Emergency Medicine.

Carbon monoxide poisoning remains a leading cause of accidental poisoning worldwide (both at home and at work), and it is also a cause of suicidal poisoning. Such poisoning can arise following prolonged exposure to low levels of CO or following brief exposure to high concentrations of the gas. In fact, despite exposure limits, high safety standards, and the availability of CO alarms, nearly 50,000 people in the United States visit the emergency department each year due to poisoning. Additionally, CO poisoning in the United States causes up to 500 deaths each year. Despite the widespread nature of this form of poisoning, known about for centuries and whose damage mechanisms have been recognized (or rather hypothesized about) since the 1800s, early recognition, especially of late complications, and treatment remain a medical challenge. A well-designed therapeutic diagnostic process is necessary so that indication for hyperbaric or normobaric therapy is correctly made and so that patients are followed up even after acute exposure to diagnose late complications early. Furthermore, it is necessary to consider that in the setting of emergency medicine, CO poisoning can be part of a differential diagnosis along with other more frequent conditions, making its recognition difficult. The last thirty years have been marked by a significant increase in knowledge regarding the toxicity of CO, as well as its functioning and its importance at physiological concentrations in mammalian systems. This review, taking into account the significant progress made in recent years, aims to reconsider the pathogenicity of CO, which is not trivially just poisonous to tissues. A revision of the paradigm, especially as regards treatment and sequelae, appears necessary, and new studies should focus on this new point of view.

Intensive care management of organophosphate insecticide (sniper) poisoning: a Preventable death—a case series

Background Organophosphate poisoning is the commonest accidental and suicidal poisoning in developing countries like Nigeria. Respiratory distress, unconsciousness, and acute cholinergic crisis are reasons for critical care. Objective We determined the clinical presentation and outcome following sniper poisoning in critically ill patients. Methods This was a retrospective case series of 13 patients managed for sniper poisoning in a six-bed private intensive care unit in Lagos, Nigeria, from June 2016 to June 2022. The diagnosis of sniper poisoning was made based on a positive history of ingestion of sniper before presentation, and clinical signs of cholinergic hyperactivity. Results A total of 13 patients were reviewed, 3 females and 10 males with median age and APACHE II score of 23.5 years (IQR, 5.75, 27.75) and 26 (IQR, 24, 27.5), respectively. Deliberate ingestion of sniper occurred in 10 patients. Respiratory insufficiency/unconsciousness, and bradycardia/hypoxia occurred in 11 and 10 patients, respectively. The median duration of ICU admission was 6.5 days, (IQR: 4, 8). Intravenous atropine and glycopyrrolate were administered in 10 and 2 patients, respectively. The median dose of atropine on days 1, 2, and 3 were 38.9 mg, 27.6 mg and 18.5 mg, respectively. Mechanical ventilation was initiated in 10 patients, 8 of whom were discharged home. Out of 13 patients, 10 survived, while 3 died. Conclusion This case series showed that sniper poisoning is a life-threatening condition that requires immediate diagnosis and treatment. Early referral for critical care, initiation of atropine, and supportive mechanical ventilation can save lives.

Understanding collective suicides in Morocco: A 35-year epidemiological study

IntroductionSuicide is a major public health concern, ranking among the leading causes of death worldwide.ObjectivesThis study investigated the epidemiological features of collective suicide incidents in Morocco.MethodsWe performed a retrospective analysis of suicidal poisoning cases recorded by the Moroccan Poison Control Center (MPCC) over a 35-year period.ResultsDuring the study’s duration, the MPCC recorded 168 suicide cases. The mean age of those involved in these incidents was 23.9 years, with a female-to-male ratio of 1.57. The majority of those affected were adolescents and young adults, specifically between 15 and 34 years of age. Pesticides and drugs were the most commonly used methods of suicide and accounted for 31.1% and 20.1% of the cases, respectively. The majority of incidents occurred in the home environment and were primarily caused by oral exposure. The symptoms of poisoning varied according to the consumed substance, amount ingested, and elapsed time until medical treatment. The symptoms included disturbances in the neurological, gastrointestinal, respiratory, and cardiovascular systems. Of the 100 cases with known outcomes, one person died due to poisoning, whereas the remaining cases survived, although some enduring complications.ConclusionsSuicide accounted for 1.3% of global mortality, ranking as the 17th most common cause of death in 2019, according to data from the World Health Organization (WHO). This trend emphasizes the urgent need for continuous efforts at all levels to address and mitigate this rapidly growing issue.Disclosure of InterestNone Declared

Retrospective analysis of elderly poisoning cases admitted to emergency departments: A two-center study

This study aims to analyze demographic, clinical, and biochemical markers of geriatric individuals admitted to emergency clinics due to poisoning to develop preventive public health projects for poisoning prevention. This study was a two-center study. Patients were categorized into accidental, suicide, and misuse groups, and the patient’s clinical and laboratory data were compared. The study included individuals aged 65 and over admitted to hospital emergencies between June 1, 2021, and June 1, 2023. The mean age of the patients admitted with poisoning was 71.7±6.3 years, and the median was 70 (65-90). 69.2% (n=27) of the patients were female, and 30.8% (n=12) were male. Common causes included misuse and suicidal poisoning, drug ingestion, corrosive substance exposure, and pesticide poisoning, Antidepressants and analgesic drugs were the most common agents. There was a statistically significant difference between the mean age rank scores of patients categorized into 3 groups: accidental, suicidal, and misuse (H(3):11.186, p=0.004). The risk of being elderly in accidental poisoning and abuse (non-suicide) patients was 1.203 times that of suicide patients. In other words, it was 20% higher (odds ratio=1.203, CI 95% [1.001-1.446], p=0.049). The mean rank score of troponin values differed significantly between the groups (p=0.027). The study highlights the high rate of poisoning among the elderly, especially women, and suggests preventive public health projects, increased public awareness, and strengthened health policies to improve their quality of life.

Demographic and Clinical Analysis of Pediatric Poisoning in Intensive Care

Aim: This study aims to improve the understanding of childhood poisoning by examining the demographic, clinical, and laboratory characteristics of critically ill patients admitted to the pediatric intensive care unit (PICU). Materials and Methods: This retrospective study analyzed 209 pediatric poisoning cases admitted to the PICU, accounting for 4.2% of total admissions. Data on age, gender, exposure route, location, time to admission, symptoms, examination findings, treatments, and PICU stay duration were collected. Patients were categorized as survivors or non-survivors, and statistical analyses were conducted to identify predictors of mortality. Results: Of the 209 cases, 62.2% were female, with a mean age of 8.75 years. Accidental poisoning was more common in children under five (56.5%), while suicide attempts (36.8%) and substance abuse (6.7%) were prevalent among adolescents. Girls had higher rates of accidental and suicidal poisoning, while boys were more involved in substance abuse. The majority of exposures were oral (90.9%) and occurred indoors (86.1%). Drug-related poisonings accounted for 53.6% of cases, with central nervous system drugs (12.4%) being the most common agents, followed by corrosive substances (7.9%). Mechanical ventilation was required in 25.4% of accidental, 9% of suicidal, and 14% of substance abuse cases. The overall mortality rate was 8.2%, with prolonged PICU stay and the absence of activated charcoal identified as significant predictors of mortality. Conclusion: This study underscores the critical need for age- and gender-specific preventive measures to mitigate pediatric poisoning. Safe storage of hazardous substances and prompt medical intervention, such as timely administration of activated charcoal, are critical to reducing mortality. Prolonged PICU stays have been associated with increased mortality, often indicating more severe cases. Unintentional poisonings in younger children, largely due to inadequate supervision, highlight the importance of preventive strategies, while intentional poisonings in adolescents require closer monitoring and mental health interventions.

Profile of Acute Poisoning and Its Outcome in Children Admitted to a Tertiary Care Hospital in Northeast India: A Cohort Study

Introduction: Acute poisoning in children is an important public health problem. It is a significant paediatric emergency in both developing and developed countries, leading to preventable morbidity and mortality. While there is substantial research literature on acute childhood poisoning from developed countries, there is a lack of data from developing countries like India due to inadequate and poor surveillance of poisoning-related data. Aim: To investigate the clinical and epidemiological profile, as well as the outcome, of acute poisoning in children admitted to the paediatric emergency department of a tertiary care hospital in Northeast India. Materials and Methods: This prospective cohort study was conducted in the Paediatrics department of Assam Medical College and Hospital, Dibrugarh, Assam, India, from April 1, 2021, to March 31, 2022. All children under the age of 12 years who presented to the paediatric department with a history of exposure to toxic substances were included in the study. The admitted children were assessed in terms of demographic variables, type of poison, route of poisoning, time of presentation, circumstances of poisoning, storage place of poison, clinical presentation, and interventions provided. Data were presented as mean and frequency. Results: A total of 78 children under 12 years of age were enrolled in the study, with a mean age of three years and three months at presentation. The majority of cases (96.2%) involved accidental poisoning, while a small proportion (3.8%) was due to suicidal poisoning. Of the two reported cases of suicidal poisoning, one involved a male child and the other involved a female child. Both children were above six years of age. The most common causes of poisoning were kerosene (34.6%), organophosphorus compounds (10.3%), and liquid mosquito repellents (9.1%). Conclusion: This study revealed both unintentional and intentional poisoning cases, with a high prevalence of accidental poisoning observed in children below three years of age. Kerosene was identified as the most common cause of childhood poisoning.

Socio-demographic Profile of the Causes of Death due to Organophosphorus Poisoning - A Retrospective Study

Background: Poisoning is a global issue occurring all over the world involving people of all ages and genders, from all ethnic and economic groups. It is estimated, there are 1 to 5 million cases of Organophosphorus poisoning per year worldwide with approximately 300,000 deaths. Aim of the study: To assess the demographic pattern of death due to organophosphorus poisoning with respect to age, sex, occupation, education, and socioeconomic status. Materials and Methods: A retrospective study was conducted by the department of Forensic Medicine, Sheikh Hasina Medical Colleges, Tangail, from January 2020 to December 2020. Result and discussion: 85(20.68%) were due to poisoning, out of those poisoning cases 77 (90.58%) were due to organophosphorus compound poisoning. The incidence was higher in females (51.94%) than in males. 90.00% of the victims in our study were married females, and 63.64% of cases were below Secondary education. Among the male deaths 83.78% were from rural areas, female rural deaths were 82.50%. Housewife (38.9%) were the major victims. Conclusion: Illiteracy, Poverty, Cheap availability of organophosphorus compounds, lack of employment, and stressful lifestyle were the common reasons behind suicidal poisoning. Health education of farmers, other agricultural laborers, and young people about the toxic and detrimental effects of organophosphorus compounds will help in preventing suicidal and accidental poisoning to some extent. J Shaheed Suhrawardy Med Coll 2022; 14(1): 62-64

Assessing the Iran Health System in Making Progress towards Sustainable Development Goals (SDGs): A Comparative Panel Data Analysis.

Sustainable development goals' (SDGs) analysis can be caused a better understanding of factors contributing to access to health services and help shape policies to attain health goals. This review aimed to measure and compare the SDGs between Iran and selected categories. This study was a comparative cross-sectional study. We identified indicators of health status based on the SDGs report 2019. The status of SDGs indicators was compared in Iran to four categories, including selected countries with similar social, economic, and health status, six regions of the WHO, the average of each income level group. SPSS 20 and Excel 2019 software were used for descriptive data analysis. The average life expectancy and healthy life expectancy were 75.7 years and 65.4 respectively in Iran. Iran's mortality rate in indicators named road traffic (32.1 per 100000 population), suicide (4.1 per 100000 population), and unintentional poisoning (1.2 per 100000 population) were higher than most of the categories. Iran's status in morbidity indicators had an approximately lower rate than all categories. Iran had full coverage in three immunization indicators like DTP3 immunization, MCV2 immunization, and PCV3 immunization, which was higher than all categories. Coverage of UHC in Iran (65%) was near to the global average (64%) and higher than the eastern Mediterranean Region (53%). Moreover, the prevalence of tobacco smoking (10.95%) and alcohol consumption (1%) were lower than global (6.4%) and the WHO regions (1.8%) average. Health status measurement is a trend that requires the collection, processing, analysis, and dissemination of data by a set of indicators. There are several weaknesses in reported data in the SDGs for some indicators, the data collection process should be noticed seriously by policymakers.

Organophosphorus Compound as Suicidal Poison in Rural Areas of Bangladesh: A Medicolegal Study

Background: Suicide by poisoning is a major public health problem in Bangladesh and other developing countries in the world. Among the poisonous substances, Organophosphorus compounds (OPC) poisoning is more common. Easy accessibility of the poison is the number one reason for the preference of OPCs as suicidal agents. Objective: This study was designed to find out demographic characteristics and postmortem findings related to suicide by OPC poisoning in Manikganj. Methodology: This retrospective cross-sectional study was carried out during January, 2019 to December, 2020 in the district hospital, Manikganj, Bangladesh. Results: During the study period, a total of 381 medico-legal autopsy have been done- among them, 83 (21.78%) cases were death due to OPC poisoning. Maximum (24, 28.91%) deaths were between ages of 21-30 years, among them majority were males (49, 59.03%). People of different occupations were involved in OPC poisoning- maximum of them were housewives (27, 32.53%), followed by agricultural workers (13, 15.66%). Regarding motive of poisoning, the most common was suicidal intent (58, 69.88%) among both males (22, 37.93%) and females (36, 62.07%), followed by accidental (25, 30.12%). About one third of the cases were illiterate (26, 31.33%). Financial constraint was the main cause of suicide. Conclusion: OPC poisoning is a burning problem in our health sector. Improvement of awareness, elimination of unemployment, financial stability, limiting availability and banning more toxic compounds would reduce the OPC poisoning rate to a considerable number. Journal of Monno Medical College, June 2023; 9 (1): 07-10

A rare cases of ferrous sulphate poisoning- A case study

A poison is a substance which when administrated, inhaled or ingested is capable of causing deleterious effect on the human body. The circumstances may be suicidal, homicidal or accidental. A suicidal poison of choice must be cheap, easily available and capable of being administered is any food or drink. It must have pleasant taste and no repulsive smell. The action of poison may be local, remote, combined and general. The preparations of iron salt, which are largely used in medicine are mostly prepared from sulphate, carbonate and perchloride of iron. When these salt are administered in large doses, they produce poisonous symptoms and may even cause hemosiderosis as a manifestation of chronic poisoning. Iron sulphate (ferrous Sulphate, FeSo4) is commercially known as green vitriol of sulphate. It forms green, efflorescence monosymmetric crystals on exposure to the atmosphere. It is freely soluble in water. It is used in making blue ink and dyes, but sometimes as a pesticide. In this case study, we'll talk about a woman who died after consuming an corrosive drug at home. For medico-legal purposes, it was critical to correlate autopsy results with medical care records and the place of the incident.