Polycystic Ovary Syndrome and Non-Suicidal Self-Injury: A community-based study

Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm, and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still little to know understanding of how non-suicidal self-injury and suicidal ideation and intention manifests in women with PCOS, and how this might differ from women without PCOS. Within this cross-sectional investigation, women with and without a diagnosis of PCOS (n = 418) completed validated metrics of emotion dysregulation, rumination, and non-suicidal self-injury, as well as self-reported indices of previous suicidal ideation and future suicidal intention. Group comparisons indicated that women with, relative to those without PCOS reported significantly greater metrics across all variables. Moreover, serial mediation analyses were conducted to test the ideation-to-action framework of suicide in women with PCOS, with the positive relationship between a PCOS diagnosis and future suicidal intention being explained through the indirect pathway of increased emotion dysregulation, recent suicidal ideation, and NSSI. Our findings call to action the need for international screening for suicide intention and self-harm in women with PCOS.

A Study on Correlation Between Serum Cholinesterase Level and Clinical Severity Based on Pop Scale in Organophosphorus Poisoning

Introduction: Organophosphorus (OP) compounds are the most commonly used pesticides worldwide and Organophosphorus poisoning has become the major public health problem especially in developing countries.The case fatality rate following ingestion of Organophosphorus pesticides in developing countries in Asia is 5-20%.Due to limited availability of facilities and resources in Nepal, it is important to prioritize treatment based on severity of poisoning as all patients can’t be managed in Intensive Care Unit. Aims: To study the correlation between serum cholinesterase level and clinical severity based on Peradenya organophosphorus poisoning scale in Organophosphorus poisoning. Methods: The study was conducted in the department of Medicine, Nepalgunj Medical College, Kohalpur, Banke from November 2019 to November 2020. It is based on the descriptive study of 66 patients with Organophosphorus poisoning attending to the emergency department. All patients with history of exposure to Organophosphorus poisoning were included in the study. Peradenya Organophosphorus Poisoning scale was used to assess the clinical severity as mild, moderate and severe. At the same time venous blood samples were collected for serum cholinesterase level. Results: Age group ranged from 16-60 years and majority of patients were in the age group of 20-29 years (34.85%). 53% were females. 74.2% of the patients were from lower socioeconomic status. 83.3% of the patients consumed poison with suicidal intention. Majority of the patients were from tharu ethinicity (40.9%) and were farmers (30.3%). It was observed that there is significant correlation between serum cholinesterase level and severity of poisoning based on Peradenya Organophosphorus Poisoning scale at initial presentation (p value <0.001). Conclusion: There is significant correlation between severity of poisoning and degree of derangement of serum cholinesterase level at the initial presentation. As the facility for the estimation of serum cholinesterase level is not available in all regions of Nepal.

Non-Suicidal Self-Injury in Those Dealing With Borderline Personality Disorder or Separation from Parents

Non-suicidal self-injury (NSSI) is a deliberate destruction of one’s own body tissue without suicidal intention that causes physical injury. NSSI is mostly found in adolescents or young adults (Paul, Tsypes, Eidlitz, Ernhout, & Whitlock, 2015). Borderline personality disorder (BPD) is one of the risk factors for developing NSSI. Individuals with borderline personality disorder also experience invalidation during their childhood, this can cause individuals with BPD to feel that they deserve to receive NSSI as a form of self-punishment (Sadeh et al., 2014). In addition, children who experience parental separation (through death, divorce or employment) have a higher risk factor for developing NSSI (Astrup, Pedersen, Mok, Carr, & Webb, 2017). A literature search was conducted in six databases, and a total of 20 relevant articles were found. The explanation of the relationship between non-suicidal self-injury, borderline personality disorder, and loss of or separation from a parent are explored in this study, in order to increase understanding of how NSSI behaviours can be prevented. Keywords: NSSI, Borderline Personality, Separation Parent

Contents of the Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea, Version 2.0

Objective Suicide is a huge nationwide problem that incurs a lot of socio-economic costs. Suicide also inflicts severe distress on the people left behind. The government of the Republic of Korea has been making many policy efforts to reduce suicide rate. The gatekeeper program, ‘Suicide CARE’, is one of the meaningful modalities for preventing suicide.Methods Multidisciplinary research team collaborated to update the ‘Suicide CARE’ to version 2.0.Results In the ‘Introductory part’, the authors have the time to think about the necessity and significance of the program before conducting full-scale gatekeeper training. In the ‘Careful observation’ part, trainees learn how to understand and recognize the various linguistic, behavioral, and situational signals that a person shows before committing suicide. In the ‘Active listening’ part, trainees learn how to ask suicide with a value-neutral attitude as well listening empathetically. In the ‘Risk evaluation and Expert referral’ part, trainees learn intervening strategies to identify a person’s suicidal intention, plan, and past suicide attempts, and connect the person to appropriate institutes or services.Conclusion Subsequent studies should be conducted to verify the efficacy of the gatekeeper program.

Clinical Presentation, Complication and Outcome of Black Stone (Paraphenylene Diamine) Poisoning

IntroductionIn recent time, developing countries of South Asia and Africa have seen significant increase in ingestion of Para-Phenylene Diamine (PPD), locally known as Kala Pathar, either accidental or for suicide. Through this study, we aim to study the clinical presentations and outcomes among patients who have ingested PPD.MethodThis retrospective case series study was conducted in a tertiary care hospital of Pakistan, from April 2013 to August 2017. Data of patients of PPD poisoning was archived from the hospital’s medical records. Around 174 consecutive cases were included in the study. Patients were evaluated based on self-administrated proforma.ResultOut of 174 cases of PPD poisoning that were identified, 57(32.8%) were males and 117(67.2%) were females. The mean age ± SD (range) of the patients was 24.16±9 (10 to 70) years. Approximately 170 (97.8%) patients used PPD for suicidal intention. The most common presentation was facial swelling which was present in 144(82.8%) patients followed by dysphagia in 143(82.2%) patients. Complications include metabolic acidosis in 50 (28.7%) patients and aspiration pneumonia in 36 (20.7%) patients. A total of 101 (58%) improved, while others were either referred or left against medical advice (LAMA).ConclusionIncreasing incidence of ingestion of PPD for suicide warrants the regulatory authorities to restrict the use of PPD in hair dyes and implement strict measures to educate masses and curtail the easy access of such poisonous substances among common people.

Complications of organophosphorus poisoning.

Organophosphate (OP) compounds are insecticides whose toxicity is well reported. They can virtually involve any organ and cardiac and renal complications are one of the most dreadful ones. Objectives: To determine the frequencies of acute renal failure and cardiac complication in patients with Organophosphorus poisoning. Study Design: Cross Sectional study. Setting: Department of Medicine, Sheikh Zayed hospital, Rahim Yar khan. Period: January 2015 to December 2015. Material & Methods: All adult cases with documented history of Organophosphorus poising either trans-dermally or oral ingestion with either accidental or intentional intake were included. The cases then underwent ECG and renal function tests. The abnormalities in ECG were documented and the urea more than 30 mg/dl and creatinine more than 1.5 mg/dl was labeled as acute renal failure. Results: In this study there were 100 cases, 58 (58%) were females and 42 (42%) males. The mean age was 22.58±48 years and mean duration of OP taken was 7±0.24 hours. Complications were seen in 35 (35%) cases out of which 6 had ARF and 29 had cardiac arrhythmias. IA, 6 had prolonged QT and remaining 3 observed ventricular tachycardia (VT). ARF was common in females but there was no significant association with any study variables. However a near significant was seen in cases that presented with more than 4 hours of toxicity (p= 0.07). Cardiac arrhythmias were also more common in females. There was significant association of it with oral intake and with suicidal intention with p= 0.001 and 0.001. Conclusion: OP poisoning is common and cardiac complications are more than acute renal failure. Oral intake and with suicidal intention are significantly associated with cardiac complications.

Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands: An Actor-Partner Interdependence Modelling

The present cross-sectional study examined the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviours during the first wave of the COVID-19 pandemic in 2020. A total of 290 pregnant women and their husbands (N = 580) were randomly selected from a list of pregnant women in the Iranian Integrated Health System and were invited to respond to psychometric scales assessing fear of COVID-19, depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. The findings demonstrated significant dyadic relationships between husbands and their pregnant wives' fear of COVID-19, mental health, and preventive behaviours. Pregnant wives’ actor effect of fear of COVID-19 was significantly associated with depression, suicidal intention, mental quality of life, and COVID-19 preventive behaviours but not anxiety. Moreover, a husband actor effect of fear of COVID-19 was significantly associated with depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. Additionally, there were significant partner effects observed for both the pregnant wives and their husbands concerning all outcomes. The present study used a cross-sectional design and so is unable to determine the mechanism or causal ordering of the effects. Also, the data are mainly based on self-reported measures which have some limitations due to its potential for social desirability and recall biases. Based on the findings, couples may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women and the foetus.

The Scenario of Acute Poisoning in Jashore, Bangladesh

Background. Acute poisoning is a common scenario in the emergency department of any general hospital globally, but its pattern may vary in different parts of the world and even may be a different regional variation in the same country. Objective. Our recent study aims to assess the demographic characteristics, psychological aspect, pattern, and treatment outcome in different acute poisoning. Method. The present cross-sectional study was conducted in the medicine department of Jashore Medical College and Hospital from 1st January to 30th June 2018, which recruited 487 eligible cases of admitted acute poisoning patients. Results. The study reveals that the total incidence of acute poisoning in Jashore, Bangladesh, is 17.1 per 100,000 populations over a 6-month period. The mean age of our study population was 27 ± 11 (SD) years with having significant female preponderance in acute poisoning (female: 253/52% and male: 234/48%; p = 0.002). Female subjects were significantly younger than male (p <0.001). Moreover, the total suicidal intension of acute poisoning in our study was 97.3%, whereas the female subjects were more committed to suicidal attempts (p = 0.027). Organophosphorus compounds (OPCs) were the significant leading agents (66.1%, p = 0.029) of acute poisoning, and even, it had been significantly used as suicidal intention of poisoning substance (65.1%, p <0.001) in our observation. Muslim (97.5%, p = 0.005), 10–29 year age group (68.0%, p = 0.002), rural (99.2%), unmarried (51.3%), middle class (50.1%), students (48.9%), and secondary educational background population (76.4%) were more victimized of acute poisoning. Among different factors, familial disharmony constituted of 56.1% cases of suicidal attempt in acute poisoning. Finally, we had observed that the death incidence by acute poisoning in Jashore, Bangladesh, was 1.9 per 100,000 population over a 6-month period. Conclusion. The recent study reveals that there is high incidence of acute poisoning in Jashore, Bangladesh, with a significant amount of death toll. Organophosphorus compound is the most common agent of deliberating self-poisoning in our study due to its easy availability in our agriculture-based community.