SUICIDAL POISONING IN BATTICALOA DISTRICT: Analysis of Admissions and Outcome, MEDICAL UNIT,TEACHING HOSPITAL,BATTICALOA. Pirasath S1, Jasotharan V2 , Sundaresan K.T3 1,3 Teaching Hospital Batticaloa, Sri Lanka. 2Faculty of Health Care Sciences, Eastern University of Sri Lanka. Annual Academic Sessions 2012

Dr.Selladurai Pirasath, RHO/TH/Batticaloa. Mr.Velapoddy Jasotharan, By: Dr.Selladurai Pirasath, RHO/TH/Batticaloa. Mr.Velapoddy Jasotharan, Medical Student/FHCS/EUSL. SUPERVISOR: Dr.K.T.Sundaresan, MBBS,MD Consultant Physician/TH/Batticaloa. Annual Academic Sessions 2012

Objective To determine the selected aspects of the epidemiology, methods, treatment and outcome of patients admitted with poisoning to single medical unit, Teaching Hospital, Batticaloa. Annual Academic Sessions 2012

Poisoning in Batticaloa A high number of suicidal poisoning is noted in Batticaloa. YOP are common among young females. Significantly contributed to Mortality and Morbidity in Batticaloa. Challenge in Batticaloa. Annual Academic Sessions 2012

Materials and methods Annual Academic Sessions 2012

Materials Methods Interviewed based predesigned questionnaires Study design : Descriptive study Study population : All victims admitting to Single Medical Unit, Teaching hospital, Batticaloa. Study period : 1st December 2011 –31st May 2012. Sampling method : Convenience sampling Sampling size : 120 Patients Annual Academic Sessions 2012

Results and Discussion Annual Academic Sessions 2012

120 victims 72females and 48 males Race Tamils (Nos-105, 87.5%) Muslims (Nos-15, 12.5%) Marital status Unmarried(Nos-78 ,65%) Married (Nos-42,35%) Religion Hindus (Nos-92, 76.6%) Christian(Nos-13,10.8%) Muslims (Nos-15,12.6%) Age 20-29 yrs (Nos-74) 61.6% 30-39yrs (Nos-20, 16%) >60yrs (Nos-15,12.6%) Annual Academic Sessions 2012

Personal characteristics on Poisoning Nos Courtship failure Nos-45, 37.5% Marital problems Nos-21, 17.5% Social problems Nos-12, 10% Economical problems Nos-24, 20% Familial problems Nos-10, 8.33% Chronic Diseases Nos-8,6.67%) Annual Academic Sessions 2011 Annual Academic Sessions 2012

Girls have attempted suicide to threaten the family (Nos-4, 3.33%). Young unmarried girls had previous attempted suicidal poisoning to threaten their partners (Nos-12, 10%). 8 out of 12 have one previous suicidal attempt and 4 out of 12 have two previous suicidal attempts. The strong familial history of poisoning influences the people to select poisoning as the suicidal method. (Nos-32, 26.6%) . Annual Academic Sessions 2012

Types of Poisoning Types of poisoning Nos Yellow oleander Nos-60, 50% Cerberus Mangus Nos-4, 3.3% Organophosphate Nos-36, 30% Kerosene oil poisoning Nos-8, 6.7% Drug overdose Nos-12, 10% Annual Academic Sessions 2011

Drug overdose are common among patients with psychiatric disorders (Nos-12, 10%). 14 (11.7%) victims had ingestion of poisoning under the influence of alcoholism. The Yellow oleander was the commonest type of suicidal poisoning among young females (Age group; 18-30years), (Nos-52, 82%). The strong familial history of poisoning influences the people to select poisoning as the suicidal method esp YOP (Nos-16, 13.3%) . Annual Academic Sessions 2012

TREATMENT MODALITIES & OUTCOME Annual Academic Sessions 2012

MODALITIES OF TREATMENT Management Nos Gastric Decontamination 92(76%) Antidotes 30(25%) TPM 02(1.6%) CCU Mx 20(16%) PU Mx 15(12.5%) Ventilator Support 6(5%) Annual Academic Sessions 2012 Annual Academic Sessions 2011

OUTCOME OUTCOME Nos Death LAMA Cardiac Toxicity Aspiration Pneumonia 4(3.33%) LAMA 18(15%) Cardiac Toxicity 40(33.3%) [40/64(62.5%)] Aspiration Pneumonia 7(5.83%) Still Hospital 5(4.16%) Ventilator Associated Pneumonia 1(.83%) Annual Academic Sessions 2011 Annual Academic Sessions 2012

Statistical analysis All data were analyzed by SPSS analytical package. Annual Academic Sessions 2012

Courtship failure and Marital problems were significantly contributed to suicidal poisoning. The strong familial history and previous attempts of poisoning significantly associated with suicidal poisoning. (P<0.05) The gastric decontamination is principal stay of treatment in most cases rather than specific antidotes and was also effective in most cases. (P>0.05) The uses of Yellow Oleander have a high morbidity among the victims. (P<0.05) Annual Academic Sessions 2012

Conclusion Poisoning Young, Unmarried, Tamil, Hindu Females. YOP Significant Method of Poisoning . Contributing Factors Courtship failure & Marital problems. Selection of Method Previous & Familial Suicidal Poisoning. Annual Academic Sessions 2012

Principal stay of Treatment Gastric decontamination. Uses of YOP High Morbidity & Mortality. Annual Academic Sessions 2012

Recommendation from research; Problem-solving ability has to be promoted to reduce the rates of suicidal poisoning among young unmarried females in Batticaloa district. Annual Academic Sessions 2012

Acknowledgements Supervisor & Co-Author Committee of BMA Sincere thanks to Supervisor & Co-Author Committee of BMA Victims of poisoning Staffs,TH/Batticaloa. Annual Academic Sessions 2012

International Toxicology Conference of Asia Pacific Association of Medical Toxicology (APAMT). On the 29th Nov-1st Dec,2012,Hong Hong. Annual Academic Sessions 2012

Thank you Annual Academic Sessions 2012