Muhammad Nadir Khan, Shamimah Hanif.
Deliberate self harm due to organophosphates.
J Pak Inst Med Sci Jan ;14(2):784-9.

This hospital based retrospective study was conducted during the period of one year from January 2001 to December 2001 to know the frequency of organophosphate poisoning in local population and refugees, its social background and contributing factors causing self harm. The study included forty six consecutive patients admitted through emergency department with diagnosis of MLC (Medicolegal Cases) of poisoning. The inclusion criteria for the diagnosis of organophosphate poisoning were: history taken from the relatives about the ingestion of insecticides, the clinical signs like excessive salivation, miosis, bradycardia, wheezing, excessive bronchial secretions, typical breath odor of organophosphate and response to atropine. The differential diagnosis was pulmonary edema due to rheumatic heart disease like mitral stenosis and barbiturate poisoning. The laboratory investigations for the confirmation of organophosphate poisoning were not readily available in Quetta. Hence the diagnosis was purely clinical. Details of personal habits, family and socioeconomic history was taken from the attendants and also from the patient after recovery. Complete psychiatric history was also obtained. Data about mode of presentation, clinical findings, management and complications was obtained. All patients were females. Maximum number of patients was between 15 to 35 years age group. Highest prevalence (65.21%) was in females of 16-25 years. It was also high in patients of lower socioeconomic group (91.30%). Twenty (43.47%) females were married with H/O disrupted family relationships. In 36 (78.26%) patients there was H/O depression and 14 (30.43%) were using antidepressants. Twenty nine (63.04%) patients had H10 facing current problems and 2 patients (4.34%) had H/O previous self-harm.

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