The Demographic Profile of Suicidal Hanging Deaths in North India.

BACKGROUND: Suicidal hanging is the most prevalent means of suicide worldwide, particularly among young people, and reveals the state of mental health in certain indigenous populations. According to the National Crime Records Bureau, hanging was the most frequent cause of suicide in India in 2019 and 2020, accounting for 53.6% and 57.8% of total suicidal deaths. AIM: The current study examines the seasonal distribution of suicide-hanging fatalities in Rishikesh, Uttarakhand, as well as the male and female incidence. METHODS: A four-year retrospective examination of autopsy data at the All India Institute of Medical Sciences (AIIMS), Rishikesh, from October 2018 to July 2022. A total of 1720 autopsies were performed during this period with 130 (7.56%) suicidal hangings. RESULTS: Males were disproportionately impacted (n=100, 76.92%). The ratio of men to women is 3.33:1. The mean ages of the males and females were 33.09 ± 12.59 and 24.9 ± 7.84 years, respectively. The majority of deaths occur in the third decade of life. The summer months saw the highest number of deaths (April-June). CONCLUSION: This data may be used to identify persons with a higher chance of committing suicide by hanging and can be utilized to help people through a nationwide suicidal prevention program that employs a multi-disciplinary team approach. Epidemiological studies should evaluate the psychosocial characteristics of men and women separately to identify the population at risk and develop preventative approaches. LIMITATIONS: This is a single-center, retrospective study.

Scale for assessment of lethality of suicide attempt.

BACKGROUND: Lethality of suicidal attempt provides useful information regarding the behavior. There is a perceived need for a clinically useful scale that can be easily adapted to various methods and circumstances of attempt. AIMS: The study intended to develop and test utility of a scale for measuring lethality that can reflect overall clinical observation taking into account various indicators of lethality and which can be used across clinical scenarios involving different methods. SETTINGS AND DESIGN: Cross-sectional study in a hospital. MATERIALS AND METHODS: The scale for assessment of lethality of suicide attempt (SALSA) has two components: The first component has four items indicating seriousness of the attempt and its likely consequences and the second component is the global impression of lethality. All the items are scored from 1 to 5, higher scores suggestive of increased lethality. SALSA was used to evaluate lethality of 82 consecutive suicide attempters; and it was compared with lethality of suicide attempt rating scale (LSARS) and risk-rescue rating scale. STATISTICAL ANALYSIS: Chi-square, t-test, analysis of variance, Cronbach's alpha, binary logistic regression. RESULT: There was significant correlation of SALSA score with that of LSARS (r: 0.89) and risk score of risk-rescue rating (r: 0.93, P < 0.001); and negative correlation with rescue score (r: -0.569; P < 0.001). Internal consistency reliability of SALSA was high (Cronbach's alpha: 0.94). Lethality scores of SALSA differentiated known groups with different lethality, e.g. deceased and survived; attempters with different levels of medical intervention: In-patient only, intensive care, ventilator support. SALSA score significantly predicted the lethal outcome (odds ratio: 3.2, confidence interval: 1.12-8.98). CONCLUSION: SALSA is a useful instrument for assessment of lethality of suicidal behaviors during clinical evaluations considering the ease of administration, its ability to differentiate clinical groups with known variations of lethality and clinical outcomes.

A psychological autopsy study of suicidal hanging from Cuttack, India: focus on stressful life situations.

Factors and stressful life situations associated with suicidal hanging in a sample from India were studied with a view to explore preventability. Information was collected on consecutive suicidal hanging victims in a 2-year period from various sources including family members through psychological autopsy method. Out of 662 autopsies involving suicide during the study period, 104 had used hanging as the method. Age group of 21-30 years, married females, unmarried males, dowry related stress, unemployment, prolonged illness, failure in examinations, relationship and financial problems were associated more frequently with suicidal hanging. Stresses stemming from social practices and perceptions are linked with considerable number of suicidal hanging, which suggest priority areas for intervention.

Clinical manifestations of lead workers of Mangalore, India.

OBJECTIVE: To correlate blood lead levels and clinical manifestations. PARTICIPANTS: Battery workers and painters (occupationally exposed to lead in and around Mangalore, India) and occupationally unexposed controls. MAIN OUTCOME MEASURES: We measured the blood lead levels by anodic stripping voltammetry, and a clinical examination was carried out on all participants. RESULTS: There was a statistically significant difference between the lead-exposed group and controls with respect to clinical manifestations. The prominent findings among the lead-exposed group were fatigue, abdominal colic, abdominal discomfort, backache, muscular exhaustability, myalgia and paresthesia, at a blood lead level ranging from 0.4 to 116.6 microg/dL. CONCLUSIONS: Such a study on battery workers and painters has not been reported in India. Several attempts have been made over the years to relate blood lead levels to adverse health effects. It was not possible to determine a precise blood lead level below which symptoms never occur or a blood lead level at which symptoms are always reported.

Validity of consent--a review of statutes.

In recent years there have been a number of malpractice suits based on lack of consent or inadequate consent from the patient for the procedure used in treatment. This is a particularly dangerous suit for the doctor since the burden of proof lies on the doctor. Furthermore since the suit is based on intentional assault, some insurance policies do not cover the doctor for his liability. The common meaning of consent is permission, whereas the law perceives it as a contract i.e. an agreement enforceable by law. So a doctor needs to understand the legal basis of consent rather than the common meaning of it. The present article aims to discuss the various legal aspects of consent as viewed in the Indian law.