Background Suicide is one of the leading mental health crises and takes one life every 40 seconds. Four out of every five suicides occur in low- and middle-income countries. Despite religion being a protective factor against suicide, the estimated number of suicides is rapidly increasing in Pakistan. Aims Our review focuses on the trends of suicide and means of self-poisoning in the past three decades, and the management of commonly used poisons. Method We searched two electronic databases (PubMed and PakMediNet) for published English-language studies describing agents used for suicide in different regions of Pakistan. A total of 46 out of 85 papers (N = 54 747 cases) met our inclusion criteria. Results Suicidal behaviour was more common among individuals younger than 30 years. Females comprised 60% of those who attempted suicide in our study sample, although the ratio of completed suicides favoured males. There were regional trends in the choice of agent for overdose. Organophosphate poisoning was reported across the nation, with a predominance of cases from the agricultural belt of South Punjab and interior Sindh. Aluminium phosphide (‘wheat pills’) was a preferred agent in North Punjab, whereas paraphenylenediamine (‘kala pathar’) was implicated in deaths by suicide from South Punjab. Urban areas had other means for suicide, including household chemicals, benzodiazepines, kerosene oil and rat poison. Conclusions Urgent steps are needed, including psychoeducational campaigns on mental health and suicide, staff training, medical resources for prompt treatment of self-poisoning and updated governmental policy to regulate pesticide sales.

Background: Wheatpill is a commonly used suicide drug in developing countries. Due to the easy availability, this drug has played a great role for those people who commit suicide due to various reasons. Aim: To investigate different features such as (Age, Gender, Education, Marital status, Treatment, Location) of all those people who deliberately self-harm by using aluminium phosphide. Study design: Retrospective study. Methodology: Patients (n=83) were enrolled at Teaching Medical Unit, DHQ Teaching Hospital, Sargodha, Pakistan from January 2019 to December 2019 in present study and study tools were age, gender, marital status, educational status, time of arrival, number of days stayed in a hospital, treatment and outcome. Cases were included irrespective of gender. Data analyzed by SPSS 22.0v. Results: Among them 42 are men and 41 were women. 77% of the patients were under 40 years of age and despite taking advantage of all available treatment options, the mortality rate was up to 83% which indicates severe consequences after taking Aluminium Phosphide. Conclusion: This study concluded that this particular aspect of pesticide poisoning was almost exclusively a concern of the developing world where aluminum phosphide was a commonly used and easily available rodenticide. Agricultural activities were undertaken in remote rural areas, which most often lack health-care facilities. Death resulted from cardiogenic shock and hypotension. Keywords: Gender, educational status, time of arrival and treatment efficacy.

Objective: People with nonfunctioning organs waiting for donation are increasing but provision of viable organs is not meeting the need. As many of the Pakistanis are poor who sell their organs for money. This has led to illegal transplants. Now a legal way has been adopted by the Government to prevent this illegal trafficking of human organs. This study was carried out to know the willingness of peoples about organs donation. Material Methods: From general population by convenience nonprobability method 130 subjects both males and females of age 18 years and above were requested to answer the questionnaire. Results: 130 subjects included 102 males and 28 females.59.8% males 32.1% females were willing for organ donation. 55.26% of educated and 31.25% of uneducated were willing for organ donation. Conclusion: To prevent illegal donation of organs and to alleviate present level of organ donation it is pertinent to improve health education levels in general people0.

In Pakistan organophosphorus compounds are basic necessity in current farming system. In addition to their benefits in yielding good crops, it causes health hazards to its users; particularly spray workers. Excessive use, inappropriate handling and unsatisfactory personal protective measures while spraying OPs put sprayers at increased risk for acute as well as chronic health hazards. This aspect of occupational exposure is less explored area in Pakistan. Almost all OPs share a general mechanism of action, by phosphorylation of cholinesterase enzyme and buildup acetylcholine neurotransmitter level at nerve terminals. Objective: The objective of present study was to measure levels of plasma cholinesterase in pesticide spray workers who take and who do not take pre and post exposure preventive measures. Material and Methods: Serum cholinesterase levels were measured in 123 rural male spray workers selected through purposive sampling method from Lahore district of Punjab. This was done using spectrophotometric analysis. Serum cholinesterase level was measured by means of kits. A planned questionnaire was arranged to get demographic and data about use of pre and post exposure preventive measures. Results: All spray workers were males with a mean age of 34±9 years, with a mean duration of work experience 10±7 years. The usage of pre and post spraying protective measures in sprayers was significantly correlated with somewhat high mean values of serum cholinesterase activity (6055 u/l) and with a minor risk of OPs related illness, as compared to those sprayers who did not use these devices (4217 u/l) . Conclusion: The above mentioned results propose that sprayers in regular contact with OPs must be screened by clinical symptoms along with serum cholinesterase enzyme levels. It can identify those spray workers who are at threat to develop chronic toxicity. Health education must be given about adopting pre and post exposure preventive measures.

Suicide is an important issue to address, especially in rural areas. Rural areas are facing unique challenges such as poor health care facilities, lack of awareness, financial constraints and many more for such matters. Aims: To find the social, educational and medical attributes which may lead a person to deliberate self harm. Study Design: Retrospective study. Methodology: Total 100 cases of suicidal attempts taken from DHQ teaching hospital Sargodha from (June to December) 2019. We considered all the suicidal and self harm cases admitted through emergency and medicolegal clinic. Moreover cases less than 9 years of age and autopsy cases were excluded. All the cases were analysed with reference to 10 features (age, gender, locality, education, marital status, duration of stay in hospital, treatment given, prevalence of psychiatric disorder, suicidal attempts, the method used for suicidal attempt). Statistical analysis: ML models work on numeric data. However the dataset we collected have categorical features except age. The most used method for such purpose is python get dummies function. The get dummies() function is used to convert categorical variable into dummy/indicator variables. Results: In this study, more preponderance of suicidal attempts at age less than 40 in males which shows the development of more mature attitude with increasing age. Conclusion: It was concluded that suicide is influenced by many personal factors that cannot be shared publicly on social platforms. However, such information can be used to lower the risk of suicide attempts in rural areas. Keywords: Machine Learning, Suicide Prevention, Suicide Detection and Ideation.