Deliberate self harm in Sri Lanka: an overlooked tragedy in the developing world

Eddleston, Michael; Sheriff, M H Rezvi; Hawton, Keith

doi:10.1136/bmj.317.7151.133

Cited by 165 publications

(127 citation statements)

References 3 publications

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“…Chronic abdominal pain, cardiac disease, epilepsy and cancer were frequently associated with suicidal hanging. 14,15 Eddlesto M et al, 1998 observed in his study that association of psychiatric illnesses was just 6.2%. 13 Soft material like cloth, saree, orna, dupatta were the preferred material for hanging in 2.…”

Section: Resultsmentioning

confidence: 99%

Suicide by hanging : a study of 334 cases

Ali¹,

Maksud²,

Zubyra³

et al. 2014

Bangladesh Med J

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Section: Resultsmentioning

confidence: 99%

Suicide by hanging : a study of 334 cases

Ali¹,

Maksud²,

Zubyra³

et al. 2014

Bangladesh Med J

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“…8 The much higher case fatality rate (CFR) from pesticide poisoning (compared with that of medicinal drug overdose) is a major contributor to deaths from suicide in developing countries. 11,12 In the absence of any restriction on the availability of the methods previously used, method substitution in self-harm (i.e. the abandonment of one common method of self-harm and its substitution with another method) has not been widely reported.…”

Section: Introductionmentioning

confidence: 99%

From pesticides to medicinal drugs: time series analyses of methods of self-harm in Sri Lanka

Silva

Senanayake

Dias

et al. 2011

Bull. World Health Organ.

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“…Few randomised-controlled trials are actually available [8][9][10] and all of them addressed poisoning by Yellow Oleander (Thevetia peruviana) that contains slightly different cardiac glycosides from NO, commonly used for deliberate selfpoisoning in Sri Lanka. 11 Actually, intoxication from common or yellow oleander is managed in the same way. Mainstays of treatment include supportive care with ECG monitoring, gastrointestinal decontamination and specific antidote administration.…”

Section: Discussionmentioning

confidence: 99%

Severe symptomatic bradycardia after a dinner of spicy oleander soup

Tampieri¹,

Mucci²,

Palmonari³

et al. 2016

Emerg Care J

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Cardiac glycosides similar to digoxin are produced by different plants in nature. Nerium oleander, commonly grown as an ornamental shrub, can be found worldwide in temperate countries. Intentional or accidental ingestion of any part of the plant can lead to clinically relevant intoxication. A 63-year-old woman came to the emergency department with acute dyspeptic symptoms after eating vegetable soup flavored with unfamiliar flowers she have collected herself. However, the electrocardiography (ECG) showed abnormalities that raised suspicions for an overdose of digoxin-like cardiac glycosides. The patient was not on treatment with digoxin and a careful anamnesis revealed that she had eaten oleander leaves. Digoxin specific Fab antibody fragments were administered for marked bradycardia that was not responding to atropine administration, after counseling with the reference toxicology center. The patient was also treated with activated charcoal and magnesium sulphate, intravenous fluids and pantoprazole. Four days later she was discharged as asymptomatic, with normal sinus rhythm. Emergency physicians should be aware of this type of poisoning, especially in cases with typical ECG alterations in patients not treated with digoxin and medical history of plants ingestion. Cardio-active glycosides are present in different plants, often used inappropriately, with potential toxic effects and harmful drug interactions.

show abstract

Deliberate self harm in Sri Lanka: an overlooked tragedy in the developing world

Cited by 165 publications

References 3 publications

Suicide by hanging : a study of 334 cases

Suicide by hanging : a study of 334 cases

From pesticides to medicinal drugs: time series analyses of methods of self-harm in Sri Lanka

Severe symptomatic bradycardia after a dinner of spicy oleander soup

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