Selected Topics: Toxicology A STUDY ON DELIBERATELY SELF-POISONED IN-HOSPITAL PATIENTS IN A TERTIARY HEALTH CARE CENTER IN NORTHEAST INDIA: A CROSS-SECTIONAL REVIEW Kaustav Bhowmick, MD,* Biswadip Ghosh, MBBS, MD,† and Shantasil Pain, MBBS, MD‡ *Department of General Medicine, North Bengal Medical College, Sushrutanagar, Darjeeling, India, †Department of General Medicine and Rheumatology, North Bengal Medical College, Sushrutanagar, Darjeeling, India, and ‡Department of General Medicine, Institute of Post- Graduate Medical Education and Research, Kolkata, India Corresponding Address: Kaustav Bhowmick, MD, North Bengal Medical College, Clinical Tutor, Department of General Medicine, Sushrutanagar, Darjeeling 734012 , Abstract—Background: The nature and profile of different modes of poisoning vary significantly in different parts of India. The assessment of the magnitude of suicidal poisoning is an area of paramount importance not only for appropriate management but also for raising social aware- ness and framing government policies for the prevention of same. Objectives: We aimed to determine the pattern of poisoning, the sociodemographic profile of patients who poi- son themselves, and the in-hospital outcome of self-poisoned patients over a 1-year period. Methods: This was a cross- sectional observational study conducted between May 2015 and April 2016 that included 492 patients >12 years of age who were admitted to our hospital after consuming poison with the intention of deliberate self-harm. Relevant history with respect to the nature and amount of poison in- gested were taken and recorded, and the patients’ sociode- mographic profiles and outcome (as either discharge or death) were noted. Results: Most of the patients were 13– 28 years of age (69%). Males (n = 293 [59.55%]) predomi- nated over females and the majority were farmers (n = 193 [39.23%]). Rural cases (n = 373 [75.81%]) outnum- bered urban cases. The major causes of deliberate self-harm attempts were impulsive actions (n = 442 [89.84%]). Pesti- cides (n = 393 [79.88%]) were the most commonly consumed poison. The overall mortality rate was 12%, with paraquat (94.74%) topping the list of fatal substances. Conclusion: Young adults and males constitute majority of the popula- tion in this study. Agricultural poisons made up the bulk of the cases, mostly taken by rural population. Paraquat, an herbicide banned in several countries, had the highest mortality rate in this study. Ó 2019 Elsevier Inc. All rights reserved. , Keywords—agricultural poisons; deliberate self- poisoning; northeast India; outcome; sociodemographic profile INTRODUCTION Self-poisoning is an important public health problem all over the world. It estimated that every year self- poisoning affects around 1 million people worldwide, and this correlates with a temporal mortality profile of 1 in 40 persons per second (1). There is a striking difference in the mortality rate of self-poisoning in the developed countries of the world, only 1–2%, compared with devel- oping countries like India, where it is 15–30% (2). These cases account for the fourth most common cause of deaths in rural India (3). The pattern of poisoning varies from place to place depending on factors like location, accessibility and availability of poison, socioeconomic status, and cultural and religious influences. An Reprints are not available from the authors. RECEIVED: 29 July 2018; FINAL SUBMISSION RECEIVED: 4 October 2018; ACCEPTED: 18 October 2018 The Journal of Emergency Medicine, Vol. -, No. -, pp. 1–7, 2019 Ó 2019 Elsevier Inc. All rights reserved. 0736-4679/$ - see front matter https://doi.org/10.1016/j.jemermed.2018.10.037