Self-inflicted Cut Injury as Common Method of Deliberate Self Harm: A Retrospective Study from Nepal.

CONTEXT: Deliberate self-injury, a fairly common condition is present across all culture. It is defined as intentional, direct injuring of body tissue without suicidal intent. We continue to lack a sufficient understanding of this behavior in the context of South East Asian region. AIMS: This study aims to explore the characteristics of self-cutting, and gender differences in homologous group of youth applying for foreign employment in Nepal. SETTINGS AND DESIGN: Cross-sectional, single interview method in an out-patient setting. SUBJECTS AND METHODS: The youths applying for foreign employment were screened for self-harm attempt using single question. Screen positive individuals were applied with inclusion and exclusion criteria. The data were collected in a single interview by consultant psychiatrist. RESULTS: Males were more than females and the mean age (standard deviation) at the time of act and current presentation were 16.52 (3.13) and 24.70 (5.54) years, respectively. Various methods were used in self-inflicting cut, and certain amount of stress was present in the majority of the participants. There was no significant difference between male and female in all descriptive characteristics except for mean age at the time of presentation. CONCLUSIONS: The descriptive results from Nepal are keeping with most of the published literature. The study is the first one from Nepal, and we expect that this will help in laying a good foundation for further studies with stronger methodologies.

Suicide burden and prevention in Nepal: the need for a national strategy

Suicide is a major cause of deaths worldwide and is a key public health concern in Nepal. Althoughroutine national data are not collected in Nepal, the available evidence suggests that suicide ratesare relatively high, notably for women. In addition, civil conflict and the 2015 earthquake have hadsignificant contributory effects. A range of factors both facilitate suicide attempts and hinder thoseaffected from seeking help, such as the ready availability of toxic pesticides and the widespread,although erroneous, belief that suicide is illegal. Various interventions have been undertaken atdifferent levels in prevention and rehabilitation but a specific long-term national strategy for suicideprevention is lacking. Hence, to address this significant public health problem, a multisectoral platformof stakeholders needs to be established under government leadership, to design and implementinnovative and country-contextualized policies and programmes. A bottom-up approach, with activeand participatory community engagement from the start of the policy- and strategy-formulation stage,through to the design and implementation of interventions, could potentially build grass-roots publicownership, reduce stigma and ensure a scaleable and sustainable response.

Blunt traumatic superior gluteal artery pseudoaneurysm presenting as gluteal hematoma without bony injury: A rare case report / 中华创伤杂志(英文版)

Blunt traumatic injuries to the superior gluteal artery are rare in clinic. A majority of injuries present as aneurysms following penetrating trauma, fracture pelvis or posterior dislocation of the hip joint. We reported a rare case of superior gluteal artery pseudoaneurysm following blunt trauma presenting as large expanding right gluteal hematoma without any bony injury. The gluteal hematoma was suspected clinically, confirmed by ultrasound and the arterial injury was diagnosed by CT angiography that revealed a large right gluteal hematoma with a focal contrast leakage forming a pseudoaneurysm within the hematoma. Pseudoaneurysm arose from the superior gluteal branch of right internal iliac artery, which was successfully angioembolized. The patient was discharged on day 4 of hospitalization with resolving gluteal hematoma. This report highlighted the importance of considering an arterial injury following blunt trauma to the buttocks with subsequent painful swelling. Acknowledgment of this rare injury pattern was necessary to facilitate rapid diagnosis and appropriate treatment.

Contralateral stroke with rapid recovery in a patient of herpes zoster ophthalmicus

Herpes zoster ophthalmicus commonly presents with vesicular eruptions of skin along a dermatome and post herpetic neuralgia. Viral invasion into the intracranial vessel and resultant arteritis is rare complication, reported mainly in elderly, children and immunocompromised individuals. We report a young immunocompetent male who reported to us with acute right sided hemiparesis following an episode of left sided herpes zoster ophthalmicus three months prior to stroke. Patient had a near complete recovery of his weakness without any treatment with persistent mild dysarthria. Magnetic resonance imaging of brain showed subacute infarct in left middle cerebral artery territory. Magnetic resonance angiogram demonstrated marked narrowing of the proximal segment of left middle cerebral artery. This case highlights herpes zoster ophthalmicus as one of the causes of stroke in young with good prognosis.