Psychosocial Factors Behind Deliberate Self-Poisoning in a Tertiary Care Hospital of Bangladesh: A Cross-Sectional Study.

INTRODUCTION: Deliberate self-poisoning (DSP) is an important cause of hospital admissions and subsequent mortality. We conducted a cross-sectional observational study in a tertiary-level teaching hospital situated in the northeastern part of Bangladesh to analyze the psychosocial factors responsible for DSP. METHODS: This cross-sectional observational study was carried out among patients with DSP admitted to the medicine ward from January to December 2017, irrespective of gender, except for cases involving poisoning due to spoiled food, food contaminated by infectious organisms, poisoning by venomous animals, and street poisoning (commuter or travel-related poisoning). Consultant psychiatrist in accordance with the Diagnostic & Statistical Manual of Mental Disorder - IV (DSM-IV) confirmed psychiatric disorders. Data were analyzed by SPSS (Statistical Package for social sciences) version 16.0 (IBM Corp., Armonk, NY). RESULTS: Total 100 patients were enrolled. Among them, 43% were male and 57% were female. The majority (85%) of the patients were young, aged below 30 years. The mean age of male patients was 26.2 years and that of females was 21.69 years. Most of the DSP patients were from the lower economic class (59%). The population sample was remarkable for students (Prevalence 37%). The highest percentage of patients (33%) had their educational status at the secondary level. The common reasons for DSP were a family problem in 31% patients, quarrel with boy/girlfriend in 20%, quarrel with a spouse in 13%, quarrel with parents or other family member in 7%, failure in examination in 6%, poverty in 3%, and unemployment in 3%. Prescription medication was the most common poison material (38%), followed by insecticides (36%), household cleaners (17%), and rodenticides (8%). Seven (7%) patients reported previous deliberate self-harm events and co-morbid psychiatric disorder was present in 30% patients among them major depressive disorder was found in 60%, and schizophrenia in 23.3% cases. CONCLUSION: DSP remains a problem mainly for the young with gender ratio-favoring females. The majority of DSPs were educated up to secondary level, unmarried, residents of rural areas, student, and belonged to the lower class. Familial disharmony and quarrel with spouse or friends were the common reason behind DSP. Prescription medication and insecticides were commonly used for DSP. Psychiatric disorders, primarily depressive disorder, and schizophrenia were common in cases of DSP.

Probing the Electronic Structure of Warm Dense Nickel via Resonant Inelastic X-Ray Scattering.

The development of bright free-electron lasers (FEL) has revolutionized our ability to create and study matter in the high-energy-density (HED) regime. Current diagnostic techniques have been successful in yielding information on fundamental thermodynamic plasma properties, but provide only limited or indirect information on the detailed quantum structure of these systems, and on how it is affected by ionization dynamics. Here we show how the valence electronic structure of solid-density nickel, heated to temperatures of around 10 of eV on femtosecond timescales, can be probed by single-shot resonant inelastic x-ray scattering (RIXS) at the Linac Coherent Light Source FEL. The RIXS spectrum provides a wealth of information on the HED system that goes well beyond what can be extracted from x-ray absorption or emission spectroscopy alone, and is particularly well suited to time-resolved studies of electronic-structure dynamics.

Kinetic modeling of x-ray laser-driven solid Al plasmas via particle-in-cell simulation.

Solid-density plasmas driven by intense x-ray free-electron laser (XFEL) radiation are seeded by sources of nonthermal photoelectrons and Auger electrons that ionize and heat the target via collisions. Simulation codes that are commonly used to model such plasmas, such as collisional-radiative (CR) codes, typically assume a Maxwellian distribution and thus instantaneous thermalization of the source electrons. In this study, we present a detailed description and initial applications of a collisional particle-in-cell code, picls, that has been extended with a self-consistent radiation transport model and Monte Carlo models for photoionization and KLL Auger ionization, enabling the fully kinetic simulation of XFEL-driven plasmas. The code is used to simulate two experiments previously performed at the Linac Coherent Light Source investigating XFEL-driven solid-density Al plasmas. It is shown that picls-simulated pulse transmissions using the Ecker-Kröll continuum-lowering model agree much better with measurements than do simulations using the Stewart-Pyatt model. Good quantitative agreement is also found between the time-dependent picls results and those of analogous simulations by the CR code scfly, which was used in the analysis of the experiments to accurately reproduce the observed Kα emissions and pulse transmissions. Finally, it is shown that the effects of the nonthermal electrons are negligible for the conditions of the particular experiments under investigation.

Kinetic effects and nonlinear heating in intense x-ray-laser-produced carbon plasmas.

The x-ray laser-matter interaction for a low-Z material, carbon, is studied with a particle-in-cell code that solves the photoionization and x-ray transport self-consistently. Photoionization is the dominant absorption mechanism and nonthermal photoelectrons are produced with energy near the x-ray photon energy. The photoelectrons ionize the target rapidly via collisional impact ionization and field ionization, producing a hot plasma column behind the laser pulse. The radial size of the heated region becomes larger than the laser spot size due to the kinetic nature of the photoelectrons. The plasma can have a temperature of more than 10 000 K (>1eV), an energy density greater than 10^{4} J/cm^{3}, an ion-ion Coulomb coupling parameter Γ≥1, and electron degeneracy Θ≥1, i.e., strongly coupled warm dense matter. By increasing the laser intensity, the plasma temperature rises nonlinearly from tens of eV to hundreds of eV, bringing it into the high energy density matter regime. The heating depth and temperature are also controllable by changing the photon energy of the incident laser light.

A computerised resident medical officer rostering system.

A computerised Resident Medical Officer (RMO) rostering system was developed by the authors over a period of two years to aid in the preparation of yearly and daily rosters for RMOs. The main aim of the system is to save the time required for repetitive rostering activities, such as preparing the weekly rosters and pay sheets. No new philosophies of resident rostering have been introduced and the program simply does more quickly what used to be done under the manual system. As an example, in preparing the weekly rosters and pay sheets, the program does in approximately 10 minutes what used to take about two hours. A secondary bonus of the system is that distribution of the costs to specific cost centres is now possible and it is hoped that this may lead to greater control over the utilisation of this rather expensive resource.

An audit of ENT referrals assessing training needs for general practice trainees.

Over 500 ENT diagnoses made by general practitioners when referring patients to one ENT department were examined and compared with the diagnoses by the specialist department. A broad grouping of the categories of referral was made and topics highlighted which seemed particularly appropriate for further postgraduate training for general practitioners.We believe the amount of postgraduate training in ENT currently available to trainees in the UK may be too low and ought to be increased and that this approach offers a logical starting point for constructing educational objectives for such training.