A Survey of Characteristics of Self-Immolation in the East of Iran
The aim of this study was investigating the characteristic and outcome of self-immolation cases admitted to the Burn Centre of Birjand, Iran over an eight year period. This study is a retrospective review of case notes for patients with self-Immolation and admitted to our referral burn centre in the last 8 years (January 2003-January 2011). A performa was designed to collect the data such as: demographic information, length of hospital stay, extent of the burn injuries as %TBSA (Total Body Surface Area) and final outcome. Data was analyzed by SPSS software. Between 2003 and 2011, 188 self-immolation cases admitted. The mean age was 26.97 ±12.6 years. Female to male ratio was 1.7:1. Housewives represented the largest group (43.1%) and kerosene was the most frequent agent used (74.6%). There was significant different between mortality and TBSA and low educational level (P=0.0001). There was a significant fluctuation time trend in the incidence (per 100,000 population) of self-immolation from 2003 (4.64, CI 95%: 4.62-4.65) to 2008 (5.2, CI 95%: 5.19-5.21). Mortality rate was 64%. The survival rates at three weeks survival for patients who self-immolated was 24 percent (CI 95%: 17-31). The mean and median survival times were 6 days (CI 95%: 4.8-7.2) and 17.5 days (CI 95%: 13.3-21.6), respectively. Our study has shown a lower incidence of self-immolation (5.3%) in the South Khorasan region, when compared with other parts of Iran, as well as a relatively low mortality rate. We have also reported self-immolation in pregnant women which has rarely been reported in medical literature.
Kanchan T, Menon A, Menezes RG. Methods of choice in completed suicides: gender differences and review of literature. J Forensic Sci 2009;54(4):938-42.
Chishti P, Stone DH, Corcoran P, Williamson E, Petridou E; EUROSAVE Working Group. Suicide mortality in the European Union. Eur J Public Health 2003;13(2):108-14.
Wei KC, Chua HC. Suicide in Asia. Int Rev Psychiatry 2008;20(5):434-40.
Ahmadi A, Mohammadi R, Stavrinos D, Almasi A, Schwebel DC. Self-immolation in Iran. J Burn Care Res 2008;29(3):451-60.
Sheikholeslami H, Kani C, Ziaee A. Attempted suicide among Iranian population. Suicide Life Threat Behav 2008;38(4):456-66.
Farzaneh E, Mehrpour O, Alfred S, Moghaddam HH, Behnoush B, Seghatoleslam T. Self-poisoning suicide attempts among students in Tehran, Iran. Psychiatr Danub 2010;22(1):34-8.
Mehrpour O, Singh S. Rice tablet poisoning: a major concern in Iranian population. Hum Exp Toxicol 2010;29(8):701-2.
Shadnia S, Mehrpour O, Soltaninejad K. A simplified= acute physiology score in the prediction of acute aluminum phosphide poisoning outcome. Indian J Med Sci 2010;64(12):532-9.
Shadnia S, Mehrpour O, Abdollahi M. Unintentional poisoning by phosphine released from aluminumphosphide. Hum Exp Toxicol 2008;27(1):87-9.
Mehrpour O, Alfred S, Shadnia S, Keyler DE, SoltaninejadK, Chalaki N, Sedaghat M. Hyperglycemia in acute aluminum phosphide poisoning as a potential prognosticfactor. Hum Exp Toxicol 2008;27(7):591-5.
Mehrpour O, Keyler D, Shadnia S. Comment on Aluminum and zinc phosphide poisoning. Clin Toxicol (Phila) 2009;47(8):838-9; author reply 839.
Islambulchilar M, Islambulchilar Z, Kargar-Maher MH. Acute adult poisoning cases admitted to a university hospital in Tabriz, Iran. Hum Exp Toxicol 2009;28(4):185-90.
Mehrpour O, Jafarzadeh M, Abdollahi M. A systematic review of aluminium phosphide poisoning. Arh Hig Rada Toksikol. 2012 Mar;63(1):61-73.
Dastgiri S, Kalankesh LR, Pourafkary N. Epidemiology of Self-Immolation in the North-West of Iran. Eur J Gen Med 2005;2(1):14-9.
Ahmadi A, Mohammadi R, Schwebel DC, Yeganeh N, Soroush A, Bazargan-Hejazi S. Familial risk factors for self-immolation: a case-control study. J Womens Health (Larchmt) 2009;18(7):1025-31.
Ahmadi A. Suicide by self-immolation: comprehensive overview, experiences and suggestions. J Burn Care Res 2007;28(1):30-41.
Rezaeian M, Sharifi G. Self-immolation is the most important way for suicide in Eilam province (a survey from 1996 to 2003). J Andishe va Rafter 2004;21:289.
Razaeian M, Mohammadi M, Akbari M, Maleki M. The most common method of suicide in Tehran 2000-2004: implications for prevention. Crisis 2008;29(3):164-6.
Zarghami M, Khalilian A. Deliberate self-burning in Mazandaran, Iran. Burns 2002;28(2):115-9.
Dibaei A, Gharebagi R. A study of self-immolation cases led to death in Legal Medicine Center of Ahvaz. Sci J Legal Med 2000;19:5-10. [Persian]
Groohi B, Alaghehbandan R, Lari AR. Analysis of 1089 burn patients in province of Kurdistan, Iran. Burns 2002;28(6):569-74.
Mabrouk AR, Mahmod Omar AN, Massoud K, Magdy Sherif M, El Sayed N. Suicide by burns: a tragic end. Burns 1999;25(4):337-9.
Mzezewa S, Jonsson K, Aberg M, Salemark L. A prospective study of suicidal burns admitted to the Harare burns unit. Burns 2000;26(5):460-4.
Laloë V, Ganesan M. Self-immolation a common suicidal behaviour in eastern Sri Lanka. Burns 2002;28(5):475-80.
Shkrum MJ, Johnston KA. Fire and suicide: a three-year study of self-immolation deaths. J Forensic Sci 1992;37(1):208-21.
Cameron DR, Pegg SP, Muller M. Self-inflicted burns. Burns 1997;23(6):519-21.
Prosser D. Suicides by burning in England and Wales. Br JPsychiatry 1996;168(2):175-82.
Anoshchenko IuD, Smirnov SV. The medicosocial status of the victims of burns as a consequence of a suicideattempt (cases of self-immolation). Zh Nevrol Psikhiatr Im S S Korsakova 1995;95(4):72-4.
Castellani G, Beghini D, Barisoni D, Marigo M. Suicide attempted by burning: a 10-year study of self-immolation deaths. Burns 1995;21(8):607-9.
Caley M, Fowler T. Suicide prevention: is more demographic information the answer? J Public Health (Oxf) 2009;31(1):95-7.
Ahmadi A. Frequency of self-immolation in attempted suicide patients in West. Islam Abad city (1997-2003). J Behbood 2005;9(1):26-37. [Persian]
Rastegar Lari A, Alaghehbandan R. Epidemiological studyof self-inflicted burns in Tehran, Iran. J Burn Care Rehabil 2003;24(1):15-20.
Dastgiri S , Kalankesh LR, Pourafkary N, Vahidi RG, Mahmoodzadeh F. Incidence, survival pattern and prognosis of self-immolation: a case study in Iran. J Public Health 2006;14:2-6.
Lari AR, Joghataei MT, Adli YR, Zadeh YA, Alaghehbandan R. Epidemiology of suicide by burns in the province of Isfahan, Iran. J Burn Care Res 2007;28(2):307-11.
Groohi B, Rossignol AM, Barrero SP, Alaghehbandan R.Suicidal behavior by burns among adolescents in Kurdistan, Iran: a social tragedy. Crisis 2006;27(1):16-21.
Saadat M, Zendeh-Boodi Z. Correlation between incidences of self-inflicted burns and means of inbreeding coefficients, an ecologic study. Ann Epidemiol 2006;16(9):708-11.
Maghsoudi H, Garadagi A, Jafary GA, Azarmir G, Aali N, Karimian B, Tabrizi M. Women victims of self-inflicted burns in Tabriz, Iran. Burns 2004;30(3):217-20.
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