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Background and Objective: Our understanding of homicide-suicide (H-S), a rare yet tragic event, is sparse. While the phenomenon has been studied in the West for many years, only limited literature is available from Asia and none to our knowledge from Pakistan. There is evidence of complexity of the interaction between cultural, societal, and psychological mechanisms underlying this phenomenon; therefore, research findings from the Western countries cannot be directly applied in non-Western societies. Our objective was to study homicide-suicides in Pakistan, describe the characteristics of offenders and victims, determine the types of H-S, and examine possible motives and any events prior to the offense. Methods: In the absence of any official data on homicide-suicides, we used newspaper surveillance approach of four most widely circulated Pakistani newspapers (one Urdu and three English Daily) for two years (1st January 2019 to 31st December 2020). Each case was categorized using the modified Marzuk et al., Tardiff, and Hirsch's classification of homicide-suicides. Descriptive statistics were used to analyze the data that was then compared with published literature. Results: There were 114 H-S incidents with 198 victims of homicide during the study period, reported in the newspapers. Familial H-S particularly filicide-suicide were predominant, followed by spousal/ consortial H-S. Forty-one (36%) H-S involved multiple victims. The perpetrators across all categories of H-S were predominantly male (67%); the victims were predominantly women and children. Firearms were used in most incidents. The primary motive for the majority of H-S cases was familial, financial, and social stressors. Conclusions: The study highlights several unique patterns (predominance of familicide, multiple victims including high proportion of children) and a series of vulnerabilities (incidents related mostly to familial/ financial and social stressors) that overlap each other and ultimately lead to this tragic end. There is need to increase our understanding and develop effective evidence-based prevention strategies for H-S in Pakistan. It is also very important to have a national surveillance network and national violent death reporting system in the country for studying H-S cases, and for evaluating the impact of prevention programs. [ABSTRACT FROM AUTHOR]

The article discusses the decriminalization of suicide in Pakistan and its implications for mental health and suicide prevention. It highlights that suicide is a global public health crisis, with a significant number of deaths occurring in low- and middle-income countries. The article argues that criminalizing suicide does not effectively prevent it and may discourage individuals from seeking help. Instead, the focus should be on implementing comprehensive suicide prevention strategies, such as developing suicide registries, creating national prevention strategies, providing training for gatekeepers, improving depression identification and treatment, restricting access to means of suicide, raising awareness, and implementing school-based training and psychosocial support. The article emphasizes the need for a compassionate and progressive approach to mental health and suicide prevention. [Extracted from the article]

Background: In Pakistan, there is lack of official suicide data due to associated stigma and socio-cultural factors. Although, suicide incidents are regularly reported in newspapers there are no official suicide reporting guidelines. Aims: The aim was to study the quality of suicide reporting in Pakistani newspapers and compare it to international media guidelines. Method: Newspaper reports on suicide deaths were searched in four Pakistani national newspapers from 1st January 2019 to 31st December 2020. Data was extracted using templates based on World Health Organization and Reporting on Suicide media guidelines. Results: There were total 2,295 suicides reported in 2 years. The word 'suicide' was mentioned in title of 2,113 (92.06%) reports. In 70.37% news articles, motive for suicide was reduced to a single factor. Method was mentioned in 95.6% suicides. Pictures accompanied 103 (4.4%) news reports. Only 13 (0.57%) the news stories recognized the link between substance abuse and suicide. None of the reports provided education to public about suicide or mentioned resources to seek help. Conclusions: The articles reporting on suicide deaths were regularly featured in Pakistani newspapers with strikingly low level of adherence to suicide reporting guidelines. [ABSTRACT FROM AUTHOR]

Background and Objective: Suicide is a serious, yet preventable global mental health problem for people of all ages and countries. It is the third leading cause of death in 15-19-year-olds. There is paucity of systematic studies and official statistics on child & adolescent suicides in Pakistan. In the absence of other means, newspaper coverage of adolescent suicides may serve as a useful source to understand the phenomena. Our objective was to report pattern of suicide deaths in children and adolescents across Pakistan and to determine the predominant methods of suicide precipitating events and associated factors Methods: This study used content analysis to analyze newspaper reports of adolescent suicide in four leading newspapers of Pakistan from January 1st, 2019, through December 31st, 2020. Search yielded 289 child and adolescent (ages<18) suicide reports. Data about various sociodemographic characteristics, methods of suicide, possible motives, and associated features (e.g., any suicide notes) was extracted and analyzed. Results: Total 289 suicides in children and adolescents in Pakistan were reported in selected newspapers during two years among both genders (51.5 % boys and 48.5% girls) with high incidence in late adolescence (66%). The predominant method of suicide in this group was ingestion of poisonous substances (50%) followed by hanging (35%) and use of firearms (7%). The behavior usually takes place within or near the adolescent’s home environment. The act was often attributed to domestic conflicts including arguments with parents of the deceased and relationship problems. Conclusion: To develop effective suicide prevention strategies for a population, it must be studied within its own socio-cultural context. Study results emphasize adolescent suicide being a reality in Pakistan. There is urgent need for further culture specific research in this area in the country. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to evaluate psychological impact of COVID-19 outbreak on postgraduate trainees in Pakistan by quantifying the symptoms of depression, anxiety and acute stress disorder and by analysing potential risk factors associated with these symptoms.Methods: Following Institutional Review Board approval, a cross-sectional study was conducted among 10,178 postgraduate trainees following COVID-19 outbreak through e-log system of College of Physicians and Surgeons of Pakistan. The nine-item Patient Health Questionnaire, seven-item Generalised Anxiety Disorder scale and Stanford Acute Stress Reaction Questionnaire were used to collect data. Statistical analyses were conducted using SPSS.26. Descriptive statistics, Mann-Whitney U test, the χ2 test and logistic regression analysis were performed. The significance level was set at α=0.05.Results: The prevalence of depressive symptoms, generalised anxiety disorder and acute stress disorder were 26.4%, 22.6% and 4.4%, respectively. Female postgraduate trainees, senior trainees and front-line workers reported experiencing more anxiety, depression and acute stress symptoms (p value<0.001). Logistic regression showed that being a front-line and senior staff member and female was associated with higher risk of experiencing symptoms of depression, anxiety and acute stress.Conclusions: Our study findings raise concerns about the psychological well-being of postgraduate trainees during the acute COVID-19 outbreak in Pakistan. It is necessary to employ strategies to minimise the psychological distress and provide adequate psychosocial support for postgraduate trainees during crisis situation such as COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis is the leading infectious cause of death and was declared as global emergency in 1993. Sputum smear microscopy is the gold standard for diagnosis of the pulmonary tuberculosis. Blinded rechecking of the slides and panel testing are WHO recommended methods for assuring the quality of the TB diagnostic centers. Period: Oct, 2014 to Dec, 2014. Objectives: To assess the quality of sputum microscopy at diagnostic centers through proficiency testing. To compare the performance of trained and untrained laboratory staff in terms of sputum microscopy. Study Design: Cross-sectional descriptive. Setting: Lahore District. Methodology: Blinded rechecking and panel testing was performed and data was collected with the help of checklists in all the 30 (75%) functional diagnostic centers of Lahore district. Results: Errors in reporting were found in 13 (43%) out of 30 diagnostic centers during the blinded rechecking. There was no error in the blinded rechecking in microscopy of 17 (68%) AFB microscopy trained lab workers, while all the 5 (100%) untrained lab workers committed error. Only 17 (56%) lab workers reported 80-100% slides correctly during the panel testing; a minimum acceptable level of skill, while 13 (44%) reported 40-60% slides correctly. One of the most striking findings of the study was the relation of training with the performance of lab workers. Conclusion: Untrained lab staff should immediately undergo standardized training for sputum smear microscopy and refresher training should be given to the trained lab workers to enhance their knowledge and skills. [ABSTRACT FROM AUTHOR]