Indian Journal of Forensic and Community Medicine

125-129

Authors: S R Saritha, K. Sasikala

Back ground and objectives: Fall from height in to water with mention of injuries, were included in the international classification of diseases (ICD) as fall from height. Severity of the injuries depends on various biological and circumstantial factors. This study was taken up with the objective to describe the pattern of injuries and socio- demographic profile of victims of fall from height into water with mention of injuries. Method: Descriptive autopsy based study on 53 cases of fall from height into water with any mention of injuries conducted at State Medico legal Institute, Medical College, Thiruvananthapuram, Kerala during the period from May 2006 to April 2008. Results and interpretation: Majority of victims were males (69.8%). Age ranged from one year one month old female child to 90 years old elderly female. Incidence was maximum in lower and lower middle income group (88.7%). Place of incidence was home in 66% of cases. Accidental death constituted 50.9%. Majority died due to fall into well (88.7%). Significant number of victims fell down from a height range of 5 to 10 meters (39.6%). Drowning was the foremost cause of death irrespective of height of fall (58.5%). External injuries were invariably present in all cases and internal injuries in 41.5%. Most frequent region involved was head in 33.9% cases. Injury severity was not proportional to the height of fall. Conclusion: Falls are extremely common, the severity not necessarily being directly related to the distance that the person falls. Along with other factors, surface of impact also plays a major role in determining the severity of injuries in cases of fall from height.

135-140

Authors: B. L. Jat, S. R. Kochar, Rashmi Gupta, Deepali Pathak, Dharmesh K. Sharma, Kusum Gaur

Background: Majority of medico-legal cases brought to the forensic specialist for assessment of age for both the victims and accused. Among newer technologies used for that Computed tomography (C.T. Scan) technology has become increasingly more accurate and precise. Objectives: To find out ability of Computed tomography (C.T. Scan) for assessment of age in age group of 10-22 years Material and Method: This study was carried out on 64 healthy subjects Sphenoid sinus was analyzed in coronal and axial position followed by 3-dimensional reconstruction in CT scan. Volume of Sphenoid sinus was assessed and significance of difference of volume of Sphenoid sinus as per age, sex and diet was assessed with Analysis Of Variance (ANOVA) and Post-hoc tests. Result: Although age wise volumetric measurement of sphenoid sinus through CT scan was found significant in only some age groups when estimated at one year interval from 10-22 years but when estimated at interval of two years interval it was found significant for most of ages. Volumetric measurement of sphenoid sinus through CT scan at the interval of 4 years was found significant in every age group. Significance of difference in volumetric measurement of sphenoid sinus as per sex, residence was found significant along with age but as per type of diet it was not found significant when assessed by age interval of 2 years. Conclusions: Age wise volumetric measurement of sphenoid sinus through CT scan can be found correct for most of ages from 10-22 years at interval of 2 year of age. Age can be estimated 100% volumetric measurement of sphenoid sinus through CT scan at the interval of 4 years from 10-22 years.

144-146

Authors: Vijaykumar P Mane, Trupti B Naik, Mallappa O, Omprakash Ambure

Introduction: Malnutrition is widely recognized as a major health problem in developing countries. For practical purposes, anthropometric measurements are the most useful tool for assessing the nutritional status of children. Mid upper arm circumference (MUAC) has been proposed as an alternative to weight-for-height (W/H) index as a measure of acute malnutrition because of its low cost and ease of performance, particularly for rapid field assessments of nutritional status in circumstances where resources and trained personnel are limited. Objectives: To estimate the validity of mid-upper-arm circumference (MUAC) measurement as a screening method in detection of wasting among preschool children Materials and methods: A community based cross sectional study was done for a duration of 3 months in Bhadravati taluk, Shivamogga district, Karnataka state. 210 preschool children of either sex in the age group of 1-3 years (12- 36 months) were included in the study by cluster sampling technique. Anthropometric measurements were recorded using standard techniques. Results: The prevalence of wasting and severe wasting was found to be in 21 (10%) and 2 (0.9%) of preschool children respectively using mid upper arm circumference against 28 (13.3%) and 6 (2.9%) respectively using Weight for Height index. The sensitivity of MUAC in detecting wasting was found to be around 35% in our study whereas the specificity was 95%. Conclusion: MUAC could identify very few children as undernourished against W/H index. Further studies are needed to test the findings of our study.

150-153

Authors: Manjunath S Kamble, Sangita C. Shelke, Bilkish Patavegar

Introduction: Immunization not only reduces morbidity and mortality from potentially infectious diseases, it also interrupts disease transmission in the community. In a developing country like India, children are not immunised at all or partially immunised and the usage of health services is also different for different segments of society. According to NFHS III data, only 44% of infants are completely immunized, which is much less than the desired goal of 85% .So, the study was undertaken to assess the immunisation status of children ( 3-6 years) coming to anganwadis under the urban field practice area of B.J.Medical College, Pune. Aim and Objective: To assess the immunization status of children (3-6 years) coming to Anganwadis. Methodology: A cross- sectional study was done among 3-6 years old children coming to anganwadis under urban field practice area of B.J.Govt.Medical College, Pune. The study was conducted between January 2013 to July-2014. All children who were enrolled in anganwadis and the parents/guardian of children who were willing to participate were included in study after taking written informed consent. Data was analysed using SPSS softwareVersion 17. Results and discussion: The number of children coming to anganwadis were more in the age group of 4-5 years (39.98%). There were more females as compared to males i.e. 41.18% & 36.44% respectively. The Immunization status was associated with various parameters but significant association was found with parameters like sex, socio-economic status, underweight and wasting (p<0.05). Most of the study results were similar to the findings of other studies conducted at different places and at different time intervals. There were few studies which showed contrast results to our study. Summary and conclusion: Majority of children were completely immunized. (85.43%). No association was found between different age groups and immunization status. (p=0.9058). It was also observed that more number of male children (21.19%) were partially immunized as compared to female children (8.82%). The number of children who were completely immunized were having lesser underweight and wasting as compared to partially immunized and unimmunized children. (p<0.05).The association was not statistically significant. (p>0.05) with respect to stunting. Recommendation: All efforts should be taken to immunize those children who were partially immunized or not immunized at all.

158-166

Authors: Anupam Datta, Santhosh Chandrappa Siddappa, Viswanathan Karibasappa Gowda, Siddesh Revapla Channabas

Introduction: Examination of bones is important for identification of deceased and determination of sex. The mandible is the largest and hardest facial bone, that commonly resist post mortem damage and forms an important source of information about sexual dimorphism. Aim: The purpose of the study is to analyze sexual dimorphism in the mandibles of South Indian population. Materials and Methods: A random collection of 50 adult, dry, complete, undamaged human mandibles of South Indian population were subjected to metrical parameters like Gonial angle, Bigonial width, Height of ramus, Bicondylar breadth, Mandibular length, Length of lower jaw, Mandibular index, Body thickness, Coronoid height, Bimental breadth, Symphyseal height and Body height using Mandibulometer and Digital Vernier caliper. Statistical Analysis used: The data’s were expressed as Mean ± SD and then analyzed by unpaired t-test by using IBM SPSS Statistics 21. Discriminating point and limiting points were also calculated. Results: After obtaining all the measurements, unpaired ‘t-test’ was performed. The Gonial angle, Bigonial width, Height of ramus, Bicondylar breadth, Mandibular length, Length of lower jaw, Body thickness, Coronoid height, Bimental breadth, Symphyseal height and Body height showed statistically significant gender difference. Conclusion: The present study highlighted that the gender of the mandible can be determined using different metrical parameters as an additional tool to establish the identity of a person.

172-175

Authors: Sudhir, Chaitra M, Deepa K

Background and objective: Health is a fundamental human right in India and several other countries. The policy concern in developing countries such as India where 70% of the population lives in rural area is not only to reach the entire population with adequate healthcare services, but also to secure an acceptable level of health for all the people through the application of primary healthcare programs. Health insurance is one of the most important aspects of health care management system. This paper tries to identify the determinants of health insurance in rural India. Methods: A Cross sectional community based study was done with sample size of 290 households estimated by using 25% national coverage according to Public Health Foundation of India. The study was conducted between July 2014 to August 2014. 290 families were covered from two Primary Health Centres which come under field practice area of our medical college. A pretested semi structured questionnaire was used to collect data. Data was entered in excel sheet and analysed using SPSS version 17 software. Results and interpretation: In this study 72.5% of respondents were in age group 26-45yrs, 69.4% of respondents were female,82.1% were from below poverty line family,72.4% were from nuclear family, 81% of respondents were aware of health insurance but only 53.1% were actually insured and off the respondents who were not insured 40.9% were not aware of health insurance. The male gender, nuclear family, affordability to pay premium, higher educational status and awareness regarding health insurance was significantly associated with being insured. Conclusions: The main determinants of being insured were male gender, nuclear family, affordability to pay premium and higher education status. In order to bridge this gap in rural India of not being insured is to educate them in order to bring about behavior change among the respondents.

179-181

Authors: T.Vedanayagam, V. Sathyamurthy

The identification of sex from human remains is of fundamental importance in forensic medicine, especially in criminal investigations, in the identification of missing people and in anthropology for reconstructing the lives of ancient civilization. The technique of osteometry has been successfully used in the estimation of stature, age, sex and race in Forensic Medicine. The accuracy of determination of the sex from skeletal remains varies with the age of the subject, bones available, fragmentation and biological factors. The objective of this study is to measure the size of the foramen magnum and find out whether the sex of an individual can be made out from these measurements. The study sample consists of 420 human bodies which underwent autopsy, comprising of 260 male and 160 female bodies within the age group of 18-60 years. The age group of 18-60 years was selected because the sexual characteristics of the bone do not begin to manifest themselves until the stage of puberty is attained. Hence the lower limit of age was fixed as 18 years. Since all the sutures of the cranium get fused by the age of 60, the upper limit was fixed at 60years. Based on the transverse diameter of the Foramen magnum, the sex determination can be done with 99.9% confidence limit. There is no statistically significant difference in the sagittal diameter.