Indian Journal of Forensic and Community Medicine

216-220

Authors: Kavita Banker, Bipin Prajapati, Jignesh Chauhan.

Introduction: Higher prevalence of social and health problems observed among geriatric population like visual impairment, tobacco use, hearing problems, urinary complain, weight loss/gain, hypertension, diabetes, ischemic heart disease, dental problems, depression, memory loss, loneliness, family pressure. Geriatric population covered 7% of the global population and it will almost double means 14% in year 2040. Objectives: To study the socio-demographic condition and health problems among elder people in urban population. Materials and Method: This cross-sectional study was carried out in UHTC which is the field practice area of GMERS Medical College, Himmatnagar, Gujarat during January 2016 to September 2016. By simple random technique, 500 houses were selected for house to house survey and all the elderly people present in house at the time of visit were included in the study and primary data collected by pre-tested and pre-design questionnaire. Result: Around 86.9% participants belonged to 60-70 years group, 30.2% were widow or widower, 64.6% were illiterate, 8% residing alone and 55.4% were dependent population. Almost 64.6% participants were illiterate, 8.0% were residing alone, 32.6% had restricted mobility, 38.3% had inadequate sleep problems, 27.4% was overweight, higher blood pressure among 37.71% and mean BMI was 22.9 ± 12.82 & 23.59 ± 4.68 in urban area respectively. Almost 36.0% participants were operated for cataract and 4.0% have night blindness problem. Conclusion: higher prevalence of loneliness, dependency ratio, restricted mobility, inadequate sleep, appetite problem, joint pain, impaired vision & hearing, dental problems, obesity (in urban) and high blood pressure. There is also required larger study with larger sample size to explore the problems among elder population.

225-228

Authors: Swapna D Kakoty, Saswati Sanyal Choudhury, Beeva Boruah, Priyanka Das.

Introduction: Maternal mortality is an important socio-demographic indicator. India has a high maternal mortality ratio and within India the state of Assam has the highest MMR in the country. Though maternal death is a biomedical event there are many factors leading to it. Social and biomedical factors are one such determinant .The present study attempt to analysis the role of such factors in a maternal death at a district level. Material and Method: The study was done in Barpeta district of Assam. The maternal deaths during this year were identified by active and passive surveillance. In 50% of death social autopsy was conducted at the home of the deceased. Results and Observation: In 64 % of maternal death social factors were found to cause or contribute to death of mother. Unlike previously reported in the state, post-partum hemorrhage is the leading cause of death followed by anemia and eclampsia. All villages in which mother died had ANM/ASHA and the mother sought antenatal care. Thus quality of ANC has to be improved. Conclusion: Social factors are important determinant of maternal death. As social factors will take a long time for improvement service related deficiencies will have to be addressed immediately for further reduction of maternal death.

232-234

Authors: Abdul Raoof M.P, Th. Meera, Memchoubi Ph., Ankit Saini.

Introduction: A suspicion of foul play is raised when a healthy person without any significant past history of illness is found dead. The present study was carried out to find out the incidence and causes of sudden natural deaths in cases brought for medicolegal autopsies. Materials & Methods: A retrospective study on cases of natural deaths brought for medicolegal autopsies during the five year period of 2012 to 2016 to our centre was conducted to find out the incidence, demographic profile and causes of death in such cases. The detailed case history, police records, hospital records, if available, and post-mortem examination reports were studied. The findings were statistically analysed using descriptive statistics to find out the mean, percentage and frequencies. Results: Out of the 1321 medicolegal autopsies brought during the period, 121 (9.2%) were cases of natural deaths, involving 110 males and 11 females with a M:F ratio of 10:1. The highest number of cases was observed in the age group of 31-50 years (57.85%). Interestingly, 66.9% of the cases had external injuries which were trivial in nature. The commonest cause of death was cardiovascular system diseases (41.32%), of which 90% were due to coronary insufficiency. Other causes include respiratory system diseases (21.62%), gastrointestinal /hepatic diseases (9.01%), central nervous system diseases (6.6%), genito-urinary system diseases (3.3%) respectively. Conclusion: Cardiovascular system disease, especially coronary insufficiency, is a common cause of sudden natural deaths in this part of the country. Awareness of routine health check-up amongst the general public would help in reducing the incidence of such deaths. A meticulous post-mortem examination always helps in avoiding unnecessary litigations in such cases.

239-241

Authors: T.Vedanayagam, K.V. Vinoth.

The purpose of a toxicological investigation on postmortem specimens is to detect the presence of alcohol, drugs or other substances that could directly or indirectly be the cause of death. The collection of suitable and representative samples is an essential requirement. The present study is a retrospective study of chemical analysis of viscera collected from the medico-legal autopsies conducted at the Mortuary of Madras medical college, Chennai over a period of one year from 1st of January 2014 to 31st of December 2014. During this period, the number of autopsies done was 2332 and 492 visceral samples were sent for chemical analysis. Out of 492 cases, 398 cases belong to males which account for 80.9%, while female cases were 94 forming 19.1%. Out of 492 cases for which samples were sent for chemical analysis, 66 were tested positive for toxic substances. Of this 66poisoning cases, 46 cases had a history of poisoning, 5 were brought dead cases, 3 were RTA cases, 4 were hanging and 8 had a history of fall from height. Out of 136 suspected poisoning case, only 46 cases were positive constituting only 33.8% which could be attributed partly to the duration of hospitalization, time of sample collection, type of poisoning, the quantity consumed etc. The maximum death occurred in the age group of 20-40 years which needs attention.

245-249

Authors: Vasundara Gayakawad, Gowri Shankar.

Introduction: Under five children are vulnerable population in the community with respect to malnutrition especially those residing in urban slums. Malnutrition is a major contributing factor for under five deaths. Objective: This study was done to know the prevalence of under nutrition and its determinants in children between 1-5 years of age. Materials and Method: This cross sectional study was conducted from June 1st 2015 to August 31st 2015. Based on prevalence of underweight (48.1%) in a study done in Gulbarga, Karnataka, a sample of 109 Children between 1-5years age group residing in urban field practice area and enrolled in anganwadi were recruited using simple random technique. Mothers of these children were interviewed using predesigned, Pretested, Semi-structured proforma after taking informed consent. Under nutrition was graded using WHO 2006 anthropometric standards. Data was analyzed by using Open Epi software. Result: Prevalence of underweight, stunting and wasting were 48.6%, 45% and 20% respectively. Low birth weight (65%) and lower socioeconomic status (class IV-58.2% and Class V- 41.7%) were significantly associated with underweight among these children (p= <0.05). Proportion of underweight was high in children aged 3-5 years (55-67.6%). Children who received colostrum, exclusively breastfed for 6 months and timely weaning was done showed lower proportion of underweight. Conclusion: Prevalence of under nutrition is high in this area and hence MCH services should focus on antenatal mothers and awareness regarding child feeding practices and low cost weaning foods should be created.

255-260

Authors: Rekha Narendra Patil, Jayashree Tijare, Waman Raut.

Electrical injuries are essentially accidental. There is significant morbidity and mortality associated with electric injury. Simple safety measures can prevent accidental electrical injuries. This is an observational retrospective study done in the department of Pathology. This was a one year study. The study year being 2016. Our aim was to study the histomorphology of the skin in electrocution deaths. The maximum cases of electrocution deaths were due to low voltage (220-240V). This is the voltage supply for the domestic and minor industries. The unique finding of the study was three accidental electrocution deaths by touching the electric farm fence, which are constructed to prevent the entry of wild animals which destroy the crops in the field. Skin is the most frequently involved tissue in electrocution. We studied skin samples from 29 cases of electrocution deaths. All 29 were accidental deaths. There were 76% males. Upper extremity was the chief area of wounding. The skin samples received showed denudation in 76% cases. The most common histopathological findings were nuclear streaming (96%), dermoepidermal separation (96%) and coagulative necrosis (89%). Electrocution deaths is one of the important cause of negative autopsy. The histopathological examination of the skin coupled with the circumstantial evidence, proper and complete inspection of the crime site can be very helpful to the forensic surgeon in arriving at the diagnosis of electrocution deaths.

267-269

Authors: Phani Kiran Peethala, Pothula Umamaheswara Rao.

The complexity of the problem of “Suspicious deaths among women within Seven years of their married life” is so intense and deep as it involves social anthropology, sociology, civilization, marriage systems and customs. Despite of the appreciable revolutionary amendments by lawmakers for the safety and well-being of women, the atrocities against women is on rise as ever. Though the educational and occupational opportunities are providing women with new roles outside the home, their social position in the family remains unchanged. In our present retrospective research, an attempt has been made to study the changing trends of the medico-legal aspects of the incidence of the suspicious deaths in the women within seven years of their married life in and around Kakinada during 2012 to 2016 in relation to the statistics during 1996 to 2000 as per the “Medico-legal study of suspicious deaths among married women under seven years of their married life in and around Kakinada during 1996 to 2000” by Dr. (Late) P.Sarath Kumar Babu et al., (Rtd). Professor, Department of Forensic Medicine, Rangaraya Medical College, Kakinada, Andhra Pradesh.

274-276

Authors: Vibhakar Kumar, A.K. Choudhery, Rani Kumari beck.

Silicosis is a common occupational lung disease in our country which is caused by the inhalation of crystalline silica dust.(8) Silica is the most abundant mineral in the mines of Jharkhand. Workers that are involved in constructions, mining, tunnel drilling, sand blasting, pottery industry or glass industry are highest risk of developing this disease. Acute silicosis cases presented with severe symptoms like cough exertional dyspnea, breathlessness, chest pain. In chronic silicosis patient are asymptomatic for several years (10-15 yrs) and simply present with minor RTI symptom. It is usually diagnosed on radiographic (x-ray chest PA View) findings like calcifications of perihilar lymph nodes, diffuse ground glass opacities, large numbers of rounded, solitary nodules or bigger, confluent opacities (Egg cell calcification). Silicosis in combination with Rheumatoid arthritis (caplan syndrome) with rapid development of basilar nodules and mild obstruction of ventilation.(16) Silicosis patient has increase risk of tuberculosis and lung cancer. Once it develops is not curable and only symptomatic treatment can be given. So prevention and control programme for silicosis is beneficial. Acute silicosis having very poor and chronic-poor prognosis.