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.

146-150

Authors: Pradeep Kumar Mishra, Jitendra Tomar, Divyesh Saxena, Pankaj Verma, Abhishek Varun.

Fire was perhaps man’s first double-edged sword, for throughout history, it has served as well destroyed mankind. Burns have tremendous medicolegal importance as they may be considered to be the one of the commonest cause of unnatural death in India. Often, the circumstances of burns are enveloped in mystery, obscurity and unreliable statements. The reason behind this action may be personal, domestic, occupational or social tragedy, and more recently dowry death. This was a prospective study carried out at Sri Aurobindo Medical College and Post Graduate Institute, Indore during March 2014 to June 2015 involving all cases admitted in burn ward and post mortem examination done in Department of Forensic Medicine and Toxicology. A total number of 120 cases of burn injuries were taken; of which 88 patients died and a detailed post mortem examination was conducted. Out of total 88 autopsies, 21 (23.86%) cases were magistrate inquest and rest 67 (76.13%) were police inquest. Manner of burn was accidental in nature in majority i.e. in 113 (94.17%) cases, followed by suicidal in 7 (5.83%) cases. Out of total 7 suicidal cases, dying declaration was recorded in 5 cases. Of all autopsied cases carbon soot particles were found in only 5 cases (5.69%). Present study is an effort in highlighting the medicolegal importance of thermal burns. The government should come forward with strict laws and monitoring should be done for strict implementation of the Anti-dowry Act would go a long way in bringing down the incidence of these ‘accidents’.

154-157

Authors: Harshal Radhakrishna Thube, Bhalchandra Gopinath Chikhalkar.

Introduction: In Mumbai region of India very few studies had done on fatal firearm deaths. So pattern wise distribution of firearm injury and demographic pattern of deceased were largely uncovered. Present study is an attempt to uncover some of the data related with firearm deaths in Mumbai region. Materials and Method: Present study was conducted at mortuary of tertiary referral hospital in Mumbai with aim to analyse fatal firearm deaths with respect of demographic data, injury pattern, manner of death, probable weapon and other post-mortem findings among the deceased and compared it with the pattern seen in other studies. Results: During study period from august 2011 to august 2013 total 43 autopsy on fatal firearm deaths were carried out. 74.4% deceased were victims of homicidal attacks, 21% of suicide and 4.6% of accidental deaths. Maximum suicidal firearm deaths were done by police persons (66%). Male from 21-30 age group were most common deceased in firearm deaths. Chest (36.9%) was most common site of involvement of entry wound of firearm. Pistol or revolver weapon most commonly used (51.17%) in both homicide and suicide cases. The most common reason behind the homicidal firearm death or killing of person was the personal rivalry (46.51%).

164-166

Authors: Ravindranath A. Bhovi, Mallikarjun K. Biradar, Sharankumar Holyachi.

Introduction: School health is an important intervention as a great deal of research tells us that schools can have a major effect on children’s health, by teaching them about health and promoting healthy behaviors. Objectives: To assess the morbidity profile of primary school children in rural Koppal. Materials and Method: This cross-sectional study was conducted in all the school children aged 6-12 years from August 2016 to December 2016. Data was compiled, tabulated and analyzed using proportions. Results: A total of 1722 school children were enrolled in study with a mean age of 9.24 years; 31.4% were in the age group of 10-11 years. On examination it was found that, 20.3% were suffering from ARI, 8.1% anemia, and 13.8% were having dental caries. Recommendation: The most common morbidities among school children were related to nutrition and personal hygiene which are linked to each other in causing various morbidities.

171-175

Authors: Jitendra Tomar, Abhishek Varun, Manish Nigam, Pradeep K. Mishra, Pankaj Verma.

In any medical college or hospital, emergency cases are dealt in casualty department, where first interaction between doctors and patients takes place. Among all the emergency cases, medicolegal cases are also dealt and a detailed MLC report is made by the attending doctor. After giving primary treatment and life saving measures to the patient, a MLC report is made and information is given to the police department as earliest as possible. Considering the importance of medicolegal work in casualty, a retrospective study was conducted in the casualty department of Sri Aurobindo Medical College and PGI, Indore for a period of 1 year, from 1st June 2016 to 31st May 2017. During the study period a total of 1421 patients came to casualty, out of which 44 were brought dead. Majority of cases were male (75.36%) and 57.70% cases were of road traffic accident (RTA), followed by cases of fall from height (10.13%), poisoning (9.21%) and assault (8.02%). In most of the cases opinion was taken from single department (64.70%). Surgery department was involved in majority of cases (52.94%), followed by orthopedics department i.e. in 43.28% cases.

181-184

Authors: Anuj Jangra, JS Malik, Srishti Singh, Nitika Sharma.

Introduction: Violence against women is a serious problem in India. There is growing recognition that violence against women has a large public health impact, in addition to being a gross violation of women’s human rights. Aim and Objectives: To find the extent of different type of domestic violence and to identify various risk factors for domestic violence against married women. Materials and Method: Population based cross­-sectional study among 170 currently married women in a rural block of North India from May to October 2016 who were selected by stratified random sampling technique. Results: 45.9% of the total study participants had experienced domestic violence. Education, occupation, financial dependence, type of family, alcohol abuse by husband and place of residence were significantly associated with domestic violence. Common reasons were disobeying husband/elders followed by neglecting household chores.

189-194

Authors: Pulak Chakma, Meera Devi Thounaojam, Ph. Madhubala Devi.

Introduction: Autopsy may reveal some natural diseases, the presence of which may trigger questions like association of the disease with trauma, work, crime etc., and its relative contribution towards death. The present study was taken up to study the presence of lung pathologies in medicolegal autopsies so as to find out the role of the co-morbidities of the lung in the cause of death. Materials and Method: Across-sectional study was carried out in the mortuary of the Forensic Medicine department in collaboration with the Pathology department of a tertiary care teaching institute in northeast India from October 2014 to September 2016. A detailed history and hospital records, if available, were recorded and the autopsy findings of the cases were noted. After gross examination of the lungs, samples of the cut sections were collected and examined for any pathology. The findings were recorded and statistically analysed. Results: The commonest lung pathology observed was pulmonary oedema (62.91%) followed by intraalveolar and interstitial haemorrhage (20.89%), pneumonia (10.56%), fibrosis (7.98%), etc. No cases of pulmonary tuberculosis were found as the primary cause of death in the present study except as co-morbidities in 1.87% of the cases. Pulmonary pathology like pneumonia and focal pneumonitis were present as contributing factors in the cause of death in 5.43% and 0.5% of the cases. Conclusion: In medicolegal autopsies, most of the cases are with unknown history of past illness. Gross and histopathological study of the lungs in the medicolegal autopsies may reveal natural diseases and their role as a contributory factor in such deaths.

199-203

Authors: Karthik RC, Balaji SM, Balaji Arumugam, Sriram RM, Ezhilvanan M.

Introduction: The prevalence of gastro esophageal reflux disease (GERD) has been increasing worldwide. Earlier it was thought that GERD prevalence in Asian countries is lower compared to western countries. But recent studies have shown that it’s on par with the west. The purpose of this study was to determine the prevalence of gastro esophageal reflux disease among medical students and the risk factors associated with it. Materials and Method: The study was done as a cross sectional study using the Gastro esophageal Reflux Disease – Health Related Quality of Life (GERD-HRQL) questionnaire developed by Velanovich et al among Medical College students in Chennai during February to March 2017. Results: Out of the 263 medical students who participated in this study, 92 (35%) were male and 171 (65%) were female. 25 % of study population had a positive family history of GERD, while majority (63.9%) of study participant’s skipped meals. A large majority of them preferred eating outside (82.9%) and liked eating spicy foods (81.4%). The prevalence of GERD in the study population was 14.4%. The association between GERD and family history, history of drug intake, skipping meals, alcohol consumption, and smoking was found to be statistically significant. (p<0.05) Conclusion: There is high prevalence of GERD in this population. There is a need for more population-based studies on GERD in India to provide insight into the various risk factors which increase the chance of developing gastro esophageal reflux disease.

209-215

Authors: Pawar RD, Mehendale AM.

Introduction: The United Nations, for statistical purposes, defines ‘Youth’ as those persons between the age of 15 and 24 years. Approximately more than one billion youth live in the world today which contributes around 18% of the world’s population. Majority (almost 85%) of the world’s youth live in developing countries, with approximately 60% in Asia alone. In the last few years, due to socio-economic and political factors, there have been increasing health problems among youth: unemployment, suicide, substance abuse, sex related offences and general adjustment problems. Youth and adolescent drug abuse is one of the major areas of concern in adolescent and young people’s behavior. WHO defines substance abuse as “harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.” Substance abuse is major public health problem amongst youth. Data are scarce on pattern of substance abuse and its association with socio demographic factors. Hence current study was an attempt to find the magnitude and pattern of substance abuse among youth in rural area. Aims and Objective: To find the magnitude of substance abuse among the youth in rural area and its socio-demographic correlates. Materials and Method: The present study was a community based observational descriptive study, cross sectional in design, conducted in the field practice area of Rural Health Training Centre of Mahatma Gandhi Institute of Medical Sciences, Sewagram which is located in rural central India, between November 2013 to December 2015. Field practice area of RHTC serves 27 villages catering the population of 70,000. Four villages were randomly selected from the field practice area having total population 4045. All the youth (15-24 years) were included in the study (Complete Enumeration). Out of the total 789 youth, 59 youth refused to participate. Remaining 730 youth were included in final analysis. Predesign and pretested proforma was used for data collection. Ethical consideration was taken from institutional ethical Committee. Statistical analysis: Data entry and analysis was done by using EPI-Info version 6.04 software. Chi square test was applied to obtained statistical significance wherever necessary in the study. Results: Magnitude of substance abuse among youth was found to be 44.1%. It was 79.5% in males as compared to 20.5% in females and this was found to be statistically significant (P<0.05). Smokeless tobacco was prevalent form of substance abuse (75.8%) followed by alcohol (10.9%). 25.1% of youth had started substance abuse below 10 years of age. Peer pressure was the commonest reason (42.2%) and Mass media was the commonest source of information. Substance abuse was significantly associated with educational status, socio-economic status, and youth from the joint families and not associated with marital status and caste. Conclusions: Magnitude of substance abuse was found to be 44.1%.Smokeless tobacco was the prevalent form (75.8%) followed by alcohol (10.9%). Substance abuse was significantly associated with educational status, socio-economic status, and youth from the joint families and not associated with marital status and caste.

73-76

Authors: Priyanka Devgun, Navpreet Kaur, Avi Singh

Depression is struggling to survive in a body that is trying to die. Depression is one of the most talked about health topics as well as being one of the most researched ones. Unfortunately, it also bears a social stigma which is probably why it is talked about in hushed voices and the sufferers are wary of coming out in the open and seeking help. Adolescent depression is well on its way to being recognized as to what ails the young today but still not much is being done to address the problem. Studies show that 1 out of 20 adolescents suffer from a major bout of depression in his lifetime. Some of which unfortunately end up committing suicide. Others battle low self-esteem, thoughts of self-harm or fall prey to sexual misadventures, drugs and alcohol abuse and indulge in antisocial behavior. The young are the assets and resource of any country. Their needs should be addressed on priority so that next generations can flourish.

81-84

Authors: Ashish Jain, DN Bhardwaj.

The trends of poisoning differ from country to country and also from one region to another within the same country due to differences in the socio-economic condition, cultural practices and ease of availability of poison or drug among various regions. There is paucity of accurate data regarding fatal poisonings in India due to lack of enough Poison Information Centers, which hampers the prevention and control of poisoning deaths. A cross sectional observational study based on autopsy and laboratory investigation was carried out over a period of 2 years, at the Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences New Delhi to find out the distribution and determinants of the fatal poisonings in South Delhi region of India. In this study, poisoning deaths accounted for 4.65% of all medico-legal autopsies done during the study period. Majority of poisoning fatalities were observed among male, age group 21-40 years, married, and middle class families. Majority of cases were suicidal. Insecticides and rodenticides were most common killer poisons followed by alcohol. Mental illness or mental depression was present in 34.5% of cases, while substance abuse was encountered in 26.1% of cases. Past history of prolonged physical illness was present in 3.4% of cases.

90-94

Authors: Anju Gahlot, Som Nath, Pankaj Kumar, Manjusha Nath.

India's population has been steadily increasing at the rate of 16 million each year and is projected to reach 1.53 billion by the year 2050. The total contraceptive prevalence rate (CPR) in India among married woman is estimated at 56.3% as per NFHS-3 data...The family welfare programme is mainly based on a "Cafeteria approach"; where by a number of methods of contraception are offered to the eligible couples. Considering the improvement in prevalence of contraceptive users & privacy, safety and efficacy of long acting injectables, the study was undertaken to evaluate prevalence of contraceptive methods among married women of different ages in urban area of Kanpur & source of information & side effect of Injectable Contraceptive DMPA in study population. Materials and Method: This is community based observational cross sectional study including randomly selected 350 Married women of reproductive age group( 18-49 years) residing in urban field practice of Rama Medical College hospital and research center, Kanpur. Data was collected with the help of set proforma and then analysed with SPSS software version 21 & Chi square test was applied appropriately. Results-Prevalence of contraceptive measures among eligible subject were, condom 27.23% followed by IUCD 22.77% & OCP 20.98%, Sterilization 13.54% & DMPA 9.8%. There is statistically significant association between different age groups & types of contraceptives used (chi square) x2 = 78.451, d.f.= 30, & p =.000. Educational status of middle or higher class passed were comparatively using more contraceptives. Majority 11(55%) had Husband/family member as the source of information for injectable contraception. Amenorrhoea (68.18%) was the main side effect of DMPA in study. Conclusion: The prevalence of contraception use (63.14.%) is improving among urban dwellers. Middle or higher classes passed were utilizing more contraceptive measures. DMPA is a safe, effective, reversible but neglected long acting injectable contraceptive. Acceptance is highest when DMPA comes into the basket of contraceptives. There is a need to develop standardized protocols for counselling, training of ASHA and ANMs and strengthening of health system.

101-105

Authors: Gowri Shankar, Bhagyalaxmi Sidenur.

Introduction: Cause of death statistics from hospitals are considered along with mortality data from other sources to constitute the essential statistics on the health of a population. Mortality data is used to periodically review health priorities, set research agendas and monitor progress towards national and global health and development goals. There has been an increase in the frequency of new health problems like coronary heart disease, hypertension, cancer, diabetes and accidents. The emerging picture is a mixture of the old and modern diseases. Hence, this study was done to know the socio demographic profile and pattern of causes of death in a Tertiary Care Teaching Hospital in Bagalkot, Karnataka, India. Materials and Method: The case reports of all deaths for the 5 year period i.e. 2012 to 2016 from the Medical Records Department were analyzed to study the socio demographic profile and the pattern of causes of death. The deaths were classified according to ICD 10th revision. Results: In all the 5 years, male deaths were more than female deaths. Almost three- fourths of deaths were in males and females from rural areas. Non communicable diseases contributed to 62.88% to 72.75% of the deaths during the 5 year study duration. Conclusion: The present study indicates that Bagalkot district is going through an epidemiological transition from communicable to non communicable diseases and there is a need for health awareness in the community about changing lifestyles and its harmful effects on health.

111-114

Authors: Zohreh Mahmoodi, Mohamad Reza Havasian, Morteza Salarzaei.

Asthma is one of the most common diseases, and it is one of the main factors behind physical disabilities as well as high economic costs. The present research aims at studying the prevalence of cardiac arrhythmias in asthmatic patients of Amir-al-Momenin Hospital of Zabol in 2013. In this cross-sectional, descriptive study, as many as 200 asthmatic patients were studied; the participants’ minimum age was 15, maximum was 80, and they had no history of heart diseases. The information and data related to the participants of the present study were collected through using standard questionnaires. Spirometry and electrocardiogram was taken from the patients, and the arterial blood oxygen was measured through using pulse oximetry. The data were analyzed through using SPSS 18. The present study indicated that from among the 200 asthmatic patients studied, 19 patients suffered from cardiac arrhythmia. Among these 19 patients, seven patients had sinus tachycardia, 8 patients had PVC, 1 patient had MAT, and 3 patients had Rbbb. With respect to the drugs taken, cardiac arrhythmia was more common among patients who used beta-agonists together with anticholinergic, glucocorticoids, and theophylline’s. The findings of the present study indicated that the prevalence of cardiac arrhythmia was relatively high among the asthmatic patients. The present study indicated that due consideration must be given to asthma and the attempts toward early cardiac arrhythmias diagnosis through taking electrocardiogram in periodic examinations and giving the patients awareness about the symptoms of arrhythmia so that early diagnosis of arrhythmia in asthmatic patients is made.

121-123

Authors: SV Parate, AK Samanta, S Harish, Girish Chandra.

Introduction and Objective: In this 21st century autopsy surgeon often encounters various types of treatment related injuries during autopsies. They must be able to distinguish between injuries caused by therapeutic procedures and those caused by other factors, such as assaults and accidents. This prospective study was conducted at M.S. Ramaiah Medical College, Bangalore, from October 2008 to March 2010 with aims and objectives to study the pattern of Iatrogenic cutaneous artefacts encountered during autopsy and to ascertain the relationship of Iatrogenic cutaneous artefacts to sex of the deceased if any. Materials and Method: Data was collected by detailed questionnaire, focusing on the history furnished by the police in requisition form and inquest report, by the relatives and hospital records. Result: Iatrogenic cutaneous artefact was present in 58.13% cases. Out of these 34.38% were males and 23.75% were females. Most common cutaneous artefact was intravenous injection line mark mimicking like contusion. It was present in 45.00% cases. Defibrillator burn artefact was present in 12.80% cases. Chest abrasion/contusion was present in 13.13% cases. Iatrogenic cutaneous artefacts were found to be independent and there is no relation between these artefacts and sex of the deceased. Discussion: In a prospective study by JP Krischer, EG Fine, JH Davis and EL Nagel defibrillator burn artefact was found in 30.70 % cases and chest abrasion/contusion was present in 59.30% cases. This may be because of increase awareness regarding proper use of Defibrillator. Conclusion: Whenever in doubt about nature of infliction of injury autopsy surgeon should refer hospital case sheet particularly emergency room records and may have talk with treating doctor whenever possible before labelling such injury as evidence of underlying assault, accident or an artefact.

128-133

Authors: Veena Naik, Saurabh Prakash, Soo Zee Yen, Sofia Binti Roslan, Sivanesan A/L Ramasamy.

Age estimation presents a complex problem and requires considerable experience in recognizing significant changes and allowing for their variability with in any particular population. Tooth eruption and tooth calcification are the two events that can be used to measure dental age in children and adolescents. Although, Demirjian's and Nolla’s method are considered standard for dental age estimation, it may not be reliable for all population. Aim: The goal of the study was to evaluate the reliability of Demirjian's and Nolla’s method of dental age estimation in determining chronological ages in younger individuals of Malaysian population based on developmental stages of third molar. Study Design: A retrospective study was performed on panoramic radiographs of 100 subjects aged between14 to 22 years. Estimated age (EA) was calculated using Demirjian's and Nolla’s methods and compared with chronologic age (CA) for each patient. Results: The mean of CA of the study sample was 18.5500 ± 2.36. Using the Demirjian method, the mean of EA was 18.8562 ± 2.10. For Nolla method, the mean of EA was 17.1625 ±2.11. Conclusion: Hence the above results indicates that the Estimated age (EA) by Demirjian method was more close to chronologic age (CA) showing no significant variations between the two, Suggesting that the Demirjian method is more significant in determining age in younger individuals of Malaysian population.

138-142

Authors: Vijay Kautilya D, Shruti P. Hegde, Khatija Begum, Prithika Chandrashekaran.

Introduction: Indian has been an agricultural nation where most of the population is involved in agriculture. Yet the farmers are a neglected section of the society. Use of pesticides has been rampant in agriculture and this has made the farmers vulnerable to the risks of pesticide application. Our aim was to survey the level of awareness of the farmer regarding pests, pesticides and their correct methods of use as this data can help us design interventional programs tailored for the population under study. Materials and Method: A Cross-sectional questionnaire based survey was conducted among 172 paddy farmers in Kancheepuram district of Tamil-Nadu, India. The questionnaire consisted of both open ended and closed ended questions directed toward collecting demographic data and other relevant data on crops being cultivated, general knowledge and attitude on pesticide handling, safety, risk perception and protection ideas. The results were analyzed using (SPSS version 20) for descriptive statistics. Results and Discussion: Of the 172 farmers 93% denied knowledge of any pesticide regulations and only 18.6% accepted reading the instructions given on the pesticide labels before application. Considering the safety precautions 94 (54.1%) of the subjects accepted not using any safety precaution while spraying. Of the 172 farmers in the study, 104 (60.5%) followed advice given by the retailers from whom they buy the pesticide. Even the dosage was being prescribed by the retailers. In only 37.2% of cases the pesticides were being sprayed in the fields by skilled labors. Conclusion: It is clear from the study is that the farmers need training, education and financial support. Safety gears need to be provided at a subsidized rates and their proper use must be demonstrated. Farmers also need to understand the use of integrated pest management.

Page No. 1-6

Authors: Brajesh Anand PD, Mukesh Shukla, Siraj Ahmad, Sneha Soni

Introduction: Population ageing is being recognised worldwide as a reality but still the quality of life (QOL) among elderly seems to be a neglected issue in developing countries like India. Therefore the present study was conducted to measure health related QOL among elderly and to ascertain some of the determinant factors. Methods: This was a community based cross-sectional survey, conducted among 782 elderly subject in rural population of Barabanki, Uttar Pradesh. WHO QOL-BREF was used to assess the data on QOL of elderly. A pre-designed, pre-tested semi structured questionnaire was used to collect socio-demographic information and a complete clinical examination was performed among the study subjects to assess chronic morbid conditions. Results: Mean scores of quality of life domains were higher among elderly of 70-79 years age group in physical, psychological, social relationship and environmental domains from other age groups. The mean quality of life scores were found to be higher among elderly without psychosocial and health related problems. Relation between physical health domain and marital status were statistically significant (p<0.05). About 44.4% of elderly living with their family or wife were of average psychological health, while 33.5% elderly living alone were of poor psychological health and relation was statistically significant (p<0.05). Association between marital status with psychological health was statistically significant and SES with social relationship was statistically significant (p<0.05) Conclusion: The study findings indicate that the elderly population living in Satrikh, Barabanki suffer from relatively poor QOL particularly among elderly women and those with lower education. Indeed to improve QOL among elderly, much more attention should be paid to all aspects of their life including health and economic status.

Page No. 13-23

Authors: C. Tej Kumar, B. Nagendra Naidu

Cardio Vascular Diseases (CVD) are one of the major NCDs comprising of a group of diseases of Heart and Vascular system. CHD accounts for nearly 50% of all deaths in the developed world and 25% in developing countries, such as India. The aetiology of CVD is multi-factorial. Most of the Risk factors of CVD are easily modifiable on simple IEC activities(Information, Education and Communication). This Cross Sectional Descriptive study on modifiable risk factors of Cardio Vascular diseases in adults at Kankipadu Village, Krishna district is conducted to estimate the prevalence of risk factors in a rural area of Andhra Pradesh. Prevalence of various risk factors in this study are systolic hypertension 16.42%, diastolic hyper tension 9.14%, over weight and obesity 19%, smoking habit 21.14%, alcohol consumption 18.86%, physical inactivity 45%.

Page No. 28-30

Authors: Sudeepa Das, Niranjan Sahoo, MK Hansda, SN Mishra, AK Shukla

Thermal burns are major cause of death and disability affecting to the developing countries like India. High mortality has become a medical problem in rural India. The females are the usual sufferers. The mortality is almost 100% at the extremes of the age. Mostly the incidence took place in living place. Thin built and medium built individuals are usual sufferers with stout built individuals pose a great defense with less mortality. Higher income group people are the least sufferers. Most important factor is the percentage of surface area burn which is responsible for the fatality of the cases.

Page No. 36-40

Authors: Syed Jawwad Ali Hashmi, Purushottam A. Giri, Mohd. Shafee

Background: The disease has been recognized as a global epidemic by WHO. According to the International Diabetes Federation (IDF), the number of people globally with type 2 diabetes mellitus (T2DM) will increase to 552 million by 2030, over twice the number in 2000. Nearly 21% of these new cases will be from India, which has the highest number of cases in any country. Methods: A cross-sectional study was carried out in the field practice area of rural health center (RHTC) Kasturwadi, Department of Community Medicine, Indian Institute of Medical Science & Research, Badnapur, Jalna, Maharashtra. As WHO has given theme for WHO day 7th April 2016 as “Beat Diabetes”, as a part of WHO day 2016 celebration a Diabetes Screening camp was organized at Kasturwadi village on 7th April 2016. Blood sugar level of all participants in camp above 30 years and who were willing to participate was taken for the study. Results: Prevalence of IGT and diabetes (combined) was 60% in 61-70 yrs age group followed by 36% in 51-60 years, 35% in 41- 50 years and 27% in 30-40 years. Prevalence of diabetes is 7.9% in males where as 3.8% in females. Prevalence of IGT is more among Muslims i.e. 31.8% than Hindus i.e. 25.6%. Prevalence of IGT and diabetes is 53.1% and 16.3% respectively in subjects with sedentary life style and difference was statistically significant among sedentary and non-sedentary subjects. There were significant difference in prevalence of IGT and Diabetes among persons with higher BMI (p=0.001). Also there is significant difference in normotensives and hypertensive as prevalence of IGT and diabetes is considered (p=0.039). Conclusion: The present study found positive association between stress, sedentary lifestyle, family history of diabetes, and hypertension with abnormal glucose tolerance. Primary prevention is possible by modifying the environmental factors influencing diabetogenesis such as obesity, diet and physical activity.

Page No. 45-47

Authors: Ratnesh, AK Singh, SB Gupta

Background: Tuberculosis (TB) is a major global health problem and ranks the second leading cause of death from an infectious disease worldwide. India is the highest TB burden country accounting for more than one fifth of the global burden of tuberculosis. It is caused by Mycobacterium tuberculosis. Objective: The objective of the current study was to find out about the socio-demographic profile of the TB patients registered under RNTCP in district Bareilly. Material and Methods: A cross-sectional study was done on TB patients registered during 1st April 2014 to 31st March 2016 under RNTCP for DOTS in Bareilly. Purposive sampling was done, 10 DMCs were selected in district Bareilly in which a total of 2010 TB patients were interviewed. Result and Conclusion: In the present cross-sectional study, total 2010 TB patients were interviewed, in which maximum number i.e. 489 (24.3%) of the study subjects belonged to the age group of less than 20 years, 1119 (55.7%) were male, 1050 (55.9%) were from urban population, Hindu by religion 1123 (55.9%), OBC caste 1403 (69.8%), married 1358 (67.6%), educated up to primary class 704 (35%), unskilled worker 769 (38.3%) and 777 (38.7%) were from nuclear family.

Page No. 53-57

Authors: Girish B., Sumanth Mallikarjuna Majgi

Background: Hypertension is an important public health challenge in both economically developing and developed countries. Hypertension is a Silent Killer, because people who have it are often symptom free or unaware of the disease. The teaching profession is highly stressful occupation due to enhanced psychosocial stress at the work place. The present study was intended to measure the prevalence of hypertension among primary school teachers of Urban Tumkur and also to identify the risk factors for hypertension among the same. Material and Methods: This was a cross sectional study conducted in Maralur area of Tumkur town during July to September, 2013. All the five schools under our Urban field practice area were selected for the study and the sample size was 70 primary school teachers. Blood pressure of all teachers were recorded in sitting position and a pre-tested questionnaire was used to obtain other details. Result: Blood pressure was recorded among 70 teachers in the 5 schools of which 19 (27.14%) were males and 51 (72.86%) were females. 20 teachers (28.57%) were diagnosed with hypertension. 65% of hypertensive teachers have positive family history of hypertension in this study. 15% of teachers with hypertension have smoking habit and 10% of teachers have the habit of alcohol consumption. 25% of hypertensives had less than 6 hours of sleep daily. 65% of hypertensives do not practice yoga and 75% of hypertensives do not practice meditation. Conclusion: Hypertension among the school teachers was 28.57%. Life style modification for prevention and control of hypertension has to be given importance among teachers. Teachers can be used as a medium for spreading these messages to their family, the students and their colleagues.

Page No. 63-66

Authors: PN Murkey, Ranjan Ambedkar, BH Tirpude, Sharjeel Khan, IL Khandekar, Pravin Zopate, Deepak Bhagwat,

Asphyxial deaths are a common phenomenon. The stressful life with financial burden, poor socio-economic status, homicidal intentions, industrialisation, psychiatric disorders, human errors, estranged relationships, accidents etc had contributed to a tremendous increase in asphyxial deaths. Hanging is second or third most popular method of suicide. Hanging has been employed as the method of suicide since time immemorial. Usually all hanging cases are suicidal. Accidental hanging is uncommon and homicidal cases are rare. Moreover there is great diversity related to marital status of victim and place of hanging which provides a rough clue for investigating authorities. The present study is based on the autopsies conducted in the mortuary of Forensic Medicine Department, situated in central India. A total number of 1833 postmortem examination were conducted during 1st August 2011 to 31st July 2016 and amongst these 121 cases were due to asphyxial deaths.

Page No. 230-233

Authors: Kedar G. Mehta, Rinal Parikh

“Lifestyle”, a simple, yet not so simple 9 letter word introduced way back in the 1950s to denote roughly the way of life of a person, has undoubtedly undergone terrific changes over the decades. Sociology defines lifestyle as “the interests, opinions, behaviors and behavioral orientations of an individual, group, or culture.” Looking into the medical aspects of lifestyle, it essentially means all the activities or tasks the person indulges himself into, which somehow directly or indirectly, influence his body functions. India is a country of traditions and culture, a nation where, lifestyles vary from state to state as per the variations in terrains or occupation. Going back to the pre-gadget era, where man was not so dependent on the inventions of technology as he is today, their lifestyle was way different and in many ways, better than today. Strenuous physical work daily, walking for long distances easily, eating healthy home cooked meals everyday, engaging in lively sports and other recreational habits daily- all these habits of the past have been taken over by the modern world. No doubt technology is a boon to mankind, but it has also brought various drawbacks.

Page No. 240-244

Authors: Ramesh C. Patil, Ashfakhussain Magi, Anand Mugadlimath, Rekha Hiremath

Introduction: Radiographic survey for appearance and fusion of ossification centers of various bones is undoubtedly one of the best methods for age estimation especially in children and adolescents till ossification is complete. The appearance of ossification centers for carpal bones especially for pisiform bone is one of the vital evidence for estimating age in young children between 9 and 13 years. Material & Methods: The present study to estimate the age of children based on radiographic evaluation of the appearance of ossification center of pisiform bone was undertaken in the department of Forensic Medicine and Toxicology, Al-Ameen medical college Vijayapur. Duration of study period is from July 2014 to August 2016 (two year) and it is a cross sectional study. Results: The mean age at which males show appearance of pisiform is 9.5+1.71 years and in case of females it is 9.5+1.7 years. The p value is <0.05 indicating that there is significant age difference in males and females with reference to appearance of ossification center of pisiform bone. Conclusions: The accurate or precise age of the individual cannot be stated by radiological examination, but a reasonable range of age can be arrived by considering the timing of appearance of ossification centers. Hence application of radiological procedures for assessment of age in living individuals is a reliable method.

Page No. 251-253

Authors: PJ Manvar, DK Vadgama, HM Mangal, PR Varu, RD Vaghela

Background: In cases of sudden death, cardiovascular disease (45 to 50%) was the most important cause of the sudden natural death. Keeping in view of the foresaid facts, it was considered worthwhile to study the coronary artery atherosclerosis in Rajkot region. Material and Method: Present study was conducted from January 2014 to December 2014 at department of Forensic Medicine, P.D.U. Govt. Medical College, Rajkot. A detailed history was taken as to the circumstances of death with special reference to any signs and symptoms suggestive of myocardial ischemia. The routine autopsy technique (Virchow’s1) was used for post mortem examination. Results: Incidence of coronary artery disease is more in males as compared to females. Most common risk factor observed in death due to coronary artery disease was Hypertension (20.09%), followed by smoking (14.95%) and followed by diabetes mellitus (12.62%). Narrowing of lumen was maximally observed in left anterior descending coronary artery.

Page No. 257-262

Authors: Fremingston Marak, Mima Maychet B. Sangma, Ganesh Kumar, Priyadharshini M

Background: In India, for individuals older than 4-years of age, more life years are lost due to traffic accidents than cardiovascular diseases. In India over 80,000 persons die in the traffic crashes annually, over 1.2 million injured seriously and about 3,000,000 disabled permanently. Objectives: To assess the pattern of injuries leading to deaths from road traffic accidents in a tertiary care hospital in Puducherry. Method: It is a retrospective study of all medicolegal autopsies of road traffic accidents conducted between January 2015 to December 2015 at the Mortuary of Forensic Medicine Department, IGMC&RI, Puducherry, India. Results: RTA accounted for 10.52% of the total cases. The highest number of victims of accidents were in the age group of 51-60 years with 32 cases (22.9%), followed by age group of 31-40 years. Male preponderance was seen in present study (85.7%) with a male female ratio of 6:1. Highest number of accidents is seen among the Hindus (94.3%) during evening hours (42.86%) maximum number occurring in the month of October (13.57%) and on weekends (40.71%). Motorcycles were the commonest vehicle involved (46.43%) and Pedestrians comprises highest number of casualties (46.43%). Abrasion (44.28%), Laceration (30.7%) and Contusions (20%) were the most common associated injuries. Most of the victims died of craniocerebral injuries (46.43%) and intracranial haemorrhages (33.57%). Conclusion: Road Traffic accidents are one of the most common vehicular transport accidents involving the motorcycle where pedestrians are the casualties in most of the cases.

Page No. 267-271

Authors: Kartik Sudhakar Patil, Meenal V. Kulkarni

Background: ICDS is the largest government run health program for children with its foot spread across complete Indian Territory. Objective: Study was aimed to obtain information about the knowledge, level of awareness and utilization of the services provided under ICDS among women living in the urban slum. Methods: Study was a community based cross-sectional study, conducted through a preformed questionnaire and house interview of women of 151 households in a slum. Results: The awareness level about Anganwadi and various services provided by ICDS through Anganwadi among women was 91.39%. Immunization, Supplementary Nutrition(SN) and Health checkup were the known services in contrast to Referral services, Nutrition and Health Education (NHE), and Preschool Non-formal Education(PNFE) which were lesser known. Utilization of these services was 77.48%. In our study 37.5%, 31.25% and 18.75% pregnant women respectively utilized facility of Take Home Rations THR), health checkup and immunization & 38.46%, 30.77% nursing mothers respectively took regular THR, regular checkup. Among children beneficiaries, the group of 6-36 month consisted of 80 children among whom 41.25% took irregular SN, 70% were completely immunized, 60% had regular health checkups. In the group of 3-6 years out of 67 children, only 22.39% took regular SN, 71.64% were completely immunized, 62.69 had regular health checkups and meager 9% attended PNFE. Conclusion: Level of awareness was found to be good. Utilization was found to be better among children as compared to women.

Page No. 276-279

Authors: S. Shavukath Ali, B. Karunakar, M. Narayana Reddy

An Analytical study conducted on cases of organophosphorus poisoning, of which all are Positive cases declared in Forensic Science Laboratory, Hyderabad. Pesticide poisoning is a significant problem in India. Organophosphorus compounds cause most self poisoning deaths in southern and central India. Among cases preponderance of male sex over female sex. It shows that maximum incidence of deaths from Organophosphorus poisoning are seen in 3rd decade of life followed by 4th and 5th decade for the both the sexes follow the common trend of overall suicidal deaths. Deaths from Organosphosphorus poisoning are 3 times more in married group compared to unmarried group in both sexes and shows that the commonest motive for suicide from Organophosphorus poisoning is health related problems in both the sexes compared to other problems. Chronic poisoning due to environmental pollution affecting the food chain and the community at large can be diagnosed and proper preventive and rehabilitative measure can be undertaken. All the records of the poisoning fatalities were studied in detail and statement prepared to show the frequency of individual poisons, age and sex distribution.

Page No. 284-287

Authors: Vijaykumar Mane, Jyoti Markam, Roseline F. William, Vidya DC, Trupti B. Naik

Introduction: Recently organ transplantation has become a safe and viable procedure for prolonging the lives of people suffering from organ failures, and as a result the need for organs has increased. Health care professionals are the most critical link in the organ procurement process and therefore, their knowledge, attitudes and behaviors are essential factors in the creation and promotion of an environment that has a positive influence on organ donation rates. Objective: To assess the knowledge, attitude and practices towards organ donation among third year medical students in the study setting. Materials and Methods: A cross sectional study was conducted among third year medical students at a Private tertiary care hospital in the rural area of Maduranthakam Taluk, Kanchipuram district, Tamil Nadu. Data was collected anonymously in a pretested and semi structured questionnaire after taking an informed consent and those who were absent on the day of data collection were excluded from the study. Data thus obtained was entered and analyzed using WHO Epiinfo software version 3.5.4. Results: The present study demonstrated favorable attitude and adequate practices among medical students towards Organ donation despite their limitations/gaps in knowledge about the same. The study identifies several areas where educational interventions are necessary. Recommendations: Need to introduce topic on Organ donation and transplantation in the undergraduate medical curriculum in order to improve knowledge of medical students. Further, appropriate use of mass media like television and newspapers will go a long way in creating awareness among them.