Recent advances in the management of poisoning cases.

Deaths due to poisoning are on the rise over the years, despite advanced knowledge regarding their pharmacokinetics and pathology, and newer and better techniques being developed for the management of poisoning cases. The management of a poisoned patient has changed over the years. Though the general principles of treatment of a poisoned patient remain the same, traditional methods like gastric lavage, for example, have taken a back seat. There has been gaining popularity of newer methods like use of activated charcoal and a variety of newer antidotes. Attention has also shifted to toxidromes, the collection of symptoms and signs that consistently occur after ingestion of a particular toxin or drug. Grouping the various signs and symptoms exhibited by a poisoned patient into different toxidromes helps the physician in rapid identification of the toxidrome and saves time in evaluating and managing a poisoned patient. However, the mainstay of the treatment, according to the experts is stabilization of the patient.

Death due to ruptured ectopic pregnancy natural death or negligence.

A young adult female of low socio-economic status, and a labourer by profession, was brought dead to the Government Medical College & hospital, Chandigarh. History provided by her husband revealed that she had pain abdomen for the last five days for which she was getting treatment from a private practitioner. She had been prescribed NSAIDs and antispasmodics for the same. However, she was not investigated upon and no attempt was made by the practitioner to arrive at any diagnosis. The autopsy was conducted on the next day and at autopsy, about two-and-a-half liters of blood was present in the abdomen and pelvic cavity. Careful internal examination revealed a ruptured ectopic pregnancy as the source of bleeding. The case is discussed with regard to establishing whether the death could have been natural, due to the negligence of the treating doctor or due to contributory negligence. However, even in cases of contributory negligence, the “last chance doctrine” may not save the physician.

A critical analysis of stab wound on the chest A case report.

Penetrating Injuries on the chest may be homicidal, suicidal or accidental in nature. There are certain features that are quite reliable pointers to the nature of these injuries. However differentiation is difficult particularly when the characteristics of stabbing are perplexed and information related to circumstances of the incident is misguiding. The present case projects the importance of careful examination of the stab wounds on the chest particularly when the information provided to the autopsy surgeon is ambiguous.

Multiple wounds by a single bullet: A case report.

A 19 year old boy with multiple entry and exit wounds was brought to the hospital where he succumbed to his injuries. According to the relatives he suffered a gun shot injury due to careless handling of firearm by his father. On autopsy it was found that a single bullet resulted in multiple wounds. The objective of this paper is to highlight the importance of careful examination of firearm wounds and to keep in mind the possibility of correlation between distantly present wounds.