Pattern of cause of death and injuries in unknown dead bodies

Aims and Objectives: To establish the identify and to study the pattern of injuries and cause of deaths in these cases

Study Design: Retrospective Study

Setting: Autopsy unit of Forensic Medicine and Toxicology Department Faisalabad Medical University Faisalabad, Pakistan

Duration of Study: 3 years from 1-1-2013 to 31-12-2015

Sample Size: 134 cases

Sampling Technique: Convenient Sampling

Data Collection Procedure: Unknown dead bodies brought in autopsy unit of Forensic Medicine and Toxicology department of Faisalabad Medical University Faisalabad during the period of three years 2013 to 2015. Data regarding these cases was compiled from the postmortem reports, Police papers and limiting counseling with different Investigating officers and Forensic Experts

Results: The number of cases were 134/1007 cases out of which 80% male 20% were female and most vulnerable age group is 21-50 years and maximum cases were reported in summer session. In maximum cases, death was due to vehicular injuries 23 [17.1%], gunshot deaths were 18[13.4%] and by blunt means, 10 cases [7.46%] 18 cases [13.4%] were by poisoning and 2 cases [1.4%] where due to Ischemic heart disease while in 23 cases [17.1%] were declared undetermined [negative autopsy]

Conclusion: The identification and cause of death can be find out by keen attention and interest of Forensic Experts and investigating officer along with the help of DNA and finger printing techniques

comparison of preventive effects of punica granatum juice and extract on weight and volume of steroid induced mice kidneys

Objective: To observe the preventive effects of Punica granatum [pomegranate] juice and extract on weight and volume of steroid induced mice kidneys. Study Design: Lab based randomized control trial. Place and Duration of Study: Department of Anatomy, Army Medical College [AMC] Rawalpindi, in cooperation with National Institute of Health [NIH] Islamabad, from Apr to May 2015

Material and Methods: Forty male and female healthy [BALB/c strain] mice with average weight of 25-30gms were divided into four groups, having ten animals each. Group A was a control group and groups B, C and D were experimental groups. Mice in experimental groups were injected Nandrolone decanoate [ND] at the dosage of 1 mg/100 gm of body weight, intramuscularly [I/M] in the hind limb once a week for 8 weeks. Mice in experimental group C were also given pomegranate juice [PJ] at the dosage of 3ml/kg of body weight through oral gavage tube for 8 weeks daily and mice in experimental group D were given pomegranate peel extract [PPE] at the dosage of 200mg/kg of body weight by oral gavage tube for 8 weeks daily. Intergroup comparison of results of experimental groups B, C and D with each other and with control group A was done

Results: The weight and volume of kidneys were significantly different in ND treated experimental group B and difference in both these parameters was seen in pomegranate administered experimental groups C and D

Conclusion: Pomegranate in both forms, as pomegranate juice and peels extract, equally prevent the weight and volume of steroid induced kidneys

Comparison of induction of labor with foley catheter and prostaglandins in postdate pregnancies

Objective: To compare the success of Foley catheter and prostaglandin E2 [PGE2] in females presenting with postdates pregnancy

Study Design: Randomized controlled trial

Place and Duration of Study: Department of obstetrics and gynecology, Combined Military Hospital [CMH], Quetta Jun 2015 to Oct 2015

Material and Methods: Through non-probability, consecutive sampling technique 150 cases were included in the study. Informed consent and demographic details were noted. All females were randomly divided in two equal groups by using lottery method. In group A, Foley catheters, were administered. Speculum examination was performed, and 16F standard latex Foley catheter was inserted, using aseptic technique, above the internal cervical os and inflated with 30 mL of sterile water. The catheter was taped to the inner thigh with slight traction, and spigot inserted to occlude the lumen. In group B, PGE2 gel was inserted into the posterior vaginal fornix. Initially 2 mg dose per vaginum for nulliparous and 1 mg per vaginum for multi parous women was used. A post-insertion cardiotocography [CTG] was performed for at least 30 minutes. The cervix was re-examined after six hours and, if required, the procedure repeated using a further 1 mg PGE2 [regardless of parity]. Success was labelled for those females who delivered vaginally within 24 hours. Statistical analysis was performed using SPSS version 16. Both groups were compared for success in terms of vaginal delivery within 24 hrs by using chi-square test. A p-value

Results: The mean age of the patients was 28.33 +/- 5.79 years, the mean gestational age was 42.00 +/- 0.82 weeks. Success was achieved in 76 cases in which 26 were from group A and 50 were from group B. Statistically highly significant difference was found between the study groups and success of the patients i.e. p-value=0.000

Conclusion: PGE2 showed significantly greater success in terms of vaginal delivery within 24 hrs as compared to Foley catheter in females presenting with postdates pregnancy

Medical prescription adherence among patient visiting gynecology department

Objective: The aim of this study was to explore the level of Medical prescription adherence among gynecological patients of Pakistan

Study Design: Cross-sectional study

Place and Duration of Study: The study was conducted in Punjab province and data were collected from June 2015 to April 2016

Material and Methods: This cross-sectional study was carried out in main cities of Punjab province of Pakistan; Lahore, Gujranwala, Faisalabad and Sheikhupura. The survey data was collected from different location of cities. Patients visiting the gynecological and going to chemists for getting the prescribed medicine were selected through probability based random sampling for this study. The questionnaire consisted on the extent to which they adhere to time, dose, frequency and procedure prescribed from their doctors. The questions were asked in native language [Urdu]. The data analysis was performed by using SPSS software [Ver.21]

Results: Results of this study, based on sample from four big cities of Punjab province of Pakistan, showed that the level of medical prescription was associated with the age, qualification and background of the patients. Adherence level of patients reporting with rural background was observed higher than the adherence level of patients from urban areas

Conclusion: Over all the patient require counseling regarding adherence to medical prescription irrespective of the nature of the disease

Role of antiprogesterone on the endometrium receptivity- a review

Estrogen produces proliferation in the functional layer of the endometrium and the differentiation in the ciliated and secretory epithelium of the uterine tube. Progesterone produces differentiation in the functional layer of the endometrium and the produces mitosis in the stroma of the endometrium. These effects of the estrogen and progesterone are mediated through interactions with specific intracellular receptors1. Mifepristone [RU 486] is a steroid hormone with a chemical structure similar to natural hormone progesterone. It has been proposed that antiprogestins may be useful in the treatment of endometrial inflammatory disease and carcinoma +breast because these conditions are dependent on the ovarian receptors and have receptors for estrogen and progesterone. Anti-progesterone compounds can antagonize the biological action of the progesterone or inhibit the synthesis of progesterone. Mifepristone, [RU 486] has been found to be the most effective and is now used in practice

Pattern of injuries in police torture victims at Faisalabad

To examine the different type of injuries after police torture. Torture study. Office of District Standing Medical Board, in DHQ Hospital Faisalabad. From 1.1.2009 to 31.12.2009. A study of 300 victims of alleged police torture examined by the District Standing Medical Board [DSMB] Faisalabad. Most of the victims at the time of examination were showing visible evidence of Physical trauma. Victims were males. Examination was conducted on the directions of judicial magistrates and District and Session Judge Faisalabad. A wide range of different types of injuries was observed on various parts of the body. Blunt trauma was most frequent. Psychological element of torture was also seen in some victims

Neonatal outcome with instrumental vaginal delivery: a study at PNS Shifa

To evaluate neonatal outcome in terms of Apgar score after forceps and ventouse delivery in pregnant ladies indicated to have instrumental deliveries. Randomized control trial. This study was conducted at Labor ward of department of obstetrics and gynecology, PNS SHIFA Karachi, between Dec 2007 to Mar 2008. The target population were all pregnant subjects who visited labor room for delivery. Out of these patients, subjects who were indicated an assisted vaginal delivery for necessary management of labor were formally requested to participate in the study after various exclusions. Instrumentation was done in only those patients with singleton term pregnancy with cephalic presentation and vertex at + 1 to +3 stations. Patients with an indication for assisted vaginal delivery [n=105], were randomized for ventouse [n=53] and forceps delivery [n=52]. Instruments used were Wrigley's outlet forceps and vacuum extractor [V.E] with silicone cups. Data was recorded on specially designed Proforma. Post delivery neonatal outcome in terms of Apgar score at one minute and five minutes were compared between two modalities. The subjects undergoing forceps delivery had a significantly higher Apgar score [8.36 +/- 1.27] at 1 minute in comparison to those subjected to vacuum delivery [7.53 +/- 1.56]. The differences in Apgar score at 5-minutes [forceps delivery: 9.136 + 1.01 vs vacuum delivery 9.00 + 1.19], were not statistically significant. Outlet forceps assisted vaginal deliveries had better neonatal outcome in terms of Apgar score in comparison to ventouse

Firearm wounds; study of morphology caused by rifled weapon

To study the different changes occurring at cellular level in firearm injuries from near to distant shots. A prospective Study. Khyber Teaching Hospital Peshawar and B.V Hospital Bahawalpur. Bodies presenting for autopsy within 12 hours after firearm injury were included. Wounds expressing maximum details were selected for study. Tissue samples were taken from wounds and preserved in 10% formalin. Sections were taken and slides were stained with Harris Haemotoxylin. Olympus P-6 was used for photography and Nikon [FE-2 body] for gross and microscopic photography. The morphology at cellular level was variable according to the distance of fire. Marked distortion and streaming of nuclei was more pronounced and evident in close contact wounds. However changes were less pronounced with the increasing distance. Section of exit lesion reveled splitting between dermis and epithelium. Further in this study rifle fire fatalities were maximum [53.33%] and distant shot fatalities were predominant [73.33%.]. Microscopy can also be used as an additional tool to differentiate between entry and exit wounds and for estimating range of fire

Evaluation of fasting and random plasma glucose for diagnosis of gestational diabetes

To compare different cut-off values of fasting and random plasma glucose as a screening test for diagnosis of gestational Diabetes in comparison to the 50 grams Glucose Challenge Test [GCT]. Comparative, cross-sectional study. This study was carried out between July 2006 to September 2007 at Departments of Pathology, Obstetrics/Gynaecology and Medicine, PNS Rahat Hospital, Karachi. A total of 53 pregnant subjects at 24-28 weeks of pregnancy were selected to undergo random and fasting blood sugar level estimation and 50-g GCT. All the subjects later underwent 100-g OGTT as well. The results were evaluated by both "Carpenter and Coustan criteria" and "NDDG criteria". The results of random plasma glucose random [cut-off: >/= 11.1 mmol/L], fasting plasma glucose [cut-off: > 5.3 mmol/L and > 5.1 mmol/L] and plasma glucose results post 50-g GCT [cut-off: >/= 7.8 mmol/L and >/= 7.2 mmol/L] were evaluated against 100-g OGTT results through ROC curve analysis. Finally, various diagnostic parameters including sensitivity, specificity, predictive values, likelihood ratios [LR] and efficiency were evaluated. Nineteen subjects were diagnosed to have GDM as per the "Carpenter and Coustan criteria" and 13 met the "NDDG criteria" as per the results of 100-g OGTT. Fasting plasma glucose at was the most efficient investigation at cut- off of 5.1 mmol/L sensitivity=66.66%, specificity=81.25%, PPV=70%, NPV=78.78%, LR+ =3.56, LR- =0.41, efficiency=75.47%. At the cut-off value of 5.3 mmol/L, the results had 64% sensitivity, 85.71% specificity, 80% PPV, 72.72% NPV, 4.48 LR+, 0.42 LR-, 75.97% efficiency]. It was followed by plasma glucose post 50-g GCT [53.57% sensitivity at cut-off of >/= 7.2 mmol/L and 54.54% sensitivity at cut-off of >/= 7.8 mmol/L]. Fasting plasma glucose is a better investigation for the screening of gestational Diabetes than plasma glucose post 50-g glucose challenge