Renal Pathologies in Medicolegal Autopsies (150 Cases)

The autopsy has for long been regarded as the gold standard as the most important tool for retrospective quality assessment of clinical diagnosis as well as a key education tool. In autopsy the kidneys are examined for disease, injury and other findings suggesting cause of death or related changes. Grossly some of the diseases may be easily noted on autopsy. Since kidney biopsy is usually avoided in critically ill patient ,histologic evaluation of autopsy of kidneys may be the first and the only opportunity to identify these diseases. Objectives: 1) To study the pattern of histological findings in kidney in minimum 150 autopsy cases based on the material received in Pathology department, GMC, Patiala. 2) To study the latent form of the disease, which couldn’t be diagnosed in lifetime, whenever full data is available. 3)To establish the exact cause of death on renal autopsy findings, wherever possible. 4) To find discrepancy with clinical diagnosis if the data are available. Methods: The present study is an observational study that was conducted over a period of two years. Postpartum renal specimens were received from August, 2016 onwards with a total of 150 cases. The specimens were preserved in 10% formalin immediately after autopsy and were received in fully sealed jars. A thorough gross examination of renal specimens including measurements, weights, consistency, cut surface, details of any lesions if preserved were recorded. Subsequently samples were processed for histopathology. The sections were thoroughly examined microscopically on 4x, 10x, and 40x power of the microscope for any pathology and the results were recorded. Results: In 57 cases (38%) microscopic findings were close to normal histology with no nephropathological diagnosis. 68 cases with tubular and interestial pathology included 43 cases of acute tubular necrosis (28.6%), 3 cases with acute pyelonephritis(2%), 2 cases with chronic pyelonephritis(1.3%) and 20 cases were noted to have cloudy swelling in the tubule(13.3%). Conclusion: In the present study majority of renal autopsies revealed histopathological pattern suggestive of tubular pathologies of which most common was acute tubular necrosis as a cause of sudden collapse of patient leading to death.

A review of pedestrian traffic fatalities.

Pedestrians injured in automobile accidents constitute one of the most frequent serious problems in management for emergency room surgeons. The incidence of deaths in pedestrians is significantly higher than in other road users. This study attempted to analyse the pattern of injuries sustained by 129 pedestrians in road traffic accidents. It was found that the pedestrians were the commonest group of victims involved in fatal road accidents comprising 28.7% of all cases. 83.7% cases were males. There were two peaks of incidence in relation to age; one at childhood (20.9%) and the other in elderly (19.37%). Cars and heavy vehicles were the commonest offending agents comprising 41.9% and 31.8% respectively. The pedestrians themselves were at fault in 43.4% cases. Head injury was seen in 80% cases; followed by lower limb fractures (42.6%), and chest injury (38.8%). The cause of death was head injury in 56.6% cases followed by thoraco-abdominal injuries in 8.5% cases and multiple injuries in 7.8% cases.

Trends of suicides in north eastern rural Haryana: A retrospective study.

Suicide patterns and rates differ in various populations and cultures. It is known that in most countries that have been studied, more than 90 percent of those who commit suicide have a mental disorder. This behavior, although often triggered by external factors, occurs in vulnerable individuals who have a neurobiological and often familial predisposition. Suicides in rural India are attributed mostly to crushing financial pressures on farmers. Indebtedness, crop failure and the inability to pay back loans due to high rates of interest have led as many as 25,000 peasants in India to commit suicide since the 1990s, according to official figures. The present study was designed to investigate the different methods of self-destruction, age and gender susceptibility to suicide, the groups particularly affected and the underlying motivating factors for such an extreme step among rural North Eastern Haryana people. Various suggestions relating to decreasing the tensions of modern life, proper use and storage of agrochemicals and financial improvement of farmers have been put forward.