Spectrum of firearm related deaths in multan city: autopsy based study

Background: Excessive use of the firearms causing severe and lethal effect to the victims and their families, delivery of health care and judicial system as well as society where they live. The easy availability of guns has increased the firearm fatalities, especially in developing countries

Objectives: To study the pattern of lethal firearm injuries, in Multan city with special reference to the regions of the body affected, seasonal variation and vulnerable age group

Study design: Retrospective study

Setting and duration: The study was carried out by examining the record of all medicolegal autopsies conducted in the department of Forensic Medicine, Nishtar Medical College Multan during calendar year 2016. Only cases of firearm related deaths were selected for detailed examination and those died of other than firearm injuries were excluded. The reports were studied in relation to Age, types of firearm used, Gender, seasonal variation and regions of the body involved

Results: During 2016, out of total 197 medicolegal autopsies, 77[39.08%] died of firearm injuries and out of those, male victim were 67[44.66%]. The most vulnerable age was 19-40 yrs [45.45%]. Male female ratio was 6.4:1, the chest being the commonest targeted area was38.96%, while during the months of July and August highest incidence of deaths due to firearm observed [15.57%]

Conclusion: The young males are the most common target and the leading cause of death was the injuries on the chest. There is need of strict implementation of law regarding possession of firearm and improvement in socioeconomic conditions of the individuals

Bacterial isolates of infected wounds and their sensitivity to antibiotics

Background: Infection of the wounds has got definite role in delaying wound healing and development of chronicity. Various studies have been carried to identify and study the pattern of pathogens present in infected wounds and efficacy of antibiotics against these organisms

Objectives: To identify the most common pathogens involved in infections of the wounds after surgical procedures, patterns of their sensitivity and resistance to the different antibiotics

Setting and Duration: The study was carried out in Surgical Unit [3] of Lahore General Hospital, Postgraduate Medical Institute [PGMI] Lahore for the period of Six months from October, 2016 to March, 2017

Methodology: Wound swabs were collected using sterile cotton swabs after obtaining consent from patients. The isolated samples were identified by using standard parameters. Kirby baur disk diffusion method used to determine sensitivity. Tube dilution method was used for minimum inhibitory and bactericidal concentration

Results: Total 150 bacterial isolates were collected from infected wounds whereas 145[96.67%] were culture positive and 5[3.33%] were bacteriologically sterile. The most common bacteria were Staphylococcus aureus 47[32.4%] followed by Escherichia coli 29[20%], Proteus species 23[16%], Coagulase Negative Staphylococci 21[14.5%], Klebsiella pneumoniae 14[10%] and Pseudomonas aeruginosa 11[8%]. All isolates showed high frequency of resistance to Ampicillin, penicillin, cephalothin and tetracycline

Conclusions: Staphylococcus Aureus has been found as the most common pathogen involved in wound infection. The antibiotics belonging to the group of Cephalothin, Ampicillin, Penicillin and Tetracycline are the least effective against pathogens isolated from infected wounds whereas Piperacillin alongwith Tazobactum; Amikacin and Norfloxacin are the most effective antibiotics against those pathogens