Death in the home: domestic violence against women in Khyber pakhtunkhwa

Domestic or Interpersonal Violence [IPV] remains a major global problem often resulting in morbidity and mortality. The present study was conducted to determine the scope of deaths related to domestic violence in the Khyber Pakhunkhwa province, Pakistan. Data were collected on all reported female fatalities due to domestic violence for the years 2009-2011 from the records of the department of Forensic Medicine, Khyber Medical College Peshawar for analysis. A total of 305 deaths were reported, showing an increasing trend of 115 deaths for 2009-10 and 190 deaths for 2010-2011. The majority, 182 [59.7%] belonged to the rural areas and 123 [40.3%] to urban areas of the province. Victims were generally of the younger age groups [17% below age 16 and 42.3% between 17-32 years]. Homicide was the manner of death in 293 [96.1%] while the most common causative agent was firearm injury [235, 77.1%]. Head and neck injuries were most common [52.6%] followed by the chest and abdomen [31.6%] while multiple sites and extremities accounted for 15.8% of injuries. Young and adult females of KPK province of Pakistan are susceptible to homicidal deaths due to domestic violence, perpetrated through firearm injuries to the head and neck regions.

Crime related use of benzodiazepine in district Peshawar

The number of reported crime in which the victims were first rendered unconscious, lacking awareness of his or her surrounding and later the planned crime ensued. Blood and urine samples were collected and tested for sedative hypnotics at the toxicology lab. The specimens, all of them were tested positive from benzodiazepine. Cross Sectional study. This study was conducted at Toxicology Laboratory, Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar from 01.01.2010 to 31.12.2010. The study was conducted on 77 samples of urine and blood obtained from the victims who were brought over by police to the tertiary care hospitals in district Peshawar. The procedure to find out the exact subtype was with the help of High Performance Liquid Chromatography [HPLC] in the Toxicology Laboratory. The chemical analysis revealed that all the samples obtained from the victims carried Clonazepam a subtype of Benzodiazepine. Easy availability of benzodiazepine and other narcotic analgesics across the country renders these technically dangerous medicines into the hands of criminals resulting in heinous and monstrous consequencesry renders these technically dangerous medicines into the hands of criminals resulting in heinous and monstrous consequences

Gastroenteritis exhumed

Nature of presenting symptoms and even signs of disease can lead to a diagnosis that seems routine but is in fact erroneous because a sufficient index of suspicion is not generated in the mind of the physician dealing with the case. A young girl of about 16 years was brought to the Casualty Department, DHQ Hospital Bannu on 12 Sep 2004 with complains of severe vomiting and diarrhoea; the casualty medical officer diagnosed her as a case of acute gastroenteritis

Morbidity and mortality of firearm injury in Peshawar region

Firearm injuries cause significant morbidity and mortality among its victims. The present study, carried out at a major tertiary care hospital of Peshawar, Pakistan was aimed at highlighting the extent and severity of firearm-related morbidity and resultant mortality despite expert medical care. All victims of firearm injury brought to the Lady Reading Hospital Peshawar Emergency Department and thereafter admitted to hospital wards during the period mid-2006 to mid-2007 were included in the study prospectively regardless of age, gender or socio-economic status. Data relevant to the background of firearm use, type of firearm used, types and extents of injuries, clinical condition of the patients and final outcome were collected on performas and entered into SPSS 15.0 for analysis. Seventy-four cases of firearm injury were recorded during the study period, with a predominant male to female ratio [9.6:1]. Most victims [79.7%] were in the age group of 15-35 years. Although there were more cases from Peshawar [28.4%], there was no major referral pattern noted. High velocity weapons were used in 95.9% of cases and homicide was the main motive for injury [60.8%]. Injuries were sustained most frequently in the abdomen and pelvis [44.6%] and 67.6% of victims sustained internal injuries. There were only 5 [6.8%] deaths from firearm injuries. It is concluded, the young males of the population must be targeted for lifestyle adjustments such as training to refrain from anger or disputes [usually over petty things] and to prevent the easy access of firearms as a weapon to settle disputes

Trauma management in a tertiary care hospital in Peshawar, Pakistan

With an increasing incidence of road traffic accidents and weapon injuries there is increasing need for improvement in trauma management. Liver being a highly vascular organ and strategically located is difficult to manage. Study was conducted in Surgical 'A' Unit, Lady Reading Hospital, Peshawar from August 2003 to September 2005. It was a descriptive study and all patients were operated in emergency department. All relevant data of patients were recorded from the emergency and admission protocols. A total of 364 trauma patients were received and among those 48 patients had liver trauma, 75% of patients had penetrating and 25% had blunt trauma. Most of the patients had grade III liver injuries. There were no grade V and VI injury. Repair with perihepatic packing for liver injuries remains the most frequently performed procedure [41% of patients]. In a stable patient blunt trauma liver can be managed conservatively by serial examinations and investigations with emergency laparotomy facilities at hand. Perihepatic packing and damage control surgery is the valuable procedure at hand. Increasing grades of liver injuries leads to increasing morbidity and mortality. The same is the case with multiple organ injuries

Homicidal deaths by firearms in Peshawar: an autopsy study

Medico legal autopsies can be valuable sources of information about the distribution of causes of reported deaths, particularly in homicidal cases. The present study provides information regarding the homicidal deaths due to firearm injuries in the district of Peshawar, NWFP, Pakistan. This descriptive study was conducted over the period of the year 2004. Data were collected from the autopsy records of the Department of Forensic Medicine, Khyber Medical College Peshawar and included all reported unnatural deaths from urban and rural areas of district Peshawar on whom autopsies were conducted in the department. Homicidal deaths constituted 77.7% [492/633] of all autopsies for the year 2004. Of 492 homicidal deaths, a vast majority of 452 [91.87%] were caused by firearm injuries. Among these, the male to female ratio was 5.5:1. The most common firearm weapon [418/452, 92.5%] were high velocity rifled weapons [Kalashnikov, rifles, pistols], followed by low velocity rifled weapons [18/452, 3.98%] and shotguns [16/452, 3.54%]. A total of 956 injuries were found in various body areas, giving an average of over two injuries per person. The head, face and neck sustained the highest injuries [257, 26.9%], followed by the chest [248, 25.9%] and abdomen [149, 15.6%]; the extremities, buttocks and genitalia together sustained 302 [31.6%] injuries. The vast majority of reported homicides in Peshawar are caused by firearm injuries, which bring up issues related to possession of firearms and changes in cultural attitudes towards use of firearms, if a decrease in firearm-related homicides is desired

Spectrum of forensic toxicological analysis at Khyber Medical College Peshawar

To see the common types of poisonings reported to the forensic toxicology laboratory at Peshawar, NWFP, Pakistan. The study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College Peshawar where records of toxicological analyses for the year 2004 were obtained. A total of 152 toxilogical analyses were done in a year. Of the total 68 samples were from autopsy cases and 84 from suspected cases of alcohol intoxication. Poisons of various types were detected in 32/68 [47.%] autopsies, while alcohol was detected in 56/84 [66.6%] cases of intoxication. All cases were males and sedative/narcotic drug abuse was the most common cause of death by poisoning [68.7% of fatal poisonings]. Majority of alcohol intoxication cases [92.86%] were referred from hospitals of Peshawar rather than police stations. Poisoning and alcohol abuse constitute a significant health hazard and cause for public concern. Informed interventions are recommended to address the problem

Homicide in Abbottabad

Homicide is one of the oldest crimes in human history. Although a large number of dimensions have been added to this crime, the age-old factors like revenge, rage, jealousy and honour persist even today. This study was conducted jointly at the attached hospitals of Women Medical College and Ayub Medical College, Abbottabad to know the various dimensions of the victims of homicide. The present study encompasses all 40 cases of homicide, which presented for autopsy at DHQ hospital and Ayub Medical Complex Abbottabad during the year 2002. The manner of death was categorized as homicide on the basis of police inquest and the autopsy findings. The homicide rate in Abbottabad was found to be 4.22/100,000 per year. Males were the primary targets usually in their prime of youth with 40% victims between 20-29 years. Firearms formed the major weapon of offence. Most victims died before reaching the hospital. Deaths were more common during the daytime and in summer months. Homicide rate is on the lower side in Abbottabad amongst places where firearm possession is not strictly controlled, but can be further reduced. Limiting firearm possession alone can go a long way in this goal