Renal profile in cases subjected to blunt trauma

To study the occurrence of renal failure in cases subjected to blunt trauma. Analytical study. This study was carried out at the Medico-legal clinic, Services Hospital, Lahore from January to December, 2007. The study was based upon 50 cases of blunt trauma reporting at Medico-legal clinic, Services Hospital, Lahore. Twenty normal healthy controls were taken for comparison purposes. The cases were clinically examined for presence of evidence of trauma. Urine and blood samples were taken for estimation of blood urea, creatinine, potassium and calcium. There were 47 males [94%] and 3 females [6%]. The age of the subjects ranged between 18-70 years with mean of 30.9 +/- 12.34, maximum number [62%] below the age of 30. The injuries found were abrasions / bruises in 45 cases [90 %], lacerated wounds in 5 cases [10%]. In most of the cases [40%] injuries were distributed in more than one body region. As single area involvement the head and face area was affected in one case [2%], chest in 4 cases [8%] and limbs in 25 cases [50%]. The most commonly involved areas were buttocks, thighs, back of chest. Twenty nine cases [58%] reported for examination within 24 hours. Thirteen cases [26%] reported between 24-48 hours and 8 cases [16%] reported between 48-72 hours after being traumatized. Urine Examination showed yellow colour in 44 cases [88%] and brownish red in 6 cases [12%]. Specific gravity ranged between 1010-1030 with mean of 1020.6 +/- 6.59. It was between 1010-1019 in 14 cases[28%], 1020-1029 in 27 cases [54%] and 1030-1039 in 9 cases[18%]. pH ranged between 5 - 8 with mean of 5.8 +/- 0.75. It was between 5 - 5.9 in 7 cases[14%], between 6.0 - 6.9 in 27 cases [54%], between 7.0 - 7.9 in 14 cases [28%] and 8.0 and above in 2 case [4%]. In control group it ranged between 6.0 - 7.0 with mean of 6.4 +/- 0.50. Blood was positive in 7 cases [14%], and negative in 43 cases [86%]. Microscopic Examination of urinary sediment showed pus cells 0 - 5 /HPF in 35 cases [70%], and above 5/PHF in 15 cases [30%]. The red blood cells were present in 15 cases [30%]. Calcium oxlate crystals were found in 39 cases [78%], triple phosphate in 5 cases [10%]. In 6 cases [12%] no crystals were found. The cellular casts were present in 6 cases [12%]. In blood examination blood urea ranged between 15.5 - 86.0 mg/dl with a mean of 43.54 +/- 15.06 . The blood urea was above reference range in 7 cases [14%]. Blood Creatinine ranged between 0.5 - 2.6 mg/dl with mean of 0.97 +/- 0.47. The raised blood creatinine was found in 7 cases [14%]. These cases are the same cases which have raised blood urea. Serum Potassium ranged between 3.2 - 5.9 mmol/dl with mean of 4.45 and S.D. 0.78. It is above reference range in 9 cases [18%]. In cases with raised blood urea and creatinine it was raised in all cases. Serum Calcium ranged between 5.6 - 10.74 with mean of 8.84 +/- 1.01. The hypocalcaemia was seen in 25 cases [50%]. In the cases with raised blood urea and creatinine the calcium was low in all cases. In our study 14% cases have shown the evidence of renal function derangement. The cases subjected to blunt trauma are at threat to develop renal failure particularly in cases with dehydration and acidosis

Firearm injuries pattern in cases autopsied at district head quarter hospital Kasur

In the recent years the fire arm possession and its use in violence has superseded many times the conventional means used even in rural setup. This study was conducted to know the pattern of injuries in fire arm related deaths, the prevalence of firearm weapons used in violence and the time interval the victim survived after sustaining injuries in such incidences. Observational study. This study was conducted at DHQ, Hospital kasur during the period from 1[st] January 2008 to 31[st] December 2010. This study includes 199 cases where death was due to some fire arm weapon out of total 451 cases autopsied at district Head Quarters Hospital kasur. The rate of fire arm related deaths during this period was 44.12%. Males accounted for 80.90% and females were 19.10%. In 60.30% cases death took place immediately after sustaining injuries, in 26.63% it was within minutes and in 3.51% the victim survived for hours after being injured. In 9.51% cases the victim remained admitted in hospital and died there due to some injury related complications. An interdisciplinary approach is required to control fire arm weapons possession, to educate the masses especially youngsters about sanctity of human life and how to control the nerves during period of mental irritability and instability

Lethality of suicidal organophosphorous poisoning in Karachi in 2010

The study was aimed to evaluate the cases of suicide using organophosphorous compounds as intoxicant with the objective to bring up possible preventive measures based upon modifiable factors associated with lethality. Cross-sectional analytical Study. This retrospective study was based upon 66 patients of poisoning treated at intensive care unit of Ward No.5, JPMC Karachi during a period of one year from January 2010 to December 2010. Out of total 66 cases of poisoning 38 were of organophosphorous compounds [OPC] poisoning, 20 males and 18 females. Most of the cases [63%] of OPC poisoning were in age range of 20-40 years, 33 [86.84%] were of suicidal poisoning while 5 [13.16%] had accidental poisoning and 57% reported to treatment facility within 6 hours. All the cases of OPC poisoning had severe symptoms with fatal out come. Suicidal ratio was quite high. The period between the ingestion of poison and initiation of treatment plays vital role. In order to reduce fatality rate urgent intervention is required by government by improving the treatment facilities at local level hospitals i.e. primary health care centres and banning of highly toxic organophosphorous compounds. Additional measures which can help include improving the public awareness regarding recognition of toxic symptoms and importance of prompt referral to an appropriate facility

break up of autopsies conducted at district head quarter hospital Kasur

This is the first time study to find out the cause and manner of death through medico-legal autopsies in a small district comprising municipal boundaries and rural setup [District Kasur] and comparing it with urban studies conducted by the Forensic Medicine Departments of various medical colleges. This study is also aimed to assess the criminal behavior in this segment of society. Observational Study. This study was conducted at District Head Quarter Hospital Kasur from 2008 to 2010. This study was carried out on 451 medico legal autopsies performed at District Head Quarter Hospital Kasur. The findings were extracted from autopsy reports, chemical examiner reports, relevant hospital record and police documents. The cases were examined for various characteristics like cause and manner of manner of death, age and sex of victim and condition of body at the time of autopsy. The results revealed that homicide was the most common manner [82.26%] among unnatural deaths and males became three times more victims than females. The most vulnerable age group in unnatural deaths were from 15 to 45 years [77.39%]. In 44.12% cases firearm is the weapon responsible for death. Regarding condition of body at autopsy, 364 [80.71%] bodies were in fresh condition. Medico legal autopsy rate reflects the incidence of crime and criminal behavior of that segment of society. Compared with more civilized societies the crime incidence in our society is very high. In order to control it, we need to change the behavior of society through improvement in literacy rate, socioeconomic status and law and order situation. In order to improve the quality of medico-legal reporting there is need to strengthen the expertise in forensic medicine both at urban and rural level

epidemiologic profile of homicidal deaths in Karachi

The study was planned to review the epidemiologic profile of homicidal deaths in Karachi. Observational study. Since Jan. 2009 to June 2009 and place of study was the Department of Forensic Medicine and Toxicology of Jinnah Postgraduate Medical Centre [JPMC], Karachi. 1'wo hundred and ninety seven cases were included in the study. The data was collected by reviewing the police papers and autopsy repons. The parameters recorded were age, sex, manner of death, type of weapon used, part of the body involved, time of death and location of fatal wound. During the study period there were 297 cases of homicides, out of which 259 [87.2%] were firearms related homicides and majority of victims were males [75.4%] and most of them were between 21 to 30 years of age [39.5%] Most of the crimes occurred during night hours [59, 5%] and head injuries were most common [49.8%]. The firearms related homicides are highest in number, the reason being easy access to firearm weapons. Further studies and effective intervention strategies are needed to be employed to reduce the occurrence of homicides. The situation demands a strict control on firearms by government

Comparative study of hypochromic microcytic anaemia in primigravida and multigravida in interior Sindh

To evaluate the frequency of hypochromic microcytic anemia commonly due to iron deficiency in female primgravida and multigravida patients. This also entails comparing both groups in the context of hemoglobin, MCV and RDW as study tools. Cross sectional analytical study. This study was conducted at the Obstetrics Department, Peoples Medical College Nawabshah from July 2008 to Oct 2008. This cross sectional study was carried out on 200 women [100 primigravida and 100 multigravida] with anaemia in their third trimester of pregnancy attending the Obstetrics Department, Peoples Medical College Nawabshah from July 2008 to Oct 2008. Hemoglobin, MCV and RDW levels were assessed in all cases. Data was analyzed using SPSS and students t test was used for evaluation of significance. Mean Haemoglobin +/- SD in Primigravida [Group A, n=100] and Multigravida [Group B, n=100] were 7.85 +/- 1.33 and 6.26 +/- 1.65 with ranges 3.1-10.9 and 3.2-10.4 gm/dl respectively. Mean MCV +/- SD in Group A and B were 63.95 +/- 4.71 and 62.08 +/- 4.97 with ranges 54.4-73.7 and 48.2 -73.7 fl respectively. Mean Red Cell Distribution Width [RDW, SD] +/- SD in Group A and B of anaemic patients were 19.83 +/- 3.05 and 21.31 +/- 3.32 with ranges 14.0-27.4 and 14.0-29.2 x 10[3] /micro l respectively. The results were significant in both groups. In Interior Sindh both primigravida and multigravida females are at high risk of developing iron deficiency anaemia and more so in multigravida. Aggressive health measures need to be taken to control this major health problem in Interior Sindh in particular and in the country as a whole especially in remote areas by promotion of regular consumption of food rich in iron and folates. The identification and treatment of severely anaemic patients with provision of iron supplement, improving personal hygiene, pure water supply and early antenatal diagnosis and follow up can decrease the prevalence of anaemia in pregnant women nationally and internationally. Need of the days remains the preparation and implementation of national nutrition plan with a special emphasis of controlling iron deficiency anemia during pregnancy

Road traffic accidents fatality and disability in D.I. Khan N.W.F.P

Road traffic accidents are important cause of death and disability in the world. More than 3000 people die on road everyday and 10 million are disabled or injured every year. The present study is an attempt to visualize the menace in D.I. Khan. The study is based upon the data of autopsies and medico legal cases examined at DHQ Hospital, D.I. Khan and Forensic Medicine Department of Gomal Medical College, D.I. Khan during year 2007 and 2008. The data was analysed for assessment of traffic accident victims. During period of study 341 cases of unnatural deaths were subjected to autopsy examination. Out of these 59 cases [22.7%] were of accidental deaths and all were male. A total of 225 injuries were recorded. The head and face sustained the highest number of injuries [42.6%] followed by the lower extremities [21.8%]. The total no. of Medico legal cases was 2153 and out of which 495 [23%] were injured due to accidents. Majority were males [99.4]. A total of 1208 injuries were found in various body areas. The maximum number of injuries [39.4%] was on head and face and next were lower extremities sustaining 28.4% injuries. The situation is alarming one and it requires immediate measures to be taken for ensuring safe traveling. Accidental death and disability can be minimized by improving roads condition, making separate pathways for cyclists and motor cyclists and adopting precautionary measures during driving

Frequency of negative autopsy and their demographic evaluation at Khyber medical college, Peshawar

This study was planned to see the frequency of negative autopsy against the total autopsies performed during the period. This descriptive study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar and was based upon autopsy data of 10 years with effect from January 1997 to December 2006. In this study fresh or minimally decomposed bodies with no external or internal injury were included. In cases where gross examinations, microscopic examination, toxicological analysis failed to detect the cause of death were labeled as negative autopsies. In a total of 7082 autopsies, 103 [1.45%] autopsies were found to be negative. Out of these negative autopsies, 89 [86.40%] were males and 14 [13.60%] were females. The age of deceased ranged from 6-75 years with mean age of 43.81 +/- 16.95 years. Majority i.e. 17 [16.5%] were in the age range of 31-35 years, followed by 15 [14.5%] in the age range of 51-55 years. Ten [9.7%] were in the age range of 46-50 years and 21-25 years each. Among these negative autopsies, 66 [64.1%] were from urban and 37 [35.9%] were from rural areas of district Peshawar. Majority of negative autopsies were of young male persons from urban areas. Negative autopsies need further studies to look for possible reasons like inadequate training of doctors performing the autopsy or limited resources like availability of histopathalogical or analytical services etc