Preoperative risk factors and incidence of glaucoma after penetrating keratoplasty.

Glaucoma following penetrating keratoplasty is one of the serious complications due to its frequency of occurrence, difficulty in diagnosis and management, risk of graft failure and irreversible visual loss due to optic nerve damage. The incidence of glaucoma after keratoplasty varies from 9% to 31% in the early postoperative period and from 18 to 35% in the late postoperative period. The aetiology of this disorder is multifactorial and the clear understanding of the various mechanisms that operate during different time frames following penetrating keratoplasty is essential to chalk out the appropriate management algorithms. Methods: Prospective analysis of 100 consecutive eyes which underwent penetrating keratoplasty during the period from September 2009 to December 2010 at Bangalore West Lions super speciality eye hospital was done. The patients were followed up for a minimum period of 9 months. Results: Out of 100 patients mean age distribution was 47 ± 11 years. Of the 100 patients male 68% and 32 female (32%). Out of 100 eyes 38% of them had vision <6/60, 36% of them had vision between 6//36-6/18 and 26% of them between 6/18-6/6. Raised intraocular pressure was found in 15 out of 100 eyes. Mean raise in intraocular pressure was 29 mmHg ± 1.5 mmHg. Out of 15 patients 4 were steroid responders. Mean time of diagnosis of raised intraocular pressure was 5 ± 9.5 months. Pseudophakic Bullous Keratopathy (PBK) in 5 (33.3%) patients, aphakic bullous keratopathy (ABK) in 3 (20%) patients, graft rejection in 2 (13.3%) patients and one each patient (6.7%) of corneal scar, adherent leucoma, chemical injury and congenital hereditary endothelial dystrophy. Aphakic group was at higher risk compared to the other groups and there was not much difference between the phakic and the pseudophakic group. Conclusions: Post penetrating keratoplasty glaucoma continues to be a clinical problem that can be sight threatening in its clinical outcome. It is mandatory that intraocular pressure is monitored on a regular basis. Recognition of the risk factors namely, indications, graft size, lenticular status & associated surgical procedure with penetrating keratoplasty would help in early diagnosis of post penetrating keratoplasty glaucoma. Most of these cases are amenable to medical management.

Estimation of stature from index and ring finger length in Davangere district.

Estimation of stature plays a special role in the field of forensic medicine and forensic anthropology. Present study was designed to investigate the ability of estimating stature from right index and ring finger length. Methods: The study was carried out by taking the measurement of index and ring finger length of right hand and individual’s actual height of 250 medical students (125 males and 125 females) of 18 to 25 years of age. The study was carried out in department of forensic medicine and toxicology at SSIMS & RC Davangere, Karnataka state, India. Obtained data was analysed statistically to establish the relationship between a person’s index and ring finger length of right hand and stature. Results: Regression equation and ‘P’ values were obtained. A moderate correlation was observed between index and ring finger length of right hand and calculated height of an individual which is statistically highly significant. Conclusion: The present study would be useful for anthropologists, Investigating Officer (IO) and forensic experts.

Estimation of stature from shoe print length while walking in females.

In Forensic Anthropology, estimation of stature from feet dimensions plays an important role in establishing individual’s identity. The foot length reflects a biological correlation with height suggesting that height may be estimated from shoe print length also. Various anthropometric studies have been conducted on foot in relation to growth and development, ergonomics, evaluation, orthopedics and other medical sciences. However, there is only little investigation, which focused on forensic importance of shoe print. Analysis of shoe prints can reveal very important clues, which can be used as forensic evidence in crime scene investigation. To study the relationship between Stature and Shoe Print length while walking, total 500 females from Karnataka in the age group of 18 to 21 years were examined. The stature estimation was done with linear and multiple regression equations. Recorded shoe print length was measured along parallel axis. The multiplication factors were also computed. The regression formula was checked for their accuracy and reliability. Highly significant and positive correlation was observed between stature and Shoe Print length while walking.

Forensic view on aluminium phosphide poisoning.

In India, acute aluminium phosphide poisoning (AAlPP) is a serious health care problem. This study aimed to determine the characteristics of AAlPP and the predictors of mortality at the time of patients' admission. We studied consecutive admissions of patients with AAlPP admitted to the intensive care unit (ICU). We noted 38 parameters at admission to the hospital and the ICU and compared survivor and non-survivor groups. A total of 54 patients were enrolled comprising 10 females and 44 males and the mean ingested dose of poison was 0.75 ± 0.745 grams. The mortality from AAlPP was 59.3%. We found the following factors to be associated with an increased risk of mortality: a serum creatinine concentration of more than 1.0 mg % (P = 0.01), pH value less than 7.2 (P = 0.014), serum bicarbonate value less than 15 mmol/L (P = 0.048), need for mechanical ventilation (P = 0.045), need for vasoactive drugs like dobutamine (P = 0.027) and nor adrenaline (P = 0.048) AAlPP causes high mortality primarily due to early haemodynamic failure and multi-organ dysfunction.

Alcohol and crime behaviour.

Alcohol use has been shown to be associated with High Risk Behaviour (HRB). However, the exact nature of this association remains to be clarified. 100 male patients admitted with an ICD-10 diagnosis of Alcohol Dependence Syndrome (ADS) were studied using both self-report and semi-structured interview. The data was analysed using an Event- analysis technique for the occurrence of HRB, namely Road traffic Accidents, Crime and Violence, Self-injurious behaviour and risky Sexual behaviour. Personality variables were studied using the Sensation Seeking Scale, Form V, Indian Adaptation and Barratt‟s Impulsivity Scale, version 11. Data was analysed using SPSS, with Independent t-test, chi square and logistic regression. Out of the 100 patients studied 64 of the sample were exposed to HRB. Analysis of the data found evidence that Severity of Dependence, Personality Constructs of Sensation Seeking and Impulsivity, and lower Educational status showed significant association with HRB. On logistic regression analysis Lower Educational Status, Sensation Seeking Scores and Severity of Alcohol Dependence were found to predict H R B. The occurrence of HRBs was substantial among patients with ADS, with majority of them involved in road traffic accidents.

Suicidal acid injury: A case report.

Deaths from exposure to caustic substances are infrequently reported in the Forensic Medicine literature. A case of death due to Sulphuric acid ingestion in a patient of Major Depressive Disorder is being reported. This patient was planned for Electro-convulsive therapy, prior to the procedure he had been to bathroom. And when planned to prepare for the procedure on the ECT table, his mouth has smell of pungent odour. This made the psychiatrist to withhold the procedure and subjected him for observation. Later he complained of severe chest pain and restlessness, for which he has been shifted to emergency ward with possible precautions taken before shifting. He was provisionally diagnosed of acid ingestion but there was no history either from patient or from his relatives, as patient has consumed in the bathroom just before the Electro convulsive therapy. Diagnosis was confirmed only after autopsy report. The legal issues concerning suicide in mentally ill patient, autopsy findings, forensic issues and Patho-physiology concerning death by acid ingestion have been discussed.