A Rare Case Report on the Role of Anaesthetist in Management of Homicidal Cut Throat Injury

Homicidal cut-throat injuries are potentially life threateningbecause of the many vital structures that course through thisarea. Management of homicidal cut-throat injuries requires amulti-disciplinary approach. The role of an anesthesiologist ininstituting an airway using an endotracheal intubation ortracheostomy before wound exploration and repair oftransected tissues, is challenging, as, such injuries are most ofthe time associated with distortion of the normal anatomy ofthe airway. Anaesthesiologist is pivotal in securing a definitiveairway in such cases thereby facilitating the wound explorationand surgical repair. We present a patient who was the victimof a homicidal cut-throat injury.

Psychiatric Symptoms in Temporal Lobe Epilepsy with Left Mesial Hippocampal Sclerosis

A 16-year-old woman was referred to us for depression and persistent suicidal and homicidal ideation. From 2010, the patient visited a neurologist due to recurrent grand mal epilepsy, auditory and visual hallucinations, episodic memory loss, and persistent depression. Upon admission, it was revealed through clinical history taking that she had suffered from chronic bullying from same-sex peers and sexual abuse, twice, from an adult male in the neighborhood when she was 10 years old. A brain magnetic resonance imaging study showed left mesial hippocampal sclerosis. The patient exhibited improvement of her psychiatric symptoms after treatment with a combination of fluoxetine (30 mg) and aripiprazole (10 mg). Children and adolescents with epilepsy experience conflicts in the family, challenges at school, stigma, and psychosocial limitations or deprivations due to their comorbid psychiatric symptoms and hence, psychiatric evaluation and early intervention is important when treating these patients.

Estrategias para la mitigación de la violencia homicida en la fronteriza ciudad de Cúcuta / Mitigaion strateegies for homicidal violence in the border cityof cúcuta

La estructura del trabajo parte de la introducción, en la que se evidencian los procesos previos en los que se enmarca el estudio y la intención de realizar una contribución a las bases teóricas y prácticas para la gestión de los conflictos sociales extremos. El objetivo se centra en la definición de las dinámicas de la violencia homicida en la ciudad fronteriza de Cúcuta y en la formulación de estrategias para aportar a su mitigación. La aproximación metodológica parte de un enfoque transdisciplinar, de un acercamiento fenomenológico, epistemológico, de diálogo y reconciliación sobre la violencia urbana en Cúcuta, aborda la conceptualización de los conflictos sociales y su manifestación en entornos urbanos, para luego contextualizar e interpretar las relaciones multidimensionales que establecen los seres humanos en el territorio de la ciudad objeto de estudio. Posteriormente, se exponen los resultados, representados en un abordaje interpretativo, cuantitativo y cualitativo de los conflictos sociales que se dan en zonas de frontera, en la identificación de los elementos que configuran las dinámicas de violencia homicida de Cúcuta y, a partir de estos, se formula una serie de lineamientos y estrategias de mitigación de la violencia en dicha ciudad, como un aporte al fortalecimiento de los escenarios de defensa y participación social de las víctimas, de construcción de ciudadanía y búsqueda de la dignidad humana.

The work structure starts with the introduction, in which the previous processes that frame the study and the attempt to make a contribution to the theoretical and practical bases for the management of extreme social conflicts is evidenced. The focus is on the definition of homicidal violence in the border city of Cúcuta and the formulation of strategies to help on its mitigation. The methodological approach starts from a transdisciplinary, a phenomenological, an epistemological, a dialogue and a reconciliation approach on the urban violence in Cúcuta. It addresses the conceptualization of social conflicts and their manifestation in urban settings, and then contextualizes and interprets the multidimensional relations human beings establish in the territory of the city under study. Subsequently, the results are presented, represented in an interpretive, quantitative and qualitative approach of the social conflicts that occur in border areas, in the identification of the elements that make up the dynamics of homicidal violence in Cúcuta and from these, a set of guidelines and strategies to mitigate violence in that city is formulated, as a contribution to strengthening the defense and social participation scenarios of the victims, to build citizenship and the search for human dignity.

Analysis of homicidal deaths in and around Bastar region of Chhattisgarh.

FREEDOM FROM VIOLENCE, not necessarily proportional with development in some basic capabilities like nutrition, longevity and literacy which positively related to economic growth. So, dealing with violence in society is intrinsically a matter of public interest. In present study 79 cases of homicidal deaths due to different mechanical injuries was studied in two year period from 1/1/2009 to 31/12/2010. The incidence of homicidal death was 9.13% during this period. Males affected more in comparison to females. Majority of cases were fall in 21-40 yrs. of age comprising 50 cases (63.28%).Injuries by blunt weapons commonly observed in 30 cases (37.97%) which followed by injuries by sharp weapons 19 cases (24.05%). Totally 329 sharp injuries observed in comparison to 152 blunt injuries. Incidences were prevalent at dense forest area 26 cases (32.91%), in married persons 55 cases (69.62%), in between 6 pm to 12 midnight 24 cases (30.37%) and revenge was main motive 23 cases (29.11%).

Gender Disparity in Autopsy Findings: How Much is It.

Bangladesh is densely populated country where male and female ratio is closer to each other. This descriptive study investigates the gender disparity of postmortem examination findings among 7 districts in the Rajshahi division of Bangladesh. Postmortem (PM) examination stations were located in Rajshahi, Rangpur, Bogra and Dinajpur Medical Colleges & Pabna, Natore and Chapai Nawabganj Sadar Hospitals. The findings of the autopsy reports (Total 3164) over the two years (2004 & 2005) were collected retrospectively from the register book of the authority. In this study we wanted to find out gender disparity - if exists in PM examination findings and, to what extent. Manually verified data were analyzed employing SPSS/WIN V-11.5. An obvious gender disparity existed in overall occurrence of unnatural deaths, male predominate female victims (M: F ratio = 1.51:1). A significant association existed in death circumstances & gender (p<0.0001); male (634) outnumbered female (250) in homicidal deaths, in suicidal deaths female (612) outnumbered male (364) and in accidental deaths male (583) outnumbered female (135). This classical gender difference in death circumstances remains similar to our national context. Findings of this study revealed an obvious gender difference in the overall numbers of cadaveric PM examination. Males were more victimized than females in majority of medico-legal aspects analyzed, except in suicidal cases.

Pattern of Poisoning Cases in a Tertiary Hospital in Bangladesh.

Background: Poisoning with various substances is a global problem. It is one of the most important reasons for emergency admission in the hospital. The earlier the initial resuscitations, gastric decontamination and use of specific antidotes, the better is the outcome. Epidemiology of poisoning differs from region to region. This study was carried out to determine the pattern and severity of poisoning in a tertiary care hospital. Objective: To characterize the poisoning cases admitted in Enam Medical College Hospital. Materials and Methods: All cases admitted to the emergency department of Enam Medical College Hospital during the period of April to December, 2010 were evaluated retrospectively. We reviewed data obtained from the hospital medical records and included the following factors: demographic characteristics, etiology and outcome of the acutely poisoned patients. Total 84 poisoning cases were found and they were included in the study. Results: The overall case fatality rate was 3.5%. More detailed data from 2010 reveals that two-thirds of the patients were 20-30 years old, 53% male and 47% female. Organophosphorus was the most common cause (73.9%) followed by unknown poisoning (9.5%), sedative (5.9%), harpic (4.7%), aluminium phosphide (2.4%), savlon (1.2%), paracetamol (1.2%) and amitryptiline (1.2%). 90.5% cases were suicidal and 9.5% were homicidal. Conclusion: This study provides important information on the characteristics of the poisoning in this region. Community education about the danger of the drugs and reduction of exposure to pesticides are recommended.

Pattern of homicidal deaths.

Killing of an individual is the highest level of aggression found in all cultures. Incidence of Homicide is on the rise worldwide and pattern is also changing except for the motive v.i.z. lust for money, women and land. The present prospective study from Oct 2005 to Sep 2007 for a period of 2 years in the Dept of Forensic Medicine, MS Ramaiah Medical College, Bangalore revealed that homicidal deaths accounted for 4.32% of autopsies and victims in the age group 20-29 years constituted 49.25% of cases. In 12.25 % of cases Police did not suspect homicide prior to autopsy. Maximum homicides took place at victim‘s residence (31.5%) and street (29.75%). Acquaintances were involved in 47% of cases. The main motive was revenge (26.5%). Sharp weapon injuries (33.25%) were the commonest pattern followed by blunt weapon injuries (28%) and 82.5 % of victims died on the spot.

Study of pattern of injuries in homicidal firearm injury cases.

Invention of fire has brought about a turning point to Human civilisation, but, invention of the firearm has come as a curse to human civilisation. Firearm is fast becoming a major killing apparatus and taking away innumerable valuable human life day by day. This study was aimed to find out the pattern of injury in homicidal firearm injury cases of different motives and also to find out the most vulnerable portion of the body so as to minimise the loss of human life. In this study a total of 108 cases of homicidal firearm injury were studied. Extremist violence and encounters accounts for 81.5% of the cases and in 13 (12.0%) cases the motive behind the killings could not be determined. Most of the victims were males having bullet injuries in their chest (59 cases), caused by rifled firearm weapons, and died because of haemorrhage and shock.

A critical analysis of stab wound on the chest A case report.

Penetrating Injuries on the chest may be homicidal, suicidal or accidental in nature. There are certain features that are quite reliable pointers to the nature of these injuries. However differentiation is difficult particularly when the characteristics of stabbing are perplexed and information related to circumstances of the incident is misguiding. The present case projects the importance of careful examination of the stab wounds on the chest particularly when the information provided to the autopsy surgeon is ambiguous.

Pattern and distribution of injuries in fatal road traffic accidents in Rohtak (Haryana).

Accidents are now one of the major causes of death. In this study pathological features of these cases as type of injury, pattern and distribution of injuries, body parts involved, fatal injuries and cause of deaths were noted at the actual autopsy examination of victim. All the data thus collected was analyzed statistically.

Individual Identification / 대한법의학회지

It is noteworthy that most unidentified dead are unnatural and violent deaths. The accurate identification of a decedent permits certification of death and notification of next of kin. Only then may they proceed with the probate of wills, apply for disbursement of benefits and insurance, and begin to work through the grieving process. Law enforcement agencies need positive identification to pick up the leads of investigation to develop suspects, establish the corpus delicti of homicide and reconstruct the sequence of events of a crime. Agencies and a variety of consultants are involved in recognizing and developing the unique features of a decedent that lead to identification. Cooperative working relations with newspaper and other media will help in publicizing the need for persons with information to come forward diagrammatically. In this paper, 5 individual identification cases in unexpected or homicidal deaths are described. The comparison between the postmortem and antemortem records show that the victims are correctly identified.

Individual Identification / 대한법의학회지

It is noteworthy that most unidentified dead are unnatural and violent deaths. The accurate identification of a decedent permits certification of death and notification of next of kin. Only then may they proceed with the probate of wills, apply for disbursement of benefits and insurance, and begin to work through the grieving process. Law enforcement agencies need positive identification to pick up the leads of investigation to develop suspects, establish the corpus delicti of homicide and reconstruct the sequence of events of a crime. Agencies and a variety of consultants are involved in recognizing and developing the unique features of a decedent that lead to identification. Cooperative working relations with newspaper and other media will help in publicizing the need for persons with information to come forward diagrammatically. In this paper, 5 individual identification cases in unexpected or homicidal deaths are described. The comparison between the postmortem and antemortem records show that the victims are correctly identified.