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Background: Poisoning due to Hair dye containing Paraphenylene diamine, famous with local name of 'Kala Pathar' is an emerging way of self harm in developing countries. The substance produces toxic effects if ingested or when applied locally including angioedema, respiratory distress, rhabdomyolysis, acute renal failure and hepatic necrosis
Objective: To study the demographic profile, clinical manifestations and outcome of the victims of 'Kala Pathar' hair dye [PPD] poisoning. Study Design, Setting and Duration: Prospective study was carried out in Bahawal Victoria Hospital, Bahawalpur [a tertiary care health institution] for the period from 1[st] January 2016 to 10[th] March 2016
Methodology: The study conducted in 109 patients of Paraphenylene diamine poisoning admitted in B.V. Hospital Bahawalpur, through Accident and Emergency Department with history of ingestion of Kala Pathar hair dye. The patients were treated conservatively and tracheostomy was done as life saving measure in all cases having acute cervicofacial and laryngeal oedema. The patients were grouped according to the age, gender, clinical presentation and final outcome. The data cleaned, analyzed and results were expressed in tables and charts
Results: Out of the total109 patients, 12[11%] were male and 97[89%] females. Majority 91 [83.48%] victim belonged to the age range of 11-30 years involving 83[76.15%] females and 26[23.85%] males. One hundred and four [95.41%] patients were of lower socioeconomic class and rural dwellers. Suicidal intention was reported in all 109 [100%] cases who developed cervicofacial oedema associated with dysponea and strider and emergency tracheostomy was done in all those victims. Eighty Six[78.90%] patients were discharged in good condition and 23[21.10%] expired due to complications of Paraphenylene diamine poisoning. Of those 23 fatalities, 19[82.60%] were females and 4[17.40%] males
Conclusion: 'Kala Pathar' Paraphenylene diamine poisoning is more common in females of younger age group belonging to rural areas and associated with high mortality. The cases could be managed by early diagnosis and prompt actions for supportive treatment because no specific antidote is available. As burden of such cases has been increasing, there is dire need for bringing awareness among the public regarding the toxic effects of hair dye [PPD]. It is suggested that sale of 'Kala Pathar' should be legally restricted by the concerned authorities
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Abstract: Autopsy means detailed postmortem examination of a deceased by cutting open the internal organs to determine the cause, manner and time since death. Its importance in administration of justice, especially in cases of un-natural and violent deaths, cannot be denied. Settings: This study was carried out by examining the record of Medico legal autopsies conducted at a tertiary care Health institution i.e. Allied Hospital Faisalabad, two District Headquarter Hospitals of Punjab; Sheikhupura and Toba Tek Singh along with three Tehsil Headquarters Hospitals and three Rural Health Centers of Faisalabad District during calendar year 2000
Aim: The study was aimed to critically analyze the quality of autopsy work in Civil Hospitals
Objectives: To identify the lapses on part of medical officers while performing autopsies and to find out the procedural irregularities in preserving and dispatch of viscera for Chemical analysis / Histo-pathological examination
Results: Out of 756 autopsies conducted during the study period, 100 cases were selected randomly for detailed examination. Seventy-five males outnumbered the twenty-five females with male to female ratio 3:1. Majority of the victims belonged to 3[rd] decade of life and died of fire arm injuries. Lapses on part of medical officers included inadequate documentation, lack of external examination on arrival, non-recording the time of death and inadequate description about extent of rigor mortis and fire arm wounds. Skull was not opened in 63% cases. Mucosa and contents of stomach were not examined in 49% cases. As regards procedural irregularities, majority of the cases were sent to the Chemical Examiner after 10-30 days of postmortem examination whereas the viscera in five cases sent for histopathology were autolyzed due to improper preservation and delayed submission of the specimen. Some of the reports of Chemical Examiner were untraceable in the record which caused further delay in finalization of the postmortem reports while most of the cases took about 2-3 months after submission of the specimen
Conclusion: Incomplete autopsies are being done by inexperienced doctors in peripheral hospitals having little knowledge of medico-legal autopsy which may lead to faulty medico legal opinions or end up without establishing exact cause of death and having negative impact on the criminal justice system. Only a few of them had true concept of it. There is prime need to provide opportunity to those involved in autopsy work to update their professional knowledge and skills. Healthcare institutions should take all necessary steps to create more awareness program on medico legal autopsy among entire community as well as training of the workers related to the medicolegal field. A national protocol regarding the standard autopsy procedures and documentation is need of the hour
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Objectives: Present study was conducted to find out the incidence, pattern and demographic characteristics of the victims died of firearm injuries brought for Medico legal Autopsy at Tehsil Headquarter Hospital located in the suburbs of Punjab, Pakistan and to study the parameters of age, gender, number and site of injuries on the body of those victims
Study Design: Descriptive study Place and Duration of Study: This study was carried out at Tehsil Headquarter Hospital Gojra, District Toba Tek Singh, Punjab Pakistan during the period of two years i.e. 1[st] January 2009 to 31[st] December, 2010
Materials and Methods: All the victims of unnatural deaths brought for Medico legal Autopsy to Government Eye-cum General Hospital [Tehsil Headquarter Hospital] Gojra District Toba Tek Singh were studied in detail
The finding were tabulated, analyzed and compared with those of other studies conducted in different areas of Pakistan as well as other countries
Results: Out of the total 110 unnatural deaths, 83 [75.45%] were males and 27 [24.55%] females. Sixty five victims of age range 21-40 years constituted 59.09% of the death toll followed by 14 [12.73%] and 13 [11.82%] cases belonging to 2[nd] and 5[th] decades of life respectively. Firearms remained the most common modality to kill 52 [47.27%] victims including 42 [80.77%] males and 10 [19.23%] females giving a male to female ratio of 4:1. Out of the total 52 victims of firearms, 67.30% belonged to rural areas while 32.70% were residents of suburbs. Thirty four victims of firearms, with the age range of 21-40 years constituted the death toll of 65.38%. The most common site of injury was neck and chest involving 57.70% victims
The fatal firearm injuries on the head were noted in 17.30% dead bodies whereas extremities were involved only in 7.70% cases
Conclusion: The young males aged between 21-40 years were commonly involved in the fatalities resulting from firearms in rural setting belonging to Tehsil Gojra of Punjab. The situation is alarming and eye opener for the law enforcing agencies
To prevent such killings, there should be combined effort from all sections of the society
Appropriate steps should be taken for control of the extremism, socio-economical development of the area and proper employment facility for the youth. Concrete efforts for prevention need to be initiated through implementation of the rule of law, strict control on the firearms, as well as education and awareness among rural / urban population
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Objectives: The present study was undertaken with objectives to study the socio-demographic and medico-legal characteristics in victims of sexual assault reporting for medico legal examination at tertiary care hospital at Bahawalpur
Study Design: Observational / descriptive study
Place and Duration of Study: This study was carried out in the Department of Accident and Emergency of a tertiary care hospital at Bahawalpur front I[st] January, 2013 to 31[st] December, 2014
Materials and Methods: This study was conducted on 87 cases of sexual assault received in the Department of Accident and Emergency of Bahawal Victoria Hospital, Bahawalpur during the calendar years 2013 and 2014. The details pertaining to sodo-demographic factors such as age, marital status, residential background, and profession of the victim, time interval between the incidence and medico-legal examination and associated physical / genital injuries sustained by the victims wene also recorded- The results of the different specimens sent to the forensic science laboratory for fiuther examination were collected and tabulated on a self designed Performa. Results: The study revealed that incidence of sexual assault was common in urban citizens as compared to the rural areas. The most vulnerable age group was 11-20 years involving 36[41.38%] cases followed by those belonging to 3[rd] decade of life involving 30[34.48%] victims. Of the total 87 cases of alleged sexual assault, 35[40.23%] were students whereas 55 [63.22%] were unmarried
As regard the time interval between sexual assault and examination, 20[22.99%]victims presented themselves for medico legal examinationwithin24 hours of the incidence. Hymen was found tom/iuptured with old tears in 72[82,76%] cases and fresh tear was noticed in 15[17.24%] victims whereas no Virgo intacta was found among all sexual assault cases. Vaginal swabs were found stained with spermatozoa in 56[64.36%] cases and on naked eye examination; the clothes of 22[25.29%]victims were stained with semen. Conclusion: The most vulnerable age group affected by the sexual violence in Bahawalpur belonged to 11 -20 years and majority unmarried. Rape and Sexual Assault is imderreported crime due to social stigma. A joint effort by law enforcing agencies. Judiciary and civil society should be made in collaboration of electronic and print media to eliminate the sexual violence from the community. The study may help to enhance awareness among public and implement the strategies to make the society a safe place for females particularly the unmarried younger age group
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To find out the magnitude, manner and modalities of unnatural deaths among all cases brought to the Forensic Medicine Department [PMC] Faisalabad for post mortem examination. Retrospective study. The study was conducted in the Department of Forensic Medicine, Punjab Medical College Faisalabad from 1[st] January, 2012 to 31[st] December, 2012. Study material has been collected from mortuary of [PMC] Faisalabad including police inquest reports, postmortem reports and hospital record / treatment history of the victims. A total of 397 cases of Medico legal deaths were brought for postmortem examination in the Department of Forensic Medicine, Punjab Medical College Faisalabad during one year study period. All these cases were grouped according to age, gender, manners and modalities of medico legal / unnatural deaths. The data collected, and analyzed. The commonest manner of death in overall age groups was homicide followed by accident, suicide and natural deaths, whereas; 59 cases remained undetermined. Among 228 homicidal deaths, Firearms were the predominant weapons of infliction [70.17%]. A total of 64 [85.33%] persons lost their lives in Road Traffic Accidents [RTA] among 75 accidental deaths. Out of total 397 cases, Males were [74.82%] and females [25.18%]. The age group most commonly involved was 20-29 years [29.97%] followed by 30-39 years [21.41%] and 40-49 years [15.61%], whereas; the victims belonging to age group of 10-19 years contributed for [12.09%]. Our study concludes that Homicide was the most dominant manner of death among the unnatural deaths. Fatalities caused by Firearms were the commonest form of homicide; Road Traffic Accident was the commonest modality among accidental deaths whereas; the suicide was found as rare manner of death
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Objective: To describe the role of Cranial Computed Tomography [CT] in the evaluation of Coup and Countercoup head injuries with its outcome
Study Design: A comparative cross-sectional study
Settings: Radiology Department of PMC/Allied Hospital Faisalabad. Duration: 09 months, October 2012 to June 2013
Sample Size: 150 patients
Materials and Methods: The patients with coup and countercoup head injuries were studied and divided into two groups: Coup injuries [n=117], countercoup injuries [n =33] .The groups were comparable with respect to age, Glasgow Coma Scale [GCS] and outcome. Site of primary impact was determined by CT scan pattern
Results: The mortality rates in each group were compared with respect to age, GCS and CT pattern. Significance was calculated using Chi-Square test. There was a statistically significant difference in mortality between patients with coup injuries [p
Conclusion: Presence of a countercoup component on CT scan may show a worse outcome in head injuries and may warrant closer monitoring and more aggressive management of these patients
RESUMEN
To study the road traffic accident [RTA] fatalities in Faisalabad, in relation to vulnerability of victims, their socio demographic characteristics and to identify the risk factors of fatal RTAs. A descriptive retrospective study. Post Mortem Unit, Allied Hospital, Punjab Medical College [PMC] Faisalabad. From January to December, 2006. Eighty-five dead bodies of fatal RTAs brought for Medico legal autopsies, to Allied Hospital, [PMC] Faisalabad, during calendar year 2006 were included in study for Post Mortem Examination. In this study maximum cases of road traffic accident were among males [91%], male to female ratio was approximately 9:1. Maximum incidence of RTA was in the age range of 21 to 50 years comprising 55.29% and commonest age group involved was 21-30 years accounted for [21.18%]. Most common victims were pedestrians 41.18% followed by motorcyclists 29.41% and cyclists 16.47%. Incidence was more common in the pedestrian. Road traffic accident is the leading cause of deaths and disabilities worldwide and it is needed to prevent them. Road traffic crashes are predictable and therefore preventable. In order to combat the problem, there is a need for close coordination and collaboration, using a holistic and integrated approach, across many sectors and many disciplines
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Violence against women is an important public health problem. It has global significance regarding violation of human rights. Violence is an important risk factor related to ill health of women, having far reaching consequences affecting physical, social, mental and reproductive health of the victims. To study the various types of interpersonal violence against women and find out the magnitude of physical violence and sexual assault among the victims. A descriptive hospital record based study. The study was conducted from January to December 2005 in casualty out patient department of Allied Hospital, Punjab Medical College [PMC], Faisalabad. Total 286 cases of violence, who reported for medico-legal examination during calendar year 2005, were included in the study. The cases of physical violence / sexual assault were examined in detail. Findings were tabulated and analyzed. Among total 286 cases, 221 [77%] victims were married, and commonly involved age group was 21-30 years accounting for 82 [28.68%] victims. Blunt trauma was sustained by 193 [67.50%] victims, sharp edged weapon affected 17 [6.0%] cases, firearm bears the responsibility in 13 [4.54%] victims, a mix pattern of injuries by sharp / blunt objects was observed in 8[2.80%] females and [1.75%] women were said to be burnt. Forty-three [15%] cases were reported as victims of alleged sexual assault with peak incidence during 2nd decade of life in age group 11-20 years involving 23 [53.5%] cases. Among total 43 cases of sexual assault, 27 [63%] victims belonged to rural areas. Twenty Eight [65%] unmarried girls were subjected to sexual assault. In 43 sexual assault victims, semen was detected in 28 [65%] cases, 13 [30%] cases were negative; whereas reports of 2 [5%] cases were not available in the record. The cases of physical violence are common in Faisalabad and incidence of sexual assault is higher in rural areas more commonly affecting the unmarried young girls. There is need to attend this public health problem with concrete efforts to stop the violence against women and reduce the incidence of sexual assaults
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To find out the job related problems faced by nurses during duty hours and to know their effects on their personal life, behavior with colleagues, senior nurses, administrators and patients. A Cross sectional study. Allied Hospital Faisalabad, a tertiary care health Institution attached with Punjab Medical College [PMC] Faisalabad. From 1[st] May to 30[th] June 2007. The study was conducted among the charge nurses and student nurses working in Allied Hospital Faisalabad. Data were collected by convenient sampling of 100 nurses, through structured questionnaire which were tabulated and analyzed. A total of 100 nurses participated, out of which 34% were charge nurses and 66% were student nurses. Needle prick injury was the most common accidental hazard among student nurses [48%] and charge nurses [35%], as the P. value was 0.189 so there was no significance difference/association between the two groups of nurses. Musculo-skeletal Problems were commonly found among [23%] charge nurses whereas [15%] student nurses also experienced musculo-skeletal pains during duty hours, as the P. value was 0.189 so there was no significance difference/association between the two groups of nurses related to Musculoskeletal Problems. Regarding problems due to work overload, irritability [35%], sleep disturbances [18%], emotional instability [35%], and mental stress [35%] were found among charge nurses whereas headache [33%], mental stress [27%] and emotional instability [33%] were reported in student nurses. Latex allergy was found among [36%] of charge nurses while [18%] student nurses also reported the same problem due to use of rubber gloves, Twenty-two [33%] student nurses had lack of support from seniors and [39%] students reported difficulty in communication with physicians and senior nursing administrators, whereas [35%] among charge nurses had communication problems with their seniors. As the P value was 0.659, so there was no significance difference / association between the two groups of nurses regarding support from seniors and communication. Needle prick injury was more common among student nurses whereas problems due to work overload were found in majority of charge nurses. Day to day problems faced by the nurses during duty hours could be reduced or prevented through the appropriate measures by concerned authorities