CHOKING IN A PSYCHIATRIC PATIENT - A CASE REPOR

Choking is one of the important types of asphyxia deaths. The incidences of which are not uncommon. The choking in children could be due toys, coins, marbles, nuts and any other small hard object or even sometimes due to stuffed in plastic bags whereas in adults most of the times food bolus or hard parts of food like bone pieces are responsible. It is mostly accidental in nature. It can cause coughing or sometimes airway obstruction leading to death. We present a case wherein a mentally ill person accidentally choked to death after consumption of food.

Asphyxial deaths at District Hospital, Tumkur A retrospective study.

Asphyxial death forms one of the modes of death which may be suicidal, homicidal or accidental in nature. A retrospective study of autopsies conducted between years 2006 - 2010 is an attempt to know the incidence of asphyxial deaths at district hospital, Tumkur. During this period there were 2288 deaths, out of which 438 deaths were of asphyxial deaths. The most common form of asphyxial death was hanging followed by drowning. The incidences of asphyxial deaths were more in males than females in the ratio of 1.4:1. These cases were studied to know age and sex distribution of the victims. In this study, we found that among asphyxial deaths hanging were more 268 (61.18%) followed by drowning 140 (31.96%), strangulation 19 (4.33%) and others respectively. Appropriate education, influencing the media in their portrayal of suicidal news, reporting method, involvement of young generations in encouraging activities may reduce the rate of suicidal death by hanging in future.

Ligature mark on neck: How informative.

Many a times, a ligature mark may be the only evidence available in cases of asphyxial deaths due either to hanging or strangulation. A through examination of the ligature mark and analysis of the information provided by it, is therefore, a must to arrive at the most probable cause of death and differentiate between hanging and the ligature strangulation. A retrospective study was conducted at the Department of Forensic Medicine and Toxicology, Government Medical College & Hospital, Chandigarh, between 1997 to 2004 to assess the information provided by a ligature mark in such cases. We found that deaths due to hanging constituted 3.4% of the total unnatural deaths subjected to medicolegal autopsy; young adults, of the age group 21 to 25 years accounted for the maximum cases, 27%; and the male: female ratio was 2:1. Chunni was the most common ligature material used. Majority of the victims preferred multiple knots (61%) and fixed knots (58%) and a single loop (93%). The mark was obliquely placed (98% cases) above the larynx (85% cases). In all the cases of ligature strangulation, the mark was transverse, below the level of thyroid cartilage. Imprint over the groove when present, corresponded with the ligature material used in all the cases. It was concluded that a thorough, scientific examination of the ligature mark, though not conclusive, but is the most important part of the postmortem examination of deaths due to hanging and ligature strangulation.