Review of un-natural death in Punjab prisons a dilemma of poor psychiatric services

Objective: the increasing trend of unnatural deaths in custody is a concern globally. So this study was conducted to examine the causes of unnatural deaths in Punjab prisons

Methods: a retrospective review of all available files of unnatural deaths from 2006 to 2009 was carried out in June-July 2010. The death certificates, inquest reports, postmortem reports and fact finding enquiry reports were examined in detail. Facts of each unnatural death were discussed with medical officer and superintendent of concerned jail. Causes of unnatural death were categorized as accidental, homicide, and overdose with substance of abuse or medication and suicide

Results: crude mortality rate for un-natural deaths was 53/100,000 per year. This account for 11 % [111/1007] of the total deaths. All unnatural deaths were among males with mean age of 35 years [Range; 16-90]. Mostly 85% [n=94] were under trial and 15% [n=17] convicted prisoners. Of the 111 unnatural deaths 49% [n=55] were from overdose, suicide 21 % [n=23], homicide 16% [n=18] and accidental deaths 14% [n=15]. Majority of the suicidal deaths was by hanging [20/23]. 50% of all un-natural deaths occur within 1st week of their entry in to jail. Majority [91 %] of those committed suicide have a history of psychiatric illness. Suicidal, homicidal and accidental deaths accounts for 43% of potential years of life loss of these persons. Postmortem of only 35% of cases conducted on the stress of prisoner heiress

Conclusion: among unnatural deaths suicide by hanging and deaths due to substance over dose are dominant. No psychological assessment being done at jail entry. Most of these premature deaths are preventable. Mental health services should be the integral part of primary health care in prisons. Inquest files have incomplete data which limits our study

Frequency and sensitivity of micro-organism in post-operative wound infections: a quest for microbes

To determine the frequency of common organisms involved in post- operative wound infection. To determine the sensitivity of micro-organism for different antibiotics. Prospective cross-sectional descriptive study. This study was carried out at Surgical Units of Civil Hospital Karachi from April to September, 2010. 72 swab samples were collected from patients who had undergone operations. Samples were obtained from the hospital and processed in Civil Hospital Karachi lab [Microbiology Department]. Out of 72 bacterial isolates found in post-operative wound infection, 30 [41.66%] were E.Coli, followed by Klebsiella species 14 [19.44%], pseudomonas aeruginosa 13 [1.38%], staphylococcus aureus 6 [9.72%], providential species 1 [1.38%], proteus mirabilis 1 [1.38%], Actinobacter 1 [1.38%] and no growth 6 [9.72%]. The result showed that the occurrence of infection was higher in the age group between 20 -40 than any other group. There is no significant difference between male and female sexes in the occurrence of infection. Infection was more in the operation done under emergency circumstance than the elective ones.There was no significant association between infection, and co-morbidities and past history of wound infection. The sensitivity pattern of 4 main bacteria, Frequently found in the study i.e. E.coli, klebsiella, pseudomonas aeruginosa and s.aureus isolates, suggested that the organisms were more sensitive to imipenem, Amikacin sulphate, Ceftazidime, Cefperazone/Sulbactum and Pipercillin/Tazobactum than other groups of drugs. The most common causative organism was E.coli, infection rate was higher among the patients operated in emergency and imipenem, Amikacin sulphate were found to be more sensitive

High sero-prevalence of transfusion transmitted infections among prisoner blood donors from Punjab prisons

Objective: prisoners as a high risk group are never recommended for blood donations. In Pakistan, prisoners are legally allowed to donate blood and get thirty days extra remission. In Pakistan, there is not much published data on prisoner blood donors. The study aimed to estimate the sero-prevalence of human immunodeficiency virus [HIV], Hepatitis B with [HBV], Hepatitis C virus [HCV] and Syphilis among physically healthy prisoner blood donors in prisons of Punjab

Material and Methods: a retrospective review of record of all prisoner donors who donated blood during camps from January 2007 to December, 2009 was carried out in January 2010. Physically fit prisoner donors were tested for HCV, HBV, HIV and Syphilis by rapid test kits before donation. Those found negative for these infections were allowed to donate blood. Donated blood was retested for anti-HIV, anti-HCV and HBsAg by ELISA and syphilis by VDRL

Results: a total of 3,074 prisoner donors were tested. 3050 [99%] donors were male. Mean age was 28 years [17-57 yr.]. Among prisoners, 235 [7.6%] were positive for HCV, 114 [3.7%] for Syphilis, 111 [3.6%] for HBV and 21 [0.7%] for HIV. Among these, 434 [14%] were positive for at least one of these infections. Three females [12.5%] were positive for syphilis and one [4.14%] for hepatitis B

Conclusion: the prevalence of HIV, HBV, HCV and syphilis is higher in prison donors as compared to blood donors from general population. So prison inmates constitute a very high risk group among blood donors. Stringent screening of blood donors and even testing of donated blood by highly sensitive tests is recommended. We also recommend further studies and then modify blood donation laws accordingly

Frequency and sensitivity of micro-organism in post-operative wound infections: a quest for microbes

To determine the frequency of common organisms involved in post- operative wound infection. To determine the sensitivity of micro-organism for different antibiotics. Prospective cross-sectional descriptive study. This study was conducted in 3 Surgical Units of Civil Hospital Karachi from April to September 2010. 72 swab samples were collected from patients who had undergone operations in 3 Surgical Units of Civil Hospital Karachi during a period of 6 month from April to September, 2010. Samples were obtained from the hospital and processed in Civil hospital Karachi lab [Microbiology Department]. Out of 72 bacterial isolates found in post-operative wound infection, 30 [41.66%] were E.Coli, followed by Klebsiella species 14 [19.44%], pseudomonas aeruginosa 13 [1.38%], staphylococcus aureus 6 [9.72%], providential species 1 [1.38%], proteus mirabilis 1 [1.38%], Actinobacter 1 [1.38%] and no growth 6 [9.72%]. The result showed that the occurrence of infection was higher in the age group between 20 -40 than any other group. There is no significant difference between male and female sexes in the occurrence of infection. Infection was more in the operation done under emergency circumstance than the elective ones. There was no significant association between infection, and co-morbidities and past history of wound infection. The sensitivity pattern of 4 main bacteria, Frequently found in the study i.e. E.coli, klebsiella, pseudomonas aeruginosa and s.aureus isolates, suggested that the organisms was more sensitive to imipenem, Amikacin sulphate, Ceftazidime, Cefperazone/Sulbactum and Pipercillin/Tazobactum than other groups of drugs. The most causative organism was E.coli, infection higher among the patients operated in emergency and imipenem, Amikacin sulphate were found to be more sensitive