Systemic Effects and Medicolegal Aspects of Formic Acid Poisoning - An Autopsy Study.

Formic acid is easily available in open market, because of its wide use in the rubber industry for processing of latex. Because of the easy availability, case of accidental and suicidal poisoning by formic acid are on the rise and most of them end fatally. On reviewing the literature, only a few were found to be reported and studied in detail. MethodsThis study was carried out on seventy-five medicolegal cases, brought with history of formic acid poisoning which were brought for autopsy during the period February 2012 - July 2013. Bits of tissues from upper part of oesophagus, lesser curvature of stomach, lungs, liver, kidney and pancreas were collected. The tissues were processed, and slides were prepared. Microscopic study of each slide was done. ResultsMales (57.3%) outnumbered females and maximum number of cases was of age group 41-70 yrs. (72%). Most of the victims were taken to hospital for treatment and died after admission (85.3%). Laboratory investigations revealed that most of the cases (85.3%) showed impairment in renal function tests, evidence of haemolysis, and metabolic acidosis, corrosion of the upper part of alimentary tract, glottic oedema and brownish fluid in peritoneal cavity. ConclusionsIn Kerala the incidence of formic acid poisoning is on the rise, probably because of the easy availability of the acid to people engaged in rubber industry which is widely prevalent in this state. Ingestion of formic acid leads to a serious systemic and metabolic damage

Role of lymphadenectomy and its impact on survival in endometrial carcinoma - an institutional experience

Pelvic and para aortic lymph nodes are the common sites of metastasis in endometrial carcinoma. The role of lymphadenectomy is widely discussed in literature with varying results. In this study we did a retrospective analysis of endometrial cancer patients to correlate lymphadenectomy with overall and disease free survival. A retrospective review of 110 patients with carcinoma endometrium who underwent staging laparotomy at our institute during the period 2006-2010. Patients who underwent node dissections were categorized as group I and the rest as group II. Median lymph node count was 10. Grade of the tumor, nodal status and lymphadenectomy were correlated with overall and disease free survival. Lymph node metastasis and grade of tumor are significant predictors of survival. Lymphadenectomy did not show significant survival benefit. It has helped to upstage the disease so that appropriate adjuvant therapy could be planned. A prospective randomized control trial with complete pelvic and para aortic node dissection and uniform adjuvant therapy considering nodal status may help to answer the confusion regarding lymphadenectomy