Study of COVID-19 Impact on Medico Legal Cases Registered at Mediciti Hospital, Ghanpur Village, Medchal Mandal, Telangana

Background and Objectives: In every tertiary care hospital, casualty deals with the emergency cases of which the majority are Medico legal cases. The knowledge about the incidence of Medico legal cases is important to recognise the socioeconomic burden. The present study was conducted to scrutinize different Medicolegal cases at the emergency department of Mediciti Hospital, Medchal. The idea of the study was to find out frequency of several types of medico legal cases at casualty of Mediciti Hospital, Medchal. Material(s) and Method(s): It was a record based cross sectional study in which all the MLC cases registered in MLC record book from March 2020-March 2021 were analyzed. The data was collected on age, sex, type of Medico legal cases, road traffic accidents, mode of occurrence, month-wise distribution of medico legal cases and the time of occurrence. Results were expressed in numbers and percentages. Result(s): Out of all 355 registered medico legal cases, of which 258(73.2%) were males and 94(26.76%) were females. Maximum cases were from the age group of 20-29 years i.e., 127(43.09%). Majority of the MLC's registered we are due to road traffic accidents 144(39.7%) followed by Assault 49(13.8%), falls-43(12.7%), poisoning-43(12.1%), and injury at workplace-43(12.1%), accidental-14(3.9%), snake bite-8(2.2%) and others (7.4%). Conclusion(s): The present study shows RTAs account for a major part of MLCs. By proper education and training of safety measures among public decreases the cases. Enforcement of strict laws reduces the incidence of road traffic accidents. And also, strict laws should be amended to reduce the incidence of Assault.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Cerebral venous sinus thrombosis following Russell's viper (Daboia russelii) envenomation: A case report and review of the literature.

Snakebite is a life-threatening and often-neglected public health hazard with high chronic disability and mortality, mainly faced by rural communities in the tropics/subtropics. Stroke and neuromuscular paralysis are the most severe neurological complications. However, cerebral venous sinus thrombosis has rarely been reported among cerebrovascular complications. We report a previously healthy middle-aged Indian woman who developed cerebral venous sinus thrombosis preceded by features of disseminated bleeding diathesis following Russell's viper bite. The cerebral venous sinus thrombosis was diagnosed by magnetic resonance imaging. The patient responded well to treatment with antivenom and subcutaneous enoxaparin and had no demonstrable neurological deficits at three months of follow-up.

A review on ethnomedicinal and phytopharmacological potential of traditionally wild and endemic plant Berberis tinctoria Lesch

Introduction: Berberis tinctoria an evergreen shrub, endemic and predominantly found at a higher altitude of the Nilgiri Biosphere Reserve, India. This leaf and fruit are edible, which are also used in homeopathic remedies for countless illnesses. Objectives: B. tinctoria with diverse ethnomedicinal uses was focused in the prevailing study to detailed the phytochemical and pharmacological properties for further imminent research in this species. Materials and methods: Published data in this review were all gathered from the online bibliographical databases: PubMed, Elsevier, Scopus, Google Scholar, Web of Science, and local ethnic community peoples of Kurumba and Toda. Results: B. tinctoria was used as a Ayurvedic and homeopathy medicine by the tribal communities. The previous findings of B. tinctoria were used for skin diseases, wound healing, inflammatory, menorrhagia, diarrhea, jaundice, and a snakebites. The phytochemical studies revealed that secondary metabolites, antioxidants, and antimicrobial activity as a result of major alkaloid isoforms of berberine, berbamine, jatrorrhizine, etc. Conclusion: B. tinctoria is an important plant due to the presence of bioactive phytochemicals, especially berberine protoberberine group of benzylisoquinoline. As a result of its diverse ethnopharmacological importance, as well as numerous commercial products and novel bioactive compounds yet to be discovered for future drug discovery and development.

Utility of APTT Based CLOT Waveform Parametersin Various Clinical Conditions-A Study at Tertiary Care Center

Introduction: Coagulation tests performed in laboratory are prothrombin time, activated partial thromboplastin time (APTT),thrombin time help in understanding of pathways involved in coagulation, yet they lack information on the complexity of haemostasis.Global coagulation assays like Thromboelastogram, Thrombin Generation Test and Clot waveform analysis (CWA) are point of caretests which provide rapid approach to a clinical condition. Clot waveis an optical waveform which measures changes in transmittance orabsorbance of light beam through sample. Various applications ofCWA have been extensively studied in last few years.Aims &Objectives: To analyze clot wave form characteristics likemorphology, first and second derivative values in cases with abnormalAPTT.Materials &Methods: APTT and curves generated by ACL TOP300 analyzer of total 125 patients and 20 controls were included.Parameters studied were first derivative (maximum velocity of clotformation), second derivatives (maximum acceleration and deceleration), morphology of curve: sigmoid, biphasic, prolonged precoagulation phase, second derivative morphology like early and lateshoulder, biphasic peak, delayed deceleration were noted. MannWhitney U test was performed and p value was determined.Result: The APTT waveforms were analyzed in 125 patients (M: F-2.2:1, mean age: 46.9 ± 20 years). A spectrum of clinical conditionsshowed covid (20%), liver disease (23%), polytrauma (10.4%), cardiac (8.8%), sepsis/DIC (7.2%), thromboembolism (7.2%), renal(6.4%), bacterial infections (4%), dengue (4%), snake bite (1.6%),factor deficiency (1.6%). There was significant difference in acceleration and deceleration peaks in cases of liver and heart disease,sepsis, dengue, polytrauma and sepsis/DIC cases. Deceleration peakwas additionally prolonged in patients of covid (p<0.05). Firstderivative peak was prolonged in only sepsis and liver diseases(p< 0.05). The pre coagulation phase was prolonged in 75 cases(60%) cases and predominantly covid patients along with secondderivative showing delayed deceleration, early and late shoulder.Conclusions: CWA is readily available on automated coagulationanalyzers being inexpensive with fast turn round time. It providesboth quantitative information on coagulation like velocity, acceleration of clot formation and qualitative details of wave pattern. Therewas significant association of second derivative with the disease inour study. Our study highlights importance to probe into quantitativeand qualitative CWA parameters acquired by performing a simpleAPTT test.

Snakebite incidents, prevention and care during COVID-19: Global key-informant experiences.

Snakebite envenoming is a long-neglected disease causing significant morbidity and mortality in snakebite endemic low- and middle-income countries (LMICs). Global awareness on snakebite was increasing steadily up to 2020, and an increasing number of countries began to acknowledge the issue, when coronavirus disease 2019 (COVID-19) started to have an unprecedented impact on societies and health systems. To better understand how snakebite incidents, prevention and care are being affected during this global emergency, we collected perspectives of snakebite community- and health system stakeholders in a qualitative key-informant study. An open-ended survey and semi-structured interviews were conducted to gather information on changes in snakebite occurrence and circumstances, community responses, access to care and health outcomes in LMICs since the COVID-19 pandemic. Forty-three informants from 21 countries participated in the study. Based on informants' experiences, in spite of COVID-19 lockdowns, exposure to snakes did not change in many rural agrarian communities, where incidences are usually highest. However, we did find several access to care issues relating to avoidance of formal care, transport barriers, overburdened healthcare systems and -providers, and antivenom manufacturing and supply disruptions, which were unique per context. On a brighter note, ventilator availability had increased in several countries, although not automatically benefitting snakebite patients directly. In conclusion, we found apparent effects of the COVID-19 pandemic on snakebite prevention and care, although its severity was highly context- and time-dependent. Interactions between the pandemic effects and snakebite incidents most severely impact remote rural communities, showing the need to invest in community-based prevention and care.