POST MORTEM DIAGNOSIS OF EARLY MYOCARDIAL INFARCTION.

Acute Myocardial Infarction as a cause of death is diagnosed in many cases of sudden death based on the indirect evidence of critical narrrowing (75%) of one or more coronary arteries. Microscopic evidence of infarction is seen in H & E stained sections only if the person has survived for a minimum period of 6 hours after sustaining fatal ischaemic attack. In this study we have used two laboratory methods for visualisation of infarcts of lesser 'age', viz.-Triphenyl Tetrazolium Chloride (TTC) Macro Test and Acridine Orange Fluorescence Study. The former is a gross staining procedure which can reveal infarcts of 5-6 hours age, while the later is UV Fluorescent microscopic examination capable of detecting infarcts of 2 hours age. Although these procedures are well accepted ones, the aim of this article is to induce Forensic Pathologists to incorporate these tests in the study protocol of all sudden death cases with the aim of 'visualising' the infarct rather than basing the diagnosis on indirect evidence of critical narrowing of Coronaries.

AIDS-MEDICOLEGAL ASPECTS.

AIDS/HIV Positivity has been the most widely debated disease of this century. Reasons for this are manifold, viz-the non-availability of cure and consequent 100% mortality of a full blown case; its mode of transmission-homosexual and heterosexual activities; widespread occurrence amongst 'main liners'; and patients receiving blood and blood products etc. These aspects have created a dreaded halo around AIDS as well as social stigma. Even the medical community is not exempt from these problems. Unfortunately, legislatures around the world, more so in India, have lagged behind in clarifying many legal issues involved by not enacting specific laws pertaining to AIDS. Consequently many legal & ethical doubts arise in the minds of doctors when confronted with a case of AIDS either in a live patient or in a dead body. In addition, the disease being incurable & 100% fatal, makes it essential to adopt effective preventive measures which in turn need thorough knowledge of social aspects of the epidemic. Certain medicolegal, and ethical aspects of the problem of AIDS are recapitulated in this article for the benefit of the medical community.

Tinidazole in the treatment of trichomoniasis, giardiasis and amoebiasis. Report of a multicentre study.

An open multicentre trial was undertaken in 8 countries to assess the efficacy and tolerance of short course treatment regimens of tinidazole Trichomoniasis: of 859 patients with trichomonal vaginitis given a 2g single dose of tinidazole 717 (95.2%) were cured. Side-effects occurred in 82 patients (9.5%) and in 12 were regarded as severe. Giardiasis: of 74 children with symptomatic giardiasis given tinidazole in a single dose of approximately 50 mg/kg body weight, 65 (88%) were parasitologically and symptomatically cured. 2 (2.7%) complained of side-effects, none of which was severe. Intestinal amoebiasis: of 502 patients, comprising 458 adults and 44 children, with symptomatic intestinal amoebiasis who received tinidazole as a single daily dose on 2 to 3 consecutive days, 477 (95%) were parasitologically cured with complete or marked improvement in symptoms. Side-effects occurred in 50 patients (10%) and in 11 were regarded as severe. Amoebic liver abscess: 82 patients were given tinidazole in single doses of 2g on 3 consecutive days. The response was rated as excellent in 60 and good in 17 (overall cure 93.9%). Side-effects occurred in 9 patients (10.9) and in 2 were regarded as severe. These findings confirm the efficacy and tolerance of short regimens of tinidazole given in single daily doses.