Epidemio-toxicological profile of fatal poisoning cases autopsied at a tertiary care centre of North India.

Background: Poisoning is an important health hazard and one of the leading causes of morbidity and mortality worldwide including in India. The study was conducted to understand the magnitude, pattern, and gender differentials of all poisoning fatalities in relation to the manner of death autopsied at a tertiary care center. Methods: A retrospective study of all fatal poisoning cases autopsied at the department of Forensic Medicine & Toxicology of a tertiary care institute in Northern India for the period 1st January 1998 to 31st December 2017 was conducted, and a profile of the victims of fatal poisoning was prepared. Data were analyzed with descriptive and inferential statistics. Results: The study included a total of 1099 cases of fatal poisoning autopsied at the department of Forensic medicine & Toxicology. Suicidal poisoning was reported in 90.2% of cases and accidental poisoning was seen in 8.9% of cases. Males were predominantly affected (63.8%). The majority of the victims were in the 3rd decade (40.0%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. Agrochemical compounds were implicated in 44.4% of the total fatalities. Conclusion: Males in the 2nd to 4th decades of life were more prone to self-poisoning with Agrochemical compounds in the region of North India. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of the epidemiology of poisoning in this region.

Relation of Primary Fingerprint Patterns With Gender and Blood Group: A Dermatoglyphic Study From a Tertiary Care Institute in Eastern India.

Background Identification of an individual plays a vital part in any medicolegal investigation. The fingerprint is one of the oldest and most reliable biometric methods and is taken as legitimate proof of identification of an individual. Positive relationships between the fingerprint pattern and blood group and the fingerprint pattern and gender were demonstrated in some of the previous studies but weren't consistent across them. Objectives (a) To study the distribution of fingerprint patterns among the study participants by gender and ABO and Rh blood groups and (b) to find an association between the fingerprint pattern and gender and blood group. Methods A cross-sectional observational study was carried out in the year 2021 on 800 healthcare students and workers of All India Institute of Medical Sciences, Patna, Bihar, Eastern India having different ABO and Rh blood groups. Healthy individuals i.e., those who were not suffering from any illness which can affect the fingerprints, aged 18 years or above were included and individuals having hand or finger deformities or missing fingers, having an allergy to the ink pad, and having blood group diseases were excluded. Rolled imprints of all the 10 digits of the participants were taken on a white A4 size Performa and were classified into loops, whorl, arches, and composite. The distribution of the fingerprint patterns was then compared by gender, ABO and Rh blood group. Chi-square/Fischer exact tests were applied to compare two groups and find the association. P-value<0.05 was taken as statistically significant. Results The majority (66.0%) of the participants in the study were males with a male: female ratio of 1.9:1. Most common blood group was blood group B (37.7%) followed by O (29.8%), A (23.0%), and AB (9.5%). Rh-positive cases constituted around 96% of all the studied cases with the rest being Rh-ve. The general distribution of the fingerprint pattern showed a high frequency of loops registering 55.9%; followed by whorls (34.9%), arches (6.0%), and composite (3.1%). The distribution of fingerprint patterns among the male and female gender was found to be similar with no significant difference (p=0.11). However, the distribution of the finger patterns across the ABO blood groups showed a statistically significant difference (p=0.0003) whereas it was non-significant across the Rh blood groups (p=0.08). Conclusion This study concludes that the distribution of the primary fingerprint patterns relates to the "ABO" blood group but not to gender and Rh blood group. An individual's fingerprints may be used to predict his/her blood group and vice versa.

COVID-Related suicide during the second wave of COVID-19 pandemic in India: A tip of the iceberg of mental health problems.

The coronavirus disease (COVID-19) pandemic has influenced the entire world. There has been great surge of mental health problems after the pandemic has started. The second wave has almost exhausted the Indian Health care system. There has also been cases of suicide due to COVID-19 infection. The objective of study was to highlight various factors involved in COVID-19 related suicide (CRS) during second wave of COVID-19 pandemic in India. CRS reports on the websites of 10 popular newspapers and television news channels in North India and official government websites such as the Ministry of Health and Family Welfare were searched between February 1, 2020, and May 31, 2021. We also searched the Medline and Google Scholar databases for CRS reports from India using the terms "corona", "COVID-19", "SARS CoV 2", "India", and "suicide" in various combinations. A total of 62 articles were included for the study. Most common mode of suicide was hanging and most common site was the deceased's home. Fear of infecting family members was the most common cause of CRS during second wave of the ongoing pandemic in India. Many individuals lost their lives to suicide due to COVID-19 pandemic. The media report does not provide the exact picture of community suicide. Proper physician counselling at the time of providing treatment can help in reducing few CRS.

Sleep Patterns, Issues, Reasons for Sleep Problems, and Their Impact on Academic Performance among First-Year Medical Students in Central India.

Introduction:Sleep is an essential part of the human daily routine. Studies have shown that sleep deprivation causes and worsens a wide range of psychological problems in people of all ages. Undergraduate students' sleep disorders are likely to persist and worsen over time. Medical students who work with sick patients on a daily basis and perform skilled activities find that sleep is very important for them. Aims and objectives: The main objective of the present study was to determine undergraduate medical students' sleeping habits as well as the numerous causes of sleep disorders. The secondary aim of our research was to determine the influence of sleep-related problems on students' academic performance. Methods:Following approval from the Ethics Committee, a cross-sectional study of 171 first-year medical students was conducted using a semi-structured self-administered questionnaire. Data was collected using Google Forms on the internet. Microsoft Excel 2019 was used to enter and analyze data. Prevalence was expressed as percentage with a 95% confidence interval. The mean and standard deviation of continuous variables was reported. Results:Of all included students, 39.2% reported they had six to seven hours of sleep each day. Study-related reasons were indicated by 32.6% of students, followed by those who utilized social media (21.7%). Laziness, exhaustion, annoyance, and restlessness were the top reasons for sleeping less (27.5%). Prior academic success was significantly connected to sleep length, while current sleep duration was not.

A Fatal Tyre Blast Injury: An Autopsy Case.

A 49-year-old man sustained an accidental injury when he was changing and inflating the tyre of a truck, and there was a sudden explosion of the truck tyre at the service station, which was by the roadside of the highway. With the pressure of air generated due to the exploding tyre, the victim was blown to around 6 feet away. He was declared dead on admission. The medico-legal examination was conducted, and death was determined to be multiple organ injuries [mainly head, chest, and abdominal injuries] caused by the shock wave produced due to tyre explosion. Tyre blast injuries are not so common. A meticulous post-mortem examination is fundamental in formulating and recording the pattern of traumatic injuries. Preventive occupational measures should be put in place.

Understanding health care seeking behavior in a tribal setting in West Bengal.

Background: The health-related problems of the tribal population depend on their ecology and culture. Often the tribal people do not utilize the medical and preventive health services available to them. Health problems in tribal groups need special attention because many tribal communities are backward. The current study was planned to determine the healthcare-seeking behavior of the tribal population in India. Method: A descriptive, cross-sectional study, conducted by interviewing key respondents of each participating family. Result: Two-thirds of the key respondents were literate and half (53.8%) of the total households in the three villages had a per capita monthly income between Rupees 500-1499. More than half (57%) of all respondents preferred government institutions for moderate illness, and the rest equally opted for private practitioners and quacks. However, for emergencies, dog bites, and snake bites, all key respondents in the three study villages unanimously preferred government institutions. A significant population (38.5%) got their children delivered at home. The majority of illiterate respondents (86.1%) preferred government institutions for health care of under-five children, while 60% of literates expressed a similar view. The choice of government institutions as a source of health care was increasingly favored with decreasing per capita monthly household income. Conclusion: Traditional healers are no longer preferred among the tribal population but they are reluctant to avail them because of the loss of valuable time. Home delivery is still prevalent. With improving socioeconomic status, people are going further away from government services as private practitioners, and quacks take less time.

The need for physical medicine and rehabilitation as an integral component in the medical education curriculum in India.

Enhanced quality of health care and increased life expectancy come with issues about the quality of life. This challenge is especially relevant to physical medicine and rehabilitation (PM and R)-a specialty focused on enhancing the quality of life. With the increasing burden of chronic diseases and disabling conditions, requirement for PM and R specialists will increase. This narrative review discusses the changing demographics, the disability trends, and the unmet needs both at present and anticipated in future. We also discussed problems faced by the present training system in PM and R, identified the lacunae, and attempted to provide suggestions to fill those.

Fatal transorbital-intracranial penetrating injury- A case report.

Transorbital injuries are rare and may lead to fatal craniocerebral damage. Ocular penetrating injuries account for 24% of all penetrating head injuries in adults, while this percentage goes up to 45% in children. Any penetrating injury through the eyes may enter the intracranial cavity and might prove fatal to the victim owing to cerebral tissue damage and complex management. The dead bodies of three victims were found by the side of the river with multiple injuries to their eyes. Further examination revealed that they had sustained multiple transorbital-intracranial injuries. In such cases, identifying injury patterns is vital so that cause and manner of death can be determined precisely. A thorough postmortem examination can help identify the alleged weapon involved in the act and may clear the doubts concerned with the manner of death.

Comparing Effectiveness of Combination of Collagen Peptide Type-1, Low Molecular Weight Chondroitin Sulphate, Sodium Hyaluronate, and Vitamin-C Versus Oral Diclofenac Sodium in Achilles Tendinopathy: A Prospective Randomized Control Trial.

Background Achilles tendinopathy, a common cause of heel pain, is primarily considered mechanical in origin, but its pathogenesis and treatment lack consensus. Molecules such as collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate and vitamin C have been shown to act as building blocks of tendon structure, and oral supplementation of these have promising results in Achilles tendinopathy. Methods This study was a prospective randomized control trial to compare the effectiveness of oral diclofenac sodium versus a nutraceutical combination of collagen peptide type-1, chondroitin sulphate, sodium hyaluronate, and vitamin C in the treatment of Achilles tendinopathy on pain and ultrasonographic structures. A total of 40 patients satisfying inclusion and exclusion criteria were randomly allocated into two groups and were given the nutraceutical combination in group A and diclofenac sodium in group B. The patient evaluation was done at baseline, six-week, and 12-week intervals in terms of VAS (Visual Analogue Scale) and tendo-Achilles thickness by ultrasound. Results Both nutraceutical combination and diclofenac reduced pain in persons with Achilles tendinopathy. The nutraceutical combination had a statistically significant better outcome in reducing pain at the end of 12 weeks. On ultrasound, both the interventions reduced Achilles tendon anteroposterior and mediolateral thickness by the end of 12 weeks. Although there was no absolute significant intergroup difference, the percentage change was more in the nutraceutical group in the case of anteroposterior thickness. Conclusion Combining collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate, and vitamin C is more effective than oral diclofenac in controlling pain in Achilles tendinopathy.