Raminder Sandhu

Determination of age from pubic symphysis: an autopsy study.

The present study was conducted on three hundred and thirty-six cases brought for autopsy to the Department of Forensic Medicine, Government Medical College, Amritsar, Punjab, India, during the period 2000-2002. Pubic bones of either sex were analysed according to Todds method (1920; 1921a,b,c) as modified by McKern and Stewart (1957) to assess and compare the known age of the corpses. Cases belonged to both sexes, i.e. 79.46% males and 20.54% females. All the cases were above the age of 17 years. No difference was noted in the scoring of right and left pubic bones. The age estimation from different components in males and females up to the total score of 10 (23-28 years) was ±6, whereas above a score of 10 the estimated age was ±12 in males and ±9 in females. The age range given for scores of 14 and 15, which were 29+ and 36+ respectively, did not account for variability of age after 40 years. Therefore, the age assessment from pubic bones in the fourth decade age group and beyond is not reliable which is in variance to the study by McKern and Stewart (1957).

Increased role of nonalbicans Candida, potential risk factors, and attributable mortality in hospitalized patients

Aim: The aim of this study was to evaluate the distribution of nonalbicans Candida (NAC) along with their associated risk factors, clinical outcome, and antifungal susceptibility pattern among inpatients. Materials and Methods: Retrospective descriptive study comprising 94 isolates of Candida species obtained from various clinical specimens of hospitalized patients. The clinical charts of patients were reviewed retrospectively who stayed in the hospital for more than 7 days irrespective of their diagnosis. Statistical Analysis: Descriptive statistics was used which involves the use of simple percentage and bar chart to analyze the data. In addition, Chi-square test was performed and P value was calculated. Results: NAC was identified in 72 (77%) patients and Candida albicans in 22 (23%). Factors associated with Candida krusei were stay in hospital ≥15 days (78%), broad-spectrum antimicrobial therapy (72%), prophylactic fluconazole therapy (67%), preterm newborn with low birth weight (LBW) (67%), stay in the Intensive Care Unit (ICU) ≥10 days (67%), indwelling devices (67%), and mechanical ventilation (67%); Candida glabrata infection as broad-spectrum antimicrobial therapy (69%), preterm newborn with LBW (62%), stay in ICU ≥10 days (62%), and indwelling devices (62%); Candida tropicalis as indwelling devices (86%), broad-spectrum antimicrobial therapy (71%), stay in ICU ≥10 days (71%), stay in hospital ≥15 days (71%), pulmonary tuberculosis (71%), neutropenia (71%). Amphotericin B was effective against both C. albicans as well as NAC with susceptibility of 91% and 89%, respectively. Mortality was similar in patients infected with C. albicans and nonalbicans species (27.27% vs. 27.77%). Conclusion: The study concludes higher prevalence of NAC with majority of patients having multiple underlying illnesses and other associated risk factors. Continued surveillance of Candida infections will be required to document changes in epidemiology and antifungal susceptibilities.