Shankar M Bakkannavar

Analysis of fatal road traffic accidents in a coastal township of South India

Road traffic accidents (RTAs) are important causes of mortality and morbidity due to the increasing number of vehicles, changes in lifestyle and the risk behaviours among general population. With the aim of exploring various epidemiological characteristics of RTAs, this retrospective analysis of medico-legal autopsies was conducted between January 2005 and December 2009 in the Department of Forensic Medicine, Kasturba Medical College, Manipal in Karnataka, South India. The information was collected from post-mortem registers and inquest documents received from the investigating police officers. The collected information was analysed using SPSS version 11.0. Out of the 879 autopsies conducted during the study period, 39% were due to RTAs. Among the victims, 89.8% were males and 10.2% were females. The mean age of victims was 38.7 years, which was slightly higher in females compared to males. Most of the male victims belonged to the age group 20-29 years. The head injuries were responsible for nearly 3/4th of deaths followed by abdominal injuries (6.7%). The mean duration of survival following road traffic accident was 6-7 days. Occupants of motorized two wheelers (43%) and pedestrians (33%) were the most common victims of RTAs followed by occupants of light motor vehicles (LMVs). The most common offending agents in road traffic accidents were heavy motor vehicles (35.2%) followed by light motor vehicles (31.7%). In view of the above finding, it is apt to conclude that RTAs are important public health hazards and should be addressed through strengthening of emergency healthcare, stricter enforcement of traffic laws and health education.

Toxicoepidemiology of fatal poisonings in Southern India.

An autopsy based retrospective study was conducted from January 2000 to December 2006 at Manipal in Southern India, and a profile of the victims of poisoning was prepared. The study was done to understand the magnitude and pattern of all poisoning fatalities in relation to the manner of death in Manipal region of Southern India. The study included a total of 198 cases of fatal poisoning. Self-poisoning was reported in 92.9% cases. Fatal accidental poisoning was seen in 6.1% cases. Homicide by poisoning was not reported during the study period. Uncertainty regarding the manner of death due to poisoning was observed only in two cases. Males were predominantly affected (71.2%). The majority of the victims were in the 3rd decade (28.3%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. While majority of the victims consumed poison during daytime, most of the poisoning fatalities were reported during summer months. Organophosphate compounds were implicated in 68.7% of the total poisoning related fatalities. Males in the 3rd to 5th decades were prone to self-poisoning with organophosphate compounds. 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 epidemiology of poisoning in our region.

Mesiodistal width of canines: a tool for sex determination:

Teeth, in the living as well as the dead, are the most useful objects in the field of forensic investigation. Their ability to survive in situations like mass disasters makes them important tools in victim identification. Though the morphology and structure is similar in both men and women, there are subtle differences. Variation in dental size can give a clue about differences between the sexes. Many authors have measured the crowns of teeth in both men and women and found certain variations. Canines, reported to survive air crash and hurricane disasters, are perhaps the most stable teeth in the oral cavity because of the labiolingual thickness of the crown and the root anchorage in the alveolar process of the jaws. Measurement of mesiodistal width of the mandibular and maxillary canines provides good evidence of sex identification due to dimorphism.

Age and gender variations in trend of road traffic fatalities in Manipal, India:

Background The incidence of road traffic fatalities has been increasing at an alarming rate and is a global cause for concern. Aims To assess the age- and gender-based variations in the pattern of road traffic fatalities in Manipal, southern India and to provide an epidemiological profile of the population at risk. Settings and design Registry-based retrospective research on road traffic fatalities in Manipal, extending from 1994 to 2009, was conducted at the Department of Forensic Medicine, Kasturba Medical College, Manipal. Material and methods The data were collected from the autopsy files and information furnished by the police in the inquest papers. Road traffic fatalities were analysed, keeping the gender and age of the victim as co-variables. Results and conclusions Road traffic fatalities constituted the majority of autopsied cases (38.6%) and unnatural deaths (37.8%). Percentage share of road traffic fatalities with regard to unnatural deaths in Manipal did not show a definite trend during the last 16 years. Male preponderance was quite evident, male–female ratio being 7.2:1. Male mortality pattern peaked during the third decade followed by a gradual decline, whereas the mortality pattern among women was almost uniform from second to seventh decade. Overall, people in their third decade were most prone to road traffic fatalities (26.9%), a trend similar to that of male mortalities. The overall pattern of road traffic fatalities was quite similar to those in other parts of India and the world. The global problem with regard to road traffic fatalities remains the same irrespective of the difference in topography and demography of the region.

Colchicine poisoning: a case report and review of literature

Colchicine, a natural pseudo-alkaloid found in plants such as the Colchicum autumnale and Gloriosa superba has tremendous medicinal properties, but if misused by an unqualified person can result in fatal consequences. We report a case of colchicine poisoning in an adult man as a result of consumption of the herb G. superba by a 50-year-old man and review the literature.

A rare case of myocardial infarction due to parathion poisoning.

Organophosphorus poisoning occurs very commonly in southern India where farmers form a significant proportion of the population who commonly use organophosphorus compounds like parathion as insecticides. Awareness of the complications caused by parathion poisoning is essential for proper monitoring and treatment. We report a case of suicidal parathion poisoning in a farmer who was treated with atropine and oximes. He subsequently developed myocardial infarction, to the treatment of which, he showed no response and succumbed. In conclusion, myocardial infarction is a rare complication of parathion poisoning. Awareness of this complication of parathion poisoning, proper monitoring and treatment could prevent fatalities.

Death by attack from a domestic buffalo

Attacks on humans by domestic animals causing fatal injuries are not uncommon in rural areas of India. But injuries due to buffalo gore are rarely observed in villages and are different from other casualties like stab injuries, road fatalities, etc. As the victims of buffalo attack are usually recovered from the fields or forest, the investigating officer could be mislead as to the nature of infliction of fatal injuries to a possible homicide. The injuries caused by the horns of buffaloes are of various shapes, sizes and directions. They are violent and goring in nature. The wound sustained may be contusions, lacerations, criss-cross wounds, penetration of body cavities, and sometimes fractures. In the absence of any eye witness, it becomes very difficult to believe the unsuspecting domestic water buffalo as attacker. This case is reported for its rarity, for the awareness of the possible injuries in such unnatural deaths, and factors predisposing to a buffalo attack.

Paraquat poisoning: Analysis of an uncommon cause of fatal poisoning from Manipal, South India

Background: Morbidity and mortality related to acute poisoning is a serious health concern worldwide. Paraquat is known to be responsible for a number of acute poisonings in south India. Aim: The study aims at presenting the various aspects of paraquat poisoning that include patient profile, clinical presentation, end-organ complications, and observations at autopsy. Materials and Methods: The present registry-based retrospective research was conducted in a tertiary care teaching hospital in south India. All the confirmed cases of paraquat poisoning were included in the present study. The postmortem and hospital records of these patients were retrieved and relevant information was collected and analyzed. Results: Paraquat poisonings constituted 14.4% of the total poisoning fatalities during the study period. Equal number of males and females were observed in the present study. The victims were aged between 17 and 65 years (mean ± SD = 30.2 ± 13.1 years). Manner of death was suicidal in 92.9% cases. Common presenting symptoms after ingestion of paraquat included vomiting, followed by difficulty in breathing. In the present series, overall survival post paraquat consumption ranged between 10 h and 25 days. Half of the victims died within 2 days of consumption of poison. The underlying cause of death included acute renal failure (ARF), adult respiratory distress syndrome (ARDS), multiorgan failure (MOF), acute liver failure, etc., In all the cases, brain was congested and edematous, and visceral organs showed marked congestion at autopsy. Lungs were congested with marked edema in 10 cases. Conclusion: It is recommended that the availability of this highly toxic substance be restricted so as to prevent its misuse as a method of suicide.

PROFILE OF ORGANOPHOSPHORUS INSECTICIDES POISONING IN KASTURBA HOSPITAL, MANIPAL, SOUTH INDIA

A prospective study was conducted from November 2007 to November 2009 in a tertiary care hospital at Manipal in Southern India, and a profile of the victims of pesticide poisoning was prepared. The objective of the study was to recognise the magnitude and pattern of poisoning in relation to the manner of consumption in this region of Southern India. In the present study, the young productive age group between 20-40 years we remostly affected. Males were predominantly affected.The most common compound was chlorpyrifos. Vomiting was the most common symptom. The most common sign was dilated pupils as against the usually observed sign of miosis which was attributed to atropine received from referral hospital. Among the complications, respiratory failure followed by pneumonia was commonly observed with severe pneumonia being the most common cause of mortality.

Eruption Pattern of Permanent Teeth in the Age Group of 5 to 15 Years of Udupi District of Karnataka

Introduction:Establishment of identity in the living and the dead individual carries tremendous medico-legal significance. Estimation of the age of an individual is an important step in establishing the identity of an individual. Identification may be complete or incomplete. Comparative techniques like anthropometry and prints involving foot, hand, nail, ear, lip, palate and fingers, superimposition technique, dental data and DNA fingerprinting help to identify an individual Materials and Methodology:Materials for the present study consisted of 1, 000 students from various schools, in the age group of 5 to 15 years belonging to Udupi district. Examination of the oral cavity was carried out. The tooth was recognized based on the morphological features. The eruption pattern of each tooth was noted in a proforma. The proof of age of the subjects were obtained from the school documents and birth certificates.Results:The sequence of eruption pattern of permanent teeth was similar in boys and girls. The mean ages for eruption in boys for first molar were 6.85 years, followed by the central incisor at 8.14 years whereas in girls it was 6.94 years, and 7.86 years, respectively. All the maxillary permanent teeth in both genders erupted first in the left quadrant, followed by the right quadrant, except the second premolar (boys) and second molar (girls), which erupted first in the right quadrant. All the mandibular permanent teeth in both genders erupted first in the left quadrant, followed by the right quadrant.