Tirath Das Dogra

Fatal road traffic accidents and their relationship with head injuries: An epidemiological survey of five years

In depth studies of fatal vehicular accidents provide valuable data for implementing effective emergency services to reduce the trauma related mortality and strengthening legal measures in peak hours of fatal accidents. We aimed to study, pattern of injuries especially fatal traumatic brain injuries occurring in vehicular accidents. Postmortem reports and clinical records of victims of road traffic accident autopsied during the period of 2001–2005 at Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, were analyzed retrospectively. Out of total 7008 medico legal autopsies conducted during the study period, 2472 (35.27 %) were of vehicular accidents. The male/female ratio was 7.49:1. Commonest age group affected was between 21-40 years involving 1341 (54.24%) cases. Pre-hospital mortality was in 985 (39.84 %) cases. Fatal traumatic brain injuries were seen in 1699 (68.73%) cases. Skull fractures were found in 1183 (69.63%) cases of head injury; most common bone fractured was temporal bone (n=559, 47.25%). The commonest variety of intracranial hemorrhage was subdural hemorrhage (n=1514, 89.11%). The craniotomy was done in 297 (17.48%) cases; maximum mortality (41.07%) was seen within 4–ays. Most commonly injured abdominal organ was liver (n=532, 21.52%). No significant difference was evident in incidence of fatal vehicular accident on weekends and weekdays. However November month took maximum toll of deaths (n=273, 11.04%) of total vehicular accident fatalities in five year duration. 53.20% of fatal accident occurred between 6 PM and 6 AM. The results of study emphasize the need to improve the pre hospital care with provision of trauma services at site and to establish neurosurgical facilities with trauma registry.

Suicide Notes in India: What Do They Tell Us?

Over 100,000 people commit suicide each year in India; yet, there has been limited micro-based study. This study marks the first study of suicide notes in India. The sample consisted of all available note-writers (n = 50), with a comparative sample of non-note writers (n = 50) of all suicides (n = 320, 16.47% of all postmortems) during a 1½ year period in the New Delhi area, India. Using the demographic (descriptive) schema of Ho, Yip, Chiu, and Halliday (1998), the results show that note writers do not differ greatly from other suicides. Males wrote more notes, but the more intriguing finding is the fact that suicide in India is associated to an array of psychiatric/psychological and social factors.

Suicide among children and adolescents in south Delhi (1991–2000)

Objective : Suicide among youth is of great concern and a subject requires thorough study to formulate prevention strategy. In this paper the incidence and trends of suicide among children and adolescent of South Delhi have been reported.Methods : A retrospective analysis was carried out on 222 cases of suicidal deaths pertaining to age group of 10–18 years, the postmortem examination on the body of which were conducted in Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi during the period from 11st January 1991 to 311st December 2000. The particular of cases were analyzed according to age group, sex, method used and causes of committing suicide.Results : Out of 222 cases 123(55.4%) were of girls (Female : Male 1.24:1). Commonest age group involved was 15–18 years in both the sexes. Commonest method used for committing suicide was hanging (57% in girls, 49.5% in boys) followed by poisoning (37.4% in girls, 49.5% in boys).Conclusion : Methods used to commit suicide are widely available and are difficult to restrict. Therefore, suicide prevention strategy based on risk factors could be more effective rather than limiting the access to methods.

Electrocution in South Delhi: a retrospective study

One hundred and fifty three unselected autopsy cases of electrocution received from South Delhi were studied during the period 1996-2001. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.98% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, season of the year, site of the body, time of day, place of occurrence and presence of entry and exit wounds on the body. Death occurred at the scene of the fatal event in 150 cases and three cases died in hospital. Three cases showed no electric burn marks on the body; the cause of death in one of these cases was polytrauma due to a fall from a height and one case had committed suicide.

Study on arsenic level in public water supply of Delhi using hydride generator accessory coupled with atomic absorption spectrophotometer.

Surveillance of drinking water is essentially a health measure intended to protect the public from water borne diseases. Hydride generator accessory coupled with atomic absorption spectrophotometer was used to analyze arsenic level in 49 ground water samples collected from different areas of Delhi. Arsenic level in ground water samples was in the range of 0.0170 to 0.100 ppm (Mean-0.0431, Standard Deviation-0.0136, Std. error of Mean-0.00194) with minimum concentration at Raney Well No. 7 (0.0170 ppm) and maximum at Kotla Mubarak Pur (0.100 ppm). Arsenic containing sediments and percolation of chemicals into soil as the result of dumping of garbage rich in chemicals into open landfills could be the possible source of arsenic in ground water of Delhi. Extensive survey and continuous monitoring is required to be made to assess the magnitude of problem and earlier intervention.

PATTERN OF CRANIO-INTRACRANIAL INJURIES IN FATAL VEHICULAR ACCIDENTS IN DELHI, 1966-76

The present study was undertaken in the Department of Forensic Medicine of the AH India Institute of Medical Sciences, New Delhi, with the object of studying various aspects of cranio-intracranial injuries in roadside vehicular accident cases. Out of a total of 3227 medicolegal post-mortem examinations conducted, the number of accidental deaths was 2279 (70·62 per cent). Vehicular accidents (1132) comprised 49·76 per cent of the total fatal accidents and 35·5 per cent of the total post-mortems. The incidence of males involved in accidents was 71·74 per cent which was about five times more than females (15·01 per cent). Children below 12 years comprised 13·25 per cent of vehicular accident victims. The most common victim involved was the pedestrian comprising 50·7 per cent, followed by the motorcyclist (18·28 percent). The commonest age group involved in fatal vehicular accidents was between 21–40 years (521 cases, 46·01 per cent). Persons between the age group 11–20 years accounted for 13·69 per cent. Trucks were responsible for accidents in 28·09 per cent of cases, buses in 17·14 per cent and cars in 22·99 per cent; these have been found to be the most common types of vehicles causing fatal accidents. Most of the victims died on the spot (36·30 per cent). A total of 72·5 per cent of the victims died within 24 hours. All victims survived up to a maximum of only 2 weeks, except one case who survived 29 days and died of pyogenic meningitis. Head injuries were responsible for causing death in 71·99 per cent of cases. Chest injuries caused death in 6·18 per cent of cases and abdominal injuries proved fatal in 7·06 per cent of cases. Death by injury to other regions occurred in 15·54 per cent of cases. The incidence of cranio-intracranial injuries was highest in cyclists (78·93 per cent), followed by motorcyclists (72–46 per cent) and pedestrians (66·02 per cent). The number of car occupants involved in fatal accidents was 65·3 per cent. Fracture of the skull was observed in 79·87 per cent of cases; the most common bone involved was the temporal bone (58·67 per cent), followed by the occipital bone (57·75 per cent). Fractures of parietal and frontal bone were almost equal, being 50·38 per cent and 49·37 per cent respectively. The commonest variety of intracranial haemorrhage was subarachnoid haemorrhage (66·9 per cent), followed by subdural haemorrhage (58·2 per cent) and extradural haemorrhage (14·2 per cent). Extradural haemorrhage was least common (14·2 per cent). Intracerebral haemorrhage was found in 22·5 per cent of cases and brain stem haemorrhage in 10·81 per cent. The incidences of contusion and laceration of the brain were almost equal, being 23·6 per cent and 24·8 per cent respectively. Fracture of the ribs was the commonest chest injury, with contusion and laceration of the lung in 18·6 per cent of cases. Laceration of the liver was commonly found in abdominal injury in 17·2 per cent of cases. These findings have been compared with other authors. An attempt was also made in the present study to correlate the post-mortem findings and the survival time in relation to those victims who gave a history of consciousness after the accident and those where there was no history of consciousness. For convenience sake, the post-mortem lesions were divided in grades as 0, I, II, IIa, III and IIIa. The maximum number of fatal cases (46·2 per cent) belonged to grade III (fractured skull, intracranial haemorrhage and brain lesion) followed by grade II (35·1 per cent) (fracture skull and intracranial haemorrhage). No relationship was established between the post-mortem findings, the survival time and the state of consciousness or un-consciousness. The grade II and grade III lesions were common in both conscious and unconscious patients. The commonest complication observed in head injury cases was bronchopneumonia.

Suicide in India, 1995-1999

The epidemiology of suicide in India from 1995-1999 was presented. The data show an increasing incidence of suicide; over 100,000 people commit suicide each year in India. The ratio of male|female is small by international comparisons. Illness and interpersonal|familial factors appear to be common motives, although suicide is more complex in India. Further, it is concluded that Indias data may well be problematic, being overly based on police records and that a much greater micro study to identify the multideterminant factors of suicide in India is needed.

Decapitation in road traffic accident--a case report

A 20-year-old girl along with four of her friends, all in their early 20s, met with a fatal accident in the early hours of the day. Their car was hit by a speeding truck at a crossing. All the occupants of the car sustained multiple injuries and died on the spot. The girl was decapitated in the accident. Her head was recovered outside the mangled remains of the vehicle and the rest of the body was extracted from the co-drivers seat of the damaged vehicle.

Comprehensive Study of Homicides in South Delhi, 1969–79

The present study was undertaken by the Department of Forensic Medicine, All India Institute of Medical Sciences (AIIMS) to find out the trends in homicides during the years 1969–79. Out of 4837 medico-legal autopsies conducted during the above-mentioned period, 140 cases (2.8 per cent) were of homicidal deaths. The commonest age group of the victims was 21–30 years (39.25 per cent) followed by 31–40 years (20 per cent). Males were victimized seven times more than females. Winter was the commonest season for the crime and most homicides occurred during the night. Most deaths occurred at the scene of the event. In our series blunt force injury was the commonest type (41.42 per cent) followed by stab injury (31.42 per cent). Defence wounds were present in 28.58 per cent of cases. Robbery and financial gain were the commonest type (37.1 per cent) of motive for the crime.

Determination of median lethal dose of combination of endosulfan and cypermethrin in wistar rat

The present study was designed to determine the lethal dose 50 (LD 50 ) of combination of cypermethrin, a pyrethroid, and endosulfan, an organochlorine compound in Wistar rats. LD 50 is the amount (dose) of a chemical, calculated as per the concentration of chemicals that produces death in 50% of a population of test animals to which it is administered by any of a variety of methods. A single oral dose of combination of cypermethrin and endosulfan were dissolved in dimethyl sulfoxide (DMSO) in a ratio of 1:1 and administered orally at the concentration of 165 mg/kg body weight (b.w), 330 mg/kg b.w, 660 mg/kg b.w, and 1320 mg/kg b.w to experimental animals. LD 50 was calculated according to the method described by Miller and Tainter (1994) and was observed as 691.83 mg/kg b.w for this combination. Single dose of test article at 165 mg/kg b.w did not reveal any toxic signs or behavioral alterations, hence considered as No observed Adverse Effect level (NOAEL).