Yashoda Rani

Fatal aluminium phosphide poisoning.

Abstract Aluminium phosphide (AlP) is a cheap solid fumigant and a highly toxic pesticide which is commonly used for grain preservation. AlP has currently aroused interest with a rising number of cases in the past four decades due to increased use for agricultural and non-agricultural purposes. Its easy availability in the markets has increased also its misuse for committing suicide. Phosphine inhibits cellular oxygen utilization and can induce lipid peroxidation. Poisoning with AlP has often occurred in attempts to commit suicide, and that more often in adults than in teenagers. This is a case of suicidal consumption of aluminium phosphide by a 32-year-old young medical anesthetist. Toxicological analyses detected aluminium phosphide. We believe that free access of celphos tablets in grain markets should be prohibited by law.

Age estimation from IV rib by phase analysis in Indian females

Metamorphosis at the sternal extremity of the rib has already been established as a reliable indicator of age at death by Iscans phase method introduced in 1985. The purpose of this paper is to apply rib phase standards to an Indian sample to test if the progression of morphological changes follows the same age sequence. The rib sample shows that an accurate estimation of age can be made by direct examination of the bone itself. The sample consisted of 63 ribs of known age, sex, and race. The ribs were assigned to one of nine phases (0 through 8) based on changes noted at the costochondral junction. These included the formation of a pit, its depth and shape, configuration of the walls and rim surrounding it, and the overall texture and quality of the bone. Statistical analysis revealed that the features chosen to delineate the phases are valid predictors of age. This study has shown that the sternal rib can provide an accurate estimation of age in females spanning a mean age of 14 to 85 years.

Anatomical Consideration and Potential Complications of Coronary Sinus Catheterisation.

INTRODUCTION Coronary venous catheterisation has been used for performing various cardiologic interventions. The procedure might become complicated due to obstruction offered by the valve of coronary sinus (Thebesian valve) the acute bend of the Great Cardiac Vein (GCV). The present study sought to expound the anatomical considerations of coronary venous catheterization and to elucidate the potential causes of obstruction and the complications of this procedure. MATERIALS AND METHODS In this cross-sectional observational study, coronary sinus and GCV were dissected in 40, formalin fixed, adult cadaveric human hearts. Course, length, diameter and angle of bend of GCV, length of coronary sinus and its diameter at its ostium in right atrium were recorded. Thebesian valve morphology and percentage coverage of coronary sinus ostium was recorded. Relation of the coronary sinus and GCV with their neighbouring arteries was described. RESULTS Coronary sinus: near its termination was directly related to the left atrium. Length: 35.35±4.43 mm (1 SD). Diameter: 11.75 ± 2.66mm. Diameter of CS ostium was more in hearts where Thebesian valve was absent. GCV travelled superficial or deep to the left diagonal artery and crossed circumflex artery superficially. Length: 96.23 ±22.52mm. Diameter: 5.99 ±1.02mm. Angle of bend: 107 ±6.74 degrees. Thebesian valve: Absent in 3 hearts. Various morphologies were observed: thin band, thin band with fenestrations, broad band with fenestrations, well developed semilunar valve (Thin/thick). In five hearts, valve covered more than 50% of coronary sinus ostium. CONCLUSION Coronary sinus and GCV diameter will help cardiologists and cardiothoracic surgeons to choose an appropriate sized catheter and their length will decide the length of catheter advancement. Thebesian valve may cause obstruction to the catheter due to an extensive coverage of coronary sinus ostium, which is seen in 12.5% cases. The obtuse angle of GCV has to be negotiated in order to enter this vessel. Arteries lying deep to coronary sinus and GCV might be compressed leading to myocardial ischemia.

Anatomical considerations of percutaneous transvenous mitral annuloplasty: a novel procedure for treatment of functional mitral regurgitation.

Percutaneous transvenous mitral annuloplasty (PTMA) has evolved as a latest procedure for the treatment of functional mitral regurgitation. It reduces mitral valve annulus (MVA) size and increases valve leaflet coaptation via compression of coronary sinus (CS). Anatomical considerations for this procedure were elucidated in the present study. In 40 formalin fixed adult cadaveric human hearts, relation of the venous channel formed by CS and great cardiac vein (GCV) to MVA and the adjacent arteries was described, at 6 points by making longitudinal sections perpendicular to the plane of MVA, numbered 1–6 starting from CS ostium. CS/GCV formed a semicircular venous channel on the atrial side of MVA. Based on the distance of CS/GCV from MVA, two patterns were identified. In 37 hearts, the venous channel at point 2 was widely separated from the MVA compared to the two ends and in three hearts a nonconsistent pattern was observed. GCV crossed circumflex artery superficially. GCV or CS crossed the left marginal artery and ventricular branches of circumflex artery superficially in 17 and 23 hearts, respectively. As the venous channel was related more to the left atrial wall, PTMA devices probably exert an indirect traction on MVA. The arteries crossing deep to the venous channel may be compressed by PTMA device leading to myocardial ischemia. Knowledge of the spatial relations of MVA and a preoperative and postoperative angiogram may help to reduce such complications during PTMA.

Age estimation from the IV rib by the components method in Indian males

Determination of age plays a pivotal role in identification of unknown skeletal remains. Changes at the sternal extremity of the fourth rib have already been established as reliable indicators of age at death. The İşcan ‘phase method’, based on the morphologic changes at the sternal extremity of the fourth rib, is one of the most effective techniques for age estimation at death. The present study was based on the component method developed by İşcan et al. for the white American population. The sample consisted of the fourth ribs on the right-hand side from 101 males of known age and race. Statistical analysis indicated that these changes were age related and also applicable to Indian males.

Accidents are caused, they do not happen

ABSTRACT The head, being the most vulnerable part of human body, is the most commonly injured body part in accidents, especially those involving road traffic. In an unusual case, the deceased succumbed to internal injuries of the brain that resulted from the neck being constricted with the loose end of a dupatta. The woman was pillion riding a motorbike when the loose end of the dupatta got entangled in the rear wheel of the motorbike. As a result, her neck was constricted by the dupatta and wentunnoticed. This paper comments on the safety of wearing the traditional style dressing of Indian women while riding on two wheeled vehicles. Additionally, this paper suggests it be mandatory to wear helmets for all pillion riders in order to prevent such mishaps in future.