Indian Journal of Forensic Medicine and Pathology

Aortoesophageal fistula is a rare and fatal disorder. Ruptured aortic aneurysms often present with suddendeath and have varied clinical presentation. Here we are reporting a case of aortic aneurysm with aortoesophageal fistula and describe the autopsy findings. An aneurysm is a permanent abnormal dilatation of blood vessel occurring due to congenital or acquired weakening or destruction of the vessel wall. Major causes of thoracic aortic aneurysm are hypertension, atherosclerosis, degenerative disease such as medial cystic degeneration and genetic disorders such as Marfan’s syndrome and type IV Ehler-Danlos syndrome. Such death may present as sudden death or death with prolonged clinical features and due care should be exercised by forensic pathologist to arrive at a conclusion.

Key words: Death, aortic aneurysm, fistula, forensic, autopsy

A case of Proteus syndrome in a 10 year old male is reported. Asymmetric progressive enlargement started on left side of face, trunk, left hand and left leg as he grew up, hypertrophied left eyelid, cataract changes in left eye, missing teeth on left maxilla and extra teeth on left mandible, depressed chest and red patches on left side of chest. Cardiomegaly, delayed milestones, slowed scholastic performance, sluggish speech were present. There are only few reports of such cases in adults are reported in medical journals and this syndrome has rarely reported from India.

Key Words: Hemihypertorphy, Proteus syndrome, Disproportionate and asymmetric overgrowth, diagnostic criteria; misdiagnosis; evaluation and management. 

Background: The threat of animal attacks on people is still a huge medico-social problem as these attacks result in millions of death and injuries worldwide. Snake bite along with other animal bites like dog bite, scorpion bite is a neglected public health problem. Snake bites are the common cause of mortality and morbidity in tropical countries. Objectives: This study was conducted to assess the extent of various bites and study the socio-demographic factors, cure rate and mortality rates of various bites at District Hospital. Materials & Methods: A retrospective descriptive study was carried out at the District Civil Hospital in Ahmednagar. Data regarding various animal bite cases coming to the District Hospital from January 2004 to December 2008 was collected from the registers maintained in the medical record department. A pre- designed and pre-tested questionnaire was used for the data collection. Results: In the present study, a total of 5461 cases of animal bites were admitted in the hospital. Majority (54.56%) were males. Maximum cases were of dog bite, 3250 (59.5%), followed by snake bites 1620 (29.6%) and 23 (0.24%) cases were of scorpion bite.Maximum cases amongst were dog bites and from 10-20 years age group, whereas snake bite was common in > 40 years. Conclusion: Majority bites were due to dog bites followed by snake bites. Awareness regarding early management of snake bites must be increased to decrease the mortality. Patient education is important for decreasing the incidence and morbidity of animal bites. 

Key words: Animal bites; Dog bite; Snake Bite; Scorpion bite.  

Background: Organophosphorous (OP) compounds are extensively used in India as insecticides and most often misused for suicide purpose. Aim: The present study was undertaken to know the incidence of organophosphorous poisoning, socioeconomic status and nature of poisons in the southern region of Odisha state. Material and Method: The study group comprised 1514 OP poisoning cases admitted to the VSS Medical College Hospital, Burla. Retrospective analysis of hospital records, post mortem reports and inquest reports were made to study the determinants. Result: Organophosphorous poisoning cases constituted 65.31% of total cases. Maximum number of organophosphorous poisoning cases were between the ages of 21-30 years of lower socioeconomic status. Males were more affected than female. 66.63 % of the cases were from rural area. Commonest symptoms were nausea, vomiting, pupillary constriction, sweating and excessive salivation. Conclusion: There is an increasing trend to use organophosphorus poison as a means of committing suicide among the rural population in western Odisha which needs urgent attention by appropriate authorities. 

Key words: Organophosphorous (OP) compounds; Insecticides; Suicide.

Background: The Presence of defense wound and its conclusive interpretation would be helpful to judiciary to solve many of such cases as it suggests that the victim was conscious, at least partly mobile and not taken completely by surprise. Material & Method: The profile of defense injuries was studied amongst the 100 cases of homicidal deaths, autopsies of which were conducted at mortuary of Government Hospital, Rajkot in a period of one and half year.Results: Defense injuries were seen in 28% cases of total cases of suspected homicides. Maximum number (37.5%) of cases were belongs to age group 41-50 years. Majority were male victims. Amongst all cases, 46.4% had defense wounds over left half of the body, while it was bilateral in 32.2% cases. Only sharp objects were inflicted in 60.7% of cases, while 28.6% cases had defense injuries by blunt object. Majority of defense wounds were present over upper limbs (84.9%). 36.2% of all defense injuries were sustained over forearms, may be due to nearest to the perpetrator.

Key words: Defense injury; Homicidal deaths; Sharp weapon. 

Background: The medical curriculum in most colleges is taught in a traditional, subject-wise fashion predominantly through didactic lectures. PBL is an effective way of delivering medical education in a coherent, integrated manner. Aim and Objectives: To compare PBL with traditional learning method. Type of Study:comparative study. Materials & Method: 96 medical students from Dr. Vasantrao Pawar medical college,Nasik were recruited during second term of their second year. Ten topics from the 2nd term syllabus of second year were selected. Out of these 10 topics, 5 were covered under PBL method and remaining under traditional lectures. For PBL sessions, all students were grouped into 12, with each group consisting of 8 students. At the end of study, prestructured and pretested questionnaire consisting of items pertaining to the process of PBL was filled from students and also performance of students was assessed in post session examination. Results: Out of the 96 students, 84(87.5%), 87(90.6%) and 75(78.13%) students said PBL increased their motivation to participate in class, to attend class and to do well in the course respectively. Also, 90 (93.75%) students said that PBL enhanced their communication skills and 88(91.67%) students said that PBL has enhanced their retention of course content. In PBL Covered Topics, 68.75%students scored above e”75% while in Traditional Lecture Covered Topics, 44.79% students scored e”75%. Average attendance in PBL session was 89.79% while in traditional lecture method it was 78.95%. Conclusion: In institute with packed curriculum, introducing more PBL sessions is not feasible as it is time consuming, though it is more effective method of learning. So the hybrid method i.e. combination of these two methods will be more effective than any of them alone. 

Key Words: Problem based learning (PBL); Traditional teaching methods (lecture-based); Medical education; Integrated teaching.