Indian Journal of Forensic Medicine and Pathology

Consent is an ethical principle. Medical treatment can only be administered with consent of a competent patient. Giving the treatment without consent is failure to respect patient’s autonomy; violating an individual’s right to self-determination. Any medical treatment given without consent is an action for trespass where damages are payable. The core idea of autonomy is one’s action and decisions are one’s own. Therefore every patient has the right to know what happens to his body. It is the moral and legal duty of a physician to inform the patient about all the aspects of his illness and help him by advising so that he is able to make a logical and intelligent decision about his treatment. Examining or treating a patient without his consent amounts to battery and assault and may invite legal liabilities for a physician.

Keywords: Consent; Clinical Practice; Medico-Legal. 

Background: Haematological manifestations are the second commonest cause of morbidity and one of the common causes of mortality in HIV patients. In the course of ART administration, clinically significant haematologic abnormalities are common in persons with HIV infection. Objectives: To study the comparison of haematological parameters in subjects with different CD4 counts, to compare haematological findings of pre-ART group with ART group and two ART regimens namely ZLN and TLE. Study Design: Prospective observational study. Material and Methods: After obtaining informed consent, 225 PLHIV were clinically evaluated and subjected to CBC, PBS, ALC, ESR and CD4 count. Statistical Analysis: Data was expressed as percentage and mean ± standard deviation. Statistical tests used were chi-square test, Fisher’s exact test and Mann-Whitney U test and Kolmogorov-smirnov analysis. Results: TLC (p=0.02), MCV (p=0.04) and ALC (p<0.0003) were significantly raised while Hb, MCH, MCHC, PCV, ESR, CD4 count showed Non significant raised values in ART group in comparison to pre-ART group. MCH (p=0.01) and ALC (p<0.001) were significantly raised and Hb, MCHC, PCV, ESR, ALC showed Non significant raised values in PLHIV on TLE regimen when compared to ZLN regimen while TLC (p=0.04) was significantly raised in ZLN regimen. Conclusion: Most significant parameter was ALC in comparison between treated and untreated PLHIV groups and two ART regimens. TLE regimen fared better than ZLN regimen in treatment of PLHIV.

Keywords: Haematological; PLHIV; TLE; ZLN. 

The proper handling and disposal of Bio-medical waste (BMW) is very imperative. There are well defined set of rules for handling BMW worldwide. In this descriptive observational cross-sectional study, 78 sanitary staff handling BMW participated. Maximum number of study participants (29.48%) belonged to age group of 41- 45 years. 65.38% BMW handling workers were addicted to tobacco either in the form of smoking/chewing/ misery/gutkha chewing while 34.61% male workers were alcoholic. 60.25% staff suffered needle stick injuries (NSI) and 19.23% staff were injured while handling sharp objects. It was observed that one worker was HIV positive and has given history of needle stick injury while one worker was found to be Hepatitis B positive. 65.38% study participants had complains of lower backache while 34.61% workers were emotionally disturbed and they were not satisfied with their job. After training the use of Personal Protective Equipments (PPE) like gloves, mask and goggles improved to 93.59%, 83.33% and 12.82% respectively. Training also was fruitful where the participants got themselves vaccinated 100% and 79.48% for Tetanus and Hepatitis B respectively.

Keywords: Bio-Medical Waste; Sanitary Staff; Needle Sticks Injuries; Personal Protective Equipments; Vaccination. 

Determination of stature from fragmented human remains is vital part of forensic investigation for thepurpose of identification. Determination of stature from dismembered body parts can play vital role for identification of person. Present study was done to derive regression formula and multiplication factor to estimate stature from Nasal dimensions mainly Nasal Height and Nasal Breadth for population in and around Rajkot region of Gujarat. Total 100male cases and 100 female cases randomly selected from cadavers brought for post-mortem examination at mortuary of P.D.U. Govt. Medical College and Hospital, Rajkot. Stature was measured with measuring tape and Nasal dimensions were measured by Spreading caliper after breaking Rigor mortis, if developed. Collected data were statistically analysed using software like Epi info 7 and Microsoft excel. Mean stature as well as mean Nasal dimensions were significantly higher for male than for female (p<0.05). Regression formula and multiplication factor derived in present study are useful to estimate stature from nasal dimensions for population in and around Rajkot region of Gujarat.

Keywords: Identification; Stature; Nasal Height; Nasal Breadth. 

Individual identification from mutilated body remains is a challenge to Forensic Experts. When incomplete skeletal material is available the stature estimation and sex differences are to be made out. Various formulae have been computed in the past using long bones but the accountability of them due to differing ethnicity and other factors like race and nutritional factors is a question. Most often a foot is brought for identification of an individual in mass disasters; natural or manmade, in assault cases where the body could be mutilated to conceal the identity of the victim. In such cases identification may not be complete, but partial identification would be of importance which helps to proceed in further investigation. One such estimate of stature of an individual by measuring foot length is of considerable value in the process of identification. Studies in the past have showed significant correlation between foot dimensions with stature and sex of an individual. It has been observed that dimensions from lower extremity have a greater correlation with the body height than those of the upper extremity. Ossification and maturation of bones of foot occur earlier than the long bones and height would be more accurately predicted from foot measurement as compared to that from long bones. This study is an effort to find correlation between foot length and stature and sex difference in this part of India and help in partial identification of the individuals.

Keywords: Forensic Anthropology; Stature; Gender; Foot Dimensions. 

Homicide is killing of a person by another person/ by group. Killing a person may be with several motives, common being property, money and women. The person may be killed in a fit of rage or there may be a detail planning executed. According to NCRB, Karnataka 2015 accounts for 27.6% of violent crime. In the current study attempt is made to study the pattern of injuries in homicidal cases. The injuries due to blunt force were present in majority of cases with head being most commonly involved region. The predominant motive was extra marital affairs and incidence was highest in males in age group of 15-29 years.

Keyword: Homicide; Head Injury; Blunt Force; Sharp Force; Ligature Compression.

Introduction: Suicide being a major contributor to fatality world over still remains an enigma for the many scholars who have devoted time and resources to unravel its secrets. As per WHO, there occurs one suicidal death every 40 seconds. Materials and Methods: A prospective autopsy based study was conducted over a 3 year period from 2014-2016 in S.C.B. Medical College and Hospital, Cuttack and a total of 904 cases of suicidal deaths were studied using a specially devised questionnaire. Multiple social, biological and psychological factors were taken into account. Result: It revealed a male to female ratio in completed suicides of 1:1.17 and 69.14% suicides to be in the age group of 15-44 years. The victims predominantly belonged to lower income groups followed by those from lower middle class. Married females clearly outnumbered the married males. Males were seen to be more vulnerable when living in a nuclear setup. Poisoning followed by hanging was found to be the most preferred methods to commit suicide. Housewives contributed heavily to the total case load. It was found that persons with a regular employment were least likely to commit suicide.

Keywords: Suicide; Demography; Marital Status; Family Structure; Occupation.