Indian Journal of Forensic Medicine and Pathology

 Context: Medical studies are demanding and require regular hard work to cope up with the competition and complexity. It may lead to depression and anxiety disorders. The stress-tolerance level among the new generation of medical students seemed to be low.    

Aims: To assess the stress tolerant levels and to know the prevalence of depression and anxiety

Settings and Design: A cross sectional, questionnaire-based survey was carried out among the undergraduate medical 1st and 2nd years students of Malla Reddy Institute of medical Sciences, Hyderabad.

Methods: About 175 students participated voluntarily out of 300 students from first and second year MBBS during the period “June 2018 to Sep 2018”. The depression levels were assessed using Zung depression scale. Students were asked to complete the questionnaire and then the depression levels calculated in reference to Zung depression scale .The stress inducing factors during their course of medical education were also assessed Statistical Analysis: The data was analyzed using proportionsResults: The overall prevalence of Depression, Anxiety & Stress (DAS) among the students was 25.14%, 24.57% 41.71% respectively without much difference among boys and girls i.e. 43.42%, 50.42% respectively. The prevalence of DAS in first year are 18.82%, 27.05%, 44.70% respectively and among second year students are  31.11%, 22.22%, 38.88% respectively.Conclusion: The prevalence of depression anxiety and stress seemed to be more prevalent among second years compared to that of first year students

Keywords: Medical Students; Depression; Anxiety & DASS- 21.

 Introduction: Autopsy is an important aspect of clinical service, providing clinicians with critical feedback regarding diagnostic accuracy, therapeutic efficacy, and medical complication [1]. Rajasthan has reportedly the second Indian state having highest number of child marriages in the country with more than 60 percent of girls getting married before 18 [1]. The practice of child marriage is common in Rajasthan. Along with cultural incest marriage leads to one most important causes of fatal anomalies. Early diagnosis of life threatening congenital malformation can pave the way for surgical correction or palliation of these infants [1].  Material and Method: We studied 217 cases of fetal autopsies from January 2017 to October 2018 duration of one year retrospective study. Purpose of study is pathological and legal correlation in aspect of M:F ratio, age of termination of pregnancy, fetal anomalies & its pattern In Pacific Institute of Medical Sciences (PIMS) and M.R. Medical College, Gulbarga, Karnatka.

Results: Total fetal autopsies done are 217, out of which 51 are anomalous.Among them 22 are male and 28 are female babies and 1 sex is not determined {ambiguous}. In our study M:F ratio is 1:1.35. Most common cause of death found in autopsy examination is meconium aspiration in male fetus and placental insufficiency in female fetus. And mean age of gestation is 29 week and 30 weeks respectively. Mean age of the mother is 29 years.  

Conclusion: Fetal autopsies provide us an important information about pattern of anomalies, their incidence and cause of death in relation with sex and age of fetus, maternal age, along with socio-economical status. Legal implications regarding fetal autopsies is still a field of interest.

Keywords: Fetal Autopsy: Fetal Anomalies: Legal Aspects.

 The study was conducted with an aim to find out the prevalence of cardiac pathology with its correlation to age, gender, occupation, risk factors and survival time in sudden cardiac deaths. 112 cases of sudden natural deaths due to cardiac and coronary pathology were reported, out of which 75% were male and 25% were female of which 45.5% were occupied with sedentary work. 42.0% cases were of lower middle class, followed by the upper middle class i.e. 29.5%. Peak incidence of sudden cardiac death was seen in the age group of 51-60 years. Maximum number of sudden deaths due to cardiac and coronary pathology were seen in obese individuals i.e. 55.4%. In these sudden deaths hypertension was seen in 29.5% cases, followed by Diabetes mellitus and Smoking in 25% and 9.8% cases respectively. Majority of sudden deaths i.e. 63.4%, occurred within 6 hours of onset of symptoms, 28% occurred within 6-12 hours and in 4% cases death occurred within 12-24 hours of onset of symptoms. Histroy of previous myocardial infarction was present in 31.2% cases. Sudden deaths due to cardiac and coronary pathology showed that 90 % of cases died due to coronary artery disease out of which 44.64% had acute coronary insufficiency while 33.9 % succumbed due to acute coronary insufficiency with Old Myocardial Infarction and 11.6 % due to Acute Myocardial Infarction.

Keywords: Sudden Cardiac Death; Coronary Pathology; Acute Myocardial Infarction; Hypertension.

 Background of the Study: A neck pain complaint was found to be one of the most emerging musculoskeletal complaints and requires attention of the health professionals. Our objective was to determine the efficacy of the motor control and endurance exercise over conventional exercise in subjects with non-specific neck pain.

Methodology: A Prospective cohort study, with Pre-post test series compared the outcomes among two intervention groups and a conventional group conducted in the Outpatient Physiotherapy department of ACS Medical College for the duration of 12 weeks.  18 Patients with non-specific neck pain were recruited and randomized into three groups. VAS, endurance, CCFT score were measured at baseline, 4th, 8th and 12th week follow up. NDI and SF-12 scores were obtained at baseline and 12th week follow up.

Result: Comparison of VAS, NDI, SF-12, endurance, CCFT score within the group at the baseline, 4th, 8th, and 12 week follow up, the subjects in the MCT group demonstrated a significant progressive change from baseline throughout the 12th week than the endurance and conventional training group in all the outcomes.  The endurance training group also showed significance difference from the baseline to 12th week follow up, however not significant than the MCT group when compared between the group

Conclusion: Motor control exercise has high impact on neck pain and led to marked relief in pain intensity, disability and in improving the endurance of the neck muscle.  Endurance training has also showed a statistically significant improvement, however lesser the significant than the motor control exercise group.  In contrast, the conventional exercise has found to reduce the pain and disability, although there was no significant improvement in the endurance of the muscle.

Keywords: Motor Control Exercise; Non-Specific Neck Pain; Activation Pressure Score; Highest Pressure Score; Jull’s Technique.

 Background: Stature of Humans has acted as symbol for the authority, also physical prowess and there had been dominance of stature over other living things. Identity of individual or skeleton remains especially the stature also the body weight had acted as an important factor in its establishment.

Place of Study: Department of Forensic Medicine Gandhi Medical College Musheerabad, Secunderabad, Hyderabad.

Material and Method: The study is made on the Volunteers. Total 194 subjects were selected irrespective of their caste, religion, dietary habits & socio-economic status at Gandhi Medical College Musheerabad, Secunderabad, Hyderabad.

Observation and Discussion: Stature of Male is highly correlated to Inter-Acromial length   (i.e. Correlation coefficient = 0.827) with p-value is 0.000000. Therefore, Regression equation of Male Inter- Acromial length on stature is, Inter-Acromial Length = 0.239 x Stature + 5.4532. Similarly for Female Stature is highly correlated to Inter-Acromial length (i.e. Correlation coefficient = 0.70) with p-value is 0.0000. Therefore, Regression equation of Female Inter- Acromial length on stature is, Inter-Acromial Length = 0.243 x Stature + 3.657 Combined Stature and Inter-Acromial length is highly correlated (i.e. Correlation Coefficient = 0.8163) with p-value is 0.00000. Therefore, the Regression equation of combined Inter- Acromial length on stature is, Inter Acromial Length = 0.2584 x Stature + 1.69481.

Conclusion: The present study has established definite correlation between stature and Inter acromial length and also regression equations have been established.

Keywords: Stature Estimation; Inter-Acromial Length; Regression Equation.

 Background: Blood is life. Blood transfusion service (BTS) is an integral and indispensable part of the healthcare system. The priority objective of BTS is to ensure safety, adequacy, accessibility and efficiency of blood supply at all levels. Inspite of this large number of well-known complications are associated with blood transfusion like transfusion-transmissible infections, such as HIV, hepatitis B, hepatitis C and VDRL.

Aims & Objective: To study seroprevalence of HIV, HBV, HCV and syphilis in blood donors at tertiary care hospital.

Material & Methods: This was a retrospective study, where the data was procured from blood bank of the tertiary care hospital, Udaipur. All the blood donors in the records over a period of three years were included in the analysis. A through search of records revealed that total 3893 donors had been screened over period of 3 years. All the samples were screened for prevalence of HIV, HBsAg, HCV and syphilis. All the seropositive donors were further divided into voluntary and replacement donor categories.

Result: Of the total 3893 donors, 1405 were voluntary and 2488 were replacement donors. The seropositive rates amongst voluntary and replacement donors were 2.6% and 2.4% respectively. The overall prevalence of seropositivity for HIV, HBsAg, HCV and VDRL were 0.12%, 0.84%, 0.07% and 1.4% respectively.

Conclusion: On comparing the data of three years an increasing trend in seroprevalence of HBsAg, anti-HCV, VDRL and decreasing trend for HIV was observed.

Keywords: Transfusion-Transmissible Infectious Dieases; HIV; HBsAg; VDRL & HCV.

 Background: Autopsy literally means to see for one self. Medico legal autopsy are performed to identify the cause of death, time of death, determine or confirm medical diagnosis that remained unknown or unclear prior to the patient’s death. Various histopathological finding not related to the cause of death are observed in the routine histopathological examination of medico legal autopsies. These findings are important learning tools for the pathologist and forensic expert and have imminence academic and research value. 

Method: This retrospective descriptive study was conducted on medico legal autopsies for ten years from 2007-2017 in the department of pathology. A total of 425 cases were included in the study.  In each case available clinical details (age, sex, clinical diagnosis, cause of death, post mortem findings), gross and microscopic findings noted from autopsy records and analyzed. Available Gross specimens and slides were reviewed.

Results: Out of 425 cases, 310 (72.9%) were males and 115 (27.05%) were females. Commonest age group was 21-30 (22.11%) followed by 31- 40 (19.05%). Normal histopathological changes were seen in 110 (25.88%) cases. The most common significant histopathological findings was pulmonary edema (13.41%) followed by atherosclerosis (12.23%), lobar pneumonia (6.11%), and acute tubular necrosis (7.52%). Interesting incidental histopathological findings accounted to 20.23%, varied from granulomatous inflammation to malignancy.

Conclusions: Incidental histopathological findings may not contribute to the cause of death, but they are of academic interest. We found various rare incidental findings (20.23%), neoplastic lesions were less compared to non-neoplastic lesions.

Keywords: Autopsy; Incidental Findings; Histopathology; Medico Legal.