B MEEL
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Repeated Sexual Assault and HIV Seropositivity: A Case Report B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17709

Abstract

Background: Sexual assaults are on an epidemic level in the Transkei region of South Africa, despite the government efforts to bring it down. Human Immuno-deficiency Virus (HIV) is also proportionally high in this region of South Africa. Objective: To highlight the problem of sexual assault and HIV infection in the Transkei region of South Africa. Case history: This is a case report of 15-year-old teenagers (SD) who was a schoolgirl in standard 6 when she was assaulted. SD was sexually assaulted repeatedly by an older man of 28 years. She was found sero-converted on HIV testing. On physical examination the introitus was red and bruised. A copious amount semen-like infected fluid was observed in her vagina. The case history, findings, beliefs, and compliance with HIV drugs are discussed. Conclusion: There is high risk of repeated sexual assault and HIV infection in the Transkei region of South Africa. Government must look deeper to prevent these rape attacks as well as HIV infection
Ethical Issue Related to ‘Save the Life of the Patient’ at Mthatha General Hospital in South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17710

Abstract

Background: Resuscitation of a patient with life threatening conditions, before referral to another department or hospital, is a legal obligation on the part of the health professionals. Several deaths occur every year in hospitals and health care centres without an emergency management. Objective: To highlight the ethical issue related to ‘Save the Life of the Patient’ at Mthatha hospital in South Africa. Case History: This is the case (AM) report of a 16-year-old Grade 10 learner who was assaulted physically as well as sexually. She was bleeding from a stab wound to her when she was brought to the Mthatha General Hospital’s (MGH) casualty. She was then referred to the Bedford hospital for repair of the tendon of her right wrist as recommended by the doctor on duty. The patient was referred to Sinawe Centre for forensic management, where she collapsed during an interview. The patient was taken on a stretcher to the MGH casualty for an emergency treatment of her blood pressure. The history of the patient and the care duty of the health professionals are discussed. Ethical issues are also highlighted in relation to the ‘preserve the life first’ principle in this case report. Conclusion: There was a serious breach in duty of care by medical officers in the Mthatha hospital, South Africa. It is an ethical priority to save the life of the patient.
Guilty of Unnatural Death but HIV Positive in Transkei Region of South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17711

Abstract

Background: HIV infections and crime have a complex relationship. It is difficult to understand its unnatural causation. HIV positivity has never accounted as an underlying cause of death in persons who have died unnaturally. Objective: To correlate HIV infection with non-natural deaths in the Transkei region of South Africa.Method: This is a record of a review study at Mthatha (Umtata) General Hospital. The data was collected from the office of medical superintendent and from the forensic pathology laboratory. Results: There has been an increase in the Mthatha General Hospital mortality rate by almost two- fold in last five years. Suicidal deaths like hanging have increased by one and half times. Fatal poisoning, possibly suicidal, has increased about five to sixtimes. Gunshot injuries, which may or may not be suicidal, have increased by one and half times. The accurate estimate of the prevalence of the HIV/AIDS is a necessity to measure the costs of disease for effective strategic planning. Conclusion: The HIV infection is increasing along with natural and non-natural deaths in the Transkei region of South Africa. It must be considered in the category of diminished responsibility as a mentally sick.
Post-retrenchment and Retirement of Mineworkers: A Poor Quality of Life in Transkei Region of South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17712

Abstract

Background: Former mineworkers are sandwiched between scare resources and little hope of getting re-employment. They do not have enough savings to maintain their families. The expenditure is at its highest when they return from the mines, as the children are grown up and are in secondary or senior secondary school. Many are not re-employable because of poor health, and some are disabled.Objective: To highlight the problem of retrenched mineworkers in the Transkei region of South Africa.Method: The case histories of these mineworkers were recorded either at Benefit Examination Clinic (BEC) or at the forensic pathology laboratory which is situated in the chest section of the Mthatha Hospital, Mthatha.Results: There were 2027 former mineworkers examined at BEC between 1997 and 2000. Of these, 172 (8.48%) were re-examined and only 51 (2.5%) received compensated over the period of four years. The examination of mineworkers has decreased from 1997 (29.6%) to 2000 (3.94%). There were 55 (2.71%) died before they received their benefit of examination.Conclusion: Retrenched mineworkers are frequently under psychosocial pressure, including their families and the community. Extreme poverty, sickness, and disabilities co-exist among these retrenched, retired mineworkers in the Transkei region of South Africa.
An Unusual Case Report on Co-Morbidity with Sexual Assault in the Mthatha Hospital, South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17713

Abstract

Background: Comorbidity or the co-occurrence of mental disorders and substance abuse disorders is common among victims of sexual assault. Occasionally life-threatening conditions have been observed in these patients which need immediate medical attention. Objective: To highlight the unusual case report of co-morbidity with sexual assault in a rural hospital in South Africa. Case History: A seven-year-old girl was referred from a health center to a rural hospital with a history of sexual assault over four days by an unknown man. She was threatened to be killed in the case of disclosure. Her aunt suspected that she had a problem as she was not walking normally. Then she opened and described the whole incident. She was having a history of vaginal discharge with vomiting and diarrhea along with mild fever. She was also depressed. On physical examination, genital injuries including a ruptured hymen were confirmed. She was having muscle guarding of abdominal muscles. The victim was refused admittance as she was labeled a case of rape, but after persistent persuasion of the staff, she was admitted and later operated on for acute appendicitis. This case history, her physical examination, and the difficulty in getting admission to a surgical ward are discussed in this report. Conclusion: Sexual assault may be associated with co-morbidity like acute appendicitis. Doctors must be vigilant in identifying such life-threatening co-morbidity to save the life of a patient.
Sexual Assault, Pregnancy and HIV Infection among Young Girls in the Transkei Region of South Africa. Case Reports B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17714

Abstract

Background: Rape continues to be one of the biggest challenges facing South Africa, alongside poverty & joblessness that the government is trying hard to eradicate. Transkei region of the Eastern Cape can best be described as deeply rural with bad roads, unclean water supply, limited electricity, few telephone connections, very limited access to transport and health services. Violence including sexual assaults is a common problem in this region. Objective: To highlight the problem of sexual assault, pregnancy, and HIV infection among young girls in Transkei region of South Africa. Case History: This is a retrospective case report from the register of sexual assault at Sinawe Center of Mthatha General Hospital, Mthatha, South Africa.These are reports of two young girls who were repeatedly raped. Histories and findings of the physical examinations are described. Consequences of teenage pregnancies and HIV transmission are discussed. The issue of consent and teenagers’ partners’ responsibility is highlighted. Solutions to reduce re-victimisation are suggested. Conclusion: There is problem of sexual assaults, pregnancy, and HIV infection among young girls in the Transkei region of South Africa. There is a need to control this epidemic of sexual assaults to prevent HIV spread, and to prevent unwanted pregnancies
Prevalence of Tobacco Smoking Among Ex-Mineworkers of Transkei, South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17715

Abstract

Background: The smoking of tobacco is one of the most important confounding factors contributing to lung pathology. It is therefore essential to know the degree of prevalence of smoking in the community of former mineworkers of the Transkei, who constitute one of the groups in South Africa most affected by smoking. Objective: Prevalence study of smoking among former mineworkers of Transkei, South Africa Method: This is a record review study from the Benefit Examination Clinic, which was carried out once a week at the chest section of Mthatha Hospital in Transkei. Results: 466 ex-mineworkers were studied for their smoking habits. Non-smokers were lower in number at 97 (21%), the number of ex-smokers was 226 (48%) and smokers numbered 143 (31%). Little more than three-fifth were smokers - 89 (20%) - and ex-smokers - 142 (30%) - who were in their middle age (40-59yrs). Between 1% and 5% were observed to be in the extreme ends of their age groups (<40 &>60). It was observed that among the ex-miners who had worked in the mines for a period of 10 to 19 years, the ex-smokers constituted 26%, the smokers 17% and non-smokers 9%. The ex-smokers, smokers and non-smokers were in a proportion of about 5:3:2. The population of smokers peaked from 15% for those with a mining history of nine or fewer year’s underground to 42% for those who had been mining for 10 to 19 years and fell almost at the same rate from 42% to 22% in the group with 20 or more years of mining. Non-smokers among the sample increased from 5% (nine or fewer years) to 9% in the 10 to 19 years group, and ultimately settled at 7% when they had worked 20 years or more. Conclusion: The prevalence of smoking among ex-mineworkers is high (79%) in the Transkei region of South Africa.
External Examiner’s Report for the 4th Year Medical Examination in Forensic Medicine: Is It A Magician With a Wand? B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17716

Abstract

Background: Externalexaminers are generally considered people of integrity, and honesty. The right to pass or fail students is within their discretion. The examination report that they produce must be congruent with their actions. The post examination comment by the external examiner for the 4th year medical examination in Forensic Medicine stating that students were weak in Forensic Medicine was not consistent, however, with the marks he awarded to the students. Objective: To validate the report of external examiner with his action. Method: Every year an external examiner is invited to conduct an examination of 4th year MB. ChB students in Forensic Medicine. There were three specialist examiners who conducted an examination of medical students. The external examiner (Mr. X) has been invited from a pioneer institute for the last three years. Mr. X also made changes, and approved course contents at the beginning of the year. Results: There were 97 students who sat for the examination. Of these, 93 (96%) passed and none of them failed. Only 4% were required to write a supplementary examination. All scripts were marked by all three examiners. One third of the students (31/32%) who received the lowest marks were exposed to the external examiner for an oral examination, together with their scripts. The external examiner made no change of marks in six cases. Of the other 24 students, six students marked were decreased up to 4%, while the remaining 18 students’ marks were increased by up to 20%20%. One student has awarded a distinction (75%) by the external examiner (increased from 55% to 75%). Conclusion: The comment of an external examiner was, however, not congruent with his actions. Therefore, the external examiner is a magician, but without a magic wand.
Poverty and Non-Natural Deaths among Former Mineworkers and in their Families in Transkei Region of South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17717

Abstract

Background: Thousands of former mineworkers across former Transkei have already passed on, are disabled, or died due to either mining related diseases or non-natural ways of dying such as accidents, suicide, or homicide. Many ex-mineworkers have died prematurely, placing a strain on their families. This has led to dysfunctional families and has created the conditions for children from these families to commit crime. Compensation could be claimed for mining related maladies, but the non-natural deaths are unbearable for a resource-stricken family. Objective: To highlight the problem of poverty and non-natural deaths among former mineworkers, and to relate the impact on their families. Method and Material: This research, a retrospective qualitative study on former mineworkers and their children, was carried out in 2000-01 at the forensic pathology laboratory of Umtata General Hospital complex, Mthatha, Eastern Cape, South Africa. The records of interviews performed during medicolegal autopsies in 2000 and 2001were reviewed at Umtata (Mthatha) General Hospital mortuary. The interviews were routinely performed in relation to victims who were admitted at the Umtata (Mthatha) General Hospital mortuary.Results: Eighty-four family records were analysed. Of these, 21 (25%) were found to be former mineworkers and their immediate family members. There were five mineworkers and 15 children of mineworkers. Only one was the spouse of a mineworker who had died unnaturally, and one person was unaccounted for in these numbers. Three mineworkers died because of firearm injuries, one was assaulted by someone with a knobkerrie, and another one died because of alcoholic intoxication. Two of them had heavy drinking habits. Three mineworkers were unemployed. The causes of unnatural deaths were as follows: five stabbed, two from firearm injuries, one from a motor vehicle accident, one assaulted with blunt object, and three committed suicides by hanging and poisoning. Most of the victims consumed alcohol. Conclusion: A high number of former mineworkers died an unnatural death. Poverty could be an associated as an underlying cause of death.
A case Report on the Obstacles in Research Publications in a Rural University, South Africa B Meel
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17718

Abstract

Background: Universities are the powerhouse; they generate knowledge through research all over the world. A university without research is a black hole that swallows the taxpayers’ money without contributing much to them. Objective: To highlight the obstacles to carry out research in a rural university of South Africa. Case History: Ms. X was enthusiastic to carry out the research in the university She had so far produced about 100 research articles in peer reviewed journals, despite all odds. She was appreciated nationally and internationally for her work, but the university under study has humiliated and victimized her. This report on Ms. X highlights how this rural university is being disadvantaged by not allowing people to go further. The author will try to present his personal views after informal discussions with various academics and researchers. The highlights of the de-motivating and inhibitory factors are discussed in this manuscript. Conclusion: The main obstacle is lack of transparency and abuse of power at this rural university. The university functions like a secretive society.