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INDONESIA
Indian Journal of Forensic Medicine & Toxicology
Published by Official Organ of Indian Association of Medico-Legal Expert
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Public Health
Arjuna Subject : Kedokteran - Epidemilogi
Articles 5,497 Documents
 215   216   217   218   219 
A Rare Case Report of Isolated Tuberculous Caecal Perforation Presented as Acute Appendicitis Lamture Y.R.1 , Gode Dilip2 , Aditya Mundada3
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12575

Abstract

Background: Koch’s abdomen is a common problem in India, with significant morbidity and mortality. Atuberculous caecal perforation without the involvement of adjacent ileum and ascending colon is very rare.Case Presentation: We report the case of a 23 years old man with clinical features of acute appendicitis.On laparotomy showed a caecal perforation with normal ileum, ascending colon and appendix. A caecalresection with end to end ileoascending anastomosis done. Histopathology confirms tuberculous granulomasof the caecum.Conclusions: We report this extremely uncommon case of caecal tuberculosis. This is very important as theincidence of tuberculosis is increasing in developing countries as well as developed.
A Rare Presentation of Systemic Lupus Erythematosus with Juvenile Dermatomyositis Ashish Varma1 , Sneh Kumar2 , Rupali Salve3 , Anjali Kher4 , Jayant Vagha4 , Sachin Damke5
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12576

Abstract

The systemic lupus erythematosus (SLE) is a rare type of autoimmune disease, which is associated with theinvolvement of multiple systems. It is characterized by the production of autoantibodies. Usually, it has arelapsing and remitting course. Juvenile dermatomyositis is the most prevalent chronic inflammatory muscledisease among children and adolescents with SLE. This disease predominantly involves the skin and skeletalsystem. Its most common symptoms include distinctive skin rashes and inflamed muscles. The insufficientdisposal of apoptotic cells may result in the stimulation of T cells and B cells by the antigens in the patientswith SLE. At the surface of the dying cell, fragments of cellular material develop during the cycle of celldeath. We presented the case of a 15-year-old female, who complained of erythema and generalized rashpresent on the face, markedly present over her cheek, bridge of the nose and the forehead since 7 months. Shedeveloped erythematous, scaly and crusted lesions on the scalp, back, trunk and upper limbs along with thevesiculobullous lesion of the oral mucosa. She also developed a progressive generalized muscle weaknessfor the past 3 months. To a large extent, intravenous glucocorticoids are helpful, but standardization of testsand treatment schemes are required to enhance the awareness of this rare case.
A Prospective Study of Etiology and Clinical Presentation of Gastric Adenocarcinoma Avinash Rinait1 , Yashwant R. Lamture2 , Pulavarty Prateek3 , Dilip Gode4
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12577

Abstract

Background: Dietary factors, Smoking, Alcohol, H. Pylori all have been linked to gastric carcinoma andmost of them are modifiable which can reduce the risk of cancer hence this study was undertaken to studythe etiology of gastric adenocarcinoma and its clinical presentation.Methodology: This was a prospective study in which 50 patients of gastric adenocarcinoma admitted in thesurgery department at a tertiary hospital were studied.Results: Out of 50 patients studied, 36 were males and 14 were females. The risk factors like H. pyloribiopsy, heredity, salt and preserved food were found less in the cancer patients while alcohol was found to bemore in them. Smoking was present equally in both the groups. Vomiting (100%) and loss of weight (100%)were the most common presenting feature. 46% had a Karnofsky score more than 80.Conclusion: Alcohol is a risk factor for gastric adenocarcinoma and loss of weight and vomiting are commonclinical presentation.
Study of Functional Outcome of Calcaneal Fractures with Percutaneous Cancellous Screws Fixation in Central Rural India Vasant Gawande1 , Ashwin Chauhan2 , Kunal K. Saoji3 , Ankit Mittal4 , Suvarn Gupta5
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12578

Abstract

Background: Calcaneum fractures are nearly 2% of all adult fractures. Calcaneum is the main weightbearing bone in the foot. Mostly these fractures are caused by high energy trauma/fall from height leadingto various patterns of fractures. There are various method of treating such fractures but due to high rateof complications by open reduction and internal fixation hence middle path regime shall be discoveredfor treating most important weight bearing bone. Inevitable malunion and arthritis due to conservativemanagement can be avoided by percutaneous fixation.Material and Method: A prospective retrospective review of 12 patients with 16 calcaneal fractures whohad percutaneous reduction and screw fixation between January 2019 to April 2020 was done at at ShalinitaiMeghe Hospital and Research center Nagpur. These cases were managed with 3-4 percutaneous cancellousscrews.Results: The results were assessed with Calcaneal fracture scoring system and Maryland foot scoring systemand showed good to excellent functional results of complex intra-articular calcaneal fractures.Conclusion: Percutaneous method of fixation with Cancellous screws is a far superior modality of treatmentof calcaneal fractures in order to get better functional outcome with minimal complications.
Principles of Agnikarma and its Advances for Shonitsthapana (Hemostasis) Fadanvis Prafulla1 , Jaiswal Reena2 , Sharma Harshala3 , Vasant Gawande4
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12579

Abstract

Agnikarma has been one of the peculiar parasurgical procedures described in Sushrut Samhita. The mostimportant indication of Agnikarma is when there is bleeding from vessel or diseases in which bleeding isexpected. Technology and instruments used for hemostasis now a days differ from ancient ones. Howeverfundamental principle of heating the tissues remains same which is widely used in present era. Earlier rods(shalaka) made from different metals were used for burning out bleeding veins. Red hot shalaka was appliedon tissues and bleeders so that contraction of vessels occurs. So hemostasis was achieved by cauterization oftissues at high temperature. With advancement of technology in bio-medical engineering various machineslike Electrocautery, Infrared coagulation, Electrosurgical unit (high frequency and low frequency) andLASERs were invented for similar purpose.In Electrocautery electrical current is used to heat a metal wire to burn or coagulate the specific areaof tissue. In Electrosurgical unit alternating current is passed through tissue and heat is created by theresistance of tissue to current. Electrodes are used to cut, coagulate or even fuse the tissue. IRC involvesthe use of infrared light as a heat source to coagulate vessels supplying blood. Lasers are used to ablate theveins in which amplified light energy is used to generate heat. Tissue dehydration, protein coagulation andvaporization are the processes involved in achieving hemostasis.Working principles and energy sources used in these devices vary from each other; however the hemostasisis achieved by common fundamental principle i.e. generating heat which is similar to Agnikarma.
Cardiovascular Risk Assessment and Profiling among Employees of Tertiary Care Rural Hospital: Central India Anjalee Chiwhane1, Gajendra Agrawal2 , Joel Joy Thomas3 , Saurbh Hadke4
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12580

Abstract

Background: Cardiovascular risk factors are the major cause of mortality and morbidity. WHO STEPSinstrument is a standard tool proposed for surveillance of Non-Communicable Diseases (NCD) risk factors.The study was aimed to assess risk factors for cardiovascular diseases in the employees of tertiary carehospital using WHO STEPS instrument.Materials and Method: WHO “STEPwise approach to surveillance of non-communicable diseases”methodology was used to conduct a cross-sectional survey among 290 employees aged 20-60 years.Results: The mean age of the study population was 39.05 out of which men constituted 52.06%. There werethe almost equal proportion of males and females with a slight male preponderance (52.06% vs. 47.93%).Family history of hypertension 22.07%, diabetes 20%, history of CVD deaths 10%, current smokers 15.52%,alcohol intake 38.28%, tobacco consumption 41.03 %, obese & overweight (?23 kg/m2) 44.49% were theprevalent major cardiovascular risk factors. 3.08% had a >10% risk of developing CVD in next 10 years.Conclusion: High prevalence of cardiovascular risk factors was seen which can lead to increased morbidityand mortality. Regular health checkup camps should be conducted to combat the disease burden and createawareness.
To Determine the Role of Clonidine as an Adjuvant to Intrathecal Bupivacaine in Patients Undergoing Lower Abdominal Surgery Priyanka Deshmukh1 , Pratibha Deshmukh2 , Sohal Parate3 , Aruna Chandak4
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12581

Abstract

Background: Clonidine is an alpha-2 adrenergic agonist with various actions, one of which enhances theeffectiveness of local anaesthetics. For patients undergoing lower abdominal surgery, we examined the effectof adding intrathecal clonidine to hyperbaric bupivacaine on postoperative pain relief and side effects, if any.Aim: To assess the efficacy of intrathecal clonidine along with hyperbaric Bupivacaine in patients undergoinglower abdominal surgeries.Method: It was a retrospective study carried out under spinal anaesthesia on 80 patients undergoing lowerabdominal surgery. The research population was assigned randomly to two groups; group B- received 15 mgbupivacaine+ 0.4mi Normal Saline and group C received 15 mg bupivacaine + 60mcg clonidine.Results: Addition of 60mcgs of intrathecal clonidine to 0.5% hyperbaric bupivacaine significantly prolongedthe duration of motor & sensory blockade along with the duration of effective postoperative analgesia. Thedemand for rescue analgesic was earlier in group B as compared to group C. Both groups were matched forthe side-effects like hypotension, bradycardia, nausea, vomiting, and shivering
Psychosocial Impact of Lock Down among College Students in Nagpur Vaishali D. Tendolkar1 , Shaini Suraj2 , Harshala Rajurkar3
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12582

Abstract

Background: The deadly COVID 19 has brought the life to a standstill in many parts of the world. Theuncertainties in lives of people are increasing along with the spread and increasing death tolls due to disease.College students, the predominant youth are maximally affected by this crucial stage. Aim:The current studyaims at assessing the psychosocial impact of lock down among the college students.Study Design: Online survey.Study Population: College students in the age group of 17 to 25 years both male and females.Sample Size: 337.Material: Psychosocial Impact Scale for students developed by investigators (r=0.85).Results: The mean age of the students is 19.93+1.14. 96.4% students were living with their parentsduring the period of lock down. 36% experienced borderline negative impact and 20.17% reported mild tomoderate negative impact of lockdown in just 15 days of lock down period. Most surprisingly despite beingwith parents; 20.18% had been out on roads during lock down, 1.48 for their job, 36.80% for purchasingmedicines, 39.17% for grocery and vegetables, 4.75% to meet their friends, 2.37% to attend a funeral, 2.97%attended family function, 9.50% to complete their academic assignments, 13.65% to refresh themselves,12.76%to help neighbour/relatives.Conclusion: Lockdown has adversely affected the psychosocial status of the college students. Whileequipping for any disaster, a nation will have to find out strategies for rebuilding mental strength of itspeople after the disaster is over so as to enhance the return to normal functioning.
Significance of Hematological Parameters in Uncomplicated Diabetes Mellitus Neha Bhatt1 , Pratibha Dawande2 , Obaid Noman3 , Sweta Bahadure3 , Arvind Bhake4
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12583

Abstract

Background: Diabetes mellitus leads in chronic metabolic syndromes worldwide. The physiochemicalchanges in the blood bought about by persistent hyperglycemia are reflected in the hematological parameterson complete blood count.Introduction: Diabetes Mellitus is a smouldering global pandemic destroying mankind slowly and silently.The associated detainable microvascular and macrovascular complications are responsible for much ofmorbidity and mortality. With ever increasing incidence and prevalence, it is important to device economicalmethod to easily monitor, predict and prevent untoward health outcomes in these patients. Complete bloodcount being used as a basic and easily available investigation can be utilized for this purpose.Material and Method: A case control study was carried out at Datta Meghe Medical College and ShaliniTai Meghe Hospital and research center in association with Acharya Vinobha Bhave hospital & researchcenter and Jawaharlal Medical College, both a tertiary care hospital for a duration of 3 months. Study groupof 100 diabetic patients and control group of 100 nondiabetic patients were evaluated using questionnaire,clinical findings, case records and hematological findings. Hemogram was analysed on Beckman coulter fivepart cell counter. Leishman stained peripheral smears were studied. The data thus collected was analysedusing test of significance to find out relevance of changes in hematological parameters in diabetic patients.Results: Anaemia along with higher leucocyte and platelet counts were observed in diabetic group.Conclusion: Monitoring changes in hematological parameters can be a useful tool in better management ofdiabetic patients.
Intubating Conditions Comparison, After Administration of Propofol with Muscle Relaxant and Profofol without Muscle Relaxant-An Observational Study Parag Sabale1 , Pratibha Deshmukh2 , Swapnil Meshram3 , Nandkishor Bankar4 , Ashok Choudhary5
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.12584

Abstract

Introduction: General anaesthesia is a condition where generally neuromuscular blocking agents in theform depolarizing or non-depolarizing agents are used for intubation of trachea. A quest for a safer andsuitable intravenous induction agent has led to the development of Propofol, a 2, 6, di-isopropyl phenol aftera series of investigations. Propofol also reduces hypertension and tachycardia which occurs response duringintubation. Thus this technique protect against the potential adverse effects of tracheal intubation like intracranial, intraocular hypertension and tachycardia.Material and Method: 100 adult patients of American Society of Anaesthesia (ASA) grade I & II of boththe sexes belonging to the age group of 18-55 years, from various surgical specialties and undergoingsurgery under general anaesthesia were divided in to two groups of 50 each. In both the group intubationwas graded and scored according to ease of laryngoscopy, position of vocal cord, coughing, jaw relaxationand movement of limb. Score of 5 was classified as excellent, 6-10 good, 11-15 poor and 16-20 as bad. Totalscore of <=10 was considered as acceptable and score of >=10 as unacceptable.Results: Youngest patient was of 18 years in group I and 20 years in group II. Eldest patient was of 54 yearsin group I and 55 years in group II. Maximum number of patients were in 20-30 years of age 31 (62%) ingroup I and 23 (46%) in group II. Excellent intubating conditions were seen in 32 (64%) patients of groupI and 49 (98%) patients of group II. Before induction baseline readings of mean arterial pressure, systolicblood pressure (SBP), diastolic blood pressure (DBP), and pulse rate were noted in both the groups values.Similarly reading above parameters were just after induction, after intubation, one minute after intubation,two minute after intubation and 5 min after intubation. In both the groups slight decrease in all the parameterwere noted just after induction. In both the groups slight decrease in all parameters were noted just afterinduction .However slight increase in value of all the parameter were noted after intubation. Differencewhich was noted was not statistically significant. Also after 5 minute of intubation parameter in both groupswere approximately similar that of baseline (p>0.05).Conclusion: 2.5 mg/kg body weight of Propofol with adequate doses of opioids and inhalational agent canproduce acceptable intubating condition when compared with Propofol 2.5mg/kg along with succinylcholine.

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