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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
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Rhinoscleroma: A Case Report K.M. Hiwale1 , Harshala Lokhande2 , Sunita Vagha3
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.v14i4.12671

Abstract

Background: Rhinoscleroma is a chronic granulomatous disease caused by gram negative bacteria;Klebsiellarhinoscleromatis. Respiratory mucosa is predominantly affected involving mainly the nasal cavityand nasopharynx and further extending to the respiratory tract. Systemic involvement is rare. The bacilli canbe stained for histopathological examination by Hand E, Gram’s stain and Giemsa stain. Treatment beingantibiotics and anti-inflammatory drugs.Case Presentation: Hereby presenting a case of 52 year old male with nasal blockage; clinically found tohave a mass encasing the bilateral chonchae and nasopharyngeal wall being investigated for malignancy, butproved to be diagnosed with rhinoscleroma on histopathology.Conclusion: Rhinoscleroma, usually difficult to diagnose, may be confused with granulomatous disease,carcinoma, tuberculosis and leprosy. Seen majorly affecting the respiratory tract, adequate biopsy materialsent for histopathology may prove to be useful in the diagnosis; along with a proper clinical history. Thepresence of inflammatory background containing Mikulicz cells are highly suspicious of rhinoscleroma. Thedisease often presents with nasal mass therefore clinically mimics with neoplastic mass. Due to its chroniccourse, it often proves challenging to treat. Early diagnosis thus ensures timely treatment further avoidingrelapses and complications.
Signet Ring Cell Carcinoma K.M. Hiwale1 , Avadh Kishor Tyagi2
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.v14i4.12672

Abstract

Signet ring cell carcinoma is very rare carcinoma of colon and aggressive subtype of colorectal carcinoma thatis mostly diagnose inadvance stage. 5-year survival rate is very poor as compared to other adenocarcinomaof the colon. First case reported in 1951 but clinical literature on this subtype of adenocarcinoma is verylimited. In this report a 32-year old male presented with SRCC of colon. Our literature review describesthe many factors that contribute to the poor outcome and high recurrence in SRCC of the colon. This studyprove that survival rate is increased by earlydiagnosis and surgical resection. However, the rarity of thiscancer and its propensity for insidious onset and aggressive course prove a challenge to the development ofsuch guidelines.
Homocysteinemia: Cause of a Rare Case Coexisting DVT and Recurrent Foetal Loss in Pregnancy Nidhi Singh1 , Neema Acharya2 , Sourya Acharya3 , Jaya Kore4
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.v14i4.12673

Abstract

Deep vein thrombosis and venous thromboembolism is a major health problem and one of the leading causesof maternal morbidity and mortality Recurrent pregnancy loss either early or late is a serious problem andhas both psychological and physical impact. Thrombophilia are one of the most important causes of DVTas well as Recurrent pregnancy loss as it worsens the physiological hypercoagulable case which exists inpregnancy. Homocysteinemia is rare but an important cause of deep vein thrombosis and recurrent pregnancyloss. Serum homocysteine levels in pregnancy have been linked to preeclampsia,recurrent abortions and lowbirth weight. Diagnosis of this condition is missed on routine basis due to extremely less frequency of theevaluation of serum homocysteine levels on a routine basis. Here we report a case of hyperhomocysteinemiaas underlying cause of bad obstetric history and DVT which are few of the classic presentations of the entityseen in the single patient. the condition was diagnosed by multidisciplinary approach.
Plasma Cell Gingivitis: A Rare Perpetuating Entity Anil Agrawal1 , Ayushi Singh2 , Arvind Bhake1 , Sunita Vagha3
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.v14i4.12674

Abstract

Background: Plasma cell gingivitis is a rare unexpected condition in an individual inconsiderate to bediagnosed for. Although many research has shown the light on the treatment and diagnosis of the diseaseagain exclusion criteria are most considerate. In the current situation patient presented with typical featuresof inflammation after the confirmatory histopathological diagnosis only plasma cell gingivitis came intocontemplation. Properly applied medications were provided to the patient and improvement was seen infollow up. Being congruent with a number of conditions, its diagnosis is served quite succour for mankind.Case Presentation: A 35-year-old female presented with swollen and occasional painful gums, withintermittent gum bleeding. Her medical, dental, family history and personal history were non-contributory.There was no history of any allergy or Para functional habits such as mouth breathing. No abnormalitieswere detected in her general physical and extra oral examination. On examination, there was erythema andinflammation of gums suggestive of gingivitis, with normal CBC and PS report. She has been refractedany of the treatment given earlier. Thereafter, a punch biopsy of gums was done and the tissue was sent forhistopathological examination.Conclusion: PCG is a remarkable condition, most likely allergic in nature. While being a purely benign, theclinical appearance and localization may conceal much more detrimental conditions Therefore, each lesionrequires due attention
Critical Appraisal of e-learning through Mobile Devices in Medical Education Gaurav Sawarkar1 , Punam Sawarkar2
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.v14i4.12675

Abstract

Summary: In COVID-19 pandemic, e-learning is the essential component of education system. All theschools, colleges, universities implemented e-learning program for the purposes of teaching and learning.Syllabus of new session is started for the said academic year through e-learning to minimize the academic lossand to coverup the academic session. Nowadays, medical education is full off with information technologysolutions, computer--assisted learning has facilitated teaching of a wide range of topics, including basicscience and advanced surgical procedures. The e-learning is totally depending upon the expertise in thehandling of technology, electronic devices as well resource material available for the conduction of e-classesand one of the most important factors i.e. internet connectivity. In due course, mental status of students andteachers along with motivation from the teaching institute is also important factor for e-learning program.There were various challenges and disadvantages reported in previous research studies regarding e-learning,suggested for periodic need assessment of educational program, emphasize upon breach in between expectedand existing system, resources management system, technical expert team, financial budget, mindset of theteachers and students and training sessions for development of e-learning culture.
Vit D Status and Osteoporosis in Tobacco Consuming Men in Rural Region Surrounding Wardha City, Maharashtra, Central Part of India Ajay Meshram1 , Komal Meshram1 , Ranjeet Ambad2 , Karuna Kacchua3 , Lata Kanyal5 , Shilpa Ingle4 , A
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.v14i4.12676

Abstract

Background: Awareness towards tobacco consumption has increased and it is well accepted too but will ithelp to cease the consumption. With widespread menace of tobacco consumption in developing country likeIndia, not much data of study is available currently about tobacco consumption and osteoporosis around therural region of Wardha a central part of India.Aim: Vit D status and osteoporosis in tobacco consumers and non consumers.Objective: To asses influence of tobacco consumption on Sr. Vit D, Sr. ionized Ca, Sr. Phosphate, Sr.parathyroid hormones the biochemical markers of bone turnover and Bone mineral density in a cohort of214 healthy men in rural area surrounding Wardha region of Maharashtra.Design: A cross sectional studySubjects: 214 healthy men aged around 30-50 years with no disease history were included in the study.Results: Tobacco consumers had significantly reduced levels of Sr 25 OH Vit D (P<0.02), PTH (P<0.001).There was no significant difference in Sr ionized Calcium between tobacco consumers and Non tobaccoconsumers. We got negative effect of tobacco consumption on Sr Osteocalcin (P<0.01).Conclusion: Calcium and Vit D metabolism is significantly deranged by habit of tobacco consumption andcannot be explained by life style factors. Vitamin D- PTH system depression among tobacco consumersrepresent a other mechanism for the deleterious effects of tobacco consumption on the bones and contributeto reported risk of osteoporosis among tobacco consumers.Sponsorship: Intra mural Grant from DMIMS(DU)
Role of Frozen Section in Neck Dissection of Oral Cancer Patients K.M. Hiwale 1 , Arzoo Alagh2 , Sunita Vagha3
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.v14i4.12677

Abstract

Introduction: Oral carcinoma is emerging as growing problem in many areas of the World and 4th mostcommon cancer among women in India. Globally, over 3,00,000 people are diagnosed with oral cavitycancer each year. Radical or modified radical neck dissection is usually a choice of surgeon in node positivepatients. Frozen section when performed along with supra-omohyoid neck dissection provides solution tothis dilemma of surgeon by detecting the metastasis in cervical lymph nodes intra-operatively during neckdissection. This study was planned to establish usefulness of frozen section examination in decision ofcorrect plan of management of patients of oral cancer with clinically nonodal metastasis in neck (N0).Objectives: To study appropriate plan of management for clinically neck examination with lymph nodestatus N0 in patients of oral cancer and to determine efficacy of frozen section examination in detection ofoccult nodal metastasis in neck in patients of oral cancer.Method and Materials: In 102 cases, excision of lesion, followed by supra-omohyoid neck dissection wasprimary mode of treatment and lymph nodes at various levels were sent to frozen section for assessment ofmetastasis by cancer cells. Intraoperatively during frozen section,if any of the lymphnode between levelsI to levels III is found positive for the metastatic disease then the plan of surgery was changed to a morecomprehensive Modified radical neck dissection.Results: Maximum cases were carcinoma tongue followed by cases of carcinoma of gingiva-buccalsulcus.Carcinomas of stage 1,stage 2,stage 3 are 43.8%, 52.2% and 3.9%. Histopathological grading of oralsquamous cell carcinoma was done by Broader’s grading system as Well differentiated SCC (52 cases),Moderately differentiated SCC (42 cases), poorly differentiated SCC (08 cases). Supra-omohyoid neckdissection was initial plan of management in cases but it changed to modified radical neck dissection in 42cases as lymph nodes between level 1 to 3 were positive for metastasis of SCC.Conclusion: Oral cancer should be surgically managed intra-operatively by frozen section examination ofalllymph nodes to avoid short term recurrences and institution of post-surgicalchemo/radiotherapy. Frozensection examination of yielded lymph nodes in these surgeries canmodify the extent of dissection of neck.
A Study on Designing, Development and Testing of an Innovative External Jig for the Percutaneous Screw Fixation of the Acetabular Column Fractures Aditya Kekatpure1 , Sandeep Shrivastava2 , Aashay Kekatpure3 , Sunil Nikose4 , Kiran Saoji5 , Ashish
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.v14i4.12678

Abstract

Background: Operative treatment of acetabulum fractures often requires open surgical fixation. Minimallyinvasive surgery (MIS) with percutaneous screw fixation can be done is some acetabular column fractureswhich are amenable to closed reduction. This can be done free hand using intraoperative fluoroscopy or withthe help of advanced 3D navigation system. Free hand technique exposes the operative staff to considerableintraoperative fluoroscopy,has a steep learning curve and there is a risk of screw malpositioning. Eventhough 3D navigation is highly accurate, the affordability of the navigation system in a rural set up is notfeasible. Use of an external universal modular jig which has been routinely used for the fixation of longbone fracture, can give similar results in the fixation of undisplaced/minimally displaced acetabular columnfractures amenable to close reduction. Currently such jigs are not available for the management of acetabularfractures.Objectives: With this study we aim to design a modular jig for the percutaneous fixation of the acetabularcolumn fracture fixation. Also we will validate in vitro efficacy and safety on cadaveric models. To test theclinical efficacy on minimally displaced acetabular column fractures.Methodology: It will be an observational study conducted at the Department of Orthopaedics, JNMC,Sawangi and Wardha, India. A 3 D model of the pelvis will be made based on the CT scan data of 40patients using Mimics 10.01 software (Materialize, Leuven, Belgium) software. After the desired jig ismade,its accuracy will be checked on the saw bone and cadaveric model. Once the accuracy of the jig hasbeen established, it will be used on the suitable patient population and the results will be compared withthe matched patient population who have been operated using the traditional free hand technique underfluoroscopy control.Results: The results will be compared based on the operating time,radiation exposure,hospital stay andpostoperative outcome. During follow up,patients in both the groups will be evaluated clinically with Harris hip score (HHS) and radiologically withMatta outcome grading. To evaluate functionaloutcome patients the patients will be categorizedinto excellent (HHS, 90-100), good (HHS, 80-90), fair (HHS, 70-80) and poor (HHS, <70).Conclusion: This study will help in designing and development of an universal external modular jig for theMIS and percutaneous fixation of acetabular column fracture.
Exploring the Etiological Evidences at Avascular Necrosis of Femoral Head by Investigative Approaches of Histopathology, Clinical Assessment and Radiology Kiran Saoji1 , Sandeep Shrivastava2 , Arvind Bhake3 , Aditya Kekatpure4 , Sunil Nikose5 , Aashay Kek
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.v14i4.12679

Abstract

Background- The avascular necrosis of the femoral head includes interference of the blood flow to thefemoral head. This ischemia leads to death of the bone cells and bone marrow followed by the collapse ofthe bone femoral head, which finally leads to the destruction of the bone tissue and arthritis,Objectives:1. Histopathological analysis of the tissue obtained after core biopsy or sections of head after head excisionwhile doing Arthroplasty.2. Correlation between histopathological evidence with clinical and radiological findings.Methodology: The tissue will be sampled from site of AVN during surgical procedure that is Coredecompression or hip arthroplasty. Tissue material obtained will be transfered to regular histological fixativeof 10 % formalin. It will be fixed for a day, later to be reprocessed for decalcification. Formalin fixed tissuewill be subjected for treatment of running water to remove excess of formalin. Later the tissue will beexamined for its gross appearance of any changes of autolysis The process of decalcification adopted forpresent work is chemical one. The decalcification tissue will be subjected for histokinette cycle. The tissueis now ready for paraffin block. These paraffin blocks will be subjected to microtomy for obtaining 5 micromilimeter sections. These paraffin sections will be stained for H/E and Van. Giesson stain. Histopathologicalassessment of the tissue will be carried out for the evidence and grading of avascular necrosis.Expected Results: Correlation between histopathological evidence with clinical and radiological findings.Conclusion: This study will be helpful in developing Histopathological staging in correlation with clinical,radiological findings.
Role of Anion Gap as a Prognostic Indicator in Acute Coronary Syndrome (ACS) Nandita Sharma1, Anuj Varma2 , Sourya Acharya3 , Samarth Shukla4
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.v14i4.12680

Abstract

Background: Cardiovascular diseases are the leading cause of mortality in India and acute coronarysyndrome (ACS) is one of its anomalies, affecting mainly the coronary arterial blood supply and further thefunctioning of heart muscle. Its subtypes are Non-ST elevation myocardial infarction (NSTEMI), unstableangina, and ST-elevation myocardial infarction (STEMI). There are various diagnostic tools available todetect ACS like; electrocardiography (ECG), Cardiac stress test, Coronary CT angiography, Coronaryangiogram and cardiac biomarkers. Yet, tools for assessment of prognosis are scanty and new prognostictools are always welcomed, one such is anion gap, which can be detected by assessment of certain ionspresent in the serum, urine or plasma, etc. In this study we will assess the role of anion gap, in the assessmentof prognosis in ACS.Objective:1. To estimate anion gap (AG) in cases of acute coronary syndrome (ACS) at the time of diagnosis;2. To evaluate association of anion gap (AG) with the prognosis of acute coronary syndrome (ACS)Methodology: The study will be conducted in the Department of Medicine of a Rural Tertiary CareHospital. Estimation of anion gap (AG) in cases of acute coronary syndrome (ACS) will be evaluated at thetime of admission and after five days of treatment. Anion gap will be calculated or measured as differencebetween measured cations (Na+ + K+) and the measured anions (Cl- + HCO3-) in serum. Any complicationsduring the management will be noted (Heart failure arrhythmias, Hypotension, Reinfarction, Death) will becorrelated with anion gap (AG). Chi square test will be applied to evaluate statistical difference betweenamong anion group quartile groups.Results: The study will play a key role in identifying and assessing various other prognostic tools like aniongap, in assessing the severity of disease to some extent in patients with acute coronary syndrome.Conclusion: High value of serum anion gap levels is associated with poorer prognosis of the disease outcomein patients with acute coronary syndrome.

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