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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
 419   420   421   422   423 
Using of Procalcitonin Level in Differentiation between Bacterial Vaginitis Due to Pathogenic Bacteria and Normal Flora Eman Ghadhban Salih; Mohammed Ismael Dawood; Nihad Khalawe Tektook
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14591

Abstract

This study conducted to view the role of PCT level in initial finding of bacterial vaginitis in pregnantwomen. A total of 150 deep vaginal swabs (100 pregnant women and 50 pregnant women as controlgroup) were collected from the beginning of February 2019 to the end of May 2019 from inpatients andoutpatients women attended to Al-Fallujah teaching hospital. Media were organized & purified according toproducer’s guidance. The ready media were utilized for segregation , definition of the viable enumeration, identifying & sensibility workout these media were achieved in the wake of being solidified. Swabs wasinoculated bacteriological agars for isolation of causative bacterial types . Blood samples collected by veinpuncture for determination of PCT by using ELISA technique. The study showed that that 57% of pregnantwomen have vaginal swab for culture as compared with 48 of the control group (non- pregnant women). Theresults demonstrated that, 54.39% of pathogenic bacteria isolated from vagina of pregnant women was G-vebacteria and 45.61% was G+ve bacteria. S. aureus represented the highest rate of pathogenic isolates 45.61%in cases (43.86%) while 29.17 of the control group were infected equally by E coli and K. pneumonia.Thehighest rate of antibiotic sensitivity toward S. aureus isolates was occurred in levofloxacin (88.46%) whileit was completely resistant to ampicillin and lincomycin, 94.11% of E. coli isolates was sensitive to each oflevofloxacin and cefotaxime and 100% resistant to lincomycin, 92.85% of Klebsiella isolates was sensitive toamoxicalve while it was 100% resistant to ampicillin, erythromycin and lincomycin. Procalcitonin level washighly elevated among pregnant ones followed by healthy ones (26.79±9.4 v.s 9.236±0.6 pg/ml) at P value<0.01. The highest mean of Procalcitoninlevel is found among pregnant women with pathogenic bacteriaisolates of HVS culture (30.15±9.84 pg/ml) and the lowest mean is recorded among pregnant women withnormal flora isolates (23.72±7.25 pg/ml).Conclusions: Serum PCT was highly elevated in pregnant womenwith vaginitis especially who diagnosed with pathogenic bacteria.
Assessing Patient Preoperatively and Role in Decreasing Risks on Patients and Preventing Post-Operative Complications for Cholecystectomy Alaa Hussein Alwan; Mohanned H Alwan; Ihab Saeed Ahmed
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14592

Abstract

Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
Clinical Characteristics of Coronavirus Disease 2019 in a Cohort of Iranian Patients: Olfactory Dysfunction as a Frequent Clinical Presentation Alireza Kamali; Mehrnoosh Ebadi; Hassan Vahidnezhad; Alireza Mohammadi; Mohsen Dalvandi
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14594

Abstract

Background: Since its outbreak, the 2019 novel coronavirus (SARS-CoV-2) has been associated withcoronavirus disease 2019 (COVID-19). The full spectrum of disease severity of COVID-19 is still unknown.In this study which is the first report from Iran, we showed that olfactory dysfunction is a frequent clinicalmanifestation among COVID-19 patients.Methods: All patients with suspected SARS-CoV-2 infection were admitted to Arak hospitals in Iran. Weretrospectively collected and analyzed data on patients with either laboratory-confirmed SARS-CoV-2infection by real-time RT-PCR and/or chest CTResults: Most patients in our cohort had mild COVID-19 (104 [60.4%] of 172) . Common symptoms atthe onset of disease included (subjective) fever (131 [76%] of 172 patients), cough (130 [75.5%]), myalgia(107 [62%]) dyspnea (92 [53.5%]), chills (96 [55.8%]), and headache (94 [54.6%]). Olfactory dysfunction(OD), including anosmia, hyposmia, hyperosmia, and dysosmia, were reported by 61 ([36.5%] of 167)patients. The most common concurrent symptoms beside the olfactory dysfunctions, were fever (39 [69.6%]of 56 patients) and chills (26 [46.4%]), respectively. For the most part, the patient’s condition worsenedafter the notice of anosmia/dysgeusia (48 [85.7%] of 56 patients). The majority of anosmic patients wererecovered from COVID-19 (50 [89.3%] of 56 patients). The anosmia/dysgeusia was resolved in 42 [75%]of 56 patients after two weeks.Conclusion: Taken together, this study reports the disease spectrum of SARS-CoV-2 infection in a cohort of172 Iranian adult patients. To the best of our knowledge, this is the first report from Iran.
A Retrospective Study of Pattern of Cranio-Cerebral Injuries Due to Road Traffic Accident in a Tertiary Care Hospital Vaidehi Singh; Siddesh Revpla Channabasappa
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14595

Abstract

Head injury is defined as sudden injury due to an external force that affects the functioning of brain. It may beeither caused by sudden blow or impact (closed head injury) or by an object penetrating the skull (Penetrating injury).The common causes of head injury include road traffic accidents, fall from height and assault. The mortality fromhead injury is reported to be between 1-2% of death from all the causes. Not only it is one of the major causes ofdeath in young adults but also may cause permanent disability in survivors. The importance of head injury as a publichealth problem cannot be overstated. In the studies of Road Traffic accidents provide valuable data for implementingeffective emergency services to reduce the trauma related mortality and strengthening legal measures in peak hoursof fatal accidents. We aimed to study, pattern of injuries especially cranio- cerebral injuries occurring in vehicularaccidents. Patients case records with history of head injury and MLC records of victims of road traffic accidentreported to Saveetha hospital, Chennai from 1st Jan 2019 to 31st Dec 2019 period were analysed retrospectively.Out of total 1846 Road Traffic Accidents cases reported to Emergency Medicine department, SaveethaMedical college hospital, Chennai, 10.40% cases had history of head injury. The male/female ratio was9:1. Commonest age group affected was between 21-40 years involving 126 (65.62%n=192) cases. Fataltraumatic brain injuries were seen in 178 (92.70%, n=192) cases. Amongst 192 head injury cases, scalpinjury noted in 167 (86.97%) cases, most common bone fractured was temporal bone 94(48.95%), followedby other bone parts. The commonest variety of intracranial haemorrhage was subdural haemorrhage 173(n=192, 90.10%) followed by Subarachnoid haemorrhage and Extradural haemorrhage. In 26 (13.54%)patients of head injury, craniotomy surgery was done. The timings between 3PM to 6PM showed the highestnumber of cases accounting to 61.7% of the cases followed by 26.0% of cases between 6PM to 9PM. Thetwo-wheeler accidents accounted for 69.9% of the head injury cases followed by that due to other vehicles(16.7%)
Awareness, Knowledge and Attitude Towards Medical Ethics among Medical Students - A Questionnaire based Study Shikha Shajil; Siddesh Revpla Channabasappa; V Dekal
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14596

Abstract

Introduction: Ethics is concerned with moral principles for the members of the medical profession in theirdealings with each other, their patients and the State. A physician must uphold dignity and honour of hisprofession. He must render service to humanity and should maintain good medical practices. A physicianmust provide highest quality assurance in patient care. Duties of physician towards sick include obligationto sick, must be patient while treating them. Its an era of litigation against medical professionals. Awareness,Knowledge of medical ethics during MBBS phase is need of the hour to prevent these.Aims & Objectives: • The study aims to assess Awareness, Knowledge and Attitude towards medical ethicsamong medical students in a teaching hospital.• To suggest and implement necessary changes in the medical curriculum like AETCOM module to trainthem & to focus on ethical practices.Materials and Methods: A Prospective, cross sectional questionnaire-based study was carried out amongmedical students of Saveetha Medical College hospital, Chennai. The Medical Students from Phase II &Phase III MBBS were approached and the questionnaires were sent to about 250 medical students, out ofwhich 216 responses were recorded & included in the study. Received responses/results were tabulated andstatistically analysed, depicted in observations.Conclusion: There are no potential risks in the study. Study helps to identify the amount of awareness ofmedical ethics among medical students and also to stress on the need for awareness programs on medicalethics. The medical students may not have sufficient knowledge towards medical ethics, need much trainingamong medical students through Value added courses on Ethics and AETCOM module of CBME curriculumin future throughout the curriculum.
A Study on Dactylographic Pattern in Relation to Abo - Blood Group and Iris Colour Vidula Ramesh; Siddesh Revpla Channabasappa
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14597

Abstract

Dactylography or Fingerprint is one of the oldest reliable biometric indicators. Dermatoglyphics (fingerprint/dactylography) is derived from the Greek word “Derma = Skin, Glyphe = Carve.” Fingerprint patterns areunique in each individual and the chance of two persons having identical fingerprints is about one in 64thousand million. Fingerprints represent the impressions left by the friction ridges of our finger.Out of many blood grouping systems available, ABO and Rh systems are the most important and areconsidered for the present study. Due to the immense potential of fingerprints as an effective method ofidentification an attempt has been made in the present work to analyse their correlation with blood group andIris colour of an individual. This study was carried out on 200 medical students (100 male and 100 female)having different ABO blood groups and belonging to different age groups. All the 10 fingers fingerprintswere taken and divided into loops, whorls, arches and composite. Iris colour recorded by direct illuminationby Slit lamp examination. Results shown that loops pattern being most common followed by whorls, archesand composite. Brown colored iris being more predominant in both the genders than green and blue colorediris.Loops are predominant in males whereas whorls and arches are seen more in females. Composites beingin same proportion in both sexes. Most of the subjects with loops pattern were belongs to O positive bloodgroup and having brown iris colour followed by B positive. Among loops ulnar loops were more predominantthan radial loop.Among all subjects, green colored iris recorded in 5 subjects, out of 5, 4 had loop fingerprint patter &another one subject had arch pattern. Blue colored iris recorded in two subjects with loop pattern.
Knowledge and Attitude of Medical Students Towards Medico Legal Autopsy- A Questionnaire Based Study Vignesh S; Siddesh Revpla Channabasappa
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14598

Abstract

Introduction: Autopsy is a research tool which has been used for centuries. Autopsy is a scientific studyof a dead body and is categorized into clinical and medico-legal autopsies. A Medicolegal autopsy or postmortem examination is a scientific examination of dead body carried out under the law of the state mainly toassist the identification and prosecution of the guilty in cases of unnatural deaths. This study is done to assessthe knowledge, Perception and Attitude of medical students towards medico legal autopsy.Materials and Methods: A questionnaire-based study was conducted among the students of Saveethamedical college, questionnaires related to autopsy were distributed and students were asked to fill them.According to the data obtained was analyzed to know the Knowledge and Attitude of Medical StudentsTowards Medico Legal AutopsyResults: Majority of the students (92.3%) thought that autopsy is necessary for all unnatural deaths. 84.6%said that inquest report, requisition letter is needed for autopsies. 80.8% knew autopsy is done to know thecause of death and reach the culprit of the crime and was a legal formality in unnatural deaths. 96.2% ofstudents have not felt performing autopsy is disrespectful to the body. 94.2% of participants had a opinionthat the autopsies they witnessed were not enough. 96.9% agreed that autopsy is necessary in medicaleducation. Almost half (49.9%) of the students felt uncomfortable while witnessing autopsy, 29.6% wereComfortable and 20.5% of students have not witnessed autopsy yet. Only 67.3% were comfortable withlive autopsies, rest 32.7% preferred virtual autopsy. 96.2% knew that preserving viscera is necessaryduring autopsy on suspected case of poisoning. Majority of students (98.1%) felt that medical studentsshould actively participate in autopsies. Most of them (98.1%) knew that both external and internalexaminations are done in autopsies and 98.5% felt that ED posting specifically for Forensic Medicine fortrauma, poisoning and other medico-legal cases is necessary during CRRI.Conclusion: Overall this study shows that students have some knowledge of autopsies but think that theautopsies that they have witnessed were not enough and encourages that medical students should witnessand actively participate in more autopsies. We also suggest to revise the Forensic Medicine curriculum byincreasing the number of teaching and practical hours thereby the students will be able to make observationsand come to conclusions in criminal matters or Medico-legal cases.
Assessment of Knowledge and Awareness about Consent among Medical Practitioners in a Tertiary Care Hospital – A Questionnaire based Study Yashwanth R; Siddesh Revpla Channabasappa
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14599

Abstract

Introduction: The medicine being a moral profession, the relationship of doctor and patient entailsthe highest conceivable degree of trust and fidelity. Good bedside manner, technical competency andcommunication skills are the physician’s behaviors most strongly associated with patient trust. The changingmedical practice of the 20th century has given place to patient’s autonomy and informed consent. Consentis not mere submission of the patient to a particular treatment, but a process of communication requiringthe fulfilment of certain established elements like competence, sufficient disclosure, understanding andvolunteering. However, less attention has been paid to the implications of obtaining informed consent, fromthe physicians’ perspective. Considering the above fact, the study was undertaken to assess the knowledgeand awareness about informed consent among medical practitioners in a tertiary care hospital.Materials and Methods: A prospective, cross-sectional, questionnaire-based study was undertaken in 100medical practitioners during May 2020 to July 2020.Results: It was observed that most of the participants were aware and had sufficient knowledge aboutinformed consent, but the law related to consent and other inner details of informed consent in medicalpractice were lacking.Conclusion: We concluded that medical institutions, various medical associations and medico-legal bodiesmust conduct regular medico legal training programmes, continuum medical education programmes,seminars and workshops and must be made mandatory to participate actively for all medical practitioners toupdate their knowledge related to consent in medical practice and law related to medical practice.
A Retrospective Study of Socio-Demographic Profile and Pattern of Poisoning Cases at Tertiary Care Hospital Vandana K; Siddesh Revpla Channabasappa
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14600

Abstract

Death due to poisoning has been known since time immemorial. Poisoning is a major problem all over theworld, although its type and the associated morbidity and mortality vary from country to country. Accordingto the WHO, more than three million poisoning cases with 251,881 deaths occur worldwide annually, ofwhich 99% of fatal poisonings occur in developing countries, particularly among agricultural workers.Pattern of poisoning in any region depends on availability of poisons, socio economic status of the population,religious and cultural influences, occupation prevalent in the region and likewise. Organophosphoruspoisoning occurs very commonly in southern India, where farmers form a significant proportion of thepopulation who commonly use organophosphorus compounds like parathion as insecticides. A retrospectiveanalysis of all poisoning cases admitted to Saveetha Medical College Hospital, Chennai from Jan 2019to Dec 2019 was done to study the pattern of poisoning reported. Acute poisoning is a common medicalemergency and one of the important causes of morbidity and mortality in developing countries due to easyavailability of poisonous substances and its low cost. So, it was necessary to know the demo-graphic profile& pattern of poisoning cases at Saveetha Medical College Hospital, Chennai. Data was collected using apretested proforma from case records, MRD department & Emergency Medicine department and the datawas analyzed and presented.
Association Between CT Scan Findings and Mortality in Covid-19 Cases Seyed Zia Hejripour; Elyas Aslinezhad; Mohammadreza Azimi Aval; Hamid Moradi; Mohammad Darvishi
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14601

Abstract

Background: Covid-19 epidemia is a worldwide infectious viral disease initiating from December 2019from Wuhan, China. Recognition of the prognostic role of imaging findings is important to improve theoutcomes in patients. Accordingly, regarding the lack of studies in this era among Iranian patients, this studywas done to determine the association between CT scan findings and mortality in Covid-19 cases.Methods: In this prognostic prospective cohort study, 192 consecutive patients with established Covid-19disease by clinical findings, and laboratory results in Besat Hospital, Tehran, Iran in March and April 2020were enrolled. The findings in CT scan were involved zone and lobe, ground glass, consolidation, groundglass with reticular, reverse hallo sign, microvascular dilation sign, fibrotic streaks, sub pleural line, airbronchogram, Bronchus distortion, broncheiectasis, pleural thickening, pleural reaction, and pleural effusion.According to involvement degree the points in CT scan were 0, 1, and 2 for lack of lung parenchymainvolvement, less than 50 percent involvement, and more than 50 percent involvement.Results: The involved zones were significantly differed between survived and dead cases (P=0.001). Asshown in Table 4, the scores of CT scan for lung involvement and also number of involved lobes werediffered across the alive and dead cases (P=0.001) the mean hospital stay was 7.1 (5.6) and 5.7 (2.5) days thatwas same across the groups (P=0.325). There were significant differences between groups for consolidation,ground glass plus reticular pattern, fibrotic streaks, sub-pleural line, air bronchogram, bronchiectasis, pleuralthickening, pleural effusion, and pleural reaction (P < 0.05).Conclusion: Totally, according to the obtained results it may be concluded that CT scan is useful prognosticmodality to predict the mortality among patients with Covid-19 disease. Consolidation, ground glass plusreticular pattern, fibrotic streaks, sub-pleural line, air bronchogram, bronchiectasis, pleural thickening,pleural effusion, and pleural reaction are the man CT scan findings predicting higher mortality rate in thesepatients.

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