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J lndian Acad Forensic Med. Aprit - June 2016, Vol. 3g, No. 2 ISSN 0971-0973
Journal of lndian Academy of Forensic MedicineVolume: 38 Number: 2 April - June 2016
ContentsSr.
l. From the Editor,s Desk
ll. Editorial
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1 33-1 33
134-135
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Original Researc h paperEstimation of stature from percutaneous Length of Radius pratik R. varu, 136_139Krunal N. Pipariya, H. M. Mangar , virar J. Aghera, aii ,. Dabhi, Mitind N. paiei
XJ^;:,Y;ilof sternal rib ends, a specific approach to justify age. sunit M. 140_143
F::;";-l;ffidical Negligence cases in lndia Anand p Rayamane, s D Nanandkar, 144-148
5:S#fohfl ,"Ti}:
:T,:,[ilj "*]:E lj:#,wrisr
J o i nt in yo u n g Ad ores ce n ts 1 4 e_ 1 5 1
A study on Gender rdentification of Dry skuil by manuar measurement ofForamen magnum dimensions xisnan. i. Siddapur, Geetha. K. Siddapursudden Deaths due to Respiratory Diseases in a Metroporitan city of southHfl:i,f ;[TJear Prospective autopsy study viswakanth B, shreedhar NC,
socio'Demographic profire of Unaturar Deaths: An Autopsy based study atSMS Medical College, Jaipur prathvi Raj Meena, R.K. punia
sex Determination by using Maximum Length of Femur Bone: A study of100 Cases O. Gambhir Singh, Sundarrapandian
A study of sudden n,aturar deaths in rmphar from 2010-2014 Memctpubi ph,Th.Meera Devi, Thongam Dolly
Dactylographic pattern in retation to Blood Group & tris colou r shouvanikAdhya, Soumyajyoti Bandyopadhyay, Sourav Biswas
case Based Learning as an Educationar strategy to Enhance ActiveLearning in Forensic Meciicine Vinay Kumar Mr, *,r i,rir'r;;;;;!!ufy.o^r Poisoriing
-9u:o.= in chitradurga District suresh Katageri, Anlit KumarSingh, H. C. Govindaraju, Ram Eabu Sharma
A study of Pattern of- poisoning cases admitted to Maharaja lnstitute ofMedical sciences, vizianagaranr, south rndia pat,arik iir, i:",u Jasadeesh M,Narayana Rao V, Lakshmi Kumar Cil, Uan"p"tr" SC
A Five Years Retrospective Study of Head rrauma cases showing theRarity of Multipre site Extradural Hiemato ma rapan Das, Raihan t-Jddin AhmedP-ersonality disorders in Arcohor Dependence syndrome rndividuarsVijayanath V, Anitha MR
A. Descriptive Study of Medicolegal Cases to Determine the lmpact ofviolence ol society Rajeev K Chaudiary, Gurmanjit Rai, Jagdish Gargi, Navpreet Kaur,Baljeet Singh, Pankaj G upta
Time Passed since Dcath from Degenerative changes rn the Skeletarmuscle vinita Kushwaha, J.v.Kiran Kumar, pusipendra singh, o.^.-ir:-r"rr" ern, ego*"t
152-155
1 56-1 59
1 60-1 64
1 65-1 66
167-170
171-175
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1BB-192
193-'196
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J lndian Acad Forensic Med. April - June 2016, Vol. 38, No. 2 lssN 0971-0973
Original Research Paper
Study of Poisoning Cases in Chitradurga DistrictlSuresh Katageri,'Amit Kumar Singh, 3H. C. Govindaraju, aRam Babu Sharma
AbstractPoisoning is one of the main contributor'to the mortality and morbidity in both develop and
developing countries. The present study consists of poisoning cases admitted to and autopsied at theDepartment of Forensic Medicine and Toxicology, Basaveshwara Medical College and Hospital,Chitradurga, Karnataka. Out of the 161 Medico-legal cases autopsied during study period of 1B monthsfrom November 2012 to June 2014, 51(31.7%) were that of poisoning. The cases were analysed onvarious parameters to find out the trends and other significant feature of poisoning in this region ofKarnataka.
Poisoning is a common method of suicide and one of the common causes of death in developingcountries, partlcularly in agricultural workers. The emphasis was given to age, sex, residence, maritalstatus, survival period, type of poison and manner of death. Organophosphate compounds were the mostcommonly used substances;74.1ok. The common reason of poisoning was ill health 20 cases (39.2%)inboth males and females.
Key Wordsi Poisoning pattern, Suicide, Organophosphate compounds, Rural
lntroduction:Poisoning, both accidental and
intentional is a significant contributor to mortalityand morbidity throughout the world. According toWHO, 3 million acute poisoning cases with 2,20, 000 deaths occur annually throughout theworld. Out of these 90% of fatal poisoning occurin developing countries particularly amongagriculturai workers.
Pattern of poisoning in any regiondepends on variety of factors such as availabilityof poisons; socio-economic status of population,religious beliefs and cultural influence. ln thelndian corrtext, the exact incidence of poisoningis uncertain, due to lack of data at central level,as majority of cases go unlepoded, and rnot'ialitydata are poor indicators of incidence ofpoisoning. ln India, the common poisons usedusually are insecticides and pesticides. Thereason for this is agriculture based economics,poverty and easily availability of highly toxicpesticides. ln lndia, organophosphates form thelargest bulk of pesticide poisoning.[1,2]
Corresponding Author:lAssociate professor, Dept. of Forensic lvledicineBasaveshwara Medical College Hospital&Research Gentre, Chitradurga-577501, KarnatakaEmail: [email protected] Professor, Dept. of FMTMayo lnstitute of Medical Sciences Gadia, Barabanki'Prof& HOD,oTutor
DOR: 1511012015 DOA: 16/05/2016DOI : 1 0.5958/097 4-0848.201 6.00046.4
Materials and Methods:This prospective study was carried out
at department of Forensic Medicine andToxicology, Basaveshwara Medical College and
,. hospital, Chitradurga. AII the cases brought tothe Department for Medico-legal autopsy withhistory of poisoning were selected.
We used standard proforma to obtaindata from the records to ensure consistency forthe whole sample. lnformation collected includesage, sex, residence, marital status, type ofpoison, survival period, motive of poisoning andmanner of death. We also extracted, if present,any other relevant information, such as history ofpsychiatric illness, drug or substance. Allcolletted data was analysed.Observations and Results:
A total of '161 cases of Post-mortem,poisoning constituted 51 cases (31.7%), duringthe study period, November 2a12b June 2014.The age of the victims varied from 1'1-70 years.Most common age observed was 21-30 years(35.3%) [Table no.1] .Males (78.4o/o)
outnumbered the females (21.%) [Table no.2].Most of the victims were married
(72.60/0), which is same for both male andfemale victims [Table no.3]
ln rural areas, poisoning cases were themost predominant, (98%) [Table no.4]. Mostcommon motive of poisoning was ill health(39.2%), followed by financial constraints(21.6%) [Table no.5]
110LIJ T
J lndian Acad Forensic Med. April - June 2016, Vol. 38, No. 2
Total 5'1 cases were hospitalised forvarious durations, of which 31/% of the victimssurvived only for 6-12 hours, 25.5% for 0-6hours, '13.7% lor 12-24 hours, 11.8% for 1-3days,7.8% for 4-7days and 9.8% for more than7 days. [Table no.6]
Unknown poison 47.1% cases, followedby lnsecticides, (39.2%), were the mostcommon encountered in this region irrespectiveof sex, followed by snake bite (9.8%). [Tableno.7l
Suicide was the most common mannerof poisoning (82.4%), followed by accidentalpattern (17.7o/o). No homicidal poisoning caseswere detected during the study period.[Tableno.8l
Discussion:Committing suicide is one of the oldest
ways of sacrificing their life by consumingdifferent poisonous substances which are easilyaccessible, compared to hanging or othermethods. Maximum number of cases was foundin the young adults of age group 21-30 isconsistent with other studies.[3-15]' The reasonsfor the trend may be that young adults are moresusceptible to frustrations caused by highlycompetitive society, unemployment, love affairs,scolding by parents etc.
The gender comparison, males (78.4%)outnumbering females (21.6%), tallied with otherstudies.[3-5,10,11] this is so because males,being the daily bread winners of the family, areexposed to stress and strain of day to day life,occupational hazards and easy availability ofpesticides. ln our study, out of 51 cases ofpoisoning, 37 were married and 14 unmarried.Early marriages in rural community, familyconflicts, social customs, and poverty may leadto mai'ried to consume poison than unmarried.This finding is consistent with previous studies.
[3'7'11-13Jq observed in the present study that
maximum cases were from rural area.[3-S,12-15]This may be due to illiteracy, easy availabilityand complete dependence on the fate of theircrop both in the field and market. The incidenceof snake bite is also more common in rural areaas compared to urban areas. Most commonmotive of poisoning was ill health (39.2%),followed by financial constraints (21.6%),unemployment (9.8%) and family conflict (7.8%),This finding is in contrast with previous
studies.[6] Among the ill health, in majority ofcases evidence of chronic illness likegastrointestinal disorders, bronchial asthma,tuberculosis, diabetes, hypertension, and
gynaecological problems as procured throughthe history and hospital records, on Autopsycorroborated with autopsy findings. Amongfinancial constraints the reasons were excessivedebts, poverty, not able to pay the loan,engaging in activities in an urge to achieveinstant richness was the prominent financialcauses noticed.
According to survival period, total 51
cases were hospitalised for various durations, ofwhich (31.4%) of the victims survived only for 6-12 hours,.... as already described. This finding is
similar with other studies.[16] The reasons isdue to the fact that highly toxic poison couldhave been consumed, individual's responses tothe type of poison consumed, much added delayoccurred in transportation and shifting thevictims to the nearby hospital from the site ofincident and in hospital due to the short comingsin treatment played a key role in (49%) of thevictims culminating in death without receivingtreatment.
From the study it was observed that in47.1% of cases, the type of poison is not known,followed by lnsecticides 39.2o/o, Snake bite 9.8%and Alcohol, 2%. This finding is similar to otherstudies.[6,17-19] The types of the poison wereknown based on the history furnished by thepolice and relatives of the deceased, Withreference to the manner of poisoning, suicidalpoisoning was the most common manner ofpoisoning followed by accidental; and homicidalpoisoning was not reported in this study.[3-5,8,111 The Manner of death that wereconcluded as suicide were based on the historyfurnished by the police and the relatives of thedeceased, Suicide note, circumstantial Evidenceand on the Post-mortem examination,
ln our study, among the 9 casesrecorded as accidental death, 5 were due to theSnake bite and 1 died due to consumption ofalcohol, while the remaining 3 have due toingested poison.
Conclusion:It is advisable to create awareness
among victims to carry the container of thepoison consumed or at least to carry the label ofthe container or to carry strips of tabletconsumed while coming to hospital for treatmentand show it to the concerned physician so that itwill be easy to identify the poison on spot andinitiate treatment according to the type of poison.
Proper implementation of social and economicprojects aimed for the upliftment of rural, poorind the downtrodden. Education campaign'should be organized with regards to properstorage, use of pesticide and the basic treatment
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Vol.38, No. 2 lssN 0971-0973J tndian Acad Forensic Med. April'June 2016'
to be instituted in cases of poisoning should be
known to the general public, which in turn can
help in reduction of mortality from insecticide
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Table 1: Distribution of the Study PopulationAcco to
Aoe 6roup (vears) Number Percentage
11-20 09 17.64
?1-30 18 35.29
3140 6 11 16
41-50 8 15.68
5'1-60o 17.64
61-70 1 L96
TOTAL 3t '100
Table 2: Distribution itud IationAccordinq to Sex
SEX Number Percentage
Male 40 78.43
Female 11 21.57
r^r-lI UEI 51 100
Table 3: Distribul lion of the StudY PoPulation
suRvtvel pentoo Number Percentaqe
0-6hrs IJ 2s.49
6-l2hrs 16a4 n1
12-24hrs 7 13.72
1 -3days 6 1 1.76
4-7days 4 7.84
>7days 5r oa1
TOTAL it 100
aUte 7: Distribution of udy Population a
According to Alleged History of Poison
8: Dis tion of the StudY PoPula
MANNER OF DEATH Number. Percentage
Suicidal 42 82.3s
Accidental 09 17.65
Homicidal 0 0.00
TOTAL JI '100
L81
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16.