Thursday, February 25, 2010

27 - Differences between Antemortem and postmortem wounds


FEATURESANTEMORTEM WOUNDPOST MORTEM WOUND
Haemorrhage-Arterial
-Blood clotted and the clot is
   ~laminated
   ~firmly adherent to
     the lining of endothelium
   ~firm, rubbery and
     variegated
-Copious amount
-Deep staining of edges
  which can't be
   washed away
-Venous
-Blood usually not clotted
 and if clots it is
   ~Non laminated
   ~Weakly adherent to the
      lining of endothelium
   ~Soft,friable chicken
      fat(yellow) or current
      jelly(red) appearance
   ~Homogenous
-Slight amount
-Staining is superficial
 and can be washed away
Wound
edges
Gaping,everted,swollenApposed,not swollen
Vital reactionSigns of inflammation,
infection(pus,slough)
and healing (granulation tissue) present
Not present
Enzyme
histo
chemistry
Negative and positive vital
reactions
Vital reaction absent
Wound
serotonin
and
histamine
content
IncreasedNo increase
Microscopy-Clot has platelets
-Leucocyte and
 RBC infiltration in
between muscle fibers
-Clot lacks platelets
-No infiltration

26 - Clinical features of Organophosphorous poisoning

*Since organophosphorous compounds are powerful inhibitors of cholinesterase, their poisoning manifests as cholinergic symptoms.

*The clinical features of Organophosphorous poisoning are :

A. MUSCARINIC ACTIONS :
1. Bronchoconstriction and increased bronchial secretion - simulates bronchial asthma. Other symptoms are dyspnea, cough, pulmonary edema and cyanosis.
2. Increased sweating
3. Increased salivation
4. Increased lacrimation - tears may be red
5. Slightly bradycardia
6. Miosis, Blurring/Dimness of vision
7. Increased frequency of micturition and involuntary micturition.
8. Abdominal cramps, diarrhea, epigastric/substernal tightness

B.NICOTINIC ACTIONS :
1. On striated muscles - easy fatigue, fasciculations, cramps, dyspnea (weakness of respiratory muscles and cyanosis)
2. On sympathetic ganglia - Pallor, Occasional elevation of B.P

C. CNS ACTIONS :
1. Restlessness, irritability, apprehension
2. Fine fibrillary tremors of hands, eye lids, tongue
3. Mental confusion, convulsions
4. Coma with absence of reflexes and depression of respiratory and circulatory centres. Death usually occurs due to paralysis of respiratory muscles.

Parikh' Textbook of Medical Jurisprudence Forensic Medicine and Toxicology

25 - Signs and Symptoms of chronic LEAD poisoning

1. Facial pallor : This is the earliest symptom.
2. Colic and Constipation : This is the first symptom that armbouses suspicion of plumbism
3. Anemia : This is associated with punctate basophilia
4. Lead line (BURTONIAN LINE) : A bluish-black line due to epithelial deposition of lead sulphide granules on the gums at the junction with the teeth. (not on teeth). Similar line may also be seen with Mercury, Copper, Bismuth, Iron and Silver poisoning.
5. Paralysis : Usually a late manifestation. Commonly causes wrist drop (extensor muscles of wrist) but may cause foot drop (peroneal muscles).
6. Lead encephalopathy : Frequently seen in children (not so common in adults).
7. Reproductive system : Menstrual disorders, abortion/still births, degenerate offsprings and sterility.

Wednesday, February 24, 2010

24 - Differences between Male and Female pelvis


BONY FRAME
WORK
Massive and heart shapedLess massive, rounded
PELVIC INLETDeep and narrowShallow and wide
ILIUMLess expanded, hence walls
are not splayed
More expanded, hence
walls are splayed
ILIAC FOSSAShallowDeep
ASISNot widely separatedWidely separated
PUBIC ARCHNarrow, V shaped, angle
less than 70,less distance
between ischia
Wide, U shaped,
angle greater than 90,
more distance ischia
ISCHIAL
TUBEROSITY
InvertedEverted
OBTURATOR
FORAMEN
Ovoid with base upwardTriangular with apex
forward
GREATER SCIATIC
NOTCH
Narrow, deep, angle
less than 90
Wide,shallow, angle
greater than 90
PREAURICULAR
SULCUS
Narrow,shallow, without
marked edges
Broad,deep, in parous
women
SACRUMLong,narrow,has greater
than 5 segments,well
marked promontory
Wide,short,has 5
segments,promontory
less marked
CURVE OF SACRUMEqual over entire length,
S-index less than 112
Straight in first 3
segments, the curve
being confined to a
point below the centre
of 3rd sacral vertebra
(J-shape)
ISCHIOPUBIC INDEX73-9491-150
ARTICULAR SURFACE
OF SACRUM
EXTENDS TO
2.5-3 Vertebral bodies2-2.5 vertebral bodies
ACETABULUMWider and deeperNarrow and shallow

Monday, February 22, 2010

23 - Causes of Post mortem caloricity

*Post mortem Caloricity is a condition where the temperature of the body remains raised for the first two or so hours after death. In certain conditions, instead of promoting the process of cooling of the body, act in a way, so that, the body temperature is either high at the time of death or is increased for sometime after death, so that, at a particular time after death the body may appear disproportionately warmer than what it should have been. This is termed as Post Mortem Caloricity and the conditions are
1.      Post mortem Glycogenolysis
a.       This is a normal phenomenon and the rise is 3.6oF or 2oC
2.      Various Causes of Death such as
a.       Septicaemia,
                                                              i.      Infectious diseases,
                                                            ii.      Bacteremia
                                                          iii.      Tetanus, Rabies, yellow fever
b.      Asphyxial Conditions
c.       Severe convulsions
                                                              i.      Tetanus
                                                            ii.      Strychnine
d.      Hyperpyrexia at death
                                                              i.      Heat Stroke (sun stroke)
                                                            ii.      Pontine Haemorrhage
e.       High Atmospheric Temperature
f.        Peritonitis, Meningitis, Nephritis
g.       Alcohol poisoning


Sunday, February 21, 2010

22 - Cognizable and Non-Cognizable offences

A cognizable offence in the criminal justice system of India is one in which the police is empowered to register a FIR, investigate and arrest an accused involved in cognizable crime without a court warrant. As defined in Cr.PC, a non-cognizable offence is one in which police can neither register a First Information Report (FIR) nor can investigate or effect arrest without the express permission or directions from the court.

 A cognizable offence is a case where the Police can arrest without a warrant. All cognizable cases involve criminal offences. Murder, Robbery, Theft, Rioting, Counterfeiting etc. are some examples of cognizable offences. Non-cognizable offences are those criminal infractions, which are relatively less serious. Examples of non-cognizable offences include Public Nuisance, Causing Simple Hurt, Assault, Mischief etc. The Police cannot register criminal cases or cause arrests with regard to non-cognizable offences. In all such cases, the Police have to take permission from a magistrate for registration of a criminal case.
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