https://medicopublication.com/index.php/ijfmt/gateway/plugin/WebFeedGatewayPlugin/atomIndian Journal of Forensic Medicine & Toxicology2024-01-18T11:48:02+00:00Prof (Dr) S K Dhattarwaleditor.ijfmt@gmail.comOpen Journal Systems<p>Indian Journal of Forensic Medicine & Toxicology is a double-blind peer reviewed international journal. The frequency is quarterly. It deals with Forensic Medicine, Forensic Science, Toxicology, DNA fingerprinting, sexual medicine, environmental medicine, Forensic Pathology, legal medicine and public health laws. It has been assigned International standard serial No. p-0973-9122 and e-0973-9130. The Journal has been assigned RNI No. DELENG/2008/21789.The journal is also abstracted in Chemical Abstracts (CAS) database. The journal is also indexed with Google Scholar, Scilit, CINAHL, EBSCOhost (USA), Embase and many other international databases.</p> <p>This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.</p>https://medicopublication.com/index.php/ijfmt/article/view/20476A Study on Pattern of Suicidal Deaths Brought for Medicolegal Autopsy at Mortuary of Siddhartha Medical College and Govt. General Hospital, Vijayawada, Andhra Pradesh2024-01-18T11:48:48+00:00Mohammad Ajas KhanNelapati SushanthV. Rajasekhar., M.D
<p>Background: The aim is to study the pattern of suicidal deaths, demographic profile including various contributary factors of victims and analyze the magnitude of deaths in and around Vijayawada part of Andhra Pradesh so that preventive measures can be set up to avoid such situation. A death by suicide is defined as the deliberate termination of life. For a death to be a suicide, it should be an un-natural death, the desire to die should originate within the person, and there should be a reason for ending their life, according to the National Crime Records Bureau. While India’s suicide rate of 14.04/lakh population in 2019 puts it at 49th rank globally, the grim reality of the highest numbers of suicides being reported annually from India cannot be overlooked. When you look at suicide deaths, the highest suicide rates are in the south. In central India, including Maharashtra, Madhya Pradesh and Rajasthan, you have “middling suicide rates”, and the rate falls up north, in Uttar Pradesh and Bihar.<br>Material & Methods: A five years retrospective and cross-sectional study was conducted in Forensic Medicine<br>and Toxicology Department, Siddhartha Medical College, Vijayawada, Andhra Pradesh. All the autopsies<br>conducted on victims of suicidal deaths during the period from Jan, 2016 to Dec, 2020 were studied from the<br>available data. Inclusion criteria includes all the suicidal deaths due to poisoning, hanging and self-immolation by burns. Exclusion criteria includes suicidal deaths from causes other than poisoning, hanging and suicidal burns like drowning, electrocution, fall from height etc.<br>Results: It is clear that committing suicide by consuming poison accounts for major number of deaths followed by committing suicide by hanging and least followed by committing suicide by self-immolation. It is also clear that committing suicides has increased year by year from 2016 to 2020 irrespective of committing suicide by hanging, poisoning. Coming to sex pattern, suicide by hanging was observed more in males. Sex pattern in suicidal deaths due to poisoning clearly showed that females outnumbered males. Sex pattern in suicidal deaths due to self-immolation clearly showed that females outnumbered males with high margin. Coming to the age pattern in committing suicidal deaths by hanging, 30 – 45 years age group showed highest incidence year by year followed by 45 – 60 years and least among 15 – 25 years age group. Where as in case of suicidal deaths by poisoning and self-immolation, incidence was highest in 30 – 45 age group followed by 15 – 30 years age group and least among 45 – 60 years group.</p> <p>Conclusion: According to the World Health Organization, in India, suicide is an emerging and serious public<br>health issue. Suicide rates in India have been rising over the past five decades. India’s contribution to global<br>suicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. In 2016, suicide was the most common cause of death in both the age groups of 15–29 years and 15–39 years in India. Factors such as frustration, family problems, love affairs, poverty, harassment, sexual violence, social boycott, chronic diseases and bankruptcy were studied as the main reasons leading to committing of suicides in people.The need for a strategy which will raise awareness and help make suicide prevention a national priority has to be recognized. Such a national strategy will need a comprehensive approach that encompasses the promotion,coordination, and support of activities to be implemented across the country at national, regional, and local levels.The program would need to be tailored for populations at risk.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20475Epidemiologies of Fatal Ground Level Falls in Autopsies Conducted in A Tertiary Care Hospital: A cross sectional Study2024-01-18T11:48:49+00:00Uthayakumar R.Rama VSabitha Devi C
<p>Background: Falls are the second leading cause of unintentional injury deaths worldwide. Falls not only causes Mortality, but also Morbidity resulting in disabilities and loss of productivity. Death due to falls not only occurs in victims falling from a height but also in Ground level falls.<br>Aim: To study the age and sex distribution, place, surface, time, and outcome of fatal accidental Ground Level<br>Falls.<br>Methods: The present study was carried out as a descriptive study in which medico legal autopsies of 115 victims of ground level fall victims were included. Lettule’s method of en masse removal of viscera and dissection of organs was used for conducting medico legal autopsy. The Collected data was entered in MS excel and analysed.<br>Conclusion: The current study revealed that most victims of ground level falls were more than 50 years of age and indoor falls were more common than outdoor falls.62% of the victims had suffered head injury. Effective fall prevention programmes should be framed to reduce the number of people who fall.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20474Age Estimation among 12-18 Years Children by Studying the Ossification Centers of Hip Joint and Pelvis2024-01-18T11:48:49+00:00R.K PuniaSuresh Kumar KajalaSiddharth Vijay VergiaDipender Singh
<p>Background: Bone age is an indicator of the skeletal and biological maturity of an individual. Skeletal ossification progression studies are one of them and are admissible in court as unparalleled scientific evidence for age estimation. Age group of juveniles between 12 - 18 years is dealt with special laws for medico- legal cases.<br>Aims & Objective: To observe age of appearance and fusion of ossification centers of hip joint and pelvic bone in adolescent population of Jaipur.<br>Material & Methodology: An observational prospective study that used inclusion and exclusion criteria was<br>conducted. Healthy Adolescents of 12-18 years of age group from Jaipur were taken in the study. The present<br>study had been conducted in the Department of Forensic Medicine & Toxicology, SMS Hospital, Jaipur with<br>Department of Radiology, SMS Medical College and Attached Hospitals, Jaipur during the period from June 2021to May 2022.Result & Observation: Appearance of triradiate cartilage was found earliest at the age of 12 – 13 years in bothsexes, complete fusion was found earliest at the age 13 - 14 years in females and 14 – 15 years in males. Appearance of ossification centre of Ischial Tuberosity was found earliest at the age of 12 – 13 years in males and females; old fusion is earliest found at the age of 17 - 18 years in females and was not found in males. Appearance of ossification centre of Iliac Crest was found earliest at the age of 12 – 13 years in males and females; old fusion is earliest found at the age of 17 - 18 years in both male & females. Appearance of ossification centre of Pubis was found earliest at the age of 12 – 13 years in males and females; old fusion is earliest found at the age of 17 - 18 years in females and was not found in males.<br>Conclusion: Appearance and fusion of ossification centers for hip joint & pelvis joint can be implemented in<br>routine forensic practice for 12 – 18 years age group to opine about age of subjects with lesser age range.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20473Evaluation of the Effectiveness of an Alternate Diatom Extraction Procedure in Diatomological Study2024-01-18T11:48:49+00:00Surangama Chakraborty
<p>Background: The “Diatom Test” is based on the recovery of diatoms in high concentration in the organs of drowned persons because diatoms pass through the alveoli into the great circulation. Acid digested extracts of various internal organs and water collected from waterbodies demonstrate the presence of diatoms. If quantitatively and qualitatively these diatoms match to each other, that is the confirmatory diagnosis of death due to drowning in that drowning medium. This study was conducted to analyze the effectiveness of alternate method of diatom extraction using diluted Sulphuric acid solution and to compare its effectiveness with the traditional method of extraction of diatoms using concentrated nitric acid.<br>Methods: It was a prospective study. Samples were collected from ten different water bodies which included lakes,rivers, canals and reservoirs, for a period of one year in all the seasons. The pH and temperature of water were recorded during sampling. From each of water samples, diatoms were extracted using both classical and alternate method. And then compared by observing the diatoms at 100X magnification under compound microscope. Total 22 genera of diatoms were identified. Most of them were pennales and few were centrales. The time demanded for complete digestion of samples with strong acids like concentrated nitric acid was much lesser time than with diluted acids as it hasstronger digestive capability in comparison to diluted sulphuric acid. The structures of different diatoms specifically Cyclotella, Cybella, Navicula were better found in almost intact state with clear background after digestion by diluted sulphuric acid.<br>Conclusion: Depending on different criterion, digestion by diluted sulphuric acid has procured better result than concentrated nitric acid digestion method. Therefore, for qualitative and quantitative diatom analysis alternate diatom extraction method is a better choice than traditional method.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20472Fasciotomy in Snake Bite Victims and Renal Outcome in a Tertiary Care Hospital2024-01-18T11:48:49+00:00Sruthi BallaM. SeenivasanC. AnandiS.A.K. Noor MohammedP. Nagrajan
<p>Background: Snake bite is a neglected tropical disease. More than 50% of death due to snake bite in the world occurs in India. Acute kidney injury (AKI) is the cause of morbidity and mortality in viper bite. The compartment syndrome is a rare manifestation of snake bite. There is paucity of data on the role of fasciotomy in viper bite.<br>Methods: A prospective observational study was done in patients admitted to a tertiary care hospital in south<br>India, with snake bite-associated acute kidney injury, from March 2018 to March 2020.<br>Results: Sixteen % of patients underwent fasciotomy following snake bite. We compared the renal outcome of 21 patients, who had undergone fasciotomy following snake bite, with 65 patients with dialysis-requiring acute kidney injury following snake bite. The patients in the fasciotomy group had a lower peak serum creatinine (5.3 mg/dl), needed less number of dialysis sessions (3.9) and were on lesser number of days (6.1) on dialysis following snake bite, when compared with the group not needing fasciotomy.<br>Conclusion: In snake bite patients presenting with compartment syndrome, fasciotomy should be considered in view of favourable renal outcome.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20470DNA Extraction from Postmortem Blood: A Pilot Study for Advancing Molecular Diagnostics in Forensic Medicine Casework2024-01-18T11:48:49+00:00Sadhu Rama Mohana RaoSravani YandavaT. Mohit Kumar MosesKattamreddy Ananth RupeshK. SatyasreeK. MamathaAnuradha Argi
<p>Background: DNA’s role in forensic practice is widely acknowledged for its unparalleled accuracy in identification. While developed countries have established molecular autopsy programs as early as two decades ago, India is yet to initiate such a program. The isolation of DNA serves as the crucial first step in the molecular autopsy protocol. The postmortem blood sample is one of the good sources for DNA extraction which wasn’t considered with rigor by the scientific community so far.<br>Aims and Objectives: The aim of this study was to investigate the specific time period within which DNA can<br>be effectively extracted from postmortem blood samples. The objective was to identify if there are patterns in the quality and purity of the extracted DNA based on the postmortem interval. Additionally, the study aimed to investigate if the cause of death influenced DNA extractability.<br>Observation and Results: DNA can be extracted from postmortem blood within a timeframe of up to 72 hours after death, given that the deceased body was preserved in cold storage within 12 hours after death. Both the salting out method and the phenol-chloroform method yielded bands of comparable quality, with the phenol-chloroform method showing a slightly higher DNA yield. The average absorbance ratio was 1.4 for the salting out method and 1.6 for the phenol chloroform method, as determined using a Nanodrop.<br>Conclusion: This study concluded that DNA extraction from postmortem blood samples is feasible within 72<br>hours after death. The integrity of the DNA remained intact during this time, but the quality and purity gradually decreased as the postmortem interval increased. The cause of death did not significantly affect DNA extractability.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20469Pattern, Severity of Injuires Sustained in Road Traffic Accident: An Autopsy Based Study2024-01-18T11:48:49+00:00Sadasivam ShanmugamSwarana SekarKaviya Kamalanathan
<p>Road Traffic Accidents (RTA’s) constitute a significant public health problem, they are rising in an alarming<br>rate and causing increased morbidity and mortality among people. Motor vehicle accidents are complex events resulting primarily from human, technical, and environmental contributing factors. That is the reason, road traffic accidents are creating the burden for people related to mortality and morbidity.<br>Objectives: The following study analyses the following: 1) Age and sex distribution of the deceased in RTA. 2)<br>Month and Time of occurrence of RTA. 3) Pattern of injury sustained in RTA.<br>Methodology: A retrospective study was conducted for a period of three month (October 2022-December 2022), in cases of road traffic accidents brought for autopsy at tertiary care teaching hospital, Madurai. All the data regarding the age, sex, month, time and place of occurrence, type and site of injuries and outcome are collected based on autopsy report. Data was analysed using standard statistical method.<br>Results: Of the total 330 road traffic accidents cases, 81.8% cases were males, 18.2% females. Majority of the victims were in the age group of 41-50 years (21%), Urban victims found to be on the highest side (77.2%), compared to Rural victims 22.8%. Most of the RTA happened during the month of NOVEMBER (38.2%) and during the time period between 2 PM and 1 0PM (40.6%). Head injuries contributes the most common injury pattern (60.7%) compared to other pattern of injury.<br>Conclusion: The present study concluded that head injuries were the most common injury pattern in RTAs and it is the main factor for death. Proper awareness about usage of helmets, punishment regarding drunk & driving and rash driving among the common people will help to reduce the mortality due to Road traffic accidents.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20468Artificial Intelligence and its Role in Forensic Karyotyping: A Systematic Review2024-01-18T11:48:49+00:00Sachin Kumar TripathiKhyati RaoRajiv Ratan SinghPradeep kumar Yadav
<p>Introduction: One of the most important aspects of forensic investigations and genetic research is forensic<br>karyotyping, which involves analyzing a person’s chromosomes to find genetic anomalies and establish<br>identification. The development of artificial intelligence (AI) technology offers a chance to improve and automate the forensic karyotyping procedure. This study examines the possible advantages and difficulties of artificial intelligence (AI) in forensic karyotyping. In forensic science, forensic karyotyping is essential for providing an accurate interpretation of genetic data for use in legal and investigative processes. It can offer useful details regarding genetic problems, such as chromosomal abnormalities or mutations, which can help with personal identification, paternity determination, or supplying proof in criminal investigations.<br>Aim: To give a general review of how artificial intelligence is used in forensic karyotyping, evaluate its possible advantages, and address any relevant issues. By being aware of Artificial Intelligence’s promise and limitations in this field, we may set the stage for its efficient integration into forensic practitioner.<br>Methods: A database search we did to start the inquiry turned up 582 documents. There were 216 unique records left after duplicates were eliminated. 232 items were subsequently eliminated as a result of download problems. A final sample of 31 research was chosen from the 134 full-text papers that were evaluated (n=134), with 103 being eliminated owing to quality issues.<br>Result: The use of artificial intelligence (AI) in forensic karyotyping has several advantages, including automated chromosomal analysis, quicker abnormality discovery, and increased uniformity. For a successful application, challenges such as a lack of labelled datasets and ethical issues must be resolved.<br>Concussion: By increasing productivity, precision, and uniformity, artificial intelligence has the potential to<br>transform forensic karyotyping. While there are obstacles, continued study and cooperation amongst several fields might help you get through them. The ethical and appropriate use of AI in forensic karyotyping will improve forensic investigations, boost genetic research, and expand the use of genetics in the legal system.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20467Trends of Poisoning Cases Coming to a Tertiary Care Center in Lucknow: A Retrospective Observational Study2024-01-18T11:48:49+00:00Richa ChaudharyRajiv Ratan SinghSachin Kumar TripathiPradeep Kumar Yadav
<p>Introduction: The term “suspected poisoning” describes the potential exposure of a human or animal to a poisonous chemical, which might result in a variety of symptoms ranging from minor symptoms to severe consequences. The kind and quantity of the poison implicated may affect the symptoms. If poisoning is suspected, it’s crucial to get help right away so that the correct toxin can be identified and the proper management can be given.<br>Aim: To monitor the epidemiological traits and clinical trends of poisoning cases at the emergency department of Dr. RMLIMS Lucknow.<br>Methods: All 295 instances of acute poisoning were reported to the emergency department between April 2022 to March 2023. It is retrospective observational research of 12 months duration carried out in a tertiary care hospital. Data on the patient’s age, gender, kind of poisoning, length of hospital stay, and result were gathered from hospital medical records and examined.<br>Result: The majority of victims have married housewives with poor socioeconomic and educational standing<br>who were between the ages of 31 and 40. Agriculture poisons and domestic poisons were the two most often used toxins. Most of the time, the general health at the time of presentation was unstable.<br>Conclusion: Suspected poisoning is a serious medical emergency that might have life-altering effects on the<br>victims. Knowledge of the probable causes and symptoms of poisoning is crucial to ensure prompt diagnosis and treatment. Those who have been exposed to harmful chemicals can recover and prevent long-term harm with the proper measures.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20466Clinical Profile and Outcome of Drug Abuse Patients Admitted in Intensive Care Unit of a Tertiary Care Hospital in Kashmir: A Prospective Observational Study2024-01-18T11:48:49+00:00Reyaz Ahmed QadriSuhail SidiqMajid JehangirTalib KhanAbdul Waheed MirMajid Khan
<p>Introduction: Drug abuse is a global public health issue that poses significant challenges to healthcare systems particularly in intensive care units (ICU). This study aims to assess the clinical profile and outcomes of drug abuse patients admitted to ICU of a tertiary care hospital in North India.<br>Methods: A prospective observational study was conducted over period of 3 years involving drug abuse patients admitted to the ICU. Demographic data, clinical characteristics, substance abuse patterns, co-morbidities, severity scores and outcomes were recorded.<br>Results: A total of 35 patients were included in the study. All patients were males with a mean age of 29.1(± 11.68).<br>25 patients were from rural areas. 42.8% were unemployed. Most of the patients (85.7%) were unmarried. 34.3% were students. Mean APACHE II score on ICU admission was 13. Most of patients were admitted for heroin overdose (60%). All 35 patients admitted in ICU had low Glasgow coma scale (GCS< 7). 32 (91.4%) patients had associated respiratory failure. 7 patients had cardiovascular instability. 4 (11.4%) patients developed multi-organ failure during the ICU stay. Mean duration of ICU stay was 3.4 (± 2.68). 23 (65.7%) patients got extubated within 24 hours of ICU admission. 4 patients expired (11.4% mortality) in study group. Sepsis was cause of death in one patient, 3 patients died of multi-organ failure<br>Conclusion: Most of the overdose was due to opioids specifically of heroin. CNS depression was found in all drug overdose patients followed by respiratory failure. Multi organ involvement have poor outcome. Mortality ensued in 11.4% of admitted patients as a result of sepsis and multi-organ failure. Majority of the patients had good outcome especially patients who presented early to healthcare facility.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20465Correlation of Canine Height to Overall Facial Height: An Observational Study2024-01-18T11:48:49+00:00Revati KeluskarNamrata PatilAnjana Bagewadi
<p>Background: Identifying individuals by determining their body parameters plays a major role in criminal<br>investigation. These parameters play an integral role in the identification of a person. Teeth, particularly canines,can help in identification, as they are the most stable teeth in the oral cavity because of the labiolingual thickness of the crown and root anchorage in the alveolar process.<br>Aim: To establish a relationship, if any between the crown length of the maxillary canine tooth and the facial<br>height of an adult individual and intersex differences.<br>Materials and methods: This study was conducted at a dental college where patients reported for treatment. The study group comprised 100 participants (50 men and 50 women, aged 18-23 years. To measure the facial height,photographs were taken and analyzed using Adobe Photoshop software. The face was divided into the upper,middle and lower thirds considering the hairlines, glabella, subnasalis, and menton as reference points. The length between the hairline and glabella is the upper facial height (UFH), that between the glabella and subnasalis is the middle facial height (MFH), and that between the subnasalis and menton is the lower facial height (LFH). For tooth measurements, impressions of the upper arches were made using alginate and dental stone casts were obtained. The length between the cervical line and cusp tip is the canine height(CH) and the mesiodistal length is the canine width(CW). Measurements of teeth were recorded using digital verniercalliper. Statistical analysis was performed using Statistical Package for the Social Sciences software (SSPS) version 16. The Mann-Whitney U test was used to determine the correlation between facial height and canine height.<br>Results: Total Facial Height (TFH), Canine Height (CH), Canine Width (CW) in males and females was done using descriptive statistics. This study demonstrated a correlation between TFH and CH in both men and women. This study showed that, as TFH increased, CH also increased. Therefore, TFH and CH were directly proportional, and hence there was a correlation between TFH and CH.<br>Conclusion: The total facial and canine heights are directly proportional to each other. There is a correlation<br>between the facial height and canine height.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20464Integrating Temperature Data with Other Forensic Methods for Time Since Death Estimation2024-01-18T11:48:49+00:00Pradeep kumar YadavRajiv Ratan SinghSachin Kumar Tripathi
<p>To reliably calculate the time since death is most important for investigating officers in all unnatural death<br>cases. Reliability of the study can be obtained only when potential influencing factors are considered during the calculation of time since death. One of the methods used for calculating the time since death is based on the cooling of the body. Cooling of the body is influenced by various internal as well as external factors. There are various body temperature-based methods in practice (Henssge’s rectal nomogram, Henssge’s brain nomogram, and Baccino’s both interval and global formulae based on ear temperature) to estimate the post-mortem interval (PMI). The rectum has been traditionally used to determine the central core temperature after death, though the external auditory canal has been proposed as an alternative site. According to published research, techniques based on ear temperature are just as trustworthy as those based on rectal temperature for determining the early PMI and may be employed as rapid, easy, and non-invasive procedures on the scene. It is vital to keep in mind that other aspects such as rigor mortis, lividity, and decomposition must also be taken into account to achieve a more accurate estimate, even if calculating the time since death based on the cooling of the corpse might be informative.<br>Aim: The goal of this study is to thoroughly examine some of the available approaches, compare the accuracy of the results, and determine which method is more accurate (reliable) at estimating the time of death.<br>Methods: It was decided to evaluate some of the earlier research’ published works from different publications and databases. A digital database was searched. Picks were made at random from the studies that were thought to be pertinent to the present goal.<br>Result: Therefore, in addition to the body’s cooling rate, other factors like post-mortem lividity, rigor mortis,<br>chemical changes in the body, and mechanical and electrical excitability of the skeletal muscles, are crucial for a more accurate prediction of the time of death.<br>Conclusion: It is usually advisable to take into account additional factors in addition to the algor mortis-based one when determining the time since death so that a more exact and trustworthy time of death can assist the investigating officer in more precisely resolving medico-legal matters.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20463Sensitivity of Preliminary Blood Test on Various Floor Surfaces After Washing with Different Cleansing Products. : Original Work2024-01-18T11:48:49+00:00Oshin HathiLav KesharwaniMunish Kumar Mishra
<p>Blood is important evidence that can assist an investigator in solving a crime. It connects the suspect to a crime and aid in the reconstruction of the crime scene. Criminals frequently attempt to wipe away blood stained evidence at a crime scene. These efforts may result in the modification or partial or total elimination of blood on the stained parts. Numerous presumptive tests are employed to identify bloodstains on floor surfaces since they are frequently cleansed after a crime using various surfactants. However, the traces of stains remain there and if analysed with appropriate reagents will give conclusive results. In This study Blood-stained floor surfaces were cleaned using a commercially available and widely used floor cleaners and After repeated washings, the Kastle-Meyer (KM),Leucomalachite green (LMG), and Tetra methylbenzidine (TMB) tests were employed to determine the presence of blood on these surfaces, and their sensitivity were assessed, this study will help the forensic investigator to select the appropriate reagents for detection of blood stains on the various washed floor surfaces and effectiveness of reagents for detection of blood stains washed with various floor cleaners.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20462Awareness, Attitude and Behavior of Dentists Towards Domestic Violence Victim Patients2024-01-18T11:48:49+00:00Noopur KokaneVandana KokaneNeena Dongre
<p>Background: Domestic violence is referred as shadow pandemic because it is seen globally. Domestic violence abuse is usually considered a problem that requires involvement of police or social services and not a problem that requires dental interference, but it is important to take under consideration that other services may even not be approached by the victim due to various reasons6. However, they may approach a dentist for facial trauma.Hence it is important to understand awareness, attitude and behaviour of dentists towards domestic violence victim patients.<br>Materials and Methods: in this cross-sectional study, a self- administered, structured questionnaire was sent to dentists practicing in central India. Collected data were subjected to statistical analysis using Chi-square test, and P < 0.05 was considered statistically significant.<br>Result: Mostly dentists were aware about and have heard about domestic violence in practice. As many as 37.6% dentist have encountered domestic violence victims in their practice but only 11.7% participants took any measures to record or report or refer DV victims<br>Conclusion: As dental professionals are usually the first line of contact for patient with head and neck trauma,they would need to undergo special training to identify, support, and treat domestic violence patients.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20461Comparative Study of Mandibular Canine Index and Maxillary Canine Index in Sex Estimation among North Indian Population2024-01-18T11:48:49+00:00Mohammad Abdurrahman KhanManisha VermaSangeeta KumariAnoop Kumar VermaKahkashan Riaz
<p>Introduction: Since teeth are easily approachable and each having different morphology, they form an excellent medicolegal and anthropological tool for sex estimation. Sexual dimorphism is difference in size and appearance among male and female teeth that can be applied for determination of sex. The basis of estimation of sex is comparing tooth parameters in male and female individual. Canine teeth shows highest sexual dimorphism among all teeth. Mesiodistal width of maxillary and mandibular canine can be used for sex determination based on sexual dimorphism.<br>Aim: The aim of our study was to evaluate the comparative sex estimation by mandibular canine index and<br>maxillary canine index in north Indian population.<br>Materials and Methods: The sample comprised of dental impression from 120 individuals (60 males and 60<br>females), all young adults between 20 and 35 years of age. Impressions of the teeth were made using irreversible hydrocolloid (alginate) material and casts poured in dental stone. Mesiodistal dimensions and intercanine distance of mandibular and maxillary canine of both right and left side was measured by caliper. Mandibular and maxillary canine index was calculated by formula given by Nageshwar Rao et al.<br>Results: Data were summarized as Mean and SD. Groups (in Gender Male vs female) were compared by unpaired or independent Student’s t test. When the level of accuracy for sex determination was measured using canine index it was found that 65% males and 65.83% females were predicted correctly. When maxillary canine index was used the sex was correctly predicted in it was found that 40.83% females and 32.50% males were predicted correctly.<br>Conclusion: Mandibular and maxillary canine index can be used for sex estimation in North Indian population but accuracy of mandibular canine index is better than maxillary canine index.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20457Electrocution Related Deaths in Catchment Area of East Point Hospital: A 3-Year Retrospective Study2024-01-18T11:48:49+00:00Manjunatha KRaghavendra RRavindra Kumar C N
<p>The present retrospective study has been carried out to find the occurrence of deaths due to electrocution in<br>Eastern part of Bengaluru with special emphasis on finding out the conditions along with pattern of injuries<br>sustained by the victims. Medico legal autopsy cases with history of electrocution over period of three years<br>between January 2019 to December 2021 were included in this study. A total of 799 cases were autopsied at our Institute during that period, out of which 51 deaths (6.38%) were deaths due to electrocution, in which male’s outnumbered females. The highest number of cases were observed in the age group of 21-30 years (n=18, 35.3%).27 victims (52.9%) were electrocuted by low tensions domestic supply. Majority of the victims (n=31, 60.8%) died on the spot. Most cases (n=38, 74.5%) were reported during the daytime between 7 am and 7 pm. The incidence of deaths during rainy season were typically higher (n=29, 56.9%). Limbs were the most common body parts affected by electrocution (n=27, 52.9%). 37 (72.5%) victims were electrocuted in dry conditions according to the surrounding places of incidence. As per police documents and history by relatives all cases of the electrocution deaths in the present series were accidental in nature.<br>The hazard of getting electrocuted in domestic surroundings from the chaotically connected electric wires without correct maintenance is certainly a matter of worry. Implementation of correct insulation safety procedures are important factors required for prevention of fatal electrocution.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20456Retrospective Observational Study on Relevance of Delayed Clinical Examination in Cases of Sexual Assault Survivor2024-01-18T11:48:49+00:00Hemant ShandilyaAnil yadavSandeepDeepali PathakD.K. Sharma
<p>Rape is a heinous crime that can have devastating effects on the survivor, The immediate medical examination and treatment of a rape survivor are crucial for their well-being and to-gather the necessary evidence to strengthen the case. Proper evidence collection is important for a successful legal prosecution. The earlier a survivor arrives for evaluation in the emergency department, the greater the chance of obtaining critical forensic evidence such as DNA samples. When patients delay presentation, or shower and change their clothes, relevant microscopic and macroscopic evidence is often lost. Evidence collection, including injury documentation, becomes less fruitful as time passes and tissue heals. Medical documentation has been shown to be positively associated with filing of charges and conviction. A Retrospective analysis of 67 cases of sexual assault examined at Department of Forensic Medicine at SMS medical college from 1st Jan to 31st Oct, 2020 was done, The clinical findings of the survivors were correlated to the time duration elapsed between incidence and medico-legal examination for all cases. 15 out of 67 cases (22%) were reported within 72 hrs; out of which 9 (60%) cases had corroborative clinical findings, 45 (67%)cases, who had reported later than 7 days only 1 (2%) had corroborative clinical findings. delayed reporting is most common hurdle for corroboration of material evidence and alleged accusation in these cases, The correlation of time of examination and clinical findings, in the present study, questions the relevance of mandatory medical examination in all cases.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20454Knowledge and Attitude towards Post-mortem Examination amongst the Residents of Imphal West2024-01-18T11:48:49+00:00A. HaricharanTh. Meera DeviBrogen Singh Akoijam
<p>A postmortem examination is still under an umbrella of misconceptions, myths, and emotions amongst the<br>people as well as physicians. The knowledge and attitude of the general public towards medicolegal postmortem examination have not been investigated thoroughly. This cross-sectional study was conducted to assess the knowledge and attitude towards postmortem examination amongst the residents of Imphal West. A total of 450 participants were approached and analyzed. It was observed that 41% of the participants had adequate knowledge about the medicolegal postmortem examinations. Further, 11 % of the participants had negative attitude towards the postmortem procedure. Despite having an important role in the machinery of justice, the knowledge and<br>attitude of the general public towards autopsy is still poor. From the findings of our study, it is evident that<br>myths, misconceptions and lack of awareness still exist in the minds of people about postmortem examinations.<br>There is a need for clarification about the essence of postmortem examination, which is an important tool in the administration of justice.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20453Comparative Soil Analysis from Different Crime Prone Areas of Kottayam and Kollam Districts of Kerala for Forensic Characterization2024-01-18T11:48:49+00:00Elsa KurianPooja RanaLav Kesharwani
<p>Soil is the loose surface material that covers land on which plants grow. It consists of a mixture of organic remains, clay, and rock particles, which gives it its uniqueness from place to place. Because of the uniqueness of soil, it has a high evidential value in the field of forensic science. In the present study, research has been conducted to check the range of variations in the soil collected from different crime-prone areas of Kottayam and Kollam districts of Kerala by physical, chemical, microscopic, and instrumental examination. In physical examination, soil colour, texture, consistency, and density were measured, and in chemical examination, pH and total soluble sulphate of the soil were measured. In instrumental examination, Heavy metal analysis was done by using Atomic Absorption Spectrometry (AAS), which helps to measure the amount of trace elements present in the soil. The study found that each soil has some significant variations that make it unique. In the field of forensic science, this can be highly helpful in determining the origin of soil by examining its colour, texture, structure, content, etc.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20452Estimation of Pattern of Skull Fractures in Homicidal Deaths: An Autopsy Based Cross Sectional Study Conducted in a Tertiary Care Hospital2024-01-18T11:48:49+00:00P.Praveen KumarK.PriyatharsiniS.Balasubramanian
<p>The head is the most vital part of the body among various organs as the injury to the head will result in fatal<br>outcomes compared to injuries sustained to other parts of the body. There has been an increased global incidence of head injuries in case of homicidal deaths. The present study aims to estimate the various patterns of the skull fractures in case of homicidal deaths and also the nature of injury causing such skull fractures in homicidal deaths.<br>The present cross-sectional study revealed that out of 4036 autopsies, there were 74 cases of homicidal deaths with 67 male and 7 female cases. The skull fracture was noticed in 54 cases out of these 74 cases. The maximum number of homicidal deaths were found to be in the age group of 21 to 40 years. Among the different types of skull fractures, the isolated cut fracture contributed to 46.30% of cases followed by isolated fissured fractures and then by the combination of other types of skull fractures. The nature of injury causing skull fractures was blunt force in 51.8% of the cases then by sharp force injuries and then by the combination of these two. To bring down the incidence of homicidal deaths among the younger individuals, strict enforcements of law may be ensued on possession of blunt and sharp force weapons which are used for the brutal attacks.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20451Comparative Evaluation of Odontometric Parameters for Determining Gender2024-01-18T11:48:50+00:00Rajeshkumar R BhootVanrajsinh K Rathva
<p>Background and Aim: Sex estimate is a crucial component of human identification in a forensic setting. Due to the sexual dimorphism of human teeth, odontometrics—the measuring and analysis of tooth size standards—is most frequently utilized in age and sex determination. The aim of this study was to assess the degree of sexualdimorphism in mandibular canine using mandibular canine index using mesiodistal (MD) and buccolingual (BL)dimensions of the crown and inter canine distance measured.<br>Material and Methods: The study sample included 200 people (100 men and 100 women), ages 18 to 35, with<br>an average age of 22 years. The distance between the mesial and distal contact points was used to calculate the mesiodistal dimension of the mandibular canine (CMD). Each subject’s right mandibular canine index and left mandibular canine index were used to construct the canine index. The standard canine index (SCI) value was used as a cutoff point to differentiate males from females.<br>Results: Men’s right and left mandibular canines mesio-distal crown widths were found to be significantly greater than those of their female counterparts. The current study demonstrates a very high significance of p value seen in the left mandibular canine and a significant difference in mesiodistal breadth between males and females of the right mandibular canine of p value. The total probability of sex determination for the right mandibular canine is 55% and for the left canine is 59.5% based on the conventional MCI calculations for the right mandibular canine (0.22) and for the left mandibular canine (0.21), suggesting that the left mandibular canine is more relevant for sex determination.<br>Conclusion: It has been proven beyond a reasonable doubt that mandibular canines exhibit significant sexual dimorphism when it comes to sex determination, and it is clear from the study that this breed is a more trustworthy source for sex determination.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20450The Dogs Prey – A Canine Menace: A Case Report2024-01-18T11:48:50+00:00R. Varun KumarM. Taqiuddin Khan
<p>A 13 years old male found dead with several bite marks in the body, with some 8 to 10 dogs around that area.The deceased body was brought to Mortuary, Osmania General Hospital at 03:30 PM on 19/05/2022 by the Investigation Officer and requested for postmortem examination under section 174 Criminal Procedure Code.On postmortem examination, there were multiple claw marks, avulsed lacerations, puncture wounds present all over the body, laceration of platysma and a retro-laryngeal hematoma with fracture of 6th cervical vertebrae were noted, all were suggestive of canine tooth injury. All the internal organs were pale and cause of death was given as massive haemorrhage consequent to animal bites over head, neck and trunk.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20449Analysis of Signature Patterns: Consistency and Distinctiveness in Handwritten Signatures for Forensic Authentication2024-01-18T11:48:50+00:00Diksha SinghDileep KumarPoonam Prakash
<p>Handwritten signatures are unique behavioural attributes that serve as a distinct form of identification for<br>individuals. This study focuses on the analysis of signature patterns using various parameters, including aspect ratio, angle of the first letter with respect to the baseline, and the ratio of the area of a circle to its radius within the signature. A dataset consisting of 1200 genuine and 1200 simulated (English) signature samples from 12 individuals were examined using an image analysis tool to record measurements for these parameters. The primary objectives were to investigate the consistency of signatures within the same person and to compare genuine signatures with simulated ones. This study contributes to the field of forensic investigations by offering insights into the authentication of signatures and the measurement of dissimilarities between signatures of the same and different individuals based on their patterns. The findings aid in identifying most influential parameter in distinguishing genuine signatures from counterfeits and enhance the evidential value of handwritten signature samples. Additionally, the simplified approach employed in this study allows for universal applicability across languages. Future research endeavours could expand the dataset and explore additional parameters to further improve the accuracy and reliability of signature verification methods in forensic analysis.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20448Prospective Study on Estimation of Stature of Adult from Length of Clavicle in a Tertiary Care Hospital in Tamilnadu2024-01-19T08:48:32+00:00Dhivya PrakashMN Rajamani Bheem RaoVijay Balaji RR.RaguramK. Priyatharsini
<p>Forensic anthropology can play an important role in the identification process. Besides determination of race, sex and age of the unknown individual, estimation of stature enhances the reliability of identification. It is easier to get those data when the whole body or the entire skeleton is<br />available to the forensic anthropologist. However incases of deliberate mutilation and disposal in parts, interference by wild animal and bomb blast by terrorist attack, recovery of the whole body or complete skeleton may not be possible. In those cases, in the forensic anthropologists have to give this opinion based upon the available supplied skeleton remains. Although approximate stature of the individual can be estimated from most of the long bones using either multiplication factors or regression<br />formulae, studies on estimation of stature from clavicle are limited. In the past, Terry, Oliver and Thieeme have tried to estimate the stature of the individual from clavicle. So the present study is planned to determine the stature from clavicle.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20447Estimation of Time Since Death by Potassium ion Level in the Vitreous Fluids: A Postmoterm Study in a Tertiary Care Center, South India2024-01-18T11:48:50+00:00Balavenkataperumal RVinoth Kumar.VRajkumar.GUdhayabanu .RJeyasingh.T
<p>Background: It is of great value to find time since death in the medicolegal investigations like serious crimes.<br>Vitreous humor was more often used for the biochemical analysis as it is less contaminated or not affected by the putrefactive changes than other fluids of the body. It was stated by many researchers that potassium levels in the vitreous humour is more accurate in predicting time since death.<br>Aim: The aim of the study is to assess the time since death using potassium level in the vitreous humor<br>Methodology: This study includes 54 cases of victims brought to the tertiary care hospital based on inclusion and exclusion criteria. Cases with known time of death and with clear vitreous humor samples were included. Baseline characteristics like name, age, gender, exact time since death was collected. Vitreoushumor was collected through appropriate standardized technique. Sampling time was also noted. The collected data was entered in MS excel and analysis done in SPSS 23 software. P value <0.05 is considered to be significant.<br>Results: Majority of the study participants belongs to 57-67 years of age group (28%) followed by 27-37 years of age (22%).Male predominance was observed in our study 41(76%). There is a linear correlation found between the vitreous potassium concentration and the postmortem interval (R2=0.907). The rate of the vitreous potassium increase was 0.36 meq/hr (Coefficient of regression =2.76 meq/l/hr)<br>Conclusion: There is a linear relationship found between vitreous potassium concentration and time since death.Thus potassium in the vitreous can be used for assessing the time since death.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20446Assessment of Applicability of Gleurich and Pyle (GP) Method for Determination of Age of Children in 14-18 Years Age-Group at S.M.S. Medical College, Jaipur2024-01-18T11:48:50+00:00Ashish Kumar SharmaSumanta DuttaManish Kumar DewatNarendra Sisodia
<p>Background, Aim and Objective: Age estimation is also one of the important factors to establish individual’s<br>identity and radiological investigations play a phenomenal role in estimation of age in conjunction with clinical examination. The aim of this study to assess the applicability of Greulich and Pyle (GP) method for determination of age in 14-18 years of age group healthy population of Jaipur region. And objective is to assess the skeletal age determined by GP method using hand radiography of study population.<br>Method: This study was carried out on total 80 subjects at the Department of Forensic Medicine in association with the Department of Radiology after obtaining due permission and approval from the RRB and IEC of SMS Medical College, Jaipur during the period from 1st July, 2020 to 31st August, 2021 of subjects between 14-18 years of age. All subjects recruited from each age sub-group category viz 14-15 years (Group A), 15-16 years (Group B), 16-17 years (Group C) and 17-18 years (Group D) including equal number of members from both sexes (10 males and 10 females of each age sub group category). After obtaining valid informed consent for age estimation all details,general physical & dental examination was done and recorded in proposed Pro forma. The skeletal age (bone age) was determined using Greulich and Pyle Atlas (2nd edition, 1959)15. X-ray image on computer was compared<br>with images on GP Atlas according to sex and most matching image to assess the skeletal age. Images were<br>separated in two groups according to their sex and examined by both observers at different occasions to determine skeletal age of subjects and result derived.<br>Result: Among all (n=80), of 81.2% Hindus (34 males and 31 females), 12.5% Muslims (4 males and 6 females) and 6.25% Jains (2 males and 3 females). Correlation of estimated skeletal age by GP method to the chronological age in both females and males showed a strong positive correlation. {r value=0.987 (females) & 0.974 (males)} and for both p<0.001 which indicates that the correlation of estimated skeletal age and chronological age was statistically significant.<br>Conclusion: Study reveals skeletal age lagged behind chronological age in all age subgroups in both boys and girls but the difference of CA and SA is less in girls as compared to boys. The G-P atlas method, although very old but used with caution can yield good results for assessment of bone age in Indian boys and girls, better for girls. Delay in skeletal maturation was observed in both males and females, but the females in the sample matured earlier then the males. Thus, G-P atlas method seems applicable on Indian children. However, studies on larger sample sizes considering other factors may yield better insight into its forensic application.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20445Study of Sudden Natural Death: An Autopsy Based Cross Sectional Study in a Tertiary Care Medical College and Hospital of Assam2024-01-18T11:48:50+00:00Ardra P MohanNayan mani ChoudhuryYengkhom Nungshiton SinghaPranay SharmaBishal KoiriRajkumari Preety Devi
<p>Sudden natural death accounts for significant portion of mortality. Autopsy is the only solution for finding the definite cause of sudden deaths. The aim of this study is to find out the causes of sudden natural death and to evaluate associated factors. Study comprise 64 cases of Sudden Death autopsies performed in Silchar Medical College during the period 1st May 2022 to 30th November 2022. The organs were retained for histopathological examination. Information gathered from available documents in departmental records. Inferences made after analyzing data. Out of 514 autopsies during the study period, 64 cases were sudden natural death. Male dominated over female victims. The maximum death occurred in the age group 40-50 years followed by 30-40 years. The cause of deaths in 39% were attributed to cardiac causes and the remaining were due to non-cardiac causes. Sudden unexpected death requires significant health concern as most death occurs in the age ranging from 30 to 50 years. Cardiac causes contribute the maximum and male population are mostly affected. This kind of death of adulthood affects the financial stability of whole family as well as the Society.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/20444A Case Report of Amitraz Poisoning2024-01-18T11:48:50+00:00Chithrapathra K.E.Munasinghe R.HSilva F.H.D.S.
<p>Amitraz is a pesticide commonly used in agriculture and veterinary practice to repel ectoparasites and insects. Poisoning with amitraz is rare especially for the purpose of self-harm. Although rarely fatal, it can result in significant symptoms. Management typically involves symptomatic treatment. We report a 34-year-old man who attempted suicide by ingesting amitraz presenting with unconsciousness. He had miosis, persistent bradycardiaand extreme hypotension. Symptomatic treatment recovered him well with discharge from care with nocomplications and good health within 36 hours.</p>
2024-01-18T00:00:00+00:00Copyright (c) 2024 https://medicopublication.com/index.php/ijfmt/article/view/19969Efficiency Improvement of Legal Proceedings Under Anti-Money Laundering Laws by Employing Digital Forensic Evidence2023-10-16T08:23:31+00:00Thammanoon KongratWoratouch Witchuvanit
<p>This research aims tostudy obstacles, problems,and approaches to increase the efficiency of proceedings by using<br>digital evidence according to the Anti-money Laundering Law.It uses qualitative measure. Key informants in the<br>research consist of (1) specialist of Civil Servant Group, Anti-Money Laundering Office (Computer Academician),<br>(2) specialist of Civil Servant Group, Anti-Money Laundering Office (Litigation Division Officers), and (3)<br>prosecutor officers of the Attorney General. And this research uses snowball sampling to collect data via semistructured<br>Interviews; data are analyzed by content analysis method. The research indicated that the problems<br>of property legal proceedings under anti-money laundering laws using digital forensic evidence consist of an<br>operation, and an expansion of the investigation of property proceedings under anti-money laundering laws.<br>There were suggestions as follows: The Anti-Money Laundering Office should formulate policies, strategies, and<br>operational plans to support the proceedings. And it should establish standards for digital evidence accreditation<br>in line with central standards in order to incorporate digital evidence into the case files, thus significantly increasing<br>the efficiency of litigation.</p>
2023-10-16T00:00:00+00:00Copyright (c) 2023 https://medicopublication.com/index.php/ijfmt/article/view/19968A Rare Complication of Intravenous Phenytoin Induced Purple Glove Syndrome2023-10-16T08:23:31+00:00TamilselvanLakshmi sabapathiSyedrajaKarthikeyanGunaseelanMayakrishnanVeenu
<p>Purple Glove Syndrome is a relatively uncommon complication of intravenous phenytoin administration with<br>clinical manifestations of pain, edema, and purple-blue discoloration at the injection site. Here we report a case<br>of Purple Glove syndrome induced by intravenous administration of phenytoin. The case report describes about a<br>75-year-old male, who presented to the Emergency Department with chief complaints of generalized tonic - clonic<br>seizures for which he was managed with Inj. Phenytoin. Later patient sensorium improved and 4 hours later the<br>patient had pain and swelling over the left hand and wrist distal to the IV cannula site followed by reddish-purple<br>discoloration over the edematous site. Left upper limb Doppler was done & it showed left-hand cellulitis with no<br>evidence of thrombus. Then the patient was reassured and treated with removal of IV cannula, left-hand elevation,<br>warmth application, analgesics and change of antiepileptics. Such medications like phenytoin should be handled<br>carefully to avoid difficulties in the future. Early detection, rapid monitoring, and management are essential.</p>
2023-10-16T00:00:00+00:00Copyright (c) 2023