Original Article


Background: Subclinical methemoglobinemia (MetHb) is an occult disease. Clinical diagnosis is difficult. Acquired MetHb is a most common presentation in practice, and its detection help to improve health status of involved individuals. Healthcare professionals enumerate as one of the at risk groups against adverse health effects.

Method: All the participations were hospital healthcare professionals and to follow designed criteria to the study.

Results: A total of 117 healthcare professionals fulfilled the criteria of study. Mean age was 39±9 SD years, ranged 20-60 years. Female sex included 52%. Frequency of MetHb was detected in 6% of population. Of them, 71% were male. All the subjects were diagnosed with MetHb located at the poor-ventilated workplaces. There were significant differences between MetHb and carboxyhemoglobin levels (P<0.001).

Conclusion: Subclinical MetHb was meaningful in the target of population. It may be originated due to ambient air pollution. There was high-frequency levels of involvement in men had. Evaluation the causal factors are an impact that will require the future studies.

Study of Violent Asphyxial Death

Ankur P Patel, Rajesh R Bhoot, Dhaval Jivanlal Patel, Khushbu A Patel

International Journal of Medical Toxicology and Forensic Medicine, Vol. 3 No. 2(Spring) (2013), 10 June 2013 , Page 48-57
https://doi.org/10.22037/ijmtfm.v3i2(Spring).4170

Background:An increasing death rate as a result of violence constitutes a large group in medico-legal autopsies especially deaths due to asphyxia are one of the most important cause in violent deaths.

Method: It was a prospective study of all medico-legal autopsies performed between December 2008 and November 2010 at mortuary of Civil Hospital affiliated with B.J.Medical College, Ahmedabad, Gujarat, India. Out of the total autopsies conducted at the Mortuary of Civil Hospital, Ahmedabad, those where the victim died as a result of violent mechanical interference with respiration like hanging, strangulation, and drowning were included.

Results and Conclusion:Incidence of violent asphyxia deaths is 5.63% of total autopsies. Hanging (82.48%) is the most commonly encountered violent asphyxia death. Males are most common victims with male:female ratio 1.69:1. Most commonly involved age group is 21-30 years (128 cases forming 32.99% of total) with 200 victims (51.54%) aged 21-40 years. 312 out of 320 cases (97.5%) of hanging were suicidal and rest 8 (2.5%) were accidental in nature. Homicidal hanging is not recorded in present study. All 12 strangulation cases were of homicide, 32 out of 56 (57.14%) cases of drowning were accidental and remaining 24 (42.86%) were suicidal.

Credibility of Various Indices of Sacrum in Identification of Sex of Sacrum

HK Shreekrishna, S Yatiraj, N Vijayakumari

International Journal of Medical Toxicology and Forensic Medicine, Vol. 3 No. 2(Spring) (2013), 10 June 2013 , Page 58-63
https://doi.org/10.22037/ijmtfm.v3i2(Spring).3598

Background: Determination of sex from skeletal remains is of paramount importance for Forensic Experts for identification of the deceased. The task becomes more difficult when only a single bone is available. Though most bones exhibit clear cut sexual variation in morphology but to determine sex with 100% accuracy, one has to use metric measurements to study various indices. These indices exhibit significant variation in range according ethnicity & geographic location, hence is suggested to arrive at Demarking Point (D.P.) for these parameters which greatly help in sexing of a bone. Sacrum has been considered amongst ideal bones to determine sex of individual because of its functional morphological variation in both sexes by virtue of its contribution to pelvis. Numerous indices have been reported to determine sex of sacra but of it none have proved to effectively & singularly differentiate sex. Hence is advised to not rely on a single index but use maximum possible indices to determine sex of sacrum. Also to be taken in consideration is fact that values of these indices so is their D.P. varies according to geographical location. Hence studies such as this are carried out to calculate anthrometric data regarding various measurements & indices for a particular region.

Method: 150 sacra of known sex from Tamil Nadu of South India were studied for metrical parameters for determination of sex. Efforts were made to find Demarking point for each parameter and then compared with similar studies.

Results: It was evident from present study that sacral index is the most important parameter as far as the sex determination of sacrum is concerned as it could singularly identify 56% male and 78% female bones. Sacral index for population under study was observed to be 99.21 for males and 119.94 for females.

Conclusion: The present study highlight importance of certain parameters like sacral index while also demonstrating insignificance other parameters, but basic fact remains that as far as the sex determination of sacrum is concerned no single parameter could identify sex in 100% of the bones and hence, it can be concluded that for sex determination of the sacrum with 100% accuracy is possible only when maximum number of parameters are taken into consideration.

Case Report


Naltrexone Induced Serotonin Syndrome

B Behnoush, A Memarian, M Teimoory

International Journal of Medical Toxicology and Forensic Medicine, Vol. 3 No. 2(Spring) (2013), 10 June 2013 , Page 64-66
https://doi.org/10.22037/ijmtfm.v3i2(Spring).3991

Background: Serotonin syndrome resulted from hyperactivity of serotonin in nervous system and is potentially life threatening. Tramadol is known as one it's causing factors. Administration of Naltrexone is associated with a significant increase in the ratio of 5-HIAA/5-HT and DOPAC/DA in the frontal cortex and dorsal hippocampus respectively. We present a rare case with some signs of serotonin syndrome and withdrawal syndrome which simultaneously use naltrexone, tramadol and benzodiazepine in the realm of opium addiction.

Case Report: A 41 years old man who was admitted due to loss of consciousness and seizure.

In simultaneous usage of naltrexone, tramadol and benzodiazepine in an addicted person, and in the case of sever agitation which was resistance to routine treatments, serotonin syndrome beside withdrawal syndrome should be considered and its treatment should be done as soon as possible.

Conclusion: In simultaneous usage of naltrexone, tramadol and benzodiazepine in an addicted person, and in the case of sever agitation which was resistance to routine treatments, serotonin syndrome beside withdrawal syndrome should be considered and its treatment should be done as soon as possible.

Premature Centromere Division and Spontaneous Abortion

Rekha G, Murali N, Geetha T, Deepthi S, Rajitha V, Panneer Selvi G, Senthil Kumar B, Anitha M.R

International Journal of Medical Toxicology and Forensic Medicine, Vol. 3 No. 2(Spring) (2013), 10 June 2013 , Page 67-70
https://doi.org/10.22037/ijmtfm.v3i2(Spring).4012

Premature Centromere Division (PCD) was observed in the chromosomes of metaphase spreads in a patient with the history of recurrent abortions. Short term leukocyte cultures were set up with blood sample from the woman with a history of recurrent abortions for the past four consequent years. 25 % of the metaphase spreads screened displayed premature centromere division of the chromosomes in each of the cells. This abnormal behavior of the centromeres may predispose the individual to cell division errors due to chromosome instability and the consequences of which may be a spontaneous abortion.

Letter to the Editor


Entomotoxicology

R Dayananda, J Kiran

International Journal of Medical Toxicology and Forensic Medicine, Vol. 3 No. 2(Spring) (2013), 10 June 2013 , Page 71-74
https://doi.org/10.22037/ijmtfm.v3i2(Spring).4068

Entomotoxicology is the analysis of toxins in arthropods (mainly flies and beetles) that feed on corpse. Forensic entomology is the use of insects in legal matters. Knowledge of the distribution, biology, ecology and behavior of insects found at crime scene can provide information on when, where and how the crime was committed. Forensic entomotoxicology studies the usefulness of insects as alternative toxicological samples. Use of insects as alternative matrix for drug detection is well documented and recommended when conventional matrices such as blood, urine or internal organs are no longer available.

The accuracy of entomological estimates in deaths involving narcotic intoxication has been subject to debate in recent years as few available studies have explored the effects of drugs contained in decomposing tissues on fly colonization and ovipositional behavior, or on the rates of development of carrion-frequenting insects feeding on such food sources.

The major lacunae in this field is the effect toxins and contaminants have on the development of immature insects feeding on the corpse containing these substances and studies have to be conducted in this grey area.