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Poisoning Scenario In Chandigarh Zone Problems & Possible Solutions

Poisoning Scenario In Chandigarh Zone Problems & Possible Solutions. Dr. PrabhSharan Singh (PG II Year) Dr. Dasari Harish (Reader) Dr. BR Sharma (Reader)

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Poisoning Scenario In Chandigarh Zone Problems & Possible Solutions

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  1. Poisoning Scenario In Chandigarh ZoneProblems & Possible Solutions Dr. PrabhSharan Singh (PG II Year) Dr. Dasari Harish (Reader) Dr. BR Sharma (Reader) Dr. Krishan Vij (Prof. & Head) Department of Forensic Medicine Govt. Medical College &Hospital Chandigarh

  2. Poisoning as a problem

  3. Year Total no. of autopsies Number of poisoning % 1994 235 34 14.46 1995 218 38 17.43 1996 225 46 20.44 1997 264 53 20.07 1998 287 57 19.86 1999 352 62 17.61 2000 387 67 17.31 2001 383 64 16.71 2002 338 67 19.82 2003 288 59 20.48 2004 369 85 23.03 Total 3346 632 18.88 Year-wise break up of cases

  4. Age group in year Total Males Female No. % No. % No. % Below 15 10 01.61 03 00.74 08 03.77 15-20 130 20.53 68 16.72 68 30.19 21-25 180 28.53 113 27.51 70 31.13 26-30 94 14.93 60 14.87 34 15.09 31-40 98 15.47 75 18.21 19 08.49 41-50 85 13.33 62 15.24 19 08.49 51-60 30 04.80 22 05.58 06 02.83 Above 60 05 00.80 05 01.22 00 00.00 Total 632 100 408 100 224 100 Age and sex-wise distribution of cases

  5. Sex Rural Urban Total Married Un married Married Un married Male 158 99 68 83 408 % 38.72 24.43 16.54 20.30 64.50 Female 95 37 67 25 224 % 42.20 16.50 30.27 11.01 35.40 Total 253 136 135 108 632 % 40.00 21.50 21.30 17.00 100 Marital status of fatal poisoning cases in Rural and Urban Areas

  6. MALES

  7. Most commonly used poisons during 1994-2004

  8. s

  9. PROBLEMS Mismatch in History and Chemical Examiners report • deliberate concealment by patient/relatives • poison consumption at the spur of moment • fallacy in lab. Analysis Diagnostic problem-EMO may not have - exact knowledge regarding manifestations - means to diagnose/treat poisoning cases

  10. PROBLEMS CONTD…. • Hospitals lack infrastructural facilities - Acute shortage of specific antidotes and life saving drugs • Sample collection: - Chain of custody - Medium and jars used for reservation

  11. PROBLEMS CONTD…. • Chemical examiner report only Qualitative not Quantitative "Mere presence of a drug/poisonous substance in the blood and viscera does not imply that the concentration of the substance has surpassed the fatal limits."

  12. POSSIBLE SOLUTIONS • Specialized Toxicological Wing in all major Govt. Hospitals and Medical Colleges • Up gradation of Hospital infrastructure

  13. POSSIBLE SOLUTIONS Contd…. • Refresher courses/CME to Medical Officer - record keeping - maintaining chain of custody - proper selection and preservation of body fluid samples • Chemical examiners reports to be both qualitative and quantitative - regular interactions between chemical examiner, MO and investigating agencies

  14. THANK YOU

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