The objective was to study the external causes of death reported in the autopsy centre in Kathmandu, Nepal. A retrospective review of case report documentation of all violent and traumatic death autopsies was conducted in Kathmandu from mid-July 2000 to mid-July 2004. A total of 4383 autopsies were conducted by the Department of Forensic Medicine in Kathmandu. There were 1072 (25%) cases of suicide, 380 (9%) homicide, 1399 (32%) accidental, 598 (14%) deaths as a result of natural diseases and 923 (21%) undetermined causes of death. The number of males was almost twice that of females (sex ratio 2.2:1). Persons aged 15 to 44 years comprised about two-thirds of the total reported fatalities (65.4%). Suicides were mostly reported due to hanging, homicides mostly due to firearms and explosives, accidents mostly due to road traffic injuries. More than 60% of road traffic injuries resulted among pedestrians. Suicides, homicides and accidental deaths remain a poorly identified public health issue in Nepal. Medico-legal autopsy reports can serve as an important tool in understanding fatalities from violence and injuries for countries similar to Nepal. Strengthening a regular mechanism for compilation and utilization of the information, however, remains a major challenge.
Background and purpose: Physical assault (PA) is a common cause of mortality and morbidity throughout the world and the prevalence is still very high in underdeveloped and developing countries. With the objective to see the spectrum of injury following PA from the medico legal point of view, this study was design in a tertiary care centre at far eastern part of Nepal.
Material and method: This is a prospective analytical study with non- probability consecutive sampling of physical assault cases presented in the emergency department over the duration of 4 months. All the patients who meet the inclusion criteria were collected in preformed proforma. Gender, types of weapons used for PA, location of external and internal injuries, various treatment strategies, and severity of injuries were presented in frequencies and percentage. Association of different age categories, gender and types of weapons used with severity of injuries were analysed using Chi square/ Fisher’s exact test wherever applicable.
Result: There were total 99 patients presented with physical assault during the study period with mean age of presentation 31.69 (SD 13.38) Years with male (70%) predominance. Among various types of weapons used for PA; punches/ kicks were used in 50% of assaults followed by blunt heavy objects (35%) and sharp heavy weapons (14%). Location of the external injuries were more common in head and neck area . Obvious internal injuries were seen in 14% of the assaulted patients. Among all the case of PA, 42% patients needed some sort of surgical intervention during hospital stay. There were 9% cases of grievous injury and 6% had life threatening injuries.
Conclusion: Physical assault is a common mode of injuries in eastern Nepal, where young males are more prone to such injuries. Violence are commonly carried out using fists, kicks and blunt objects. Severity of injuries is similar with all the types of weapons used.
Science and myth have been closely linked and argued upon by philosophers, educationalists, scientists, enthusiasts and the general public. Faith healing, when added as an adjuvant or alternative aid to medical science, will not necessarily be confined to mere arguments and debates but may also give rise to series of complications, medical emergencies and even result in death. We present an unusual case where reliance on faith healing led to the death of a young man.
Ascaris lumbricoides or roundworms' propensity to produce large number of eggs that are resistant to extremes of environmental conditions have made them one of the highly prevalent and geographically well distributed nematodes among poor socio-economic regions throughout the world. We present an unusual case of fatal gastro-intestinal ascariasis where general neglect, and firm and prolonged reliance on traditional healing methods led to aggregation of roundworms to such an extent that otherwise seems improbable in modern times and, hence, is worth reporting.
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