Acute alcohol intoxication: prevalence, recognition and medicolegal importance.

OBJECTIVE: To highlight the clinical criteria of persons who are accused of being under the intoxicating effect of alcohol brought to medicolegal officer by the police. METHODS: Included cases of alcohol intoxication reported to the medicolegal sections of three major government hospitals of Karachi i.e., Jinnah Post Graduate Medical Centre, Civil Hospital and Abbasi Shaheed Hospital, Karachi, during the period January to December 1996. RESULTS: During one year of study, 338 persons were brought from police stations all over Karachi to the medicolegal sections of the above three hospitals. Out of these, 260 persons were disposed off by the medicolegal officers by use of their clinical judgement, 78 persons were suspected to be under the effect of alcohol intoxication and were referred to the chemical examiner where urine and blood analysis for alcohol was positive in 40 and negative in 38 cases. Only one fatal case of alcohol intoxication was reported to the chemical examiner and the viscera sent for examination were positive for alcohol. CONCLUSION: The incidence of the positive cases of alcohol intoxication on laboratory analysis was 11.8% while negative results were obtained in 11.2% cases, out of 23% cases referred to the chemical examiner, indicating that the bulk of cases i.e. 76.9% were disposed off on clinical criteria only which is a crude method of assessment of cases of acute alcohol intoxication.

Importance of correct interpretation of postmortem artifacts in medicolegal autopsies.

PURPOSE: To study whether various injuries labelled as antemortem are in fact postmortem artifacts. STUDY SUBJECTS: 780 postmortems conducted in mortuary of S.M.C. Karachi from 1-1-95 to 20-9-95. MAIN FINDINGS: Out of 780 autopsies, 229 showed postmortem artifacts which included decomposition in 78, animal and insects producing changes in 45, injuries due to rough handling in 40, breaking of rigor mortis and shifting of postmortem lividity during transportation in 37, iatrogenic fracture of skull during opening in 15, fractured ribs during resuscitation after death in 8 and exhumation producing fractures of bones in 6 bodies.

Percutaneous removal of a biliary stone impacted in a cystic duct remnant.

Occasionally, percutaneous removal of retained biliary stones may be difficult in patients with unusual anatomic configurations. The authors describe a procedure used in the removal of an impacted stone retained in a long cystic duct remnant.

Intralobar pulmonary sequestration: value of aortography and pulmonary arteriography.

Twelve patients with plain roentgenographic findings of intralobar pulmonary sequestration were evaluated with aortography and, in most instances, pulmonary arteriography. Correlative criteria from aortography and pulmonary arteriography permit a precise diagnosis to be made. Pulmonary infections must be differentiated from intralobar pulmonary sequestration because treatment for the latter should be surgical.