Serial cholinesterase estimation in carbamate poisoning.

Poisoning is one of the most important causes of morbidity and mortality in developing countries like India. Anticholinesterase compounds like organophosphates (OP) and carbamates account for the majority of these poisoning cases because of their easy availability and agricultural use. Carbamates are as popular as OPs as insecticides that often go undiagnosed. A fatal case of carbofuran poisoning is presented where serial cholinesterase estimation played a major role in the diagnosis of the same. The pertinent medical literature on carbofuran poisoning is reviewed. The establishment of poison information center in each state is needed for proper diagnosis and management of poisoning cases.

Profile of unnatural deaths in Manipal, Southern India 1994-2004.

Pattern of unnatural deaths is a reflection of the prevailing social set up and mental health status of the region. In an attempt to understand the magnitude and pattern of unnatural deaths in Manipal, Southern India, a 11-year retrospective study was carried out in the Department of Forensic Medicine, Kasturba Medical College, Manipal. The study revealed a rise in road traffic fatalities (37%) that constituted the majority of autopsies carried out followed by death due to poisoning and burns. Male preponderance was quite evident (2.5:1) except for death due to burns where ratio was reversed (1:2.9). People in 3rd decade were most prone to such fatalities. Of the total medicolegal autopsies conducted in this period, the manner of death was unnatural in 98% of the cases and 71% of them were accidental in nature.

Victims of homicidal deaths - an analysis of variables.

In the 11-year period from January 1993 to December 2003, 61 homicide victims were autopsied in the Department of Forensic Medicine, Kasturba Medical College, Manipal. Documents concerning the age and sex of the victims, time of assault, method used for assault, location of fatal injuries and number of offenders involved were analyzed. Of the 61 victims of homicide, majority were males and most of them were between 21 and 30 years. Most of the crimes occurred during the evening and night hours (52.4%) and winter was the commonest season for homicide. There were significantly more homicides over the weekends (Saturday and Sunday). 37.7% of the victims exhibited evidence of injuries due to sharp force trauma. Head injuries were more common. Multiple offenders were involved in 47.5% of cases whereas single offender was involved in 40.9%.

Toxicoepidemiology of fatal poisonings in Southern India.

An autopsy based retrospective study was conducted from January 2000 to December 2006 at Manipal in Southern India, and a profile of the victims of poisoning was prepared. The study was done to understand the magnitude and pattern of all poisoning fatalities in relation to the manner of death in Manipal region of Southern India. The study included a total of 198 cases of fatal poisoning. Self-poisoning was reported in 92.9% cases. Fatal accidental poisoning was seen in 6.1% cases. Homicide by poisoning was not reported during the study period. Uncertainty regarding the manner of death due to poisoning was observed only in two cases. Males were predominantly affected (71.2%). The majority of the victims were in the 3rd decade (28.3%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. While majority of the victims consumed poison during daytime, most of the poisoning fatalities were reported during summer months. Organophosphate compounds were implicated in 68.7% of the total poisoning related fatalities. Males in the 3rd to 5th decades were prone to self-poisoning with organophosphate compounds. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of epidemiology of poisoning in our region.