Emedinews:Insights on Medicolegal Issues:Phenol poisoning is known as carbolism

• Dettol is a chlorinated phenol and it is nontoxic to adults even in higher concentrations; some fatalities have occurred in children.
• Poisoning by phenol or Dettol is known as carbolism because of the carbolic acid.
• The acid in a concentrated form acts as a corrosive and remotely as a narcotic poison.
• It coagulates proteins but does not form a firm chemical combination with them. Applied to the skin, it causes a burning sensation followed by tingling, numbness and anesthesia due to its effect on sensory nerve endings.
• Dangerous symptoms may be caused by 0.3 to 0.42 g of carbolic acid; about 2g is the average fatal dose.
  A quarter of a teaspoon full dissolved in glycerin killed a six month old child.
• Carbolic acid is largely used as an antiseptic, as a disinfectant and as a preservative. It is used in the preparation of many disinfecting powders.
• Carbolic soaps should not be used for enemas. Several cases of accidental and suicidal poisoning by carbolic acid have occurred as it can be easily procured.
• On account of its powerful odor and taste, it is rarely used for homicidal purposes though it has been sometimes used for murdering children and infants.

Emedinews:Inspiration:Things change, keep up your faith

 For most people, graduation is an exciting day – the culmination of years of hard work. My graduation day… was not.

I remember that weekend two years ago. Family and friends had flown in from across the country to watch our class walk across that stage. But like everyone else in my graduating class, I had watched the economy turn from bad to worse my senior year. We graduates had degrees, but very limited prospects. Numerous applications had not panned out and I knew that the next day, when my lease ended, I would no longer have a place to call home.

The weeks ahead weren’t easy. I gathered up everything I couldn’t carry and put it into storage. Then, because I knew my small university town couldn’t offer me any opportunities, I packed up my car and drove to Southern California to find work. But what I thought would take a week dragged into two, and then four, and 100 job applications later, I found myself in the exact same spot as I was before. And the due date to begin paying back my student loans was creeping ever closer.

You know that feeling when you wake up and you are just consumed with dread? Dread about something you can’t control – that sense of impending failure that lingers over you as you hope that everything that happened to you thus far was just a bad dream? That feeling became a constant in my life.

Days felt like weeks, weeks like months, and those many months felt like an unending eternity of destitution. And the most frustrating part was no matter how much I tried, I just couldn’t seem to make any progress.

So what did I do to maintain my sanity? I wrote. Something about putting words on a page made everything seem a little clearer – a little brighter. Something about writing gave me hope. And if you want something badly enough… sometimes a little hope is all you need!

I channeled my frustration into a children’s book. Beyond the River was the story of an unlikely hero featuring a little fish who simply refused to give up on his dream.

And then one day, without any sort of writing degree or contacts in the writing world – just a lot of hard work and perseverance – I was offered a publishing contract for my first book! After that, things slowly began to fall into place. I was offered a second book deal. Then, a few months later, I got an interview with The Walt Disney Company and was hired shortly after.

The moral of this story is… don’t give up. Even if things look bleak now, don’t give up. Two years ago I was huddled in my car drinking cold soup right out of the can. Things change.

 If you work hard, give it time, and don’t give up, things will always get better. Often times our dreams lie in wait just a little further upstream… all we need is the courage to push beyond the river.

Emedinews:Insights on Medicolegal Issues:Forensic opinion in case of fatal hanging

Medicolegal Update (Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

• Hanging was formerly thought to be a pure asphyxia as a result of ‘cutting off the air’ by occlusion of the airway during the fatal pressure on the neck.
• It has been recognized by many forensic authors that the rapidity of death in many cases made it impossible for hypoxia to be the sole or even major cause. Many victims died almost immediately and exhibited none of the so–called ‘classic’ signs of asphyxia.
• Hanging means self–suspension; the body weight is constricting force/partial/complete, which constricts the laryngeal/tracheal lumen, root of tongue/venous congestion/reflex vagal inhibition/cerebral ischemia/fracture and dislocation of cervical vertebra as in case of typical/judicial hanging.
• The doctor who is conducting the postmortem examination, on the basis of position and type of knot/material/partial/complete hanging/length of duration of hanging/slipping of ligature/partial hanging, has to opine with clarity on the followin
• go Whether the death is due to strangulation by ligature and subsequent postmortem hanging? This is a point of contention and requires clarity.
• What is the medicolegal inference of injury in neck as described ligature mark? Whether it is a case of antemortem homicidal hanging by use of force or poisoning?
• Whether it is a case of death due to asphyxia as a result of antemortem hanging or not? If yes then whether it is a case of suicidal hanging?
• What is the forensic importance/explanation of any other injury on body……poisoning?

Emedinews:Inspiration:God is never wrong

An Inspirational Story (Dr Anupam Sethi Malhotra)

A king who did not believe in the goodness of God, had a slave who, in all circumstances, said: My king, do not be discouraged, because everything God does is perfect, no mistakes!

One day they went hunting and along the way a wild animal attacked the king. His slave managed to kill the animal, but could not prevent his majesty losing a finger.

Furious and without showing his gratitude for being saved, the nobleman said "Is God good? If He was good, I would not have been attacked and lost my finger."

The slave replied: "My king, despite all these things, I can only tell you that God is good, and he knows "why" of all these things. What God does is perfect. He is never wrong!" Outraged by the response, the king ordered the arrest of his slave. Later, he left for another hunt and was captured by savages who made human sacrifices.

In the altar, ready to sacrifice the nobleman, the savages found that the victim had not one of his fingers, so he was released. According to them, it was not so complete to be offered to the gods. Upon his return to the palace, he authorized the release of his slave that he received very affectionately.

"My dear, God was really good to me! I was almost killed by the wild men, but for lack of a single finger, I was let go! But I have a question: if God is so good, why did he allow me to put you in jail?"

"My King, if I had gone with you in this hunt, I would have been sacrificed for you, because I have no missing finger, therefore, remember, everything God does is perfect. He is never wrong."

Often we complain about life, and negative things that happen to us, forgetting that nothing is random and that everything has a purpose.

Every morning, offer your day to God, don’t be in a rush.

Ask God to inspire your thoughts, guide your actions, and ease your feelings. And do not be afraid. God is never wrong!

You know why this message is for you? I do not know, but God knows, because he never makes mistakes………

The path of God and his word is perfect, without impurities. He is the way of all those who trust in Him.

What you do with this message is up to you. May God put in your heart the desire to send it to someone. God knows why He choose you to receive this message. Please bless someone with it.

Emedinews:Insights on Medicolegal Issues:What is the nature of bullet wounds of the head?

In most cases of these injuries, the bullet passes completely through the skull. As it enters the skull, it produces a clean cut hole in the outer table and a larger hole in the inner table. At the exit point, these conditions are reversed and the hole in the outer table is larger than the hole in the inner table. These facts are often of importance in determining the direction of fire in bullet injuries of the head. The track of a bullet through the brain tissues varies greatly, depending on the range and stability of the bullet. On the other hand, if it remains high velocity at the time of impact with the skull, there may be considerable damage from the cavitation effect within the skull.

• Fissured fractures often radiate through the vault and base of the skull from the bullet entrance and exit holes.
• In certain bullet injuries of the head, the bullet may fail to emerge from the skull and in these cases an area of bony comminuting is often found at the site of lodgment.
• When a bullet strikes the head at a tangent, penetration of the skull may fail to occur, but the force of the bullet may be sufficient to fragment the inner table at the site of impact. Delayed pressure effects and cranial edema may be produced as a result of this.

Emedinews:Inspiration:Nothing is too big for God

An Inspirational Story

Two men went fishing. One man was an experienced fisherman, the other wasn’t. Every time the experienced fisherman caught a big fish, he put it in his ice chest to keep it fresh. Whenever the inexperienced fisherman caught a big fish, he threw it back.

The experienced fisherman watched this go on all day and finally got tired of seeing this man waste good fish. "Why do you keep throwing back all the big fish you catch?" he asked. The inexperienced fisherman replied, "I only have a small frying pan."

Sometimes, like that fisherman, we throw back the big plans, the big dreams, the big jobs and the big opportunities that God gives us. Our faith is too small. We laugh at that fisherman who didn’t figure out that all he needed was a bigger frying pan; yet how ready are we to increase the size of our faith?

Whether it’s a problem or a possibility, God will never give you anything bigger than you can handle. That means we can confidently walk into anything God brings our way.

Emedinews:Insights on MEdicolegal Issues:World Medical Association (WMA) guidelines for medical doctors in biomedical research involving human subjects

• Doctors should abstain from engaging in research projects involving human subjects unless they are satisfied that the hazards involved are believed to be predictable. Doctors should cease any investigation if the hazards are found to outweigh the potential benefits.
• In publication of the results of his or research, the doctor is obliged to preserve the accuracy of the results. Reports of experimentation not in accordance with the principles laid down in this Declaration should not be accepted for publication.
• In any research on human beings, each potential subject must be adequately informed of the aims, methods, anticipated benefits and potential hazards of the study and the discomfort, it may entail. He or she should be informed that he or she is at liberty to abstain from participation in the study and that he or she is free to withdraw his or her consent to participation at any time. The doctor should then obtain the subject’s freely given informed consent, preferably in writing.
• When obtaining informed consent for the research project the doctor should be particularly cautious if the subject is in a dependent relationship to him or her or may consent under duress. In that case the informed consent should be obtained by a doctor who is not engaged in the investigation and who is completely independent of this official relationship.
• In case of legal incompetence, informed consent should be obtained from the legal guardian in accordance with national legislation. Where physical or mental incapacity makes it impossible to obtain informed consent, or when the subject is a minor, permission from the responsible relative replaces that of the subject in accordance with national legislation.
• The research protocol should always contain a statement of the ethical consideration involved and should indicate that the principles enunciated in the present Declaration are complied with.

(Ref: 18th World Medical Assembly, Helsinki, Finland, 1964 and revised by the 29th World Medical Assembly, Tokyo, Japan, 1975).