Emedinews: Insights on Medicolegal Issues:Section 324 of IPC in medical practice

Section 324. Voluntarily causing hurt by dangerous weapons or means: "Whoever, except in the case provided for by section 334, voluntarily causes hurt by means of any instrument for shooting, stabbing or cutting, or any instrument which, used as weapon of offence, is likely to cause death, or by means of fire or any heated substance, or by means of any poison or any corrosive substance, or by means of any explosive substance or by means of any substance which it is deleterious to the human body to inhale, to swallow, or to receive into the blood, or by means of any animal, shall be punished with imprisonment of either description for a term which may extend to three years, or with fine, or with both".

It is the duty of the attending doctor to record all injuries, their dimension as much as possible, and the body parts where the injuries are located; the nature of injury whether simple or grievous, whether caused by sharp/blunt object, age or duration of injury and vital parameters like blood pressure, pulse respiration along with the mental status of the patient.

When an investing officer comes to the hospital he needs some specific answers for his legal investigation and to book a case under the law of land.

• Are the injuries present self–inflicted or fabricated? If yes, please mention the forensic justification.
• Are there any signs/symptoms or smell of alcohol or any drug intoxication? If yes, please opine about the mental status due the influence of intoxication. Also, preserve the sample of blood.
• Please opine if the injured or intoxicated patient is fit to give statement? If no, please give due reasons and an approximate time interval for medical re–evaluation for his/her fitness for statement.
• Is the condition of patient critical, severe or serious? If so, the dying declaration must be recorded by attending doctor before one or two witnesses.

Emedinews:Inspiration:Do not judge, and you will never be mistaken

An Inspirational Story

(Dr GM Singh)

Everything in life holds both a blessing and a curse. We deny this when we label the events of our lives as either good or bad. The following old Zen story illustrates this lesson most effectively.

A farmer had a horse but one day, the horse ran away and so the farmer and his son had to plow their fields themselves. Their neighbors said, "Oh, what bad luck that your horse ran away!" But the farmer replied, "Bad luck, good luck, who knows?"

The next week, the horse returned to the farm, bringing a herd of wild horses with him. "What wonderful luck!" cried the neighbors, but the farmer responded, "Good luck, bad luck, who knows?"

Then, the farmer's son was thrown as he tried to ride one of the wild horses, and he broke his leg. "Ah, such bad luck," sympathized the neighbors. Once again, the farmer responded, "Bad luck, good luck, who knows?"

A short time later, the ruler of the country recruited all young men to join his army for battle. The son, with his broken leg, was left at home. "What good luck that your son was not forced into battle!" celebrated the neighbors. And the farmer remarked, "Good luck, bad luck, who knows?"

 "Do not judge, and you will never be mistaken."

Emedinews:Insights on Medicolegal Update:What is embalming?

Embalming is the process of chemically treating a dead body developed by the ancient Egyptians of preserving a person’s body after death to delay the decomposition of the body, restore it to an acceptable physical appearance and reduce the presence and growth of bacteria to prevent foul smell as well as perfume or add fragrance to corpse. Embalming certificate is required by law in certain circumstances like air/rail transportation.

• The process of embalming has a very long history, dating back to the Egyptian process of mummification. Though their techniques were quite different from those used today, the effect was the same — to preserve an individual’s body after death. The ancient Egyptians believed that the spirit would return to the body after death, so it must remain in good condition. To preserve the corpses, they covered bodies in a drying chemical called natron, and then wrapped them in linen sheets.
• Today, embalming is done by injecting chemicals directly into the bloodstream to preserve the corpse’s appearance. The most commonly used chemicals for embalming are formaldehyde and ethanol. A combination of these two chemicals is sufficient to preserve the body for a short time i.e. up to a week.
• To keep the corpse in a good condition for a longer period i.e. up to a month, a solution made up almost entirely of formaldehyde is used.
• There are several steps involved in modern embalming. First, the embalming fluid is injected directly into the deceased’s blood vessels, and pushed through the body with a mechanical pump. Next, the internal organs are hollowed of their contents and filled with embalming fluid. The chemicals are then injected beneath the skin wherever necessary, followed by a final surface embalming on injured areas of the body.
• One of the most famous embalmed corpses today is that of Russian communist leader Vladimir Lenin, whose embalmed corpse is on display at the Red Square mausoleum in Moscow. The corpse is very well-preserved, and should last for at least another hundred years.

Emedinews:Inspiration:A Female Pilot with No Arms – True Story

 Born in 1983 in Sierra Vista, Arizona, USA, Jessica has learned to live her life with her feet. Born without arms and all doctors did not know why.

 There were many questions at the time about whether Jessica would be able to live a “normal” life. However, Jessica’s father has said he never shed a tear about her birth condition. He had full confidence in her potential. With the support of her parents and family, Jessica became confident in herself as an adult and continued to explore the world with her feet.

 As a child, Jessica studied dance in her home town. When the first performance arrived, she asked to be put in the back row. Her dance teacher told her there was no back row. Tentatively she took the stage with the other students and performed her routine. When she finished, the applause from the audience gave her encouragement and the confidence to continue dancing for 14 years.

 Jessica’s parents eventually met a Taekwondo instructor named Jim Cunningham. His response when told of her birth condition was that she would be more than physically able and that only her attitude could hold her back. At the age of 14, Jessica earned her first Black Belt in the International Taekwondo Federation.

 After graduating from high school, Jessica attended the University of Arizona where she earned a bachelor’s degree in Psychology. When talking about her degree, she frequently explains that psychology credits the way people think has a greater impact on their lives than a physical limitation.

 Jessica’s most famous accomplishment was learning how to fly. It took three states, four airplanes, two flight instructors and a discouraging year to find the right aircraft: a 1946 415C Ercoupe Airplane. She received the Guinness World Record for being the first person certified to fly an airplane with only their feet.

 Jessica now works as a motivational speaker. She travels the world sharing her story and encouraging people to be creative and innovative with the mantra “Think outside the shoe.”

 By Jessica Cox

Source: http://academictips.org/blogs/a-female-pilot-with-no-arms-true-story/

Emedinews:Inspiration:Angel Rescued sick girl – True story!

An Inspirational Story

This incident happened in Charlotte, North Carolina, USA, in September 2008. 14-year-old Chelsea Barton was born five weeks prematurely which resulted in developmental disabilities and serious health problems all her life.

Chelsea got sick very easily and going back and forth to the hospital very often. In 2008, she caught pneumonia and was eventually put on life support at Presbyterian Hospital in Charlotte, North Carolina. Doctors told Chelsea’s mother that there was no hope for young Chelsea’s recovery.

The family gathered one last time in Chelsea’s hospital room to say their goodbyes and the order was giving to disconnect her from the life support system and “just let nature take its course.” It appeared that Chelsea had another visitor just after the life support was disconnected!

As her mother waited for the girl to take her last breath, an image of bright light appeared on the hospital’s security monitor screen. Within an hour, the dying girl began a recovery that doctors were at a loss to explain.

The mother and other workers noticed an image of an angel in light on the security surveillance monitor near the hospital room door and the mother managed to capture the image with her cell phone camera.

The mother told that at first she thought that it was the angel-of-death coming to take her daughter but shortly afterwards Chelsea started showing signs of improvement. It would be another two months before Chelsea finally left the hospital to return home but her mother is so convinced that Chelsea was saved by divine intervention.

God is real and does care for us!

Source: http://academictips.org/blogs/angel-rescued-sick-girl-true-story/

Emedinews:Insights on Medicolegal Issues:What is a coup lesion of brain?

Medicolegal Update 

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

• The flax cerebri and tentorium divide the cranial cavity into three communicating compartments and have a partly restraining effect on brain movements.
• Injuries like contusion and lacerations of the brain seen in vehicular accidents and falls from heights are caused by the application of violence to the head and may occur with or without external injury to the scalp and fracture of the skull.
• Injuries may be seen superficially anywhere on the surface of the brain, though the commonest site is the outer surface of the parietal and temporal lobes or deep within the brain substance and are associated with hemorrhages limited in small areas or multiple hemorrhages diffused largely within the brain tissues. They are also associated with disturbances of cerebrospinal fluid circulation.
• These injuries, also known as coup lesions, are commonly found under the site of application of the blow, but are also sometimes found particularly during autopsy on the surface of the brain diagonally opposite the site of impact, and are called countercoup injuries.
• Coup injuries are most commonly found on the frontal lobes and near the tips of the temporal and frontal poles, rarely on the occipital poles. They are usually severe injuries.

(Ref: Modi’s Medical Jurisprudence 25th Edition)

Emedinews:Inspiration:The greatest gift is love

An Inspirational Story

 A woman came out of her house and saw three old men with long white beards sitting in her front yard. She did not recognize them. She said, “I don’t think I know you, but you must be hungry. Please come in and have something to eat.”

“Is the man of the house home?” they asked. “No”, she said. “He’s out.”

“Then we cannot come in”, they replied. In the evening when her husband came home, she told him what had happened. “Go tell them I am home and invite them in!” The woman went out and invited the men in. “We do not go into a House together,” they replied.

“Why is that?” she wanted to know. One of the old men explained: “His name is Wealth,” he said pointing to one of his friends, and said pointing to another one, “He is Success, and I am Love.” Then he added, “Now go in and discuss with your husband which one of us you want in your home.”

The woman went in and told her husband what was said. Her husband was overjoyed. “How nice!!” he said. “Since that is the case, let us invite Wealth. Let him come and fill our home with wealth!” His wife disagreed. “My dear, why don’t we invite Success?”

Their daughter-in-law was listening from the other corner of the house. She jumped in with her own suggestion: “Would it not be better to invite Love? Our home will then be filled with love!” “Let us heed our daughter-in-law’s advice,” said the husband to his wife. “Go out and invite Love to be our guest.”

The woman went out and asked the three old men, “Which one of you is Love? Please come in and be our guest.” Love got up and started walking toward the house. The other two also got up and followed him. Surprised, the lady asked Wealth and Success: “I only invited Love, Why are you coming in?”

The old men replied together: “If you had invited Wealth or Success, the other two of us would’ve stayed out, but since you invited Love, wherever He goes, we go with him. Wherever there is Love, there is also Wealth and Success!”

Emedinews:Insights on MEdicolegal Issues:What are the organo phosphorous poisons?

They are derived from phosphoric acids and form two series of compounds known as alkyl phosphates, and aryl phosphates

• These are basically chemical insecticides and used to prevent agricultural products but when ingested by humans adversely affect health or may become life–threatening.
• Fatal dose: TEPP 50 mg IM or 100 mg orally/OMPA 80 mg IM or 175 mg orally/Parathion 80 mg IM or 175 mg orally/HETP 60 mg IM or 350 mg orally/Malathion and diazinon 1g orally
• The fatal period is usually within 24 hours in untreated cases and within 10 days in those treated cases when treatment is not successful. In non–fatal cases, the acute effect lasts for 6 to 30 hours which disappear in 2 to 3 days but may sometime persist for 2 weeks. Complete recovery occurs in 10 days in patients treated early.
• Atropine is the antidote.
• Cause of death is by paralysis of respiratory muscles, respiratory arrests due to failure of respiratory centre or intense bronchi constriction resulting in respiratory failure.

Emedinews:Inspiration:Who Named the Curiosity Mars Rover?

An Inspirational Story

 The Curiosity Mars rover was named by an 11 year old girl in Lenexa, Kansas, USA. Her name is Clara Ma and below is her inspiring story.

 On Aug. 5 at 10:31 p.m. PST, a rover named Curiosity touched down safely on the surface of Mars, and I was lucky enough to have a front-row seat.

My name is Clara, and when I was in 6th grade, I won the essay contest NASA held to name its next Mars rover. The essay I wrote was not even 250 words long, but somehow it was enough to change my life.

 I still remember that chilly December day, sitting in science class. I’d finished a worksheet early and decided to get a TIME for Kids magazine off of Mrs. Estevez’s bookshelf. It was the 2008 Invention Issue, but that wasn’t the only thing that caught my eye. In the magazine, there was an article about a girl who named the Mars Exploration Rovers, Spirit and Opportunity.

 The article also talked about the essay contest NASA was holding to name its next Mars rover. Before I even knew anything else about it, a single word flooded my 11-year-old mind: Curiosity.

 I couldn’t wait for the bell to ring so I could get started on my essay. That afternoon, I raced home from the bus stop, sat down at the computer, and typed until my fingers ached. It turns out I was just in time. A few days later, and the contest would have closed.

 Five months later, shortly after I had turned 12, I was watching a National Geographic special on mammoths when the phone rang. My mom answered, and immediately, a wide smile spread across her face.

 When she told me that I had won, I was happier than I could ever remember being. I screamed and ran up and down the stairs and all around the house. I completely forgot about the mammoths and did not even remember to turn off the TV until it was really late.

 Curiosity is such an important part of who I am. I have always been fascinated by the stars, the planets, the sky and the universe. I remember as a little girl, my grandmother and I would sit together in the backyard for hours. She’d tell me stories and point out constellations.

 Here in the heart of the country, my grandmother would say, there were no bright city lights to compete with the brilliance of the stars. There was just the chirping of the cicadas and the soft summer breeze.

 My grandmother lived in China, thousands of miles away from my home in Kansas. I loved the stars because they kept us together even when we were apart. They were always there, yet there was so much I didn’t know about them. That’s what I love so much about space. No matter how much we learn, it will always possess a certain degree of mystery.

 In the past, space exploration may have been a competition to see who got somewhere first or the fastest. But now, it is one of the few things that bring people together. Science is a language that needs no translation. It doesn’t matter where you’re from or what you look like — you just have to have a thirst for knowledge and a passion for learning in order to succeed.

 People often ask me why we go to faraway places like Mars. Why do we explore? My answer to that is simple: because we can. Because we’re curious. Because we as human beings do not just stay holed up in one place. We are constantly wondering and trying to find out what’s over the hill and beyond the horizon.

 The Curiosity rover is more than just a robot. It is more than just a titanium body and aluminum wheels. Curiosity represents the hard work, passion, love and commitment of thousands of people from all over the world who were brought together by science.

 Science is so awesome. It is breathtaking and mind-blowing, intertwining and unifying; and sometimes, it’s just a little bit crazy. The discoveries we make about our world are incredibly humbling. They move us forward and have the potential to benefit all of mankind.

 This December it will be four years of my life that have been tied to Curiosity in some way. I’ve met so many amazing people through this experience, from scientists to engineers to administrators to volunteers. Their dedication and fervor inspire me immensely. My journey with Curiosity and the MSL mission team has shaped the person that I am today, as well as the person I would one day like to become.

 I am deeply grateful to everyone who made it possible for me to have this amazing adventure. And to you, I hope your curiosity takes you far.

 By Clara Ma

Source: http://academictips.org/blogs/who-named-the-curiosity-mars-rover/

Emedinews:Insights on Medicolegal Issues:No two people except identical twins have the same DNA structure

• Human being has a unique signature that lives within every cell of our body. This signature is commonly known as DNA, testing is done by taking DNA extracts from biological sample putting them into a gel matrix and then using probes to help extract certain markers.
• We get our DNA from our biological mother and biological father. Each of them contributes 50% of our chromosomes that will make up our DNA, which will stay with us for our entire lives without change. This is the very reason that makes DNA such a great choice for uniquely identifying a person.
• Questions may arise as to how accurate DNA tests are. After all, in the past blood tests cannot have been as accurate as we might have hoped. They often left a bit of uncertainty or could not be conclusive in many areas. But thanks to the uniqueness of DNA almost all of these doubts can now be taken away.
• Testing can be done on DNA to help determine parentage, ancestry, presence of genetically–based diseases and to help identify someone who may have been present at a crime scene.
• Most DNA tests are run at least twice, both independent of each other. This not only builds upon the credibility of the test but also helps ensure that no wrong data or incorrect marker analysis was performed on the first test. If any discrepancies are detected between the two tests then a new sample is used and the entire test is performed again to understand where the discrepancy may lay.
• Modern testing procedures and rules for DNA analysis mean that with rare exception DNA testing results can be guaranteed to be more than 90% accurate for most paternity, forensic and genetically–based disease analysis.
• However human error can come into play. A lab may mistakenly switch samples or key in data incorrectly. All of these factors are possible, but are very rare in occurrence. If there is ever any doubt as to the authenticity or correctness of a test it can simply be performed again to confirm accuracy.

Emedinews:Inspiration:Be content about your life

An Inspirational Story

Wonder if any of you ever had the feeling that life is bad, real bad…and you wish you were in another situation. Do you find that life seems to make things difficult for you, work sucks, life sucks, and everything seems to go wrong….

It was not until yesterday that I totally changed my views about life; after a conversation with one of my friends.

He told me despite taking 2 jobs, and bringing back barely above 1K per month, he is happy as he is. I wonder how he can be as happy as he is now, considering that he has to skimp his life with the low pay to support a pair of old-age parents, in-laws, wife, 2 daughters and the many bills of a household.

He explained that it was through one incident that he saw in India……

That happened a few years ago when he was really feeling low and was touring India after a major setback. He said that right in front of his very eyes, he saw an Indian mother chopped off her child’s right hand with a chopper. The helplessness in the mother’s eyes, the scream of the pain from the innocent 4 years old child haunted him until today. You may ask why did the mother do so, has the child been naughty, was the child’s hand infected??

No, it was done for two simple words — to beg. The desperate mother deliberately caused the child to be handicapped so that the child can go out to the streets to beg. I cannot accept how this could happen, but it really did, just in another part of the world which I don’t see.

Taken aback by the scene, he dropped a small piece of bread he was eating half-way. And almost instantly, flock of 5 or 6 children swamp towards this small piece of bread which was then covered with sand, robbing of bits from one another... the natural reaction of hunger. Stricken by the happenings, he instructed his guide to drive him to the nearest bakery. He arrived at two bakeries and bought every single loaf of bread he found in the bakeries.

The owner is dumbfounded, but willing sold everything. He spent less than $100 to obtain about 400 loaves of bread (this is less than $0.25/per loaf) and spend another $100 to get daily necessities. Off he went in the truck full of bread into the streets. As he distributed the bread and necessities to the children (mostly handicapped) and a few adults, he received cheers and bows from these unfortunate. For the first time in life he wondered how people can give up their dignity for a loaf of bread which cost less than $0.25. He began to ask himself how fortunate he is as a Singaporean. How fortunate he to be able to have a complete body, have a job, have a family, have the chance to complain what food is nice what isn’t, have the chance to be clothed, have the many things that these people in front of him are deprived of…..

Now I begin to think and feel it, too. Was my life really that bad?

Perhaps….no,… it should not be bad at all….

What about you? Maybe the next time you think you are, think about the child who lost one hand to beg on the streets.

Emedinews:Insights on MEdicolegal Issues:Immediate first aid may stop serious poisoning and may save life

In cases of poisoning, if breathing and the heart stop, the person will die within a few minutes unless first aid is given at once. Here is an action list. Each step is explained in more detail below the list. Start with the first step and follow each step in the order given. Act as quickly as you can, but stay calm.

·         Check if the patient is conscious. Try to wake up the patient. Shout "Are you all right?" and gently shake the shoulders, but take care not to make any injuries worse. Pinch the skin on the neck and watch the face. A patient who is just sleeping will wake up, but an unconscious patient will not.

·         Open the airway. The airway is the tube through which air passes from the mouth and nose to the lungs. If it is blocked the patient cannot breathe and air cannot get into or out of the lungs. A patient who cannot breathe will die within 4 minutes. In an unconscious patient, the tongue may block the throat and the airway. Make sure the airway is open and air can get down the throat. Place the patient on his or her back. Tilt the head back and lift the chin up with the finger and thumb of one hand on the bony part of the chin, while pressing the forehead back with the other hand. This will open the airway and stop the tongue blocking the throat.

·         Check whether the patient is breathing after opening the airway; quickly check whether the patient is breathing. Look for the belly or the chest moving up and down. Feel the chest moving up and down. Feel the patient’s breathe on your cheek. Listen for breath sounds. Put your ear close to the patient’s mouth. Use all four checks. Remember that the chest may move up and down even when the throat is completely blocked and air cannot get to the lungs.

Emedinews:Inspiration:Learn an earn

An Inspirational Story

Chuan and Jing joined a wholesale company together just after graduation. Both worked very hard.

After several years, the boss promoted Jing to sales executive but Chuan remained a sales rep. One day Chuan could not take it anymore, tender resignation to the boss and complained the boss did not value hard working staff, but only promoted those who flattered him. The boss knew that Chuan worked very hard for the years, but in order to help Chuan realize the difference between him and Jing, the boss asked Chuan to do the following. Go and find out anyone selling water melon in the market? Chuan returned and said yes. The boss asked how much per kg? Chuan went back to the market to ask and returned to inform boss the $12 per kg.

Boss told Chuan, I will ask Jing the same question? Jing went, returned and said, boss, only one person selling water melon. $12 per kg, $100 for 10 kg, he has inventory of 340 melons. On the table 58 melons, every melon weighs about 15 kg, bought from the South two days ago, they are fresh and red, good quality.

Chuan was very impressed and realized the difference between himself and Jing. He decided not to resign but to learn from Jing. My dear friends, a more successful person is more observant, think more and understand in depth. For the same matter, a more successful person sees several years ahead, while you see only tomorrow. The difference between a year and a day is 365 times, how could you win?

Think! How far have you seen ahead in your life? How thoughtful in depth are you?

Emedinews:Insights on Medicolegal issues:Surgical error death

A UK survey has suggested that the damage to underlying structures is the commonest complication for which patients successfully sue surgeons.

• The survey found that damage to veins, nerves, and other underlying structures accounted for nearly one third of 115 successful claims, with infection accounting for another 12%.
• Patients also sued successfully after they were burnt by diathermy, after spirit–based skin preparations ignited, and after adverse reactions to iodine.
• Retained items and failed or delayed diagnosis accounted for 8% and 7% respectively of successful medical negligence claims.
• The retained items—which included a pair of forceps and a surgical pack after a hemorrhoid surgery occurred despite formal written procedures for swab and needle counts in operating theatres.
• The top award was for £550000 ($880000) and was allocated to relatives of a patient with a history of deep vein thrombosis and pulmonary embolism who died of an embolism four weeks after elective surgery for varicose veins. The patient had received no anticoagulant treatment until two weeks after surgery.

Emedinews:Inspiration:One Step

An Inspirational Story

Foolish people with all their other thoughts, have this one too: They are always getting ready to live, but never living.

Your success will start when you begin to pursue it. To reach your goal or to attain success, you don’t need to know all of the answers in advance. You just need to have a clear idea of what your goal is.

Don’t procrastinate when faced with difficult problems. Break your problems into parts, and handle one part at a time.

Develop tendencies toward taking action. You can make something happen right now. Divide your big plan into small steps and take that first step right away.

Everyone who ever got where they are had to begin where they were. Your big opportunity is where you are right now.

A journey of a thousand miles begins with one step. Take it.

Emedinews:Insights on mEdicolegal Issues:What is Forensic Thanatology?

Thanatology is the branch of science that deals with death in all its aspects. Shapiro, a well–known thanatologist defined death as the irreversible loss of the properties of living matter. However, it is difficult to appreciate his claim that this definition satisfies the practical requirements for death certification. 

• Black’s law dictionary (Black 1951) in United States defines death as "The Cessation of life, the ceasing to exit", defined by physicians as total stoppage of circulation and cessation of vital functions, thereupon such as respiration and pulsation
• Section 46 IPC states that death denotes the death of a human being unless the contrary appears from the context.
• Section 2 (b) of the Registration of Births and Deaths Act defines death as Permanent disappearance of all evidence of life at any time after live birth gas taken place.

(Ref: Dr. PC Dikshit, Head (MAMC) MD LLB, Concise Textbook of Forensic Medicine & Toxicology, Peepee Publishers)

Emedinews:Inspiration:You are unique

An Inspirational Story

Think what a remarkable, unduplicatable, and miraculous thing it is to be you! Of all the people who have come and gone on the earth, since the beginning of time, not ONE of them is like YOU!

No one who has ever lived or is to come has had your combination of abilities, talents, appearance, friends, acquaintances, burdens, sorrows and opportunities.

No one’s hair grows exactly the way yours does. No one’s finger prints are like yours. No one has the same combination of secret inside jokes and family expressions that you know.

The few people who laugh at all the same things you do, don’t sneeze the way you do. No one prays about exactly the same concerns as you do. No one is loved by the same combination of people that love you – NO ONE!

No one before, no one to come. You are absolutely unique!

Enjoy that uniqueness. You do not have to pretend in order to seem more like someone else. You weren’t meant to be like someone else. You do not have to lie to conceal the parts of you that are not like what you see in anyone else.

You were meant to be different. Nowhere ever in all of history will the same things be going on in anyone’s mind, soul and spirit as are going on in yours right now.

If you did not exist, there would be a hole in creation, a gap in history, something missing from the plan for humankind.

Treasure your uniqueness. It is a gift given only to you. Enjoy it and share it!

No one can reach out to others in the same way that you can. No one can speak your words. No one can convey your meanings. No one can comfort with your kind of comfort. No one can bring your kind of understanding to another person.

No one can be cheerful and lighthearted and joyous in your way. No one can smile your smile. No one else can bring the whole unique impact of you to another human being.

Share your uniqueness. Let it be free to flow out among your family and friends and people you meet in the rush and clutter of living wherever you are. That gift of yourself was given you to enjoy and share. Give yourself away!

See it! Receive it! Let it tickle you! Let it inform you and nudge you and inspire you! You are unique!

Author Unknown

Emedinews:Insights on MEdicolegal Issues:What is the Native American Graves Protection and Repatriation Act 1990?

Doctors and scientists have long sought to understand life in early civilizations through the excavation of burial grounds and exhumation of human remains. In the United States the attempt to understand early cultures led to the exhumation of the remains of Native Americans, many of which ended up in the nation’s museums and archaeology labs. In an attempt to prevent the desecration of Native American graves, the Native American Graves Protection and Repatriation Act was introduced in Congress in July 1990 and subsequently passed into law.

·         The bill states that any human remains and objects found on federal or tribal lands after the date of enactment are to be considered owned or controlled by lineal descendants, the tribe on whose land it was found, the tribe having the closest cultural affiliation, or the tribe which aboriginals occupied the area. Anyone who discovers items covered by the bill must cease his or her activity, notify the federal land manager responsible and the appropriate tribe, and make a reasonable effort to protect the items.

·         Anyone who violates the provisions of the bill may be fined, imprisoned not more than one year, or both. The penalty may increase to five years for a second violation.

·         The act further states that all federal agencies and museums receiving federal funds that have control over any of the items covered in the bill are to, within five years, inventory and identify the items, notify the affected tribes, and make arrangements to return such items if the appropriate tribe made a request. If an item was acquired with the consent of the tribe or if the item was part of a scientific study which was expected to be of major benefit to the country, the request for repatriation (i.e., return) could be denied.

Emedidnews:Inspiration:Life's struggles

An Inspirational Story

A man found a cocoon of an emperor moth. He took it home so that he could watch the moth come out of the cocoon. On the day a small opening appeared, he sat and watched the moth for several hours as the moth struggled to force the body through that little hole.

Then it seemed to stop making any progress. It appeared as if it had gotten as far as it could and it could go no farther. It just seemed to be stuck. Then the man, in his kindness, decided to help the moth, so he took a pair of scissors and snipped off the remaining bit of the cocoon. The moth then emerged easily.

But it had a swollen body and small, shriveled wings. The man continued to watch the moth because he expected that, at any moment, the wings would enlarge and expand to be able to support the body, which would contract in time. Neither happened! In fact, the little moth spent the rest of its life crawling around with a swollen body and shriveled wings. It never was able to fly.

What the man in his kindness and haste did not understand was that the restricting cocoon and the struggle required for the moth to get through the tiny opening was the way of forcing fluid from the body of the moth into its wings so that it would be ready for flight once it achieved its freedom from the cocoon. Freedom and flight would only come after the struggle. By depriving the moth of a struggle, he deprived the moth of health.

Sometimes struggles are exactly what we need in our life. If we were to go through our life without any obstacles, we would be crippled.

We would not be as strong as what we could have been. Give every opportunity a chance, leave no room for regrets. 

Emedinews:Insights on Medicolegal Issues:What are causes of food poisoning?

Food or drinks can be contaminated by poison from microscopic organisms such as bacteria, viruses, or mould, or by chemical poisons. Some plants, mushrooms, animals or sea–creatures contain poisonous chemicals. Poisons made by plants, animals or microorganisms are called toxins.

• Food may be contaminated by bacteria before or after cooking, during preparation or storage, by contact with hands that have not been thoroughly washed, or with contaminated surfaces, containers or kitchen utensils. It may also be contaminated by animals or insects, particularly flies. Heating food thoroughly destroys most – but not all – bacteria and bacterial toxins. However, if cooked food is kept warm or at room temperature for any length of time, bacteria present in the food will multiply and may cause disease.
• Moulds grow on foods that are damp or damaged by insects, and some moulds produce poisons. Moulds growing on nuts or grain that has been gathered and stored before it is dry may cause serious poisoning. Some ways of drying and preserving food do not stop moulds growing on the food.

Emedinews:Inspiration:Reflections of a Girl

An Inspirational Story

I am a teenage girl - a Mormon girl.

I stand before the mirror of life and ponder the reflection I see.

For the moment I stand on Life's dividing line.

Behind me, the Yesterday of years without caring; before me, the vague Tomorrow of sharing. Today seems akin to neither.
I am no longer a child, not yet a woman, but the last reluctant bonds of childhood still cling, as I strive to heed the inner urge of womanhood.

Help me understand the image that I see! - The reflection of the child I was - the girl I am - the woman I'll soon be.

I am bewildered, but dare not confess it. I am frightened, but dare not admit my fright. Sometimes I seem lost and must trust in reassurance from above, for no one understands.

I have donned a new mantle of dignity, but I have not yet learned how to wear it.

Help me catch the vision of the woman I'm meant to be, for looking in the mirror of life a girl is all I see.

Somehow I sense that I am a person of importance; I am destined to be part of the Tomorrow that lies before me.

I shall be Tomorrow’s wife; the mother of Tomorrow’s sons and daughters.

I am tomorrow!

I am a teenage girl - a Mormon girl.

I stand before the mirror of life and joy in the reflection I see ---

I am a daughter of deity!

Adapted From The Adolescent Girl (Author Unknown) 

Emedinews:Insights on Medicolegal Issues:No Narco test without valid informed consent, rules Supreme Court of India

The most exhausting/frustrating and laborious part of a criminal investigation for agencies like CBI or FBI is extracting information from an uncooperative alleged accused and suspects by investigators in India as well as abroad. No individual should be forcibly subjected to any of these techniques/method of interrogation in question, whether in the context of investigation in any criminal cases or otherwise. The narcoanalysis test began to be used with the presumption that it provides a simple, nonviolent method of finding out the truth. In a world where until quite recently, torture was employed in criminal cases, perhaps narcoanalysis is a simple, civilized way of conducting criminal investigation

·         The Supreme Court of India said that the so–called narcoanalysis, brain mapping and polygraph tests cannot be conducted on any person without their consent.

·         The Apex Court further said the confession of guilt during the course of the tests cannot be treated as evidence in court.

·         The results of narco test provided clues and did not have any evidentiary value. There is no scientific literature to prove that truth serum works; human rights groups have held the tests to be mental torture.

·         "The compulsory administration of any of these techniques is an unjustified intrusion into the mental privacy of an individual. It would also amount to ‘cruel, inhuman or degrading treatment’ with regard to the language of evolving international human rights norms," said a Bench comprising Chief Justice K G Balakrishnan and Justices R V Raveendran and J M Panchal. The police, instead of collecting real evidence, relied on these tests to spread rumors about the suspect, and selective leaks were made to the media that a particular suspect has made confession during the tests."

Emedinews:Inspiration:An interesting story

An Inspirational Story

(Dr GM Singh)

There was a king who was a great admirer of art. He encouraged artists from all over his country and gave them valuable gifts.

One day an artist came and said to the king, "Oh King! Give me a blank wall in your palace and let me paint a picture on it. It will be more beautiful than anything you have ever seen before. I promise you shall not be disappointed." Now, the king happened to be constructing a big hall at the rear end of the palace. So he said, "All right you may work on one of the walls in the new hall."

So the artist was given the job and he was very pleased indeed. Just then, another young man said, "Oh King! Please allow me to work on the opposite wall. I too am an artist."

The king said, "What would you like to make?"

The man said, "My Lord, I shall make exactly what that man will make on the opposite wall. Moreover, I shall do so, without looking at his work. I would even request you to have a thick curtain put up between the two walls so that either of us cannot see the other." Now, that was a tall statement. Everyone in the king's court, including the king and the first artist were intrigued. But the king loved surprises and he decided to give the young fellow a chance. The following day a thick curtain was put into place and both the artists got to work. The first artist brought in a regular supply of paint, oil, water etc. The second one would come with a cloth and a bucket of water every day.

After a month the first artist told the king that his work was complete and he would like to show it to the king. The king sent for the second artist and asked him, "Young man, when would your work be ready? I am coming to see the first wall this evening."

The man said, "My Lord, my wall is ready too!"

The king went to see the first artist's wall. He was very, very impressed with the painting and gave a hefty sum as a reward to the artist. He then asked for the curtain to be opened up

Lo and behold! The same painting was to be seen on the opposite wall too!

 Amazing! But true! Each line, each minor detail was exactly as it was on the first wall. But this man had not been seeing what was going on, on the other side of the curtain. So how had he done it? The king wanted to know the secret.

 He gave a double reward to the fellow. Then he said, "Young man, I am indeed very happy with your work. But you must tell me; how did you do it?"

 The lad said simply, "It's very easy! I just polished the wall every day!"

 It was a wall made of white marble! The fellow polished it till it shone like a mirror. The reflection of the painting across the room, showed up in it!

 That is what it means to polish yourself. For when we polish our hearts and souls, we see God's reflection within.

 It is said that the world is a reflection of you. Whatever you are, the world will seem to be that too. If you are sad, jealous, dejected, angry, restless ... that is what the world will seem to be!

 If you are happy, the world will seem to be paradise.

 You decide how you want your world to look... 

Emedinews:Insights on Medicolegal Issues:What is contributory medical Negligence?

The pregnant woman delivered a child with spina bifida however she failed to regularly attend the advised dates for antenatal ultrasounds that would have identified this problem. The patient was found to be 100% at fault."

• In a medical malpractice/maloccurence case, medical negligence is the foremost ingredient to establish the liability of damage and dereliction in provided medical care. However, it is important to establish the difference between malpractice and contributory negligence when determining liability.
• Contributory negligence means the patient/legal heirs/parties are partially to blame for the maloccurrence or medical untoward incident. For e.g., a patient is admitted to the emergency room for treatment and they fail to inform the doctor about a pre–existing condition e.g. any allergy to a drug. The patient is guilty of contributing to the negative outcome/damage of the treatment.
• If the victim is found to be even one percent at fault, they will be unable to recover compensation for their injuries. However, comparative negligence is used to determine degree of liability of the doctor/medical care provider.
• Contributory negligence will determine who will receive compensation for their losses and how much they may be entitled to receive in compensation for their injuries. Pure comparative negligence means that in case of an aggrieved patient, damages will be calculated and then reduced to reflect his or her contribution to the injury.

In India, the doctors take the defense against malpractice cases when determining how the parties involved are responsible. In US, 4 categories apply in compensation cases in many of its states: Pure Comparative Negligence/Pure Contributory Negligence/ Modified Comparative Negligence—50% Bar Rule and Modified Comparative Negligence—51% Bar Rule. Twenty–one states that recognize the 51% Bar rule which means that the party who is less than 51% liable can seek compensation; only 11 US states use the 50% Bar rule, which means that if the damaged party is less than 50% responsible, they can collect damages.

Emedinews:Inspiration:Gossip

An Inspirational Story

A peasant with a troubled conscience went to a monk for advice.  He said he had circulated a vile story about a friend, only to find that the story was not true.

"If you would make peace with your conscience," said the monk, "you must first fill a bag with goose downs, go to every door in the village, and drop in each one of them a feather."

The peasant did as he was told.  Then he came back to the monk and said he had done penance for his folly.

"Not yet," replied the monk.  "Take a bag, go two rounds again, and gather up every down that you have dropped."

"But the wind must have blown them all away," said the peasant.

"Yes, my son" said the monk.  "And so it is with your vile words.  Words and goose downs are quickly dropped, but try as hard as you will, you can never get them back." 

Emedinews:Insights on Medicolegal Issues:DNA Test reliability – Accreditation of lab must be proven

The Nobel Prize winning inventor of PCR, Kary Mullis, said that he does not think that genotyping should be used for forensics, except as one piece of the puzzle.

The reliability and acceptability of DNA test result rests on the accuracy of the samples of DNA that are collected for analysis. Poor collection procedures, improper storage of samples and mishandling of samples/false results are the leading causes for errors in DNA testing. The credentials of scientist/accreditation of laboratory must be carefully scrutinized before the legal use of DNA report by law enforcement agency.

• Samples may be rejected in the lab because the swab is contaminated in such a fashion that makes it impossible to obtain usable DNA samples from it. Sample may be contaminated if it is dropped on the floor or counter, or used accidentally by people who are not trained or even semi trained individuals who are unaware of the intricacies of DNA science. Such samples should be disposed of and a fresh swab should be used.
• The swab collection method is an important part of proper tracking and identification of the sample. This is not a failure of the swab, but of the people who handle the swab. It must be correctly identified and tracked through the system to make sure that it is not confused with other samples that may be in the lab. All swabs come with a bar–coded container that they are placed in.
• Embedding a tiny RFID chip in the swab itself may further help to track and identify the swab.

Emedidnews:Makesure:A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.
Reaction: Oh my God! Why was additional insulin given?
Lesson: Make sure that insulin dose is correct. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.

Emedinews:Inspiration:Making a difference

An Inspirational Story

One day a man was walking along the beach when he noticed a figure in the distance.  As he got close, he realized the figure was that of a boy picking something up and gently throwing it into the ocean.  Approaching the boy, he asked, "What are you doing?"

The youth replied, "Throwing starfish in the ocean.  The sun is up and the tide is going out.  If I don't throw them in, they'll die."

"Son," the man said, "don't you realize there are miles and miles of beach and hundreds of starfish?  You can't possibly make a difference!"

After listening politely, the boy bent down, picked up another starfish, and threw it into the surf.  Then, smiling at the man, he said, "I made a difference for that one." 

Emedinews:Insights on Medicolegal Issues:Exhumation of corpse without legal order is criminal offence – Indian Penal Code

The Autopsy Surgeon/Forensic Expert and Magistrate should be present along with the concerned police official with the order of court; however, the local police official should be called if exhumation is carried out.

·         Exhumation should be conducted preferably in the morning hours after proper sunrise.

·         More than two times of the digging area should be screened off.

·         The grave/place of cremation for which the order has been passed should be identified properly/authentically by police officer; an estimation of number of persons, whether single, double or multiple body/bodies should be made so that adequate arrangements can be done in advance.

·         The burial should be removed in layer of about 10cm and the condition of soil, water, any plantation growth, ants, cockroaches, and smell should be noted.

·         After removal of dirt above the dead body, it should be photographed from all corners in the original position found.

·         A drawing should be made of graveyard/depth and state of decomposition/skeletal remains of the body.

·         The dead body/its remains should be transferred in a plastic sheet covered with a cloth sheet.

·         Sample of soil, burial cloth, and any material found in grave, loosen hair/teeth/nail/should be collected and photographed.

·         The body should be shown to close relatives for identification.

·         The dug grave should be kept as it is for further burial after autopsy.

·         All the available details should be provided to the doctor with request to conduct the postmortem examination with any specific instruction or query related with forensic/medical examination to find out age, cause of death, details of injury, any poisoning, time since death etc.

·         Videographs of all procedure must be done.

Emedinews: Makesure:A patient with LBBB in ECG developed acute pulmonary edema.

Situation: A patient with LBBB in ECG developed acute pulmonary edema.

Reaction: Oh my God! Why was underlying low cardiac function not suspected?
Lesson: Make sure all patients with LBBB (left bundle branch block) undergo Echo to rule out ejection fraction. This may not be true for RBBB.

Emedinews:Inspiration: God's embroidery

An Inspirational Story

When I was a little boy, my mother used to embroider a great deal. I would sit at her knee and look up from the floor and ask what she was doing. She informed me that she was embroidering. I told her that it looked like a mess from where I was. As from the underside I watched her work within the boundaries of the little round hoop that she held in her hand, I complained to her that it sure looked messy from where I sat. She would smile at me, look down and gently say, "My son, you go about your playing for awhile, and when I am finished with my embroidering, I will put you on my knee and let you see it from my side." I would wonder why she was using some dark threads along with the bright ones and why they seemed so jumbled from my view. A few minutes would pass and then I would hear Mother's voice say, "Son, come and sit on my knee." This I did only to be surprised and thrilled to see a beautiful flower or a sunset. I could not believe it, because from underneath it looked so messy.

Then Mother would say to me, "My son, from underneath it did look messy and jumbled, but you did not realize that
there was a pre-drawn plan on the top. It was a design. I was only following it. Now look at it from my side and you will see what I was doing." Many times through the years I have looked up to my Heavenly Father and said, "Father, what are You doing?" He has answered, "I am embroidering your life." I say, "But it looks like a mess to me. It seems so jumbled. The threads seem so dark. Why can't they all be bright?" The Father seems to tell me, "'My child, you go about your business of doing My business, and one day I will bring you to Heaven and put you on My knee and you will see the plan from My side."

Author Unknown

Emedinews:Insights on Medicolegal Issues:Contributory medical Negligence

A pregnant woman delivered a child with spina bifida however she failed to attend regularly advised dates for antenatal ultrasounds that would have identified this problem. The patient was found to be 100% at fault. • In a medical malpractice case, medical negligence is the foremost ingredient to establish the liability of damage and dereliction in provided medical care. However, it is important to establish the difference between malpractice and contributory negligence when determining liability • Contributory negligence means the patient/legal heirs/parties are partially to blame for the maloccurrence or medical untoward incident. For e.g., a patient is admitted to the emergency room for treatment and they fail to inform the doctor about a pre–existing condition e.g. any allergy to a drug. The patient is guilty of contributing to the negative outcome/damage of the treatment • If the victim is found to be even one percent at fault, he/she will be unable to recover compensation for their injuries. However, comparative negligence is used to determine degree of liability of the doctor/medical care provider • Contributory negligence will determine who will receive compensation for their losses and how much they may be entitled to receive in compensation for their injuries. Pure comparative negligence means that in case of an aggrieved patient, damages will be calculated and then reduced to reflect his or her contribution to the injury. In India, the doctors take the defense against malpractice cases when determining how the parties involved are responsible. In US, 4 categories applied in compensation cases in many of its states: Pure Comparative Negligence/Pure Contributory Negligence/Modified Comparative Negligence—50% Bar Rule and Modified Comparative Negligence—51% Bar Rule. Twenty–one states that recognize the 51% bar rule which means that the party who is less than 51% liable can seek compensation; only 11 US states use the 50% bar rule, which means that if the damaged party is less than 50% responsible, they can collect damages.

Emedinews:Makesure:A 60–year–old male developed acute heart attack after consuming Viagra.

Situation: A 60–year–old male developed acute heart attack after consuming Viagra.
Reaction: Oh my God! Why was cardiac clearance not taken before?
Lesson: Make sure that all older patients get a cardiac clearance before they are given Viagra group of drugs.

Emedinews:Inspiration:The seed of honesty

A successful business man was growing old and knew it was time to choose a successor to take over the business. Instead of choosing one of his Directors or his children, he decided to do something different. He called all the young executives in his company together. He said, “It is time for me to step down and choose the next CEO. I have decided to choose one of you.”

The young executives were shocked, but the boss continued. “I am going to give each one of you a SEED today – one very special SEED. I want you to plant the seed, water it, and come back here one year from today with what you have grown from the seed I have given you. I will then judge the plants that you bring, and the one I choose will be the next CEO.”

One man, named Jim, was there that day and he, like the others, received a seed. He went home and excitedly, told his wife the story. She helped him get a pot, soil and compost and he planted the seed. Every day, he would water it and watch to see if it had grown. After about three weeks, some of the other executives began to talk about their seeds and the plants that were beginning to grow.

Jim kept checking his seed, but nothing ever grew. Three weeks, four weeks, five weeks went by, still nothing. By now, others were talking about their plants, but Jim didn’t have a plant and he felt like a failure.

Six months went by — still nothing in Jim’s pot. He just knew he had killed his seed. Everyone else had trees and tall plants, but he had nothing. Jim didn’t say anything to his colleagues, however… He just kept watering and fertilizing the soil – He so wanted the seed to grow. A year finally went by and all the young executives of the company brought their plants to the CEO for inspection.

Jim told his wife that he wasn’t going to take an empty pot. But she asked him to be honest about what happened. Jim felt sick to his stomach, it was going to be the most embarrassing moment of his life, but he knew his wife was right. He took his empty pot to the board room. When Jim arrived, he was amazed at the variety of plants grown by the other executives. They were beautiful — in all shapes and sizes.

Jim put his empty pot on the floor and many of his colleagues laughed, a few felt sorry for him! When the CEO arrived, he surveyed the room and greeted his young executives. Jim just tried to hide in the back. “My, what great plants, trees, and flowers you have grown,” said the CEO. “Today one of you will be appointed the next CEO!”

All of a sudden, the CEO spotted Jim at the back of the room with his empty pot. He ordered the Financial Director to bring him to the front. Jim was terrified. He thought, “The CEO knows I’m a failure! Maybe he will have me fired!” When Jim got to the front, the CEO asked him what had happened to his seed – Jim told him the story.

The CEO asked everyone to sit down except Jim. He looked at Jim, and then announced to the young executives, “Behold your next Chief Executive Officer! His name is Jim!” Jim couldn’t believe it. Jim couldn’t even grow his seed. “How could he be the new CEO?” the others said.

Then the CEO said, “One year ago today, I gave everyone in this room a seed. I told you to take the seed, plant it, water it, and bring it back to me today. But I gave you all boiled seeds; they were dead – it was not possible for them to grow. All of you, except Jim, have brought me trees and plants and flowers. When you found that the seed would not grow, you substituted another seed for the one I gave you. Jim was the only one with the courage and honesty to bring me a pot with my seed in it. Therefore, he is the one who will be the new Chief Executive Officer!”

* If you plant honesty, you will reap trust.

* If you plant goodness, you will reap friends.

* If you plant humility, you will reap greatness.

* If you plant perseverance, you will reap contentment.

* If you plant consideration, you will reap perspective.

* If you plant hard work, you will reap success.

* If you plant forgiveness, you will reap reconciliation.

* If you plant faith in God, you will reap a harvest.

 So, be careful what you plant now; it will determine what you will reap later. “Whatever You Give To Life, Life Gives You Back”

Emedinews:Insights on Medicolegal Issues:WMA guidelines for clinical research combined with professional care

The mission of medical doctor is to safeguard the health of the people. The Declaration of Geneva of the World Medical Association (WMA) binds the doctor with the words, "The health of my patient will be my first consideration." In the treatment of the sick person, the doctor must be free to use a new diagnostic and therapeutic measure, if in his/her judgment it offers hope of saving life, re–establishing health or alleviating suffering.

·         The potential benefits, hazards and discomfort of a new method should be weighed against the advantages of the best current diagnostic and therapeutic methods.

·         In any medical study, every patient including those of a control group, if any, should be assured of the best proven diagnostic and therapeutic method.

·         The refusal of the patient to participate in a study must never interfere with the doctor–patient relationship.

·         If the doctor considers it essential not to obtain informed consent, the specific reasons for this proposal should be stated in the experimental protocol for transmission to the independent committee.

·         The doctor can combine medical research with professional care, the objective being the acquisition of new medical knowledge, only to the extent that medical research is justified by its potential diagnostic or therapeutic value for the patient.

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