Emedinews:Insights on Medicolegal Issues:What is blast lung?

• When a bomb explodes, it causes disruptive effect due to burns, air blast, flying missiles injuries, falling masonry, fumes and incendiary bombs
• A bomb explosion create a pressure of 1000 to 1500 tons per square inch; but, a pressure of 200 kg per square inch is enough to cause destructive injuries to human tissues
• The injuries to the pulmonary tissues and alveoli tissues that occur due to air blast effect are called blast lung injuries. The lungs air blast victims show pleural patchy bleeding on scans. The reactive pulmonary swelling converts into bronchopneumonia and may prove fatal in these cases.

Emedinews:Inspiration:Couple’s heartbreak

An Inspirational Story

A boy was born to a couple after eleven years of marriage. They were a loving couple and the boy was the apple of their eyes.

One morning, when the boy was around two years old, the husband saw a medicine bottle open. He was late for work so he asked the wife to cap the bottle and put it in the cupboard. The mother, preoccupied in the kitchen, totally forgot the matter.

The boy saw the bottle and playfully went to it and, fascinated with its color, drank it all. It happened to be a poisonous medicine meant for adults in small dosages. When the child collapsed, the mother hurried him to the hospital, where he died. The mother was stunned; she was terrified. How would she face her husband?

When the distraught father came to the hospital and saw the dead child, he looked at his wife and uttered just four words, “I Love You Darling.”

The husband’s totally unexpected reaction is proactive behavior. The child is dead. He can never be brought back to life. There is no point in finding fault with the mother. Besides, if only he have taken time to put the bottle away, this would not have happened.

No point in attaching blame. She had also lost her only child. What she needed at that moment was consolation and sympathy from the husband. That is what he gave her. Sometimes we spend time asking who is responsible or who’s to blame, whether in a relationship, in a job or with the people we know and miss out on the warmth in human relationships we could receive by giving each other support.

After all, shouldn’t forgiving someone we love be the easiest thing in the world to do?

Treasure what you have. Don’t multiply pain, anguish and suffering by holding onto forgiveness. Let go of all your envies, jealousies, unwillingness to forgive, selfishness, and fears and you will find things are actually not as difficult as you think.

If everyone could look at life with this kind of perspective, there would be fewer problems in the world.

 Source: http://academictips.org/blogs/a-couples-heartbreak/

Emedinews:Insights on Medicolegal Issues:How is death finally certified?

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

Permanent and irreversible stoppage of respiration, circulation and brain function, the so called the ‘Tripod of life’

• Generally the practicing doctor diagnoses death by auscultation; but, this can be difficult in cases of excessive fat, emphysema, apex beat below the rib, poorly beating heart and shallow diaphragmatic respiration. All these conditions dampen the conduction of heart sound with body wall.
• Diagnosis of recent death is also very difficult whenever the death of the person has not been observed. When a doctor is called to certify a patient brought by ambulance ‘as dead’, he must insist that the body be removed to a well lit room where he can carry out his examination.
• Even though the condition is satisfactory, there can be errors during examination. The signs of life can be detected by special methods like oscilloscope, ECG, and EEG etc.
• It can never be assumed that attempted resuscitation is pointless. On the other hand, resuscitative measures should always be continued for half an hour.
• In cases of electric shock, asphyxia particularly drowning and drug overdose, resuscitative measures should always be done
• There is segmentation of blood in retinal blood vessels in ophthalmoscopic examination. If still there is little doubt, the patient should be taken to intensive care unit for further investigation of heart and brain function.

(Ref: Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of Forensic Medicine, Peepee Publisher)

� o b `0z �w size:11.0pt;font-family:"Times New Roman";color:#222222'> 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:Inspiration:Be content about your life

 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 two 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 dumb folded, but willing sold everything. He spent less than $100 to obtain about 400 loaf 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 wonders 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:'WMA declaration of Malta on hunger strikers

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

Such difficult ethical situations in medical practice and the guidelines to deal with them have been addressed thoroughly in the revised WMA Declaration of Malta on hunger strikers with principles of Duty to act ethically, in 2006. All physicians are bound by medical ethics in their professional contact with vulnerable people, even when not providing therapy. Whatever their role, physicians must try to prevent coercion or maltreatment of detainees and must protest if it occurs. The other important component is respect for autonomy. Physicians should respect individuals’ autonomy. This can involve difficult assessments as hunger strikers’ true wishes may not be as clear as they appear. Any decisions lack moral force if made involuntarily by use of threats, peer pressure or coercion. Hunger strikers should not be forcibly given treatment they refuse. Forced feeding contrary to an informed and voluntary refusal is unjustifiable. Artificial feeding in form of intravenous fluid/nutrition with the hunger striker’s explicit or implied consent is ethically acceptable.

Emedinews:Inspiration:Benefits of Struggling

 A man found a cocoon of a butterfly. One day a small opening appeared, he sat and watched the butterfly for several hours as it struggled to force its 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. Then the man decided to help the butterfly, so he took a pair of scissors and snipped off the remaining bit of the cocoon. The butterfly then emerged easily.

 But it had a swollen body and small, shriveled wings. The man continued to watch the butterfly 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 butterfly 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 butterfly to get through the tiny opening were God’s way of forcing fluid from the body of the butterfly into its wings so that it would be ready for flight once it achieved its freedom from the cocoon.

 Sometimes struggles are exactly what we need in our life. If God allowed us to go through our life without any obstacles, it would cripple us. We would not be as strong as what we could have been.

 And we could never fly.

Emedinews:Insights on Medicolegal Issues:Do not misrepresent documents/medical literature in the Court of Law

Medical Testimony of Doctor in the Court of Law (Contd.)

Do not misrepresent documents/medical literature in the Court of Law

When evidence is read into the record of a trial, only that portion of the document which validates the information being discussed needs to be read aloud. One paragraph or even one part of a paragraph may be all that is necessary to substantiate the point you are making. Documents must be presented in the words of the author. When you paraphrase evidence, you argue in a circle. Reading the remainder of the document, even if it establishes a context for the evidence, is unnecessary and time–consuming. When a document is cut in a manner which lends the quoted passage a meaning other than what would be derived from a more complete reading, you are misrepresenting the document. This does not mean, however, that you are responsible for drawing the same conclusions from information as the author of the document.

Drawing a contrary conclusion from passages accurately interpreted does not constitute misrepresentation. The fact that the author of the document reached a different conclusion from the information argues perhaps persuasively against your conclusion. However, you have not misused the evidence.